Dataset Information

The association between loneliness and depressive symptoms among adults aged 50 years and older: a 12-year population-based cohort study.

ABSTRACT:

Background

Loneliness is experienced by a third of older adults in the UK and is a modifiable potential risk factor for depressive symptoms. It is unclear how the association between loneliness and depressive symptoms persists over time, and whether it is independent of related social constructs and genetic confounders. We aimed to investigate the association between loneliness and depressive symptoms, assessed on multiple occasions during 12 years of follow-up, in a large, nationally representative cohort of adults aged 50 years and older in England.

Methods

We did a longitudinal study using seven waves of data that were collected once every 2 years between 2004 and 2017, from adults aged 50 years and older in the English Longitudinal Study of Ageing (ELSA). The exposure was loneliness at baseline (wave two), measured with the short 1980 revision of the University of California, Los Angeles Loneliness Scale (R-UCLA). The primary outcome was a score indicating severity of depression measured at six subsequent timepoints (waves three to eight), using the eight-item version of the Centre for Epidemiologic Studies Depression Scale (CES-D). Analyses were linear multilevel regressions, before and after adjusting for social isolation, social support, polygenic risk scores, and other sociodemographic and health-related confounders. The secondary outcome was depression diagnosis, measured using a binary version of the CES-D.

Findings

4211 (46%) of 9171 eligible participants had complete data on exposure, outcome, and confounders, and were included in our complete case sample. After all adjustments, a 1-point increase in loneliness score was associated with a 0·16 (95% CI 0·13-0·19) increase in depressive symptom severity score (averaged across all follow-ups). We estimated a population attributable fraction for depression associated with loneliness of 18% (95% CI 12-24) at 1 year of follow-up and 11% (3-19) at the final follow-up (wave eight), suggesting that 11-18% of cases of depression could potentially be prevented if loneliness were eliminated. Associations between loneliness and depressive symptoms remained after 12 years of follow-up, although effect sizes were smaller with longer follow-up.

Interpretation

Irrespective of other social experiences, higher loneliness scores at baseline were associated with higher depression symptom severity scores during 12 years of follow-up among adults aged 50 years and older. Interventions that reduce loneliness could prevent or reduce depression in older adults, which presents a growing public health problem worldwide.

Funding

National Institute on Aging and a consortium of UK Government departments coordinated by the National Institute for Health Research.

SUBMITTER: Lee SL

PROVIDER: S-EPMC8009277 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:Abstract Background and Objectives Loneliness is consistently linked to worse depression/depressive symptoms; however, there are few studies that have examined whether the relationship between loneliness and depressive symptoms varies by race. The purpose of this study was to determine whether race moderated the relationship between loneliness and depressive symptoms. Research Design and Methods Data come from the 2014 wave of the Health and Retirement Study (HRS) Core survey and Psychosocial Leave-Behind Questionnaire; only black and white older adults were included in the analysis (N = 6,469). Depressive symptoms were operationalized by the eight-item Center for Epidemiological Studies—Depression scale; however, the “felt lonely” item was removed given concerns with collinearity. Loneliness was operationalized using the Hughes 3-Item Loneliness Scale. Sociodemographic variables included gender, age, education, household income, employment status, marital status, and living alone or with others. Furthermore, social support and negative interactions from family members and friends, and religious service attendance were included in the analysis. Lastly, we created an interaction term between race and loneliness. All analyses used survey weights to account for the complex multistage sampling design of the HRS. Missing data were multiply imputed. Results In multivariable analysis, we found race significantly moderated the relationship between loneliness and depressive symptoms while controlling for sociodemographic covariates, social support and negative interaction variables, and religious service attendance. Discussion and Implications Our findings demonstrate a differential racial effect for loneliness and depressive symptoms. For both blacks and whites, greater loneliness affected depressive symptoms; however, the effect was stronger among whites than it was for blacks. Given this is one of the first studies to examine the differential effects of race on loneliness and depressive symptoms, more research is necessary to determine the consistency of these results.

