PhotoHaving a lot of people around can be pretty annoying. They listen to music, crash around in the kitchen and sometimes make you go places and do things you would rather not do.

But there's something even worse, especially if you're over 60. That something is loneliness, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication. Another study found that, even if you're not lonely, simply living alone was associated with an increased risk of death.

Loneliness in individuals over 60 years of age appears associated with increased risk of functional decline and death, the journal reported. In older persons, loneliness can be a common source of distress and impaired quality life, according to the study background.

Carla M. Perissinotto, M.D., M.H.S., of the University of California, San Francisco, and colleagues examined the relationship between loneliness and risk of functional decline and death in older individuals in a study of 1,604 participants in the Health and Retirement Study.

The participants (average age 71) were asked if they felt left out, isolated or a lack of companionship. Of the participants, 43.2 percent reported feeling lonely, which was defined as reporting one of the loneliness items at least some of the time, according to the study results.

Risk of death

Loneliness was associated with an increased risk of death over the six-year follow-up period (22.8 percent vs. 14.2 percent), the results indicate. Loneliness also was associated with functional decline, including participants being more likely to experience decline in activities of daily living (24.8 percent vs. 12.5 percent), develop difficulties with upper extremity tasks (41.5 percent vs. 28.3 percent) and difficulty in stair climbing (40.8 percent vs. 27.9 percent).

“Loneliness is a common source of suffering in older persons. We demonstrated that it is also a risk factor for poor health outcomes including death and multiple measures of functional decline,” the authors comment.

The authors conclude their study could have important public health implications.

“Assessment of loneliness is not routine in clinical practice and it may be viewed as beyond the scope of medical practice. However, loneliness may be as an important of a predictor of adverse health outcomes as many traditional medical risk factors,” the researchers note. “Our results suggest that questioning older persons about loneliness may be a useful way of identifying elderly persons at risk of disability and poor health outcomes.”

Cardiovascular disease

If loneliness seems too imprecise, consider this: another study published today finds living alone was associated with an increased risk of death and cardiovascular death in an international study of stable outpatients at risk of or with arterial vascular disease, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication.

Living alone was associated with higher four-year mortality (14.1 percent vs. 11.1 percent) and cardiovascular death (8.6 percent vs. 6.8 percent), according to the study results.

Social isolation may be associated with poor health consequences, and the risk associated with living alone is relevant because about 1 in 7 American adults lives alone. Epidemiological evidence suggests that social isolation may alter neurohormonal-mediated emotional stress, influence health behavior and effect access to health care, which may result in association with or acquisition of, cardiovascular risk, according to the study background 

Jacob A. Udell, M.D., M.P.H., of Brigham and Women’s Hospital, Harvard Medical School, Boston, and colleagues examined whether living alone was associated with increased mortality and cardiovascular (CV) risk in the global REduction of Atherothrombosis for Continued Health (REACH) Registry. Among 44,573 REACH participants, 8,594 (19 percent) lived alone. 

Based on age, living alone was associated with an increased risk of death among those patients 45 to 65 years old compared with those living with others (7.7 percent vs. 5.7 percent) , and among those participants 66 to 80 years old (13.2 percent vs. 12.3 percent). However, among patients older than 80 years, living alone was not associated with an increased risk of mortality compared with those living with others (24.6 percent vs. 28.4 percent), the results indicate.

“In conclusion, living alone was independently associated with an increased risk of mortality and CV death in an international cohort of stable middle-aged outpatients with or at risk of atherothrombosis,” the authors conclude. “Younger individuals who live alone may have a less favorable course than all but the most elderly individuals following development of CV disease, and this observation warrants confirmation in further studies.”


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