Loneliness as a gender-specific predictor of physical and mental health-related quality of life in older adults

Abstract

Purpose Health-related quality of life (HRQOL) in older persons is influenced by physical and mental health, as well as by their social contacts and social support. Older women and men have disparate types of social networks; they each value social ties differently and experience loneliness in unique and personal ways. The aim of this study is, therefore, to determine the longitudinal association between loneliness and social isolation with HRQOL in older people—separated by gender. Methods Data stem from the third and fourth follow-up of the ESTHER study—a population-based cohort study of the older population in Germany. A sample of 2171 older women and men (mean age: 69.3 years, range 57–84 years) were included in this study; HRQOL was assessed by using the Short Form-12 questionnaire (SF-12). Data on physical and mental health, loneliness, and social networks were examined in the course of comprehensive home visits by trained study doctors. Gender-specific linear regression analyses were performed to predict physical quality of life (measured by the PCS, physical component score of the SF-12) and mental quality of life (measured by the MCS, mental component score) after three years, adjusted by socioeconomic variables as well as physical, mental, and social well-being. Results At baseline, PCS was 41.3 (SD: 10.0) in women and 42.2 (SD: 9.6) in men (p = .04). MCS was 47.0 (SD: 10.2) in women and 49.6 (SD: 8.6) in men (p < .001). In both genders, PCS and MCS were lower three years later. Loneliness at t0 was negatively associated with both PCS and MCS after three years (t1) among women, and with MCS but not PCS after three years among men. In both genders, the strongest predictor of PCS after three years was PCS at t0 (p < .001), while the strongest predictors of MCS after three years were MCS and PCS at t0. Conclusion HRQOL in elderly women and men is predicted by different biopsychosocial factors. Loneliness predicts decreased MCS after three years in both genders, but decreased PCS after three years only in women. Thus, a greater impact of loneliness on the health of older women can be surmised and should therefore be considered in the context of their medical care.

Cumulative loneliness and subsequent memory function and rate of decline among adults aged ≥50 in the United States, 1996 to 2016

“…Our observed effect modification by sex is consistent with several studies demonstrating the effects of loneliness on mental health are greater among women than men. 51,52 Gender roles and social norms, such as the expectations and demands of social relationships where women tend to have larger and more multifaceted social networks than men, may make women less likely to feel lonely than men, but more vulnerable once experiencing cumulative loneliness. 21,23,51,52 However, existing studies focusing on the sex-specific association between loneliness and cognitive function have yielded inconsistent findings.…”

Gender Differences in Correlates of Loneliness among Community-Dwelling Older Koreans

“…However, these effects of social networks on physical and mental health can be gender specific. For example, a longitudinal study in Germany found that a stronger social network was related to decreased physical health-related quality of life in older men, but not in older women [ 18 ]. Women are usually expected to play the role of caregiver, whereas men are not [ 19 ].…”

“…Thus, older men having health-related issues gain more benefits from social networks, such as their family’s caregiving, and instrumental and emotional support, than do older women [ 20 , 21 ]. In the same study, the size of the social network was reported not to be linked to the physical health-related quality of life in German older women [ 18 ]. Other studies in Western populations also found that having a greater connection to social networks was inversely related to depressive symptoms in men, but not in women [ 13 ].…”

“…Older men tend to prefer more acquainted ties, whereas older women tend to have more extensive social ties by creating new close ties [ 26 ]. Although gender-specific effects of social networks on health have been extensively studied in older adults, the findings are inconsistent [ 13 , 18 , 24 ]. Additionally, we found very few studies regarding gender differences in the association between social networks and loneliness [ 13 ].…”

Vulnerable populations during COVID-19 response: Health-related quality of life among Chinese population and its influence due to socio-demographic factors and loneliness

“…Studies conducted before the pandemic suggested that the influence of loneliness on people's HRQoL varies across socio-demographic characteristics. For instance, a study found that loneliness could predict decreased HRQoL after 3 years in women only ( 13 ). A meta-analytic study has also suggested that loneliness is associated with worse HRQoL among women than men ( 14 ).…”