Annette Hegeman1,2, Natasja Schutter3,4, Hannie Comijs4, Tjalling Holwerda4,5, Jack Dekker6,7, Max Stek4, Roos van der Mast2,8. 1. Department of Psychiatry, St. Antonius Ziekenhuis, Utrecht, The Netherlands. 2. Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of Geriatric Psychiatry, Arkin Mental Health Care, Amsterdam, The Netherlands. 4. Department of Psychiatry, EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. 5. Department of Psychiatry PuntP, Arkin Mental Health Care, Amsterdam. 6. Department of Psychology, VU University Medical Center, Amsterdam, The Netherlands. 7. Department of Clinical Research, Arkin Mental Health Care, Amsterdam, The Netherlands. 8. Department of Psychiatry, CAPRI, University of Antwerp, Antwerp, Belgium.
Abstract
OBJECTIVE: Loneliness and depression have a strong reciprocal influence, and both predict adverse health outcomes at old age. Therefore, this study examines whether loneliness is associated with the presence of cardiovascular diseases taking into account the role of late-life depression. METHODS: Cross-sectional data of 477 older adults in the Netherlands Study of Depressed Older Persons were used. Logistic regression analysis was performed to examine the relation between loneliness and cardiovascular disease. Depression was added to the regression model to examine whether depression is an explanatory factor in the association between loneliness and cardiovascular disease. Interaction terms between loneliness and depression and between loneliness and sex were introduced in the regression model to investigate whether depressed and non-depressed participants, and men and women differed in their association between loneliness and cardiovascular disease. RESULTS: Of the overall group, 61% were lonely, 28% had a history of cardiovascular disease and 74% were depressed. Loneliness and cardiovascular disease were not associated in the overall group after adjustment for confounders (continuous: odds ratio [OR] = 1.04, 95% confidence interval [CI] = 0.98-1.10), p = 0.25; dichotomous: OR = 1.27, 95% CI = 0.80-2.03, p = 0.32). For women, there was an association between loneliness and cardiovascular diseases (continuous: OR = 1.13, 95% CI = 1.06-1.21, p < 0.001; dichotomous: OR = 2.64, 95% CI = 1.50-4.65, p = 0.001), but this association was not present in men (OR = 0.96, 95% CI = 0.88-1.05, p = 0.38). This association remained significant after adjustment for confounders, but it lost significance after adding depression to the model. CONCLUSION: For women only, there was an association between loneliness and cardiovascular disease. However, this association was explained by depression, indicating that loneliness in its own right seems not related with cardiovascular disease.
OBJECTIVE:Loneliness and depression have a strong reciprocal influence, and both predict adverse health outcomes at old age. Therefore, this study examines whether loneliness is associated with the presence of cardiovascular diseases taking into account the role of late-life depression. METHODS: Cross-sectional data of 477 older adults in the Netherlands Study of Depressed Older Persons were used. Logistic regression analysis was performed to examine the relation between loneliness and cardiovascular disease. Depression was added to the regression model to examine whether depression is an explanatory factor in the association between loneliness and cardiovascular disease. Interaction terms between loneliness and depression and between loneliness and sex were introduced in the regression model to investigate whether depressed and non-depressedparticipants, and men and women differed in their association between loneliness and cardiovascular disease. RESULTS: Of the overall group, 61% were lonely, 28% had a history of cardiovascular disease and 74% were depressed. Loneliness and cardiovascular disease were not associated in the overall group after adjustment for confounders (continuous: odds ratio [OR] = 1.04, 95% confidence interval [CI] = 0.98-1.10), p = 0.25; dichotomous: OR = 1.27, 95% CI = 0.80-2.03, p = 0.32). For women, there was an association between loneliness and cardiovascular diseases (continuous: OR = 1.13, 95% CI = 1.06-1.21, p < 0.001; dichotomous: OR = 2.64, 95% CI = 1.50-4.65, p = 0.001), but this association was not present in men (OR = 0.96, 95% CI = 0.88-1.05, p = 0.38). This association remained significant after adjustment for confounders, but it lost significance after adding depression to the model. CONCLUSION: For women only, there was an association between loneliness and cardiovascular disease. However, this association was explained by depression, indicating that loneliness in its own right seems not related with cardiovascular disease.