Highlights
- •What is the primary question addressed by this study?We explored the association between long-term trajectories of late-life loneliness and incident dementia.
- •What is the main finding of this study?Five distinct loneliness trajectories were found: long-term low, persistently decreasing, persistently increasing, long-term moderate, and long-term high. Compared with long-term low loneliness, persistently increasing, long-term moderate, and long-term high loneliness significantly increases the risk of dementia in older adults.
- •What is the meaning of the finding?To prevent dementia, we should pay attention to the elderly with long-term loneliness and persistently increasing loneliness, especially the elderly with long-term high loneliness.
ABSTRACT
Objective
Some older adults with loneliness might have transient loneliness, followed by full
remission, while others might have persistent loneliness. Such different courses might
differ in predicting the risk of dementia, but most previous studies assessed short-term
loneliness at a single time point, ignoring the long-term changes of loneliness. This
study aimed to explore the association between 8-year trajectories of late-life loneliness
and incident dementia.
Methods
Data were from the English Longitudinal Study of Ageing (waves 2−9). This study included
6,722 older adults measured for loneliness greater than or equal to three times from
wave 2 (2004−2005) to wave 6 (2012−2013) and free from dementia in wave 6. Loneliness
was assessed using the short 1980 version of the University of California, Los Angeles
Loneliness Scale. Group-based trajectory modeling was used to explore loneliness trajectories
during waves 2−6. Cox proportional hazard models were used to investigate the association
of loneliness trajectories with incident dementia during waves 6−9.
Results
Five distinct loneliness trajectories were identified: long-term low, persistently
decreasing, persistently increasing, long-term moderate, and long-term high. Compared
with long-term low loneliness, the HRs (95% confidence intervals) for persistently
decreasing, persistently increasing, long-term moderate, and long-term high loneliness
were 1.29 (0.83−2.00), 1.55 (1.04−2.31), 1.56 (1.03−2.38), and 3.35 (1.89−5.91), respectively.
Conclusion
The elderly show distinct patterns of loneliness over time, which cannot be captured
by a single assessment of loneliness. The elderly with long-term loneliness and persistently
increasing loneliness might be the high-risk group for dementia. Further studies are
needed to determine whether reducing loneliness can prevent dementia.
Key Words
Abbreviations:
CES-D (Center for Epidemiologic Studies Depression Scale), CI (Confidence interval), ELSA (English Longitudinal Study of Ageing), GBTM (Group-based trajectory modeling), HR (Hazard ratio), IQCODE (Informant Questionnaire on Cognitive Decline in the Elderly), R-UCLA (Short 1980 version of the University of California, Los Angeles Loneliness Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 05, 2022
Accepted:
December 1,
2022
Received in revised form:
November 15,
2022
Received:
October 3,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
