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Zhou X, Yang F, Gao Y. A meta-analysis of the association between loneliness and all-cause mortality in older adults. Psychiatry Res 2023; 328:115430. [PMID: 37647699 DOI: 10.1016/j.psychres.2023.115430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 08/19/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Abstract
Despite the well-established association between loneliness and all-cause mortality in older adults, it remains unknown whether this association holds for older adults of different sex and whether it is influenced by different samples and study characteristics. Thus, this meta-analysis aims to examine moderators of the association between loneliness and all-cause mortality in older adults. To this end, relevant literature was retrieved from the PubMed, Embase, PsycINFO, Web of Science, Chinese National Knowledge Infrastructure, Weipu, and Wanfang databases (inception to May 2023) and was processed in the Comprehensive Meta-Analysis 3.3 software. Moreover, subgroup analysis was performed to explore the sources of heterogeneity and further explore potential moderators. Funnel plots, Begg's test, and Egger's linear regression test were used to examine the publication bias, and sensitivity analysis was used to test the robustness of the results. Thirty-six studies involving 128,927 older adults were included in this meta-analysis. In general, loneliness was related to an increase in all-cause mortality in older adults (HR = 1.09, 95% CI = 1.06-1.12, I2 = 63.31%, p < 0.001). The overall effect size for older men was 1.18 (95% CI = 1.04-1.33, p = 0.010). The association between loneliness and all-cause mortality was found to be significantly influenced by the source country of the data, follow-up length, and covariates for chronic disease as moderators. In conclusion, loneliness among older adults deserves more attention, and services are needed to improve their mental health.
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Affiliation(s)
- Xiang Zhou
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Nanchen Road, Baoshan District, Shanghai, 200444, China
| | - Fang Yang
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Nanchen Road, Baoshan District, Shanghai, 200444, China.
| | - Yourong Gao
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Nanchen Road, Baoshan District, Shanghai, 200444, China
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2
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Díaz-Mardomingo MDC, Utrera L, Baliyan S, García-Herranz S, Suárez-Falcón JC, Rodríguez-Fernández R, Sampedro-Piquero P, Valencia A, Venero C. Sex-related differences in the associations between diurnal cortisol pattern and social and emotional loneliness in older adults. Front Psychol 2023; 14:1199405. [PMID: 37744609 PMCID: PMC10517049 DOI: 10.3389/fpsyg.2023.1199405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/08/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Loneliness is a distressful feeling that can affect mental and physical health, particularly among older adults. Cortisol, the primary hormone of the Hypothalamic-Pituitary-Adrenal axis (HPA-axis), may act as a biological transducer through which loneliness affects health. While most previous studies have evaluated the association between loneliness, as a unidimensional construct, and diurnal cortisol pattern, no research has examined this relationship discriminating between social and emotional loneliness in older adults. As sex differences in the negative mental health outcomes of loneliness have been reported, we also investigated whether diurnal cortisol indices and loneliness associations occur in a sex-specific manner. Methods We analyzed the diurnal cortisol- pattern in 142 community-dwelling, non-depressed, Caucasian older adults (55,6% female) aged 60-90. Social and emotional (family and romantic) loneliness scores were assessed using the Spanish version of the Social and Emotional Loneliness Scale for Adults (SELSA). Five salivary cortisol samples were used to capture key features of the diurnal cortisol pattern, including: awakening and bedtime cortisol levels, awakening response (CAR), post-awakening cortisol output (post-awakening cortisol [i.e., the area under the curve with reference to the ground: AUCG]), total diurnal cortisol release (AUCG), and diurnal cortisol slope (DCS). Results After controlling for sociodemographic variables, the hierarchical linear multiple regression analyses revealed that in male older adults, higher scores on social and family loneliness were associated with elevated awakening cortisol levels, total diurnal cortisol output, and a steeper diurnal cortisol slope (DCS). However, these associations were not observed in female older adults. In addition, feelings of romantic loneliness were positively associated with bedtime cortisol levels and AUCG in older males. Multilevel growth curve modeling showed that experiencing more social and emotional loneliness predicted higher diurnal cortisol output throughout the day in older male adults. Discussion The presence of sex differences in the relationship between cortisol indices and loneliness among older adults holds particular significance for diagnostic and screening procedures. Combining loneliness scales as screening tools with diurnal cortisol measures has the potential to be an effective and cost-efficient approach in identifying higher-risk individuals at early stages.
