Pain as a Risk Factor for Loneliness Among Older Adults

Emerson, Kerstin G.; Boggero, Ian A.; Ostir, Glenn V.; Jayawardhana, Jayani

doi:10.1177/0898264317721348

Cited by 45 publications

(52 citation statements)

References 26 publications

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“…15 While the associations between loneliness and later pain parallel previous research, 19 the longitudinal results for pain being related to later loneliness were more robust than those of other population studies. For example, analyses of the Health and Retirement study reported by Emerson et al 12 did not find that baseline pain predicted future loneliness, though the combination of pain both at baseline and follow-up was related to loneliness. Another study of a community sample from Arizona found minimal associations between pain intensity or pain frequency and loneliness measured 6-53 months later.…”

Section: A C C E P T E Dmentioning

confidence: 97%

“…An investigation of the Health and Retirement Study over a 4 year period indicated that incident loneliness was predicted by pain, but only if pain was present both at baseline and follow-up. 12 Another community study documented cross-sectional associations between pain and loneliness, but found that baseline pain was minimally related to future loneliness. 4 The potentially bidirectional links between pain and loneliness have typically been investigated in separate studies, making it difficult to determine the relative importance of the two temporal sequences.…”

Section: A C C E P T E Dmentioning

confidence: 99%

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Bidirectional longitudinal associations between loneliness and pain, and the role of inflammation

Loeffler

Steptoe

2020

Pain

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Pain and loneliness are consistently associated, but the direction of the relationship is uncertain. We assessed bidirectional associations over a 4 year period in a sample of 4,906 men and women (mean 65.1 ± 8.72 years) who were participants in the English Longitudinal Study of Ageing. The role of inflammation in these links was also investigated. Pain was defined by reports of being often troubled by pain at a moderate or severe intensity, while loneliness was measured using the shortened UCLA scale. Age, sex, ethnicity, educational attainment, wealth as a marker of socioeconomic resources, marital status, physical activity, and depressive symptoms were included as covariates. We found that baseline loneliness was associated with pain 4 years later after adjusting for baseline pain and other covariates (odds ratio (OR) = 1.25, 95%CI 1.06-1.47, P = 0.007). Similarly, baseline pain independently predicted loneliness 4 years later (OR = 1.34, 95%CI 1.14-1.58, P = 0.001). Associations remained significant after additional adjustment for baseline mobility impairment. Likelihood of pain on follow-up was heightened when baseline loneliness was accompanied by elevated C-reactive protein concentration (OR = 1.50, 95%CI 1.13-2.00, P = 0.006), while inflammation did not predict future loneliness or contribute to the association between baseline pain and future loneliness. Both pain and loneliness are distressing experiences that impact well-being and quality of life. We conclude that there were bidirectional longitudinal relationships between pain and loneliness in this representative sample of older men and women, but that the mechanisms underlying these processes may differ.

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Section: A C C E P T E Dmentioning

confidence: 97%

Section: A C C E P T E Dmentioning

confidence: 99%

Bidirectional longitudinal associations between loneliness and pain, and the role of inflammation

Loeffler

Steptoe

2020

Pain

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“… 106 , 107 Chronic pain and long-term illness, on the other hand, increase the risk for loneliness. 108 , 109 Combining virtual social interaction with the relaxation effect of VR nature could thus contribute to both avoiding feeling lonely and to decreasing the risk for illnesses associated with loneliness.…”

Section: Pathways Linking Health With Nature Exposure and The Applicamentioning

confidence: 99%

A prescription for “nature” – the potential of using virtual nature in therapeutics

White¹,

Yeo²,

Vassiljev³

et al. 2018

NDT

176

130

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Many studies suggest that increased exposure to urban greenness is associated with better population health. Accessing nature can in some circumstances, however, be difficult, especially for individuals with mobility constraints. Therefore, a growing body of work is investigating the ways to replace the in vivo experience with forms of “virtual” contact, in order to provide these individuals with at least some benefits of the natural environment. The aim of this paper is to provide a review of previous use of virtual reality (VR) nature in health and care settings and contemplate the potential use of this technology in future. Our central question is whether engaging with virtual nature can contribute to enhanced physical and emotional well-being in housebound or mobility-constrained individuals. We conclude that while contact with real-world nature is preferred, VR use can be an alternative in cases when in vivo contact with nature is not possible. There are many possibilities for the use of VR technology in psychiatric and medical care; however, the risks, benefits, and cost efficiency of these attempts should be carefully assessed and the outcomes should be measured in a scientifically valid manner. The current review has nonetheless demonstrated that VR nature could play a role in each of the proposed mediating mechanisms linking natural environments and health.

