Unwelcome Companions: Loneliness Associates with the Cluster of Pain, Fatigue, and Depression in Older Adults

Abstract

Objective: Pain, fatigue, and depression commonly co-occur as a symptom cluster in pathological inflammatory states. Psychosocial stressors such as loneliness may lead to similar states through shared mechanisms. We investigated the association of loneliness with pain, fatigue, and depression in older adults. Methods: Using Health and Retirement Study data ( N = 11,766), we measured cross-sectional prevalence of frequent, moderate to severe pain; severe fatigue; depressive symptoms; and co-occurrence of symptoms surpassing threshold levels (i.e., symptom cluster). Logistic regression models evaluated associations with loneliness. Results: Pain, fatigue, and depression were reported in 19.2%, 20.0%, and 15.3% of the total sample, respectively. The symptom cluster was seen in 4.9% overall; prevalence in lonely individuals was significantly increased (11.6% vs. 2.3%, p < .0001). After adjusting for demographic variables, loneliness associated with the symptom cluster (adjusted OR = 3.39, 95% CI = 2.91, 3.95) and each symptom (pain adjusted OR = 1.61, 95% CI = 1.48, 1.76; fatigue adjusted OR = 2.02, 95% CI = 1.85, 2.20; depression adjusted OR = 4.34, 95% CI = 3.93, 4.79). Discussion: Loneliness strongly associates with the symptom cluster of pain, fatigue, and depression. Further research should examine causal relationships and investigate whether interventions targeting loneliness mitigate pain, fatigue, and depression.

Loneliness, social isolation, and pain following the COVID-19 outbreak: data from a nationwide internet survey in Japan

“…These results were consistent with previous studies which investigated the negative effects of loneliness and social isolation with pain 10 , 11 , 13 , 14 . However, the association between social isolation and a higher risk of pain was partly contrary to a previous study that reported that people who experienced chronic musculoskeletal pain had a higher risk of loneliness but had a lower risk of being socially isolated 12 .…”

“…A previous epidemiological study using data from the English Longitudinal Study of Ageing (ELSA) cohort reported that loneliness was associated with the higher prevalence of musculoskeletal pain 12 . Other studies demonstrated that loneliness is strongly associated with pain 10 , 13 , 14 , and social isolation predicted pain interference 11 . Therefore, a worsening of psychological stress due to the increased loneliness and social isolation experienced during the COVID-19 pandemic may contribute to the onset of pain 15 .…”

COVID-19 and low back pain: previous infections lengthen recovery time after intradiscal ozone therapy in patients with herniated lumbar disc

“…The English Longitudinal Study of Ageing (ELSA) epidemiological study established that loneliness leads to higher prevalence of musculoskeletal pain [ 35 ]. In accordance, other studies showed that loneliness is strongly associated with pain exacerbation [ 33 , 36 , 37 ] and that social isolation is likely to amplify the perception of pain [ 34 ]. Therefore, the psychological stress and the physical isolation due to COVID-19 pandemic surely contributed to the onset of pain [ 38 ] and had a large impact on patients with chronic back pain and low tolerance to psychological stress [ 38 – 40 ].…”

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

“…Furthermore, women tend to live longer than men. Living without a spouse can shrink a women’s family networks, which may then reduce the impact of family networks on loneliness among women [ 44 , 45 ]. In our analyses, the contribution to the variance of health variables was equally strong for loneliness in both men and women, and was around 35%.…”