Kexin Yu1, Shinyi Wu2, Yuri Jang3, Chih-Ping Chou4, Kathleen H Wilber5, María P Aranda3, Iris Chi3. 1. Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA; Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA. Electronic address: kexin@usc.edu. 2. Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA; Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA; Viterbi School of Engineering, Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California, Los Angeles, CA. 3. Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA; Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA. 4. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA; Department of Bio-Industry Communication & Development, National Taiwan University, Taipei, Taiwan. 5. Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA.
Abstract
OBJECTIVES: In response to the lack of longitudinal evidence, this study aims to disentangle time sequence and directionality between the severity of geriatric conditions (GCs) and loneliness. DESIGN: Longitudinal panel study. SETTING AND PARTICIPANTS: The working sample had 4680 participants of 2006, 2010, and 2014 waves of the Health and Retirement Study (HRS). All participants were at least 65 years old at baseline. Proxy responded cases and individuals who suffered from moderate to severe cognitive impairment were excluded from the analysis. METHODS: Loneliness was measured with the 3-item UCLA loneliness scale. Five GCs were included: falls, incontinence, vision impairment, hearing impairment, and pain. Severity indicators were the number of times fallen in the past 2 years, number of days experiencing loss of bladder control in the past month, self-rated eyesight, self-rated hearing, and participants' perceived level of pain. RESULTS: Random-intercept cross-lagged panel models were run to analyze the relationship between the severity of each individual GC and loneliness. All models were controlled for baseline demographics, social isolation, self-rated health, physical function, comorbidities, and hospitalization. The longitudinal association between loneliness and fall was bidirectional: a higher loneliness score predicted an increased number of falls and vice versa. Incontinence, vision impairment, hearing impairment, and pain were not significantly associated with loneliness longitudinally. The association between the random intercept of loneliness and some GCs (vision and pain) were significant, indicating the severity of these GCs were related to loneliness at the between-person level at baseline. CONCLUSION AND IMPLICATIONS: Findings of the longitudinal analysis suggest a reciprocal relationship between fall and loneliness. Fall prevention programs could be integrated with social service for addressing loneliness, and alleviating loneliness might be beneficial for preventing falls. Results of this study highlight the importance of integrating clinical management of falls with social services addressing loneliness in long term care.
OBJECTIVES: In response to the lack of longitudinal evidence, this study aims to disentangle time sequence and directionality between the severity of geriatric conditions (GCs) and loneliness. DESIGN: Longitudinal panel study. SETTING AND PARTICIPANTS: The working sample had 4680 participants of 2006, 2010, and 2014 waves of the Health and Retirement Study (HRS). All participants were at least 65 years old at baseline. Proxy responded cases and individuals who suffered from moderate to severe cognitive impairment were excluded from the analysis. METHODS: Loneliness was measured with the 3-item UCLA loneliness scale. Five GCs were included: falls, incontinence, vision impairment, hearing impairment, and pain. Severity indicators were the number of times fallen in the past 2 years, number of days experiencing loss of bladder control in the past month, self-rated eyesight, self-rated hearing, and participants' perceived level of pain. RESULTS: Random-intercept cross-lagged panel models were run to analyze the relationship between the severity of each individual GC and loneliness. All models were controlled for baseline demographics, social isolation, self-rated health, physical function, comorbidities, and hospitalization. The longitudinal association between loneliness and fall was bidirectional: a higher loneliness score predicted an increased number of falls and vice versa. Incontinence, vision impairment, hearing impairment, and pain were not significantly associated with loneliness longitudinally. The association between the random intercept of loneliness and some GCs (vision and pain) were significant, indicating the severity of these GCs were related to loneliness at the between-person level at baseline. CONCLUSION AND IMPLICATIONS: Findings of the longitudinal analysis suggest a reciprocal relationship between fall and loneliness. Fall prevention programs could be integrated with social service for addressing loneliness, and alleviating loneliness might be beneficial for preventing falls. Results of this study highlight the importance of integrating clinical management of falls with social services addressing loneliness in long term care.
Authors: Sonia M Thomas; Amanda Parker; Jennifer Fortune; Gary Mitchell; Areej Hezam; Ying Jiang; Margaret de Groh; Kerry Anderson; Amélie Gauthier-Beaupré; Joan Barker; Jennifer Watt; Sharon E Straus; Andrea C Tricco Journal: BMJ Open Date: 2022-09-29 Impact factor: 3.006