Loneliness, social network size, and mortality in older adults and the role of cortisol

Schutter, Natasja; Holwerda, Tjalling J.; Comijs, Hannie C.; Naarding, Paul; Van, Rien; Dekker, Jack; Stek, Max L.; Rhebergen, Didi

doi:10.1080/13607863.2020.1843001

Cited by 8 publications

(6 citation statements)

References 80 publications

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“…We also failed to find a relationship between loneliness and DCS. This result agrees with other previous studies (Schutter et al, 2017(Schutter et al, , 2020Montoliu et al, 2019), although it contrasts with studies that found a flattened DCS in married participants (Johar et al, 2021) and in a selected sample with extremely high loneliness scores (Cole et al, 2007). In both of these studies, the sample was composed of people who could suffer from alcohol abuse, smoking, or diabetes, which can influence the DCS (Adam et al, 2017).…”

Section: Discussionsupporting

confidence: 90%

“…Several studies have investigated the relationship between loneliness, the cortisol awakening response (CAR), and the diurnal cortisol slope (DCS) in aging, but with inconsistent results. In middle-aged adults, loneliness was found to be associated with CAR (Steptoe et al, 2004;Adam et al, 2006;Okamura et al, 2011), but no differences were found in CAR or DCS based on loneliness in older males and females (Schutter et al, 2017(Schutter et al, , 2020. However, in older people, a flatter DCS was found in lonely people in comparison with non-lonely individuals (Cole et al, 2007).…”

Section: Introductionmentioning

confidence: 88%

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Loneliness and Health Indicators in Middle-Aged and Older Females and Males

Crespo-Sanmiguel

Zapater-Fajarí

Garrido-Chaves

et al. 2022

Front. Behav. Neurosci.

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Loneliness is a complex and uncomfortable feeling that results from the perception of a lack of desired personal and social ties. Loneliness is accentuated with aging. It has been related to a wide range of objective and subjective health indicators and is a risk factor for morbidity and mortality. One of the proposed underlying mechanisms through which loneliness affects health is the dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. However, the relationship between loneliness and cortisol, the main product of the HPA axis, is unclear and requires more research. The aims of this cross-sectional study were to investigate the relationships between loneliness, subjective health, and cortisol indexes, taking the sex into account, and investigate whether the HPA axis mediates the relationship between loneliness and subjective health. For this purpose, 79 participants (between 55 and 75 years old) completed several scales on loneliness, depression, perceived stress, psychological and physical health, and social relationships. Various salivary cortisol measurements were obtained on two consecutive days. The initial results showed that loneliness was related to psychological and physical health in the mixed-sex sample. However, when covariates were introduced, loneliness was only associated with psychological health in males. In addition, the cortisol indexes employed were not related to loneliness and did not mediate the relationship between loneliness and subjective health. Hence, we did not find a relevant role of the HPA axis in the association between loneliness and subjective health. More severe perceptions of loneliness would probably be necessary to detect this role. Overall, these results also show that the expected negative outcomes of loneliness associated with aging can be countered by an active life that can compensate for the natural losses experienced with age or at least delay these negative outcomes. Finally, some sex differences were found, in line with other studies, which warrants further examination of social variables and dimensions related to gender in future research.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 88%

Loneliness and Health Indicators in Middle-Aged and Older Females and Males

Crespo-Sanmiguel

Zapater-Fajarí

Garrido-Chaves

et al. 2022

Front. Behav. Neurosci.

