Recent research published in the journal BMC Public Health Determine the impact of loneliness on healthy life expectancy (HLE) and identify ways to improve subjective well-being and health in older adult populations.
study: Loneliness shapes inequalities in health life expectancy: A multi-state analysis of ChinaImage credit: De Visu / Shutterstock.com
Loneliness and health
Loneliness is a feeling of disconnection and dissatisfaction in relationships, and it has been well-studied as a significant predictor of mental and physical illness.
Loneliness activates autonomic responses and may lead to chronic stress. Furthermore, loneliness may exacerbate age-related diseases and increase the risk of cardiovascular disease (CVD), disability, dementia, and frailty. Loneliness may act differently in men and women, and lonely older women are more likely to be depressed and have poorer physical functioning.
As China becomes increasingly urbanized, traditional family relationships and support are declining. Chinese older adults are at high risk of loneliness, with up to 25% currently estimated to be experiencing loneliness.
About the Research
The study used data from the China Longitudinal Health and Longevity Study, which included 15,500 participants aged 65 to 99 years. The survey asked participants about their activities of daily living (ADLs) and self-rated health (SRH) as measures of health and well-being.
Participants’ health status was assessed using ADL and SRH as parameters rather than assessing the presence or absence of specific diseases. Survival selection bias was also avoided by using HLE rather than disease prevalence.
By eliminating age structure and integrating both mortality and morbidity rates, the HLE serves as a reliable assessment tool for evaluating quality of life.”
The aim of this study is to determine the association between loneliness and life expectancy (LE), HLE, and predicted healthy proportion of life expectancy in each age group.
What did the study find?
The average age of participants was 72.9 years. Older women were more likely to have less education, lower income, be widowed, and live alone.
Feelings of loneliness were also higher among women than men, at 29.5% and 20.2%, respectively. However, around 96% of both men and women were physically active, and 82.5% of men and 85.3% of women considered themselves healthy.
One year after baseline, lonely older adults were more likely to get sick and stay sick than non-lonely older adults, and lonely older adults were more likely to die during this time period, regardless of whether they were healthy or unhealthy at baseline.
Lonely people have lower ADL and SRH. Based on ADL, lonely people are expected to live 20 years longer at age 65, while non-lonely people are expected to live 23 years longer.
Lonely people also have a higher HLE of 16.1 years compared to 19 years for non-lonely people. Taking SRH into account, lonely people can expect to live 15.4 years longer in good health compared to 18 years for non-lonely people.
Lonely adults had an ADL-based HLE/LE of 87% compared with 85% for non-lonely adults, likely because lonely adults are often better able to care for themselves.
ADL outcomes showed a greater decline among older adults: women had a 53.6% decline in HLE/LE compared with 51.7% in non-lonely women aged 65-99 years. Thus, loneliness was associated with a 2% worsening of HLE/LE in older women. In men, the decline in HLE/LE was 52%, regardless of whether they were lonely.
Based on SRH, lonely older adults’ HLE changed more than non-lonely individuals, and HLE/LE increased over time for both lonely and non-lonely individuals when assessed by SRH.
At age 65, the HLE/LE ratios of lonely and non-lonely older adults were 77% and 82%, respectively. Based on SRH, the changes in HLE/LE were similar in both sexes. Women showed lower HLE/LE ratios for both parameters, suggesting a poorer quality of life.
Conclusion
In SRH, HLE/LE was low despite the high ratios obtained from ADL-based scoring, i.e. the ability to care for oneself may allow for a solitary life with more psychological distress and isolation.
Overall, women were found to have a lower quality of life and be more affected by loneliness, supporting previous findings from studies such as the Health and Retirement Study.
Health promotion interventions, specifically targeted at older women, are essential to reduce these adverse outcomes.. “
Journal References:
- Yo, Q,, Ren, Y., Wu, J. (2024). Loneliness shapes disparities in healthy life expectancy: A multi-state analysis of China. BMC Public Health. doi:10.1186/s12889-024-18975-z.
