Some of the older elves in the woodland don’t join in with our social activities as much as they used to. The younger elves call them ‘cranky’ and laugh at them sitting alone in their tree houses. Personally I worry that they might be feeling lonely and I doubt that shutting themselves away from the rest of us is doing much for their health.
I was intrigued to see the findings of the AMSTEL study published in Psychological Medicine recently. It’s not a lager-tasting placebo controlled trial as some of you might presume, but a prospective cohort study of over 4,000 people from Amsterdam aged 65-84 years old. Older Amsterdammers aren’t so very different from older elves, so I read the paper with interest.
The authors were concerned about the impact that social isolation and loneliness can have on people, particularly if it can increase the risk of mortality. They randomly selected people from different age categories and ended up with a sample that was representative of Amsterdam’s elderly population.
They carried out structured interviews in people’s homes to find out how lonely and isolated they were. Loneliness was measured subjectively by asking them if they felt lonely and social isolation was assessed by finding out if they had help from their family, neighbours or any other form of home support.
Potential confounders were controlled for in the analysis. These confounders included mental health and medical conditions, substance misuse, cognitive function, functional status and education.
Participants were followed up for nearly 10 years and associations between social isolation, feelings of loneliness and mortality were calculated using Cox proportional hazard regression models.
Here’s what they found:
- At baseline, fewer men (12%) than women (27%) reported feeling lonely
- Self-reported feelings of loneliness were associated with a significantly increased risk of death:
- In men (HR 1.30, 95% CI 1.04 to 1.63)
- But not women (HR 1.04, 95% CI 0.90 to 1.24)
- Social isolation was not associated with a higher risk of death
Feelings of loneliness rather than social isolation factors were found to be a major risk factor for increasing mortality in older men. Developing a better understanding of the nature of this association may help us to improve quality of life and longevity, especially in older men.
The limitations of this study include that:
- Loneliness was measured at baseline but the severity was not assessed
- Other changes in personal status (e.g. the death of a partner, moving into care) were not accounted for during the study
Of course, these findings don’t mean that individuals can’t live independently and happily on their own. I’m going to keep inviting my local elf elders out for a regular game of boules and a walk around the woods.
Link
Holwerda TJ, Beekman AT, Deeg DJ, et al. Increased risk of mortality associated with social isolation in older men: only when feeling lonely? Results from the Amsterdam Study of the Elderly (AMSTEL). Psychol Med 2012;42:843–53. [PubMed abstract]
It’s really good to see a study like this being done for a start off – it’s been years since increased mortality rates, after hospital admissions, in elderly people were linked to loneliness. It’s also good that someone has started to unpick what factors comprise loneliness with a mixture of self reporting but also with social isolation as a measurable external factor.
I’m intrigued that less men report feeling lonely as they are the target group in suicide prevention at the moment & a type of loneliness due to not expressing emotion is being seen as the key issue (though I think role uncertainty due to recession would be a large factor) – I wonder if Amsterdam is comparable to the USA & UK on this? Did mortality include suicide in this study? Though this does link mortality & loneliness in men, but not women – unpicking that discrepancy could be really helpful.
Will loneliness be able to have a quantative measure, knowing that it is not just social isolation is very helpful. Will useful public health solutions, that don’t impinge on choice in people’s personal choices, privacy & lifestyle be forthcoming? An increase in an ageing populations is going to make this an important issue.
I am also intrigued by the finding that less men report feeling lonely. Two factors that spring to mind are that firstly men tend to die younger and so women are more often left widowed and alone, so I’m wondering whether this was taken into account. I also wonder whether older men are like the generalized younger men who don’t easily acknowledge emotion. I wonder whether this has an impact on the findings. It’s interesting though, and I am sure that the isolation and loneliness that sometimes exist for older people must have a big impact on their mental health and their life expectancy.
bonjour
je travaille sur l’association du sentiment de solitude, la solitude , et l’impact sur le décès
merci de me dire comment je peux faire pour retrouver retrouver l’article de Mr holwerda