Rahul Malhotra1,2, Md Ismail Tareque3, Yasuhiko Saito4, Stefan Ma5, Chi-Tsun Chiu6, Angelique Chan1,2. 1. Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore. 2. Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore. 3. Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh. 4. College of Economics, Nihon University, Tokyo, Japan. 5. Ministry of Health, Singapore, Singapore. 6. Institute of European and American Studies, Academia Sinica, Taipei, Taiwan.
Abstract
BACKGROUND: The population health impact of loneliness remains unknown. We quantified the impact of loneliness on total life expectancy (TLE) and health expectancy (the duration of remaining life lived in different health states) among older adults, aged ≥60 years. DESIGN: Multistate life table analysis of a nationally representative longitudinal survey. SETTING: Singapore. PARTICIPANTS: Survey participants (n = 3449) interviewed in 2009, 2011-12, and 2015. MEASUREMENTS: Health states were defined using self-rated health (SRH) status and activity of daily living (ADL)/instrumental ADL (IADL) status. Participants with somewhat or very unhealthy SRH were considered as unhealthy. Those reporting health-related difficulty with any ADL/IADL were considered to have limitation in ADLs/IADLs. TLE and health expectancy (healthy and unhealthy life expectancy (HLE and UHLE) in the context of SRH, and active and inactive life expectancy (ALE and IALE) in the context of ADLs/IADLs) were estimated using the multistate life table method with a microsimulation approach, considering loneliness as time varying. RESULTS: At age 60, 70, and 80, those sometimes lonely or mostly lonely generally had shorter TLE, HLE and ALE, similar UHLE and IALE, and a higher proportion of remaining life with unhealthy SRH or with ADL/IADL limitations versus those never lonely. For example, at the age of 60, those sometimes lonely versus never lonely had shorter TLE (by 5.4 [95% Confidence Interval: 3.4-7.9] years), shorter HLE (by 5.9 [4.1-8.6] years), similar UHLE (difference: 0.6 [-0.7-1.7] years), and higher proportion of remaining life with unhealthy SRH (by 6.2 [1.2-10.8] percentage points). For those mostly lonely versus never lonely, TLE was shorter by 3.6 (0.7-6.6) years, HLE was shorter by 4.8 (2.3-8.2) years, UHLE was similar (difference: 1.2 [-0.1-4.0] years), and proportion of remaining life with unhealthy SRH was higher by 7.2 (2.1-18.1) percentage points. CONCLUSION: Identification and management of loneliness may increase years of life with healthy SRH and without limitation in ADLs/IADLs among older adults.
BACKGROUND: The population health impact of loneliness remains unknown. We quantified the impact of loneliness on total life expectancy (TLE) and health expectancy (the duration of remaining life lived in different health states) among older adults, aged ≥60 years. DESIGN: Multistate life table analysis of a nationally representative longitudinal survey. SETTING: Singapore. PARTICIPANTS: Survey participants (n = 3449) interviewed in 2009, 2011-12, and 2015. MEASUREMENTS: Health states were defined using self-rated health (SRH) status and activity of daily living (ADL)/instrumental ADL (IADL) status. Participants with somewhat or very unhealthy SRH were considered as unhealthy. Those reporting health-related difficulty with any ADL/IADL were considered to have limitation in ADLs/IADLs. TLE and health expectancy (healthy and unhealthy life expectancy (HLE and UHLE) in the context of SRH, and active and inactive life expectancy (ALE and IALE) in the context of ADLs/IADLs) were estimated using the multistate life table method with a microsimulation approach, considering loneliness as time varying. RESULTS: At age 60, 70, and 80, those sometimes lonely or mostly lonely generally had shorter TLE, HLE and ALE, similar UHLE and IALE, and a higher proportion of remaining life with unhealthy SRH or with ADL/IADL limitations versus those never lonely. For example, at the age of 60, those sometimes lonely versus never lonely had shorter TLE (by 5.4 [95% Confidence Interval: 3.4-7.9] years), shorter HLE (by 5.9 [4.1-8.6] years), similar UHLE (difference: 0.6 [-0.7-1.7] years), and higher proportion of remaining life with unhealthy SRH (by 6.2 [1.2-10.8] percentage points). For those mostly lonely versus never lonely, TLE was shorter by 3.6 (0.7-6.6) years, HLE was shorter by 4.8 (2.3-8.2) years, UHLE was similar (difference: 1.2 [-0.1-4.0] years), and proportion of remaining life with unhealthy SRH was higher by 7.2 (2.1-18.1) percentage points. CONCLUSION: Identification and management of loneliness may increase years of life with healthy SRH and without limitation in ADLs/IADLs among older adults.
Authors: Iria Dobarrio-Sanz; Crístofer Ruiz-González; Cayetano Fernández-Sola; Pablo Roman; José Granero-Molina; Jose Manuel Hernández-Padilla Journal: Int J Environ Res Public Health Date: 2021-11-17 Impact factor: 3.390
Authors: Ashwin A Kotwal; Stephanie Batio; Michael S Wolf; Kenneth E Covinsky; Julia Yoshino Benavente; Carla M Perissinotto; Rachel M O'Conor Journal: J Am Geriatr Soc Date: 2022-08-25 Impact factor: 7.538