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Affiliation(s)
- María del Carmen Díaz-Mardomingo
- Department of Basic Psychology I, UNED, Madrid, Spain
- Instituto Mixto de Investigación – Escuela Nacional de Sanidad (IMIENS), Madrid, Spain
| | - Lucía Utrera
- Department of Psychobiology, UNED, Madrid, Spain
- Escuela Internacional de Doctorado – Universidad Nacional de Educación a Distancia (EIDUNED), Madrid, Spain
| | - Shishir Baliyan
- Department of Psychobiology, UNED, Madrid, Spain
- Departamento de Psicología Experimental, Procesos Cognitivos y Logopedia, Instituto Pluridisciplinar, Universidad Complutense de Madrid, Madrid, Spain
| | - Sara García-Herranz
- Instituto Mixto de Investigación – Escuela Nacional de Sanidad (IMIENS), Madrid, Spain
- Department of Basic Psychology II, UNED, Madrid, Spain
| | | | | | | | - Azucena Valencia
- Instituto Mixto de Investigación – Escuela Nacional de Sanidad (IMIENS), Madrid, Spain
- Department of Psychobiology, UNED, Madrid, Spain
| | - César Venero
- Instituto Mixto de Investigación – Escuela Nacional de Sanidad (IMIENS), Madrid, Spain
- Department of Psychobiology, UNED, Madrid, Spain
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3
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Hong JH, Nakamura JS, Berkman LF, Chen FS, Shiba K, Chen Y, Kim ES, VanderWeele TJ. Are loneliness and social isolation equal threats to health and well-being? An outcome-wide longitudinal approach. SSM Popul Health 2023; 23:101459. [PMID: 37546381 PMCID: PMC10400921 DOI: 10.1016/j.ssmph.2023.101459] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 08/08/2023] Open
Abstract
The detrimental effects of loneliness and social isolation on health and well-being outcomes are well documented. In response, governments, corporations, and community-based organizations have begun leveraging tools to create interventions and policies aimed at reducing loneliness and social isolation at scale. However, these efforts are frequently hampered by a key knowledge gap: when attempting to improve specific health and well-being outcomes, decision-makers are often unsure whether to target loneliness, social isolation, or both. Filling this knowledge gap will inform the development and refinement of effective interventions. Using data from the Health and Retirement Study (13,752 participants (59% women and 41% men, mean [SD] age = 67 [10] years)), we examined how changes in loneliness and social isolation over a 4-year follow-up period (from t0:2008/2010 to t1:2012/2014) were associated with 32 indicators of physical-, behavioral-, and psychosocial-health outcomes 4-years later (t2:2016/2018). We used multiple logistic-, linear-, and generalized-linear regression models, and adjusted for sociodemographic, personality traits, pre-baseline levels of both exposures (loneliness and social isolation), and all outcomes (t0:2008/2010). We incorporated data from all participants into the overall estimate, regardless of whether their levels of loneliness and social isolation changed from the pre-baseline to baseline waves. After adjusting for a wide range of covariates, we observed that both loneliness and social isolation were associated with several physical health outcomes and health behaviors. However, social isolation was more predictive of mortality risk and loneliness was a stronger predictor of psychological outcomes. Loneliness and social isolation have independent effects on various health and well-being outcomes and thus constitute distinct targets for interventions aimed at improving population health and well-being.