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“…We report that loneliness is associated with an increased risk of AD and dementia, while no significant association between loneliness and MCI risk or VaD was observed. Loneliness has previously been identified as a risk factor for premature mortality ( Holt-Lunstad et al, 2015 ; Schutter et al, 2021 ), adverse biological parameters (e.g., hypertension), health-risk behaviors (including smoking, physical inactivity, and excess alcohol consumption), physical and mental morbidity, and increased health service use ( Hawkley et al, 2009 ; Shankar et al, 2011 ; Dyal and Valente, 2015 ). However, the strength of this relationship between loneliness and dementia remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Loneliness is experienced across the lifespan and across cultures. Most adults present transient symptoms of loneliness throughout the course of their lives ( Victor et al, 2020 ; Schutter et al, 2021 ). Symptoms of loneliness and social isolation overlap; however, loneliness has been shown to be independently associated with health outcomes ( Holt-Lunstad et al, 2015 ; Leigh-Hunt et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Association between loneliness and dementia risk: A systematic review and meta-analysis of cohort studies

Qiao

Wang

Tang

et al. 2022

Front. Hum. Neurosci.

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Loneliness has been reported to be associated with an increased risk of dementia; however, the extent of this relationship remains controversial. This study aimed to assess the strength of the relationship between loneliness and dementia using a meta-analysis approach. PubMed, EMBASE, and China National Knowledge Internet databases were systematically searched for potentially included studies from inception up to 17 February 2022. A meta-analysis was performed using a random-effects model to assess pooled relative risks (RRs) and 95% confidence intervals (CIs). A literature search identified 16 cohort studies (published in 15 articles), among which 4,625 dementia cases and 62,345 individuals were selected for further meta-analysis. Loneliness was associated with an increased risk of Alzheimer’s disease (AD) (RR: 1.72, 95% CI: 1.32–2.23; P < 0.001) and dementia (RR: 1.23, 95% CI: 1.16–1.31; P < 0.00001). However, no significant association between loneliness and risk of mild cognitive impairment (MCI) (RR: 1.34, 95% CI: 0.97–1.87; P = 0.080) or vascular dementia (VaD) (RR: 1.01, 95% CI: 0.51–1.99; P = 0.973) was observed. Results revealed that loneliness might increase the risk of Alzheimer’s disease and dementia. Early interventions that limit loneliness may reduce risk of dementia and Alzheimer’s disease.

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“…As a consequence, the effects of loneliness and social network size cannot be compared directly. Only two studies investigated both loneliness and social network size (Ellwardt et al 2015 ; Schutter et al 2020 ). One of these studies concluded that social network size was associated with mortality, but loneliness was not (Ellwardt et al 2015 ); the other study concluded that neither was associated with mortality (Schutter et al 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Loneliness, social network size and mortality in older adults: a meta-analysis

et al. 2022

Self Cite

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Loneliness and social network size have been found to be predictors of mortality in older adults. The objective of this study was to investigate whether loneliness and small social network size are associated with an increased mortality risk and to review the evidence for either network size, or loneliness that constitutes the higher mortality risk. A systematic literature search was performed in PubMed, EMBASE and PsychInfo in January/February 2018 and March/April 2021. Studies that mentioned outcome data were included in the meta-analysis and coded using the Newcastle–Ottawa Quality Assessment Scale for Cohort Studies. The meta-analysis showed that both loneliness and small social network size are associated with mortality risk in older adults (Hazard Ratio 1.10 (95% Confidence Interval 1.06–1.14) for loneliness and 0.96 (95% Confidence Interval 0.93–0.99) for larger network size). Sensitivity analyses according to the Newcastle–Ottawa Quality Assessment Scale yielded varying results. Heterogeneity was large. In conclusion, both loneliness and small social network size in older adults are associated with increased mortality, although the effect size is small. Targeting subjective and objective aspects of older adults’ social contacts should be on the agenda of preventive as well as personalized medicine. In order to be able to compare the association between loneliness and network size and mortality, more studies are needed that include both these risk factors. Supplementary Information The online version contains supplementary material available at 10.1007/s10433-022-00740-z.

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Loneliness, social network size, and mortality in older adults and the role of cortisol

Cited by 8 publications

References 80 publications

Loneliness and Health Indicators in Middle-Aged and Older Females and Males

Loneliness and Health Indicators in Middle-Aged and Older Females and Males

Association between loneliness and dementia risk: A systematic review and meta-analysis of cohort studies

Loneliness, social network size and mortality in older adults: a meta-analysis

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