Loneliness – the unpleasant feeling of emptiness or desolation –
can creep in and cause suffering to people at any age. But it can be
especially debilitating to older adults and may predict serious health
problems and even death, according to a new study by UCSF researchers.
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, published today
in the Archives of Internal Medicine, focused specifically on the
question of loneliness and its impact.
typical medical model, we don’t think of subjective feelings as
affecting health,” said first author Carla Perissinotto, MD, MHS,
assistant professor in the UCSF Division of Geriatrics. “It’s intriguing
to find that loneliness is independently associated with an increased
rate of death and functional decline.”
Lonely Without Being Alone
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.”
UCSF focused on death and a decrease in the ability to perform daily
activities such as upper extremity tasks, climbing stairs, and walking.
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.
is one of those outcomes you don’t want to see because it was terrible
to find out it was actually true,” Perissinotto said. “We went into the
analysis thinking that there was a risk we could find nothing, but there
actually was a strong correlation.”
Depression vs. Loneliness
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.
“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.
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.
about chronic diseases is not enough,” she said. “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,” she said.
what 85-year-old jazz singer Barbara Dane is trying to avoid as she
continues to entertain well into her 80s. Dane’s husband passed away in
September 2010. She stays active by continuing to perform in the East
“When your spouse dies, there’s a missing
space in your heart,” she said. “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 has been an
accomplished jazz singer for more than seven decades. She credits her
active social life to her positive outlook on life.
lot of people around me are aging, and some are not doing so well,” she
said. “Some who never developed social skills are having the hardest
time and those are the ones we need to watch out for.”
my age need to appreciate who they are,” she said. “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.”
mean age of the 1,604 participants in the study was 71 years.
Researchers limited their analysis to participants 60 and older.
Eighty-one percent were Caucasian, 11 percent African American, six
percent Hispanic, and two percent of unknown ethnicity.
are Kenneth Covinsky, MD, MPH, of the UCSF Division of Geriatrics and
the San Francisco Veterans Affairs Medical Center; and Irena Stijacic
Cenzer, MA, of the UCSF Division of Geriatrics.
study was supported by the National Institute on Aging (Grant
#5R01AG028481-03). Dr. Perissinotto is also supported in part by the
Geriatric Academic Career Award, Health Resources and Services
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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