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Affiliation(s)
- Joanna H. Hong
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Julia S. Nakamura
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Lisa F. Berkman
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Frances S. Chen
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Koichiro Shiba
- Department of Epidemiology, Boston University, Boston, MA, USA
| | - Ying Chen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | - Eric S. Kim
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tyler J. VanderWeele
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Ho ISS, McGill K, Malden S, Wilson C, Pearce C, Kaner E, Vines J, Aujla N, Lewis S, Restocchi V, Marshall A, Guthrie B. Examining the social networks of older adults receiving informal or formal care: a systematic review. BMC Geriatr 2023; 23:531. [PMID: 37653368 PMCID: PMC10470175 DOI: 10.1186/s12877-023-04190-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/23/2023] [Indexed: 09/02/2023] Open
Abstract
PURPOSE To address the care needs of older adults, it is important to identify and understand the forms of care support older adults received. This systematic review aims to examine the social networks of older adults receiving informal or formal care and the factors that influenced their networks. METHODS A systematic review was conducted by searching six databases from inception to January 31, 2023. The review included primary studies focusing on older adults receiving long-term care, encompassing both informal and formal care. To assess the risk of bias in the included studies, validated appraisal tools specifically designed for different study types were utilized. Network analysis was employed to identify the grouping of study concepts, which subsequently formed the foundation for describing themes through narrative synthesis. RESULTS We identified 121 studies relating to the formal and informal care of older adults' networks. A variety of social ties were examined by included studies. The most commonly examined sources of care support were family members (such as children and spouses) and friends. Several factors were consistently reported to influence the provision of informal care, including the intensity of networks, reciprocity, and geographical proximity. In terms of formal care utilization, older age and poor health status were found to be associated with increased use of healthcare services. Additionally, physical limitations and cognitive impairment were identified as factors contributing to decreased social engagement. CONCLUSION This review found that older people were embedded within a diverse network. The findings of this review emphasize the importance of recognizing and incorporating the diversity of social networks in care plans and policies to enhance the effectiveness of interventions and improve the overall well-being of older adults.
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Affiliation(s)
- Iris Szu-Szu Ho
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK.
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK.
- , 47 Potterow, Bayes Centre, Edinburgh, EH8 9BT, UK.
| | - Kris McGill
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
| | - Stephen Malden
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- School of Health in Social Science, Medical School, University of Edinburgh, Doorway 6, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Cara Wilson
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Institute for Education, Community and Society, University of Edinburgh, Old Moray House, Holyrood Road, Edinburgh, EH8 8AQ, UK
| | - Caroline Pearce
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Edinburgh College of Art, University of Edinburgh, 74 Lauriston Pl, Edinburgh, EH3 9DF, UK
| | - Eileen Kaner
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Population Health Science Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
| | - John Vines
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK
| | - Navneet Aujla
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Population Health Science Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
| | - Sue Lewis
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- School of Health in Social Science, Medical School, University of Edinburgh, Doorway 6, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Valerio Restocchi
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK
| | - Alan Marshall
- School of Social and Political Science, University of Edinburgh, 15a George Square, Edinburgh, EH8 9LD, UK
| | - Bruce Guthrie
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
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Wang F, Gao Y, Han Z, Yu Y, Long Z, Jiang X, Wu Y, Pei B, Cao Y, Ye J, Wang M, Zhao Y. A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality. Nat Hum Behav 2023; 7:1307-1319. [PMID: 37337095 DOI: 10.1038/s41562-023-01617-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 04/27/2023] [Indexed: 06/21/2023]
Abstract
The associations between social isolation, loneliness and the risk of mortality from all causes, cardiovascular disease (CVD) and cancer are controversial. We systematically reviewed prospective studies on the association between social isolation, loneliness and mortality outcomes in adults aged 18 years or older, as well as studies on these relationships in individuals with CVD or cancer, and conducted a meta-analysis. The study protocol was registered with PROSPERO (reg. no. CRD42022299959). A total of 90 prospective cohort studies including 2,205,199 individuals were included. Here we show that, in the general population, both social isolation and loneliness were significantly associated with an increased risk of all-cause mortality (pooled effect size for social isolation, 1.32; 95% confidence interval (CI), 1.26 to 1.39; P < 0.001; pooled effect size for loneliness, 1.14; 95% CI, 1.08 to 1.20; P < 0.001) and cancer mortality (pooled effect size for social isolation, 1.24; 95% CI, 1.19 to 1.28; P < 0.001; pooled effect size for loneliness, 1.09; 95% CI, 1.01 to 1.17; P = 0.030). Social isolation also increased the risk of CVD mortality (1.34; 95% CI, 1.25 to 1.44; P < 0.001). There was an increased risk of all-cause mortality in socially isolated individuals with CVD (1.28; 95% CI, 1.10 to 1.48; P = 0.001) or breast cancer (1.51; 95% CI, 1.34 to 1.70; P < 0.001), and individuals with breast cancer had a higher cancer-specific mortality owing to social isolation (1.33; 95% CI, 1.02 to 1.75; P = 0.038). Greater focus on social isolation and loneliness may help improve people's well-being and mortality risk.
