Loneliness, Functional Decline, & Mortality

It is well known that social connectedness and the avoidance of loneliness are important aspects of healthy aging. The psychological experience of loneliness is distinct from the objective lack of social connections, and researchers are beginning to explore how the feeling of loneliness may be a separate risk factor for poor health, different from the risks of objective social isolation or other feelings of psychological distress such as depression.

To explore whether loneliness is a distinct risk factor for functional decline and mortality, researchers analyzed data from the large-scale Health and Retirement Study (HRS), a representative longitudinal sample of older adults in the US. Randomly selected participants within the larger HRS sample are selected for additional, in-depth surveys on particular topics. This study looks at the HRS sub-sample who received an additional psychosocial module, which includes items on loneliness, in addition to the general HRS survey topics on physical health, physical functioning, and demographic information. For this study, data from 1,604 participants were analyzed to see if loneliness was related to functional decline and death

Three components of loneliness were assessed: feeling left out, feeling isolated, or lacking companionship. Participants were classified as lonely if the reported experiencing any of these feelings “some of the time” or “often.” Functional decline was assessed by difficulties in tasks of daily living, walking, stair climbing, or use of the upper body. Data on mortality, socioeconomic status, demographic and medical information, and depression were also drawn from the HRS. In their analysis, the researchers assessed whether feelings of loneliness increased the risk of functional decline or death, even when factoring in the other factors.

Loneliness increased the risk of death over a six-year follow-up period when controlling for all other factors, suggesting a relationship with mortality distinct from that of depression or from other social factors. Loneliness was also associated with an increased risk of functional decline, other than for mobility, which was not associated with loneliness when adjusting for other factors. These findings suggest that loneliness is a significant risk factor for poor health outcomes among older adults and should be considered as a target for intervention.


Perissinotto CM, Cenzer IS and Covinksy KE. Loneliness in older persons. Archives of Internal Medicine (2012); doi:10.1001/archinternmed.2012.1993

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