Lonely elders decline, die

By Sarah Guy

Loneliness is a risk factor for functional decline and death in the elderly, say US researchers.

Their study findings show that loneliness - as distinct from depression - is common in adults aged over 60 years, even if they are married and do not live alone.

Indeed, study participants who reported being lonely were significantly more likely to experience a decline in the ability to perform activities of daily living (ADL), upper extremity tasks, mobility, and stair climbing than their peers who were not lonely.

Furthermore, loneliness was associated with an increased risk for death, report Carla Perissinotto (University of California, San Francisco) and colleagues.

The team suggests that if loneliness predicts such adverse health outcomes in this population, primary care providers should question older persons about loneliness to identify those at risk.

Providers may also wish to consider "referral of high-risk patients to social workers or community agencies for consideration of social programs such as group meals, senior center activities, and volunteerism, which may ameliorate loneliness," write Perissinotto et al in the Archives of Internal Medicine.

They reviewed data for 1604 participants of the Health and Retirement Study 2002, which asked whether the individuals (aged a mean 71 years) felt left out, isolated, or lacking in companionship.

A total of 43% of participants reported feeling lonely - defined as reporting at least one of the above items at least some of the time.

During the 6-year follow-up period, the researchers found that loneliness increased the risk for death by 1.70 times, an association that remained significant even after adjustment for socioeconomic status, depression, and other health and function measures.

The risks for ADL decline and experiencing difficulties with upper extremity tasks or stair climbing also increased 1.59-, 1.28-, and 1.31-fold in lonely compared with not lonely participants.

In addition, while lonely individuals were more likely to live alone and/or be depressed, the majority of lonely and/or depressed individuals lived with someone and were not depressed.

In an associated commentary, Emily Bucholz and Harlan Krumholz from Yale University in New Haven, Connecticut, believe loneliness "is a negative feeling that would be worth addressing even if the condition had no health implications."

They suggest that social support- "the care and companionship we receive from family and friends" - is a difficult concept to define, but that researchers examining the topic should build on the work of Perissinotto to develop practical interventions that address social factors undermining health.

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