CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

June 18th, 2012

The Grim Impact of Loneliness and Living Alone

Two new reports published in the Archives of Internal Medicine throw a spotlight on the grim effects of loneliness and living alone on health.

As part of the Health and Retirement Study, 1604 people were followed for 6 years after answering a questionnaire about loneliness. Some 43% reported feeling lonely. Loneliness was associated with significantly increased risks for death and other adverse outcomes:

  • Death: 22.8% vs. 14.2%, adjusted risk ratio (RR) 1.45, CI 1.11-1.88
  • Decline in activities of daily living: 24.8% vs. 12.5%, RR 1.59, CI 1.23-2.07
  • Difficulty with upper extremity tasks: 41.5% vs. 28.3%, RR 1.28, CI 1.08- 1.52
  • Decline in mobility: 38.1% vs. 29.4%, RR 1.18, CI 0.99-1.41
  • Difficulty with climbing: 40.8% vs. 27.9%, RR 1.31, CI 1.10-1.57

The authors of the study recommend that physicians ask their patients about loneliness so that they “will be better able to target interventions intended to prevent functional decline and disability.”

In the second study, investigators from the REduction of Atherothrombosis for Continued Health (REACH) Registry analyzed data from 44,573 individuals, 8594 of whom were living alone. This group had significantly higher risks for death and cardiovascular death than those not living alone (p<0.01):

  • 4-year mortality: 14.1% vs. 11.1%
  • CV death: 8.6% vs. 6.8%

In an invited commentary, Emily Bucholz and Harlan Krumholz (who is also editor-in-chief of CardioExchange) discuss the myriad difficulties and complexities involved in understanding and employing social support. Scientists, they write, should be “challenged to investigate mechanisms as well as practical interventions that can be used to address the social factors that undermine health.”

Categories: General, Prevention
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3 Responses to “The Grim Impact of Loneliness and Living Alone”

  1. Donald Hislop, MS MD says:
    June 18, 2012 at 7:43 pm

    As a geriatrician I am trying to understand the benefits of community living.

  2. Leon Hyman, Ms M.D. says:
    June 18, 2012 at 9:51 pm

    Unless they have a significant allergy, a pet is an excellent way to mitigate the feeling of loneliness. A puppy or kitten can work wonders.

    • Martha Dickens, MD says:
      June 19, 2012 at 9:55 am

      I’ve written prescriptions for shelter dogs/cats. Sometimes puppies and kittens are too much for elderly. Older animals who have been neglected, mistreated or unappreciated in their lives offer a ‘mutual bond’, if you will, kind of a commiseration. It seems to be a win-win unity. My little rat terrier/beagle mix was mistreated and obviously abused by her former owner and discarded/abandoned when pregnant. Best dog I’ve ever had. BFF&E! Just wish our lifespans were similar; but this gap is narrowed with the elderly.