TY - JOUR
T1 - Association Between Types of Loneliness and Risks of Functional Disability in Older Men and Women
T2 - A Prospective Analysis
AU - Qi, Xiang
AU - Belsky, Daniel W.
AU - Yang, Yang Claire
AU - Wu, Bei
N1 - Funding Information:
The Health and Retirement Study is sponsored by the National Institute on Aging (grant U01AG009740) and is conducted by the University of Michigan. The authors thank all participants and staff for their contribution to this study. This study is supported by the National Institute on Aging ( R01AG057800 and P30AG059304 ), National Institute on Minority Health and Health Disparities ( P50MD017356 ), University Cancer Research Funds, Lineberger Cancer Center at University of North Carolina at Chapel Hill. The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Publisher Copyright:
© 2023 American Association for Geriatric Psychiatry
PY - 2023/8
Y1 - 2023/8
N2 - 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.
AB - 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.
KW - Physical function
KW - cohort study
KW - gender disparity
KW - mental health
KW - social isolation
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U2 - 10.1016/j.jagp.2023.02.046
DO - 10.1016/j.jagp.2023.02.046
M3 - Article
C2 - 36935279
AN - SCOPUS:85150250277
SN - 1064-7481
VL - 31
SP - 621
EP - 632
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 8
ER -