Highlights
- •What is the primary question addressed by this study?Could the effect of loneliness on physical health consequences differ by its patterns and duration and whether there are sex differences in its effect.
- •What is the main finding of this study?Chronic loneliness is an independent risk factor for new-onset ADL disability in both men and women, but transient loneliness is not.Chronic loneliness was associated with the risk of IADL disability in women, not in men.
- •What is the meaning of the finding?Tailored interventions are needed for the right people at the right time to avoid loneliness chronicity and prevent functional disability.
ABSTRACT
Objective
To examine the association between types of loneliness (transient, incident, and chronic)
and the risk of functional disability.
Methods
Data were from the Health and Retirement Study 2006/2008-2016/2018. A total of 7,148
adults aged ≥50 was included. Functional status was measured by activities of daily
living (ADL) and instrumental activities of daily living (IADL). Loneliness was assessed
using the 3-item UCLA Loneliness Scale. We defined loneliness as no/transient/incident/chronic
loneliness based on the pattern and duration of loneliness across 2006/2008 and 2010/2012.
We applied multivariate Cox proportional hazard models with the new-onset ADL/IADL
disability as outcome.
Results
Overall, 69.3% respondents showed no loneliness; while 10.3%, 8.9%, and 11.5% showed
transient, incident, and chronic loneliness, respectively. A total of 1,298 (18.16%)
and 1,260 (17.63%) functionally normal respondents developed ADL and IADL disability
during 36,294 person-years of follow-up, respectively. After adjusting for socio-demographic,
behavioral, and health factors, chronic loneliness was associated with higher risks
of ADL (hazard ratio [HR] = 1.37, 95% confidence interval [CI] = 1.16–1.63, p <0.001,
χ2 = 3.60, degree of freedom [df] = 1) and IADL disability (HR = 1.25, 95% CI = 1.09–1.44,
p = 0.002, χ2 = 3.17, df = 1) compared to no loneliness. By contrast, no significant associations
between transient loneliness and ADL (HR = 1.17, 95% CI = 0.88–1.57, p = 0.273, χ2 = 1.10, df = 1) or IADL disability (HR = 1.16, 95% CI = 0.97–1.39, p = 0.112, χ2 = 1.59, df = 1) were found. Chronic loneliness was not associated with the risk of
IADL disability in men (HR = 1.13, 95% CI = 0.91–1.40, p = 0.263, χ2 = 1.12, df = 1).
Conclusion
Chronic loneliness, rather than transient loneliness, is an independent risk factor
for functional disability in middle-aged and older adults, especially for women.
KEY WORDS
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Article info
Publication history
Published online: February 24, 2023
Accepted:
February 20,
2023
Received in revised form:
February 19,
2023
Received:
August 3,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The data has not been previously presented orally or by poster at scientific meetings.
Identification
Copyright
© 2023 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
