Dataset Information

Loneliness and type 2 diabetes incidence: findings from the English Longitudinal Study of Ageing.

ABSTRACT: AIMS/HYPOTHESIS:Loneliness is associated with all-cause mortality and coronary heart disease. However, the prospective relationship between loneliness and type 2 diabetes onset is unclear. METHODS:We conducted a longitudinal observational population study with data on 4112 diabetes-free participants (mean age 65.02?±?9.05) from the English Longitudinal Study of Ageing. Loneliness was assessed in 2004-2005 using the revised University of California, Los Angeles (UCLA) Loneliness Scale. Incident type 2 diabetes cases were assessed from 2006 to 2017. Associations were modelled using Cox proportional hazards regression, adjusting for potential confounders, which included cardiometabolic comorbidities. RESULTS:A total of 264 (6.42%) participants developed type 2 diabetes over the follow-up period. Loneliness was a significant predictor of incident type 2 diabetes (HR 1.46; 95% CI 1.15, 1.84; p?=?0.002) independent of age, sex, ethnicity, wealth, smoking status, physical activity, alcohol consumption, BMI, HbA1c, hypertension and cardiovascular disease. Further analyses detected an association between loneliness and type 2 diabetes onset (HR 1.41; 95% CI 1.04, 1.90; p?=?0.027), independent of depressive symptoms, living alone and social isolation. Living alone and social isolation were not significantly associated with type 2 diabetes onset. CONCLUSIONS/INTERPRETATION:Loneliness is a risk factor for type 2 diabetes. The mechanisms underlying this relationship remain to be elucidated. Graphical abstract.

SUBMITTER: Hackett RA

PROVIDER: S-EPMC7527325 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Loneliness and type 2 diabetes incidence: findings from the English Longitudinal Study of Ageing.

Hackett Ruth A RA Hudson Joanna L JL Chilcot Joseph J

Diabetologia 20200915 11

<h4>Aims/hypothesis</h4>Loneliness is associated with all-cause mortality and coronary heart disease. However, the prospective relationship between loneliness and type 2 diabetes onset is unclear.<h4>Methods</h4>We conducted a longitudinal observational population study with data on 4112 diabetes-free participants (mean age 65.02 ± 9.05) from the English Longitudinal Study of Ageing. Loneliness was assessed in 2004-2005 using the revised University of California, Los Angeles (UCLA) Loneliness Sc ...[more]

PMID: 32929525

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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 and type 2 diabetes incidence: findings from the English Longitudinal Study of Ageing.

Publications

Loneliness and type 2 diabetes incidence: findings from the English Longitudinal Study of Ageing.

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