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Cited by 153Health disparities and outcomesAging, Health, and DisabilityAging and Gerontology Research

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Associations of Loneliness and Social Isolation With Health Span and Life Span in the U.S. Health and Retirement Study

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Crowe, Christopher L, Domingue, Benjamin W, Graf, Gloria H, Keyes, Katherine M, Kwon, Dayoon, Belsky, Daniel W·2021·The Journals of Gerontology: Series A
DOI 10.1093/gerona/glab128PMC PMC8514074

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Abstract

Background: Loneliness and social isolation are emerging public health challenges for aging populations. Methods: We followed N = 11 302 U.S. Health and Retirement Study participants aged 50–95 from 2006 to 2014 to measure persistence of experiences of loneliness and exposure to social isolation. We tested associations of longitudinal loneliness and social isolation phenotypes with disability, morbidity, mortality, and biological aging through 2018. Results: During follow-up, 18% of older adults met criteria for loneliness, with 6% meeting criteria at 2 or more follow-up assessments. For social isolation, these fractions were 21% and 8%. Health and Retirement Study participants who experienced loneliness and were exposed to social isolation were at increased risk for disease, disability, and mortality. Those experiencing persistent loneliness were at a 57% increased hazard of mortality compared to those who never experienced loneliness. For social isolation, the increase was 28%. Effect sizes were somewhat larger for counts of prevalent activity limitations and somewhat smaller for counts of prevalent chronic diseases. Covariate adjustment for socioeconomic and psychological risks attenuated but did not fully explain associations. Older adults who experienced loneliness and were exposed to social isolation also exhibited physiological indications of advanced biological aging (Cohen’s d for persistent loneliness and social isolation = 0.26 and 0.21, respectively). For loneliness, but not social isolation, persistence was associated with increased risk. Conclusions: Deficits in social connectedness prevalent in a national sample of U.S. older adults were associated with morbidity, disability, and mortality and with more advanced biological aging. Bolstering social connectedness to interrupt experiences of loneliness may promote healthy aging.

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  • The Newcastle-Ottawa quality assessment scale for cohort studies was used to evaluate methodological quality.

    “Because all eligible studies had a cohort study design, the Newcastle-Ottawa quality assessment scale for cohort studies was used to evaluate methodological quality 30 31 .”

    From A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality (2023) · cites this paper as [31]

    The Statistical Analysis and Sensitivity Analysis sections describe analyses of the Health and Retirement Study cohort, not quality appraisal of a set of eligible studies (page numbers unavailable). Searches for the Newcastle–Ottawa scale and methodological quality assessment found no passage addressing their use. (LLM, conf=0.76)

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Research works printed but not linked: 28

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Metadata

Authors
Crowe, C. L., Domingue, B. W., Graf, G. H., Keyes, K. M., Kwon, D., & Belsky, D. W.
Affiliations
  • Columbia University (US)
  • Stanford University (US)
Corresponding author
Belsky, Daniel W
ORCID
Venue
The Journals of Gerontology: Series A
Publisher
Oxford University Press (OUP)
Published
2021-05-08
Volume
76
Issue
11
Pages
1997-2006
ISSN
  • 1079-5006 (ISSN-L)
  • 1758-535X
DOI
10.1093/gerona/glab128
PMC
PMC8514074
OpenAlex
W3157751089
Cited by
153
References
20
Citations by year
2026: 33 · 2025: 36 · 2024: 31 · 2023: 24 · 2022: 25 · 2021: 3
FWCI
10.28
Type
journal article
Language
en
Open access
Licence
Locations
  • The Journals of Gerontology Series A (publishedVersion)
  • medRxiv (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Robert N. Butler Columbia Aging Center
  • Russel Sage Foundation (1810-08987)
  • Jacobs Foundation
  • National Institute of Mental Health (5T32MH013043)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Psychology › Developmental and Educational Psychology › Aging and Gerontology Research
Keywords
loneliness, social isolation, healthspan, lifespan, older adults, mortality, disability, chronic disease, biological aging, social connectedness, healthy aging, socioeconomic risk, psychological risk
MeSH terms
Aged, Aging, Humans, Loneliness, Longevity, Retirement, Social Isolation

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