How loneliness can kill
Loneliness – the unpleasant feeling of emptiness or desolation – can be especially debilitating to older adults and may predict serious health problems and even death, say researchers.
A UCSF researcher team analyzed data in the Health and Retirement Study, a nationally representative study by the National Institute on Aging conducted on 1,604 older adults between 2002 and 2008.
The research focused specifically on the question of loneliness and its impact.
“In our typical medical model, we don’t think of subjective feelings as affecting health. It’s intriguing to find that loneliness is independently associated with an increased rate of death and functional decline,” said first author Carla Perissinotto, MD, MHS, assistant professor in the UCSF Division of Geriatrics.
One of the more surprising findings of the team’s analysis is that loneliness does not necessarily correlate with living alone. The study found 43 percent of surveyed older adults felt lonely, yet only 18 percent lived alone.
“We are interested in identifying the different factors that cause adults to become functionally impaired and ultimately at risk for nursing home admission,” Perissinotto said.
“The aging of our population and the greater odds of institutionalization make it important for us to think about all the factors that are putting elders in danger, including social and environmental risks,” she explained.
Researchers at UCSF focused on death and a decrease in the ability to perform daily activities such as upper extremity tasks, climbing stairs, and walking.
People who identified themselves as lonely had an adjusted risk ratio of 1.59 or a statistically significant 59 percent greater risk of decline. For death, the hazard ratio was 1.45 or 45 percent greater risk of death.
“This is one of those outcomes you don’t want to see because it was terrible to find out it was actually true. We went into the analysis thinking that there was a risk we could find nothing, but there actually was a strong correlation,” Perissinotto noted.
Perissinotto and her colleagues believe the impact of loneliness on an elderly patient is different from the effects of depression. While depression is linked with a lack enjoyment, energy and motivation, loneliness can be felt in people who are fully functional but feel empty or desolate.
The “baby boomer” generation – those born between 1946 and 1964 – represents the largest population growth in U.S. history. Some of them now are part of the 39.6 million population of people older than 65. That number is expected to more than double to 88.5 million by 2050.
As that population continues to expand, Perissinotto said she hopes to be able to start to integrate social and medical services for elderly patients more comprehensively, and be more mindful of what kinds of social interventions they require.
“Asking about chronic diseases is not enough. There’s much more going on in people’s homes and their communities that is affecting their health. If we don’t ask about it, we are missing a very important and independent risk factor,” she said.
“We don’t think we can change genetics, but we can intervene when someone is lonely and help prevent some functional decline,” she added.
The research has been published in the Archives of Internal Medicine.
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