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Affiliation(s)
- Fan Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, P. R. China
| | - Yu Gao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Zhen Han
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Yue Yu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Zhiping Long
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Xianchen Jiang
- Department of Chronic Disease Prevention and Control, Quzhou Center for Disease Control and Prevention, Quzhou, P. R. China
| | - Yi Wu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Bing Pei
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Yukun Cao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Jingyu Ye
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Maoqing Wang
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, P. R. China.
| | - Yashuang Zhao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China.
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, P. R. China.
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6
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Schutter N, Holwerda TJ, Comijs HC, Stek ML, Peen J, Dekker JJM. Loneliness, social network size and mortality in older adults: a meta-analysis. Eur J Ageing 2022; 19:1057-1076. [PMID: 36692789 PMCID: PMC9685120 DOI: 10.1007/s10433-022-00740-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 11/23/2022] Open
Abstract
Loneliness and social network size have been found to be predictors of mortality in older adults. The objective of this study was to investigate whether loneliness and small social network size are associated with an increased mortality risk and to review the evidence for either network size, or loneliness that constitutes the higher mortality risk. A systematic literature search was performed in PubMed, EMBASE and PsychInfo in January/February 2018 and March/April 2021. Studies that mentioned outcome data were included in the meta-analysis and coded using the Newcastle-Ottawa Quality Assessment Scale for Cohort Studies. The meta-analysis showed that both loneliness and small social network size are associated with mortality risk in older adults (Hazard Ratio 1.10 (95% Confidence Interval 1.06-1.14) for loneliness and 0.96 (95% Confidence Interval 0.93-0.99) for larger network size). Sensitivity analyses according to the Newcastle-Ottawa Quality Assessment Scale yielded varying results. Heterogeneity was large. In conclusion, both loneliness and small social network size in older adults are associated with increased mortality, although the effect size is small. Targeting subjective and objective aspects of older adults' social contacts should be on the agenda of preventive as well as personalized medicine. In order to be able to compare the association between loneliness and network size and mortality, more studies are needed that include both these risk factors.
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Affiliation(s)
- Natasja Schutter
- Department of Geriatric Psychiatry, Arkin Mental Health Care, Nieuwe Kerkstraat 156, 1018 VM Amsterdam, The Netherlands
| | - Tjalling J. Holwerda
- Department of Psychiatry, Arkin Mental Health Care, Roetersstraat 210, 1018 WE Amsterdam, The Netherlands
| | - Hannie C. Comijs
- GGZ InGeest/Department of Psychiatry and the Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Max L. Stek
- GGZ InGeest/Department of Psychiatry and the Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Jaap Peen
- Department of Clinical Research, Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Jack J. M. Dekker
- Department of Clinical Research, Arkin Mental Health Care, Amsterdam, The Netherlands
- Department of Psychology, VU University Amsterdam, Amsterdam, The Netherlands
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7
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Qiao L, Wang G, Tang Z, Zhou S, Min J, Yin M, Li M. Association between loneliness and dementia risk: A systematic review and meta-analysis of cohort studies. Front Hum Neurosci 2022; 16:899814. [PMID: 36530204 PMCID: PMC9751343 DOI: 10.3389/fnhum.2022.899814] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 11/16/2022] [Indexed: 10/03/2023] Open
Abstract
Loneliness has been reported to be associated with an increased risk of dementia; however, the extent of this relationship remains controversial. This study aimed to assess the strength of the relationship between loneliness and dementia using a meta-analysis approach. PubMed, EMBASE, and China National Knowledge Internet databases were systematically searched for potentially included studies from inception up to 17 February 2022. A meta-analysis was performed using a random-effects model to assess pooled relative risks (RRs) and 95% confidence intervals (CIs). A literature search identified 16 cohort studies (published in 15 articles), among which 4,625 dementia cases and 62,345 individuals were selected for further meta-analysis. Loneliness was associated with an increased risk of Alzheimer's disease (AD) (RR: 1.72, 95% CI: 1.32-2.23; P < 0.001) and dementia (RR: 1.23, 95% CI: 1.16-1.31; P < 0.00001). However, no significant association between loneliness and risk of mild cognitive impairment (MCI) (RR: 1.34, 95% CI: 0.97-1.87; P = 0.080) or vascular dementia (VaD) (RR: 1.01, 95% CI: 0.51-1.99; P = 0.973) was observed. Results revealed that loneliness might increase the risk of Alzheimer's disease and dementia. Early interventions that limit loneliness may reduce risk of dementia and Alzheimer's disease.