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“…24 Studies have documented there are demographic and physical risk factors associated with loneliness, including lower educational attainment, 25 unemployment, 25 being unmarried, 25 having a physical impairment, 26 and self-reported pain. 23 TBI is associated with all or most of these factors, and the negative consequences of TBI and loneliness share similar sequela. Despite this, the association between TBI and loneliness has not been rigorously tested.…”

Section: Lonelinessmentioning

confidence: 99%

“…In addition, loneliness has been observed to be accompanied by marked physiological changes, including increased systemic inflammation, stress reactivity, abnormal neuroendocrinology, and higher blood pressure . Loneliness is also associated with cognitive impairment, depression, suicidal ideation, cardiovascular disease, pain, and functional impairments in activities of daily living (ADLs) . Loneliness is also related to increased health care utilization among older adults .…”

Section: Introductionmentioning

confidence: 99%

Lifetime history of traumatic brain injury is associated with increased loneliness in adults: A US nationally representative study

Kumar

Ornstein

Bollens‐Lund

et al. 2020

Int J Geriat Psychiatry

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Background/Objectives An estimated 55 million individuals worldwide live with chronic disability associated with traumatic brain injury (TBI), which may include cognitive, behavioral, and social impairments. Reduced participation in social activities is common after TBI; however, few studies have evaluated loneliness among survivors of TBI. The current study aimed to evaluate the association between history of TBI and loneliness and to identify mediators of this association. Methods/Design Retrospective cohort study. Nationally representative sample of N = 724 adults over age 50 years (Health and Retirement Study). Loneliness was evaluated using the 11‐item Revised University of California Los Angeles (R‐UCLA) Loneliness Scale (range 11‐33). Lifetime history of TBI evaluated retrospectively using the Ohio State University TBI Identification Method. We included the following covariates: age, sex, race, and education; and mediators: depressive symptoms, number of comorbidities, chronic pain, difficulty with activities of daily living, and social network index. Results History of TBI was associated with a 1.28‐point (95% CI, 0.46‐2.11; P < .05; Cohen's D = 0.284) increase in R‐UCLA Loneliness Scale scores after covariate adjustment. Individuals with more recent injuries (within 10 years) and multiple lifetime TBIs reported the highest loneliness scores. In the structural equation model, depressive symptoms partially mediated the relationship between TBI and loneliness. All models were adjusted for US population sampling weights. Conclusions History of TBI was associated with greater loneliness compared with individuals without TBI in a representative sample of US adults. Managing depressive symptoms and medical consequences of TBI may be a target to ameliorate reporting of loneliness in this population.

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Pain as a Risk Factor for Loneliness Among Older Adults

Abstract: The results indicate that pain may increase the risk of loneliness in older adults. This suggests that appropriate pain interventions could prevent future loneliness, which in turn could prevent functional decline, disability, and premature mortality.

Cited by 45 publications

References 26 publications

Bidirectional longitudinal associations between loneliness and pain, and the role of inflammation

Bidirectional longitudinal associations between loneliness and pain, and the role of inflammation

A prescription for “nature” – the potential of using virtual nature in therapeutics

Lifetime history of traumatic brain injury is associated with increased loneliness in adults: A US nationally representative study

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Pain as a Risk Factor for Loneliness Among Older Adults

Abstract: The results indicate that pain may increase the risk of loneliness in older adults. This suggests that appropriate pain interventions could prevent future loneliness, which in turn could prevent functional decline, disability, and premature mortality.

Cited by 45 publications

References 26 publications

Bidirectional longitudinal associations between loneliness and pain, and the role of inflammation

Bidirectional longitudinal associations between loneliness and pain, and the role of inflammation

A prescription for &ldquo;nature&rdquo; &ndash; the potential of using virtual nature in therapeutics

Lifetime history of traumatic brain injury is associated with increased loneliness in adults: A US nationally representative study

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A prescription for “nature” – the potential of using virtual nature in therapeutics