Loneliness Affects Mortality Risk
June 19, 2012

Loneliness Affects Mortality Risk

Connie K. Ho for redOrbit.com

Thoughts of neglect. Feelings of isolation. These are symptoms evaluated in two new studies that examined the influence of loneliness on increased risk of mortality.

One study, conducted by Dr. Jacob A. Udell of the Brigham and Women´s Hospital of the Harvard Medical School in Boston and his colleagues, found that living alone was connected with increased mortality and cardiovascular risk for particular age groups. They looked at data from the global Reduction of Atherothrombosis for Continued Health (REACH) Registry where 19 percent of REACH participants lived alone. According to study results, living alone correlated with a higher four-year mortality and cardiovascular rate. The age range of the study showed that those between the ages of 45 and 65 years of age as well as 66 to 80 years of age had an increased amount of risk when living alone; however, for those who were 80 years and up, living alone didn´t increase their risk of mortality.

"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," wrote the authors in the report. "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."

Another study by University of California, San Francisco (UCSF) researchers also found that loneliness can be especially harmful to older adults and it can be linked to serious health problems, possibly even resulting in death.

The team of researchers studied data in the Health and Retirement Study, which is a national representative study conducted by the National Institute on Aging. There were 1,604 older adults who participated in the study between 2002 and 2008. The average age of the participants was 71 and they were asked if they felt left out, isolated, or lacked companionship. The study´s results, published recently in the Archives of Internal Medicine, highlighted the issue of loneliness

"In our typical medical model, we don't think of subjective feelings as affecting health," remarked first author Dr. Carla Perissinotto, an assistant professor in the UCSF Division of Geriatrics, in a prepared statement. "It's intriguing to find that loneliness is independently associated with an increased rate of death and functional decline."

In this study, the scientists found that loneliness is not necessarily correlated with living alone. In the results, 43 percent of surveyed older adults stated that they felt lonely but only 18 percent lived alone.  The researchers also looked at death and increasing difficulties to perform daily activities like climbing stairs, walking, or upper extremity tasks.

"We are interested in identifying the different factors that cause adults to become functionally impaired and ultimately at risk for nursing home admission," explained Perissinotto in the statement. "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."

Those who identified themselves as lonely showed a 49 percent greater risk of decline and the hazard ratio was 45 percent greater for 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," noted Perissinotto in the statement. "We went into the analysis thinking that there was a risk we could find nothing, but there actually was a strong correlation."

The scientists believe that the effects of loneliness on the elderly differ from the impact of depression. While depression can be related to lack of enjoyment, energy, or motivation, loneliness can be seen in people who are high functioning but report feelings of emptiness or desolation. With the “baby boomer” generation becoming older, researchers hope that the study´s results will integrate social and medical services for elderly patients in a more comprehensive manner.

"Asking about chronic diseases is not enough," commented Perissinotto in the statement. "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. We don't think we can change genetics, but we can intervene when someone is lonely and help prevent some functional decline.”

In an invited commentary, Emily M. Bucholz and Dr. Harlan M. Krumholz remarked on the difficulties of social support for the elderly.

"As we look forward to future studies on social support, the importance of clarifying the mechanisms by which this amorphous concept influences health becomes clear," wrote the authors in the commentary.

Both recommend that scientists look into how programs for the elderly can be designed with social support services in mind.

"Loneliness is a negative feeling that would be worth addressing even if the condition had no health implications. Nevertheless, with regard to health implications, scientists examining social support should build on studies such as those published in this issue and be challenged to investigate mechanisms as well as practical interventions that can be used to address the social factors that undermine health,” the authors concluded in the commentary.

Other elderly people have taken the results to heart and some, such as 85-year-old Barbara Dane, have worked to entertain themselves in old age. Dane´s husband passed away in September 2010 and she stays active by continuing to perform as a jazz singer. Interesting enough, she has been a jazz singer for over seven decades.

"When your spouse dies, there's a missing space in your heart," remarked Dane in the statement. "You still want to know that someone cares about you. Connection to other people becomes even more important at this point in your life."

Dane also believes that her active social life has helped her have a positive outlook on life.

"People my age need to appreciate who they are," noted Dane. "Everyone has some skill and if they want to expand their horizons, they need to figure out what they can use to pull themselves back into the stream of life."