Sociodemographic and health -related risks for loneliness and outcome differences by loneliness status in a sample of older U.S. adults

Abstract

BACKGROUND: Loneliness is a prevalent problem for older adults and has been shown to be associated with negative physical, psychological, and social variables. There has been limited research focusing on the relationship of loneliness to health. There is a gap in the literature when it comes to understanding how the problem of loneliness relates to the health of older adults in the United States. PURPOSE: The purpose of this study was to address this gap in the literature through the testing of two models, the first model represented the postulated risks for loneliness and the second model represented the postulated outcomes for those who experience loneliness. Variables were chosen for inclusion in the models based on a review of pertinent quantitative and qualitative literature. METHODS: The models were tested using a representative sample of U.S. older adults. Data analysis was performed using data from the 2002 and 2004 waves of the Health and Retirement Study. The sample was limited to respondents aged 50 and older who participated in wave 6 (2002) and wave 7 (2004) without proxy, answered the lonely question at both waves, were community-dwelling in 2002 and who had complete data on selected variables in the model. Univariate and bivariate analyses were followed by logistic regression analysis to identify risks. One-way ANOVAs, comparative means testing and independent analysis of covariance tests were used to evaluate the difference in outcomes for those who were never lonely, briefly lonely, or chronically lonely. RESULTS: Non-married status was consistently the primary predictor of self-report of loneliness, followed by poorer self-report of health status, lower educational level, functional impairment, increasing number of chronic illnesses, younger age, lower income, and less people living in the household. Gender and use of home care were not significant predictors of loneliness. Those who were chronically lonely reported less exercise, more tobacco use, less alcohol use, a greater increase in number of chronic illnesses, higher depression scores, more physician contacts and greater average number of nights in a nursing home than those who were never lonely or briefly lonely. After controlling for significant covariates of loneliness, those who were chronically lonely did not have significantly more physician contacts. DISCUSSION: Loneliness is a prevalent problem for older adults in the United States with its own unique health-related risks and outcomes. Given the prevalence, it should be considered a healthcare priority in the United States. Based on the results of this study, inclusion of loneliness and loneliness risk screening as part of routine health histories for those aged 50 and over should be considered. Future research needs to focus on evaluating the effectiveness of both prevention and treatment interventions for loneliness to provide empirical data to guide evidenced based practice.

The impact of depression and sense of coherence on emotional and social loneliness among nursing home residents without cognitive impairment – a questionnaire survey

“…But Luanaigh and Lawlor (2008) showed reciprocal influence between loneliness and depression. Theeke (2010) found in a study among people living at home that those who report being lonely had a higher depression score than those who were not lonely. Similarly, Golden et al.…”

Loneliness, Depression, and Physical Activity in Older Adults: The Therapeutic Role of Human–Animal Interactions

“…The prevalence of depression among Americans aged 65 or older is estimated to be 18.4% (National Alliance on Mental Illness, 2009). Risk factors for depression include bereavement, sleep disturbances, disability, prior depression, female gender (Cole & Dendukuri, 2003;Djernes, 2006); low physical performance (Veronese et al, 2017); loneliness (Cohen-Mansfield & Parpura-Gill, 2007;Shankar et al, 2011;Theeke, 2010); medical morbidity, functional limitations, social isolation (Choi et al, 2010); and cognitive impairment (Djernes, 2006).…”

“…Physical inactivity is identified as the fourth risk factor for global mortality (WHO, 2010) and has a prevalence of 26.9% among those aged 65-74 years, and 35.3% among those aged > 75 years (Watson et al, 2016). Risk factors for physical inactivity include presence of loneliness (Luo & Waite, 2014;Netz et al, 2013;Shankar et al, 2011;Theeke, 2010);depression (Lok et al, 2017); and hypertension, heart disease, osteoporosis, colon and breast cancer, obesity, adult onset diabetes, depression, and anxiety (DePietro, 2016).…”

Loneliness and social isolation of older adults: Why it is important to examine these social aspects together

“…In the past two decades, there has been an increased recognition and acceptance of the importance of social isolation and loneliness to the health and well-being of older adults. Importantly, studies have uncovered potential direct (e.g., blood pressure, immune system function) and indirect (e.g., restorative sleep processes) pathways that can explain such connections (e.g., Cacioppo et al, 2002;Hawkley, Burleson, Berntson, & Cacioppo, 2003;Pressman et al, 2005;Theeke, 2010). Perhaps the most strongly worded argument that social isolation and loneliness are public health risks was put forth by Holt-Lunstad, Smith, and Layton (2010), who at the conclusion of their comprehensive meta-analysis of social relationship-related constructs and mortality note:…”