Loneliness in older primary care patients and its relationship to physical and mental health‐related quality of life

Abstract

BackgroundLoneliness is a significant public health challenge in the United States, especially among older adults. The epidemiology of loneliness among older adults in primary care is lacking, and specific research is needed on how loneliness impacts older primary patients' physical, mental, and cognitive health. A large sample of older primary care patients were recruited for a trial during the COVID‐19 pandemic to measure the relationship between loneliness and physical and mental quality of life (QOL).MethodsBaseline data come from the Caregiver Outcomes of Alzheimer's Disease Screening (COADS) study, an ongoing randomized controlled trial evaluating benefits and risks of Alzheimer's disease and related dementias screening among primary care patients ages 65 and older, collected April 2020 to September 2021. Loneliness was measured with the 5‐item, Loneliness Fixed Form Ages 18+ from The NIH Toolbox Emotion Battery, physical and mental health‐related QOL was measured with the SF‐36v2, and depression and anxiety severity were measured with the PHQ‐9 and GAD‐7, respectively.ResultsSpearman correlation analyses revealed that loneliness was moderately correlated with mental health QOL (r[601] = −0.43, p < 0.001), anxiety severity (r[601] = 0.44, p < 0.001), and depression severity (r[601] = 0.42, p < 0.001), while weakly correlated with physical health QOL (r[601] = −0.15, p < 0.001). After conducting unadjusted and adjusted linear regression models, we found that loneliness was significantly associated with both lower mental (p < 0.001) and physical (p < 0.001) QOL. Furthermore, loneliness remained significantly associated with worse mental QOL after adjusting for age, gender, race, ethnicity, educational level, perceived income status, neighborhood disadvantage, severity of comorbidities, and comorbid depression and anxiety.ConclusionPrimary care providers should discuss loneliness with their older adult patients and provide resources to help patients develop and maintain meaningful social relationships.

Comparison of networks of loneliness, depressive symptoms, and anxiety symptoms in at-risk community-dwelling older adults before and during COVID-19

“…These factors led to an increased prevalence of depressive and anxiety symptoms, especially among older persons with chronic illness during COVID-19, with 61% and 85% for depressive and anxiety symptoms, respectively 7 . Loneliness is another common issue experienced by older people, and the association between loneliness and mental health consequences has been consistently established 8 . For older people, the alteration of social networks, often due to retirement or the passing of a spouse, can increase loneliness and impact their quality of life and mental health 8 .…”

“…Loneliness is another common issue experienced by older people, and the association between loneliness and mental health consequences has been consistently established 8 . For older people, the alteration of social networks, often due to retirement or the passing of a spouse, can increase loneliness and impact their quality of life and mental health 8 . Loneliness has been identified as both a risk factor for mental illness and as a mental health problem warranting attention 9 .…”