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Cited by 9Aging, Health, and DisabilityHealth disparities and outcomesAging and Gerontology Research

Combined effects of social isolation and loneliness on disability incidence in older adults

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Shimada, Hiroyuki, Doi, Takehiko, Tsutsumimoto, Kota, Makino, Keitaro, Harada, Kenji, Tomida, Kouki, Morikawa, Masanori, Arai, Hidenori·2025·Archives of Gerontology and Geriatrics
DOI 10.1016/j.archger.2025.105749
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Abstract

Objectives Relationships among social isolation, loneliness, and disability onset remain unclear. We investigated the distinct patterns of disability development among Japanese older adults who experience social isolation and loneliness. Design This study applied a prospective observational approach. Participants Data from 4,716 community-dwelling independent older adults were analyzed. Measurements The Japanese version of the University of California, Los Angeles Loneliness Scale Version 3 and the Social Isolation Scale were used to measure loneliness and social isolation, respectively. The long-term care insurer conducted monthly follow-ups with participants over two years to determine their care needs. Disability onset was defined as the point at which participants were certified by a care manager as requiring long-term care. Results During the follow-up period, 265 participants (5.6 %) required long-term care insurance certification due to disability onset. The incidence of disability in the lonely and not lonely groups was 8.0 % and 4.5 %, respectively. In the socially isolated and not socially isolated groups, it was 7.1 % and 4.4 %, respectively. The Cox proportional hazards regression model revealed a significantly higher risk of disability incidence in the lonely and socially isolated groups. The high-risk group experiencing both loneliness and social isolation exhibited significantly higher hazard ratios than the low-risk group without these symptoms. Conclusions Th…

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  • A small number of studies point to cumulative effects of loneliness and isolation in mid-life and older adulthood on health, disability and quality of life, and synergistic effects on mortality risk.

    “While a small number of studies point to cumulative effects of loneliness and isolation in mid-life and older adulthood on health, disability and quality of life (Barnes et al., 2021;Shimada et al., 2025), as well as synergistic effects on mortality risk (Beller & Wagner, 2018;Foster et al., 2023;Ward et al., 2021), these studies have largely relied on cross-sectional data and focused on physical”

    From Investigating the interplay of loneliness and social isolation across adolescence: Findings from a nationally representative longitudinal study (2026) · cites this paper as Shimada et al., 2025

  • The non-additive finding diverges from some existing evidence of cumulative effects on health in late adulthood, suggesting that pathways through which loneliness and isolation shape outcomes may vary across the life course.

    “The finding that the impact of loneliness and isolation on outcomes are non-additive in adolescence and young adulthood diverge from some existing evidence of cumulative effects on health in late adulthood (Barnes et al., 2021;Shimada et al., 2025), suggesting that the pathways through which they shape outcomes may vary across the life course.”

    From Investigating the interplay of loneliness and social isolation across adolescence: Findings from a nationally representative longitudinal study (2026) · cites this paper as Shimada et al., 2025

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Authors
Shimada, H., Doi, T., Tsutsumimoto, K., Makino, K., Harada, K., Tomida, K., Morikawa, M., & Arai, H.
Affiliations
  • National Center for Geriatrics and Gerontology (JP)
  • Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology (JP)
Corresponding author
Shimada, Hiroyuki
ORCID
Venue
Archives of Gerontology and Geriatrics
Publisher
Elsevier BV
Published
2025-04
Volume
131
Pages
105749
ISSN
0167-4943 (ISSN-L)
DOI
10.1016/j.archger.2025.105749
OpenAlex
W4406061621
Cited by
9
References
48
Citations by year
2026: 4 · 2025: 5
FWCI
8.15
Type
journal article
Language
en
Open access
Licence
Locations
  • Archives of Gerontology and Geriatrics (acceptedVersion)
  • PubMed (publishedVersion)
Funders
Japan Society for the Promotion of Science (23K24720, 24K02362)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
Keywords
social isolation, loneliness, disability onset, older adults, long-term care insurance, community-dwelling older adults, healthy aging, disability prevention
MeSH terms
Aged, Aged, 80 and over, Disability Evaluation, Female, Persons with Disabilities, Humans, Japan, Loneliness, Male, Prospective Studies, Social Isolation, Incidence, Proportional Hazards Models, Independent Living

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