Siiri-Liisi Kraav1,2, Olutosin Awoyemi1,3,4, Niina Junttila5, Riitta Vornanen2, Jussi Kauhanen6, Timo Toikko2, Soili M Lehto7,8,9, Sari Hantunen6, Tommi Tolmunen1,10. 1. Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland. 2. Department of Social Sciences, University of Eastern Finland, Kuopio, Finland. 3. Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom. 4. Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland. 5. Department for Teacher Education, Centre for Education and Research on Social and Health Services, University of Turku, Turku, Finland. 6. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. 7. Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 8. R&D Department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway. 9. Department of Psychiatry, University of Helsinki, Helsinki, Finland. 10. Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland.
Abstract
OBJECTIVES: Loneliness and social isolation both increase mortality and are likely to affect health via several pathways. However, information on the potential pathways remains scarce. We investigated the associations between loneliness, social isolation, and mortality, and possible mechanisms underlying these connections. METHODS: The analyzed data comprised a prospective population-based cohort of Finnish men (42-61 years at baseline, n = 2588) who were followed up for an average of 23.2 years. Mortality data were obtained from the national population register in 2012. Cox proportional hazards analysis with adjustments for possible confounding factors was used to examine the associations between loneliness and social isolation at baseline and all-cause, injury, cancer, and cardiovascular disease (CVD) mortality. Mediation analysis was conducted to investigate the mechanisms underlying the associations of loneliness and social isolation with mortality. RESULTS: Loneliness predicted all-cause mortality, even after adjustments for all covariates. Loneliness predicted cancer mortality, except after adjustments for lifestyle variables or Human Population Laboratory (HPL) depression scores, and also predicted CVD mortality, except after adjustments for HPL depression scores. Social isolation predicted all-cause mortality and injury mortality. The effect of social isolation on all-cause mortality was mediated by loneliness and HPL depression scores. CONCLUSIONS: Our findings suggest that both loneliness and social isolation increase the risk of all-cause mortality, while they have differing effects on different causes of death. Loneliness and depressive symptoms may mediate the effect of social isolation on increased mortality.
OBJECTIVES: Loneliness and social isolation both increase mortality and are likely to affect health via several pathways. However, information on the potential pathways remains scarce. We investigated the associations between loneliness, social isolation, and mortality, and possible mechanisms underlying these connections. METHODS: The analyzed data comprised a prospective population-based cohort of Finnish men (42-61 years at baseline, n = 2588) who were followed up for an average of 23.2 years. Mortality data were obtained from the national population register in 2012. Cox proportional hazards analysis with adjustments for possible confounding factors was used to examine the associations between loneliness and social isolation at baseline and all-cause, injury, cancer, and cardiovascular disease (CVD) mortality. Mediation analysis was conducted to investigate the mechanisms underlying the associations of loneliness and social isolation with mortality. RESULTS: Loneliness predicted all-cause mortality, even after adjustments for all covariates. Loneliness predicted cancermortality, except after adjustments for lifestyle variables or Human Population Laboratory (HPL) depression scores, and also predicted CVDmortality, except after adjustments for HPL depression scores. Social isolation predicted all-cause mortality and injury mortality. The effect of social isolation on all-cause mortality was mediated by loneliness and HPL depression scores. CONCLUSIONS: Our findings suggest that both loneliness and social isolation increase the risk of all-cause mortality, while they have differing effects on different causes of death. Loneliness and depressive symptoms may mediate the effect of social isolation on increased mortality.
Entities:
Keywords:
All-cause mortality; depression; loneliness; longitudinal study; mediation; social isolation
Authors: Jiao Wang; Wei Sen Zhang; Chao Qiang Jiang; Feng Zhu; Ya Li Jin; Kar Keung Cheng; Tai Hing Lam; Lin Xu Journal: BMC Med Date: 2022-05-02 Impact factor: 11.150
Authors: Katharina Dost; Fabian Heinrich; Wiebke Graf; Anna Brennecke; Veronika Kowalski; Anna Leider; Anika Kraus; Victoria van Rüth; Benjamin Ondruschka; Klaus Püschel; Hans-Helmut König; Franziska Bertram; André Hajek Journal: Int J Environ Res Public Health Date: 2022-10-05 Impact factor: 4.614