Loneliness in Older Persons: A predictor of functional decline and death

By Carla M Perissinotto, I. Cenzer, K. Covinsky. Archives of Internal Medicine, 2012

1,180 citations recorded by the source corpus.

Background Loneliness is a common source of distress, suffering, and impaired quality of life in older persons. We examined the relationship between loneliness, functional decline and death in adults over age 60 in the United States. Methods This is a longitudinal cohort study of 1604 participants in the psychosocial module of the Health and Retirement Study (HRS), a nationally representative study of older persons. Baseline assessment was in 2002 and follow-up occurred every two years until 2008. Subjects were asked if they feel 1) Left Out 2) Isolated or 3) Lack Companionship. Subjects were categorized as not lonely if they responded hardly ever to all three questions and lonely if they responded some of the time or often to any of the three questions. The primary outcomes were time to death over 6 years, and functional decline over 6 years on 4 measures: difficulty on an increased number of activities of daily living (ADL), difficulty in an increased number of upper extremity tasks, decline in mobility, or increased difficulty in stair climbing. Multivariate analyses adjusted for demographic variables, socioeconomic status, living situation, depression, and various medical conditions. Results The mean age of subjects was 71 years, 59% were women, 81% White, 11% Black, 6% Hispanic, and 18% lived alone. 43% of elders reported feeling lonely. Loneliness was associated with all outcome measures. Lonely subjects were more likely to experience decline in ADLs, (24.8% vs. 12.5%, Adjusted Risk Ratio 1.59, 1.23-2.07); develop difficulties with upper extremity tasks (41.5% vs. 28.3%, ARR 1.28, 1.08-1.52); decline in mobility (38.1% v. 29.4%, ARR 1.18, 0.99-1.41); or difficulty in climbing (40.8% vs. 27.9%, ARR 1.31, 1.10-1.57). Loneliness was associated with an increased risk of death (22.8% vs. 14.2%, AHR 1.45, 1.11-1.88). Conclusions Among participants who were older than 60, loneliness was a predictor of functional decline and death.

Subfields: Clinical Psychology, General Health Professions, Health

View Paper: https://www.semanticscholar.org/paper/f8be9125dd1bd58ac224e88e1b4bd2a7ce9feda1

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Citations in the corpus

Loneliness among older European adults: results from the survey of health, aging and retirement in Europe (2018, background): “…of physiological, behavioral and psychological changes, such as increased stress-related responses (Steptoe et al. 2004), elevated blood pressure, cardiovascular activation, sleep disturbance (Cacioppo et al. 2002; Hawkley and Cacioppo 2010) and functional decline (Perissinotto et al. 2012).”
Social isolation, loneliness, and all-cause mortality in older men and women (2013, background): “They also suggest that the health implications of loneliness may be overestimated if studies do not take account of the strength of objective social connections (17, 18).”
Why Social Relationships Are Important for Physical Health: A Systems Approach to Understanding and Modifying Risk and Protection (2018, background): “Social trends in most Western cultures suggest that individuals are becoming more socially disconnected (McPherson et al. 2006, Perissinotto et al. 2012, Pew Res.”
Factors influencing acceptance of technology for aging in place: A systematic review (2014, background): “Supporting older adults to remain in their own homes and communities is also favored chronic diseases, a diminishing social network, and a low level of physical activity [6–9].”
Social Relationships and Health: The Toxic Effects of Perceived Social Isolation. (2014, background): “…with living circumstances (Hector-Taylor & Adams, 1996), physical health symptoms (Hawkley et al., 2008), disabilities (Hawkley et al., 2008; Perissinotto et al., 2012), chronic work and/or social stress (Hawkley et al., 2008), a small social network (Hawkley et al., 2005; Mullins & Dugan,…”
Can Digital Technology Enhance Social Connectedness Among Older Adults? A Feasibility Study (2019, background): “Older adults’ experiences of social isolation and loneliness negatively affect their health and well-being (Cornwell & Waite, 2009; Perissinotto et al., 2012; Steptoe, Shankar, Demakakos, & Wardle, 2013).”