Dataset Information

Loneliness as a risk factor for care home admission in the English Longitudinal Study of Ageing.

ABSTRACT: Background:loneliness has an adverse effect on health and well-being, and is common at older ages. Evidence that it is a risk factor for care home admission is sparse. Objective:to investigate the association between loneliness and care home admission. Setting:English Longitudinal Study of Ageing (ELSA). Participants:two-hundred fifty-four individuals across seven waves (2002-15) of ELSA who moved into care homes were age, sex matched to four randomly selected individuals who remained in the community. Methods:logistic regression models examined associations between loneliness, socio-demographic factors, functional status and health on moving into care homes. Results:loneliness (measured by the University of California, Los Angeles (UCLA) Loneliness Scale and a single-item question from the Center for Epidemiological Studies Depression Scale (CES-D)) was associated with moving into a care home (CES-D OR 2.13, 95% CI 1.43-3.17, P = 0.0002, UCLA OR 1.81, 95% CI 1.01-3.27, P = 0.05). The association persisted after adjusting for established predictors (age, sex, social isolation, depression, memory problems including diagnosis of Alzheimer's disease, disability, long-term physical health and wealth). The impact of loneliness (measured by CES-D) on admission accounted for a population attributable fraction of 19.9% (95% CI 7.8-30.4%). Conclusions:loneliness conveys an independent risk of care home admission that, unlike other risk factors, may be amenable to modification. Tackling loneliness amongst older adults may be a way of enhancing wellbeing and delaying or reducing the demand for institutional care.

SUBMITTER: Hanratty B

PROVIDER: S-EPMC6481549 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Loneliness as a risk factor for care home admission in the English Longitudinal Study of Ageing.

Hanratty Barbara B Stow Daniel D Collingridge Moore Danni D Valtorta Nicole K NK Matthews Fiona F

Age and ageing 20181101 6

<h4>Background</h4>loneliness has an adverse effect on health and well-being, and is common at older ages. Evidence that it is a risk factor for care home admission is sparse.<h4>Objective</h4>to investigate the association between loneliness and care home admission.<h4>Setting</h4>English Longitudinal Study of Ageing (ELSA).<h4>Participants</h4>two-hundred fifty-four individuals across seven waves (2002-15) of ELSA who moved into care homes were age, sex matched to four randomly selected indivi ...[more]

PMID: 30007359

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Project description:BackgroundResearch into men and masculinities suggests men may be more reluctant than women to state they are lonely, more reliant on partners/spouses and/or alcohol to tackle it, and that this may be a result of poorer social relationships. Ageing is often associated with loneliness, and research has indicated gendered results in older people, but existing evidence lacks generalisability and cultural context. This study tests hypotheses on sex differences in loneliness in older England-based men and women.MethodsWe conducted a cross-sectional study using a sample of 6936 respondents aged 50 + from the English Longitudinal Study of Ageing (wave 8). Multiple imputation with chained equations was conducted to handle missing data. Multivariate regression was used to investigate the impact of sex on a direct question on loneliness whilst controlling for the University of California loneliness (UCLA) scale. Multivariate regression with interaction terms were used to examine sex differences in loneliness and alcohol consumption, partner status, and social relationships.ResultsOlder men were less likely than older women to state they are lonely even when controlling for UCLA score. Older men showed a greater association between loneliness and alcohol consumption, but only when measuring the number of units consumed in the last week, and not using a less precise measure of the past year. Older men who cohabited with a partner were less lonely than cohabiting older women, whereas previously married but not cohabiting older men were lonelier than their female counterparts. However, never married older men were less lonely than never married older women. Evidence was found to suggests older men's worse friendships mediated this association, but social isolation and number of close relationships did not. Severe isolation predicted greater loneliness in older women, but not older men.ConclusionsCultural ideals of masculinity and older men's poorer quality friendships may explain their reluctance to directly state loneliness, greater dependency on partners/spouses, and use of alcohol. Severely isolated older men may under-report loneliness on the UCLA scale as well as a direct question.

Project description:BACKGROUND:As the population ages, cognitive decline and dementia have become major health concerns in the UK. Loneliness has been linked to cognitive decline, but the reverse causality of this association remains unclear. This study aims to examine whether there is a bidirectional relationship between loneliness and cognitive function in older English adults (age 50?years and over) over a 10-year follow-up. METHODS:Data came from a nationally representative sample of 5885 participants in the English Longitudinal Study of Ageing (ELSA), free of stroke or dementia and followed every 2 years up to wave 7 (2014-15). At each wave, cognitive function was measured with word recall and verbal fluency tests, and loneliness was measured with the abridged version of the revised UCLA Loneliness Scale. Bivariate dual change score models were used to assess the multivariate associations between loneliness and cognitive function, used interchangeably as exposures and outcomes. RESULTS:Greater loneliness at baseline was associated with poorer memory [? intercept = -0.03, standard error (SE) = 0.01, P? = ?0.016] and verbal fluency (? intercept = -0.01, SE? = ?001, P = ?0.027) at baseline, and with a stronger linear rate of decline in both memory (? linear slope = -0.07, SE? = ?001, P ???0.001) and verbal fluency (? linear slope = -0.09, SE? = ?0.03, P = ?0.003) over a 10-year follow-up period, although the performance on verbal fluency did not change substantially on average over this period. We also found that higher baseline memory, but not verbal fluency, predicted a slower change in loneliness (? linear slope = -0.01, SE? = ?001, P = ?0.004) and that a linear decline in memory was associated with an acceleration in loneliness (? quadratic slope = -0.02, SE? = ?001, P ???0.001) during follow-up. CONCLUSIONS:Higher loneliness is associated with poorer cognitive function at baseline and contributes to a worsening in memory and verbal fluency over a decade. These factors seem, however, to be partially intertwined, since baseline memory and its rate of decline also contribute to an increase in loneliness over time.

Dataset Information

Loneliness as a risk factor for care home admission in the English Longitudinal Study of Ageing.

Publications

Loneliness as a risk factor for care home admission in the English Longitudinal Study of Ageing.

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