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Affiliation(s)
- Luyao Qiao
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Gege Wang
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhenyu Tang
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Institute of Neuroscience, Nanchang University, Nanchang, Jiangxi, China
| | - Siqi Zhou
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jun Min
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Institute of Neuroscience, Nanchang University, Nanchang, Jiangxi, China
| | - Min Yin
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Institute of Neuroscience, Nanchang University, Nanchang, Jiangxi, China
| | - Min Li
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Institute of Neuroscience, Nanchang University, Nanchang, Jiangxi, China
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8
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Crespo-Sanmiguel I, Zapater-Fajarí M, Garrido-Chaves R, Hidalgo V, Salvador A. Loneliness and Health Indicators in Middle-Aged and Older Females and Males. Front Behav Neurosci 2022; 16:809733. [PMID: 35359585 PMCID: PMC8961269 DOI: 10.3389/fnbeh.2022.809733] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Loneliness is a complex and uncomfortable feeling that results from the perception of a lack of desired personal and social ties. Loneliness is accentuated with aging. It has been related to a wide range of objective and subjective health indicators and is a risk factor for morbidity and mortality. One of the proposed underlying mechanisms through which loneliness affects health is the dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. However, the relationship between loneliness and cortisol, the main product of the HPA axis, is unclear and requires more research. The aims of this cross-sectional study were to investigate the relationships between loneliness, subjective health, and cortisol indexes, taking the sex into account, and investigate whether the HPA axis mediates the relationship between loneliness and subjective health. For this purpose, 79 participants (between 55 and 75 years old) completed several scales on loneliness, depression, perceived stress, psychological and physical health, and social relationships. Various salivary cortisol measurements were obtained on two consecutive days. The initial results showed that loneliness was related to psychological and physical health in the mixed-sex sample. However, when covariates were introduced, loneliness was only associated with psychological health in males. In addition, the cortisol indexes employed were not related to loneliness and did not mediate the relationship between loneliness and subjective health. Hence, we did not find a relevant role of the HPA axis in the association between loneliness and subjective health. More severe perceptions of loneliness would probably be necessary to detect this role. Overall, these results also show that the expected negative outcomes of loneliness associated with aging can be countered by an active life that can compensate for the natural losses experienced with age or at least delay these negative outcomes. Finally, some sex differences were found, in line with other studies, which warrants further examination of social variables and dimensions related to gender in future research.
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Affiliation(s)
- Isabel Crespo-Sanmiguel
- Laboratory of Social Cognitive Neuroscience, Psychobiology-IDOCAL, University of Valencia, Valencia, Spain
| | - Mariola Zapater-Fajarí
- Laboratory of Social Cognitive Neuroscience, Psychobiology-IDOCAL, University of Valencia, Valencia, Spain
| | - Ruth Garrido-Chaves
- Laboratory of Social Cognitive Neuroscience, Psychobiology-IDOCAL, University of Valencia, Valencia, Spain
| | - Vanesa Hidalgo
- Department of Psychology and Sociology, Area of Psychobiology, IIS Aragón, University of Zaragoza, Teruel, Spain
- *Correspondence: Vanesa Hidalgo,
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, Psychobiology-IDOCAL, University of Valencia, Valencia, Spain
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