Social Isolation, Loneliness, and Health Behaviors at Older Ages: Longitudinal Cohort Study
Open accessAbstract
Background: The prospective associations between social isolation, loneliness, and health behaviors are uncertain, despite the potential importance of these relationships over time for outcomes including mortality. Purpose: To examine the associations between baseline social isolation, baseline loneliness, and engagement in health behaviors over 10 years among older adults. Methods: Data were from 3,392 men and women aged ≥52 years in the English Longitudinal Study of Ageing from 2004/2005 to 2014/2015. Modified Poisson regression was specified to estimate relative risks (RRs) and 95% confidence intervals for the associations between baseline social isolation, baseline loneliness, and consistent weekly moderate-to-vigorous physical activity, consistent five daily fruit and vegetable servings, daily alcohol drinking at any time point, smoking at any time point, and a consistently overweight/obese body mass index over the follow-up (all yes vs. no). Models were population weighted and adjusted for sociodemographic factors, health indicators, and depressive symptoms, with mutual adjustment for social isolation and loneliness. Results: Socially isolated participants were less likely than non-isolated participants to consistently report weekly moderate-to-vigorous physical activity (RR = 0.86; 0.77-0.97) or five daily fruit and vegetable servings (RR = 0.81; 0.63-1.04). They were less likely to be consistently overweight or obese (RR = 0.86; 0.77-0.97) and more likely to smoke at any time point (RR = 1.46; 1.17-1.82). Loneliness was not associated with health behaviors or body mass index in adjusted models. Among smokers, loneliness was negatively associated with successful smoking cessation over the follow-up (RR = 0.31; 0.11-0.90). Conclusions: Social isolation was associated with a range of health-related behaviors, and loneliness was associated with smoking cessation over a 10 year follow-up in older English adults.
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Both social isolation and loneliness are related to negative health-related behaviors, such as reduced physical activity and smoking.
“Moreover, both social isolation and loneliness have been shown to be related to negative health-related behaviors, such as reduced physical activity and smoking [24,27–29]”
The social isolation index was dichotomized with scores 2 or more classified as socially isolated to allow a sufficient sample size in each of the four groups.
“To allow a sufficient sample size in each of the four groups, individuals with scores 2 or more were classified as socially isolated and those with 0 or 1 as not socially isolated, similar to previous research [20,27,54].”
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- Authors
- Kobayashi, L. C., & Steptoe, A.
- Affiliations
- Harvard University (US)
- University College London (GB)
- Corresponding author
- Steptoe, Andrew
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-01-25
- Volume
- 52
- Issue
- 7
- Pages
- 582-593
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- PMC
- PMC6377432
- OpenAlex
- W2793714205
- Cited by
- 351
- References
- 62
- Citations by year
- 2026: 39 · 2025: 47 · 2024: 57 · 2023: 56 · 2022: 49 · 2021: 55 · 2020: 31 · 2019: 14 · 2018: 3
- FWCI
- 27.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute on Aging (2RO1AG7644-01A1, 2RO1AG017644)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- social isolation, loneliness, health behavior, older adults, physical activity, fruit and vegetable intake, alcohol consumption, smoking, smoking cessation, overweight and obesity, English Longitudinal Study of Ageing
- MeSH terms
- Diet, Healthy, Age Factors, Aged, Aged, 80 and over, Alcohol Drinking, Female, Humans, Loneliness, Longitudinal Studies, Male, Middle Aged, Risk, Sex Factors, Social Isolation, Health Behavior, Exercise, Body Mass Index, Poisson Distribution, Marital Status
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