Project description:Background and objectivesPerceived discrimination is a risk factor for poor mental health. However, most studies measure discrimination at one time point, which does not account for heterogeneity in the cumulative patterning of exposure to discrimination. To address this gap, we examine the association between discrimination trajectories and depressive symptoms among black middle-aged and older adults.Research design and methodsData were analyzed from a subsample of black Health and Retirement Study respondents (2006-2018, N = 2926, older than 50 years). General discrimination and racial discrimination trajectories were constructed based on the Everyday Discrimination Scale using repeated measures latent profile analyses. We examined the extent to which the association between discrimination trajectories are differentially associated with depressive symptoms (8-item Center for Epidemiological Studies-Depression scale) using negative binomial regression models adjusted for potential confounders. Effect modification by age and gender was tested.ResultsIndividuals in the persistently high (incident rate ratio [IRR]: 1.70; 95% confidence interval [CI]: 1.49-1.95) and moderate general discrimination trajectories (IRR: 1.19; 95% CI: 1.06-1.33) were more likely to have elevated depressive symptoms in comparison to those in the persistently low trajectory. This relationship was strongest among older adults aged older than 65 years. Respondents in the persistently high racial discrimination trajectory (IRR: 1.50; 95% CI: 1.29-1.73) had a higher risk of elevated depressive symptoms in comparison to respondents in the persistently low trajectory. Sensitivity analyses indicated that there was an independent association between persistently high racial discrimination trajectory class and elevated depressive symptoms, after adjusting for racial discrimination measured at a single time point.Discussion and implicationsCharacterizing longitudinal patterns of perceived discrimination may facilitate the stratification of mental health risk and vulnerability among black middle-aged and older adults. Trajectories of racial discrimination may inform risk of worse depressive symptoms more accurately than a single assessment of discrimination.

Project description:BackgroundIncome inequality has dramatically increased worldwide, and there is a need to re-evaluate the association between socio-economic status (SES) and depression. Relative contributions of household income and education to depression, as well as their interactions, have not been fully evaluated. This study aimed to examine the association between SES and depressive symptoms in Japanese adults, focusing on interactions between education and household income levels.MethodsThis cross-sectional study used data from baseline surveys of two cohort studies. Participants were 38,499 community-dwelling people aged 40-74 years who participated in baseline surveys of the Murakami cohort study (2011-2012) and Uonuma cohort study (2012-2015) conducted in Niigata Prefecture, Japan. Information regarding marital status, education level, household income, occupation, activities of daily living (ADL), and history of cancer, myocardial infarction, stroke, and diabetes was obtained using a self-administered questionnaire. Depressive symptoms were examined using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regression analysis was used to obtain odds ratios (ORs). Covariates included age, sex, marital status, education, household income, occupation, ADL, and disease history.ResultsIndividuals with higher education levels had lower ORs (adjusted P for trend = 0.0007) for depressive symptoms, independently of household income level. The OR of the university-or-higher group was significantly lower than that of the junior high school group (adjusted OR = 0.79). Individuals with lower household income levels had higher ORs (adjusted P for trend< 0.0001) for depressive symptoms, independently of education level. The type of occupation was not associated with depressive symptoms. In subgroup analyses according to household income level, individuals with higher education levels had significantly lower ORs in the lowest- and lower-income groups (adjusted P for trend = 0.0275 and 0.0123, respectively), but not in higher- and highest-income groups (0.5214 and 0.0915, respectively).ConclusionsBoth education and household income levels are independently associated with the prevalence of depressive symptoms, with household income levels showing a more robust association with depressive symptoms than education levels. This suggests that a high household income level may offset the risk of depressive symptoms from having a low education level.

Project description:BackgroundSmart home technology (SHT) can be useful for aging in place or health-related purposes. However, surveillance studies have highlighted ethical issues with SHTs, including user privacy, security, and autonomy.ObjectiveAs digital technology is most often designed for younger adults, this review summarizes perceptions of SHTs among users aged 50 years and older to explore their understanding of privacy, the purpose of data collection, risks and benefits, and safety.MethodsThrough an integrative review, we explored community-dwelling adults' (aged 50 years and older) perceptions of SHTs based on research questions under 4 nonmutually exclusive themes: privacy, the purpose of data collection, risk and benefits, and safety. We searched 1860 titles and abstracts from Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, Scopus, Web of Science Core Collection, and IEEE Xplore or IET Electronic Library, resulting in 15 included studies.ResultsThe 15 studies explored user perception of smart speakers, motion sensors, or home monitoring systems. A total of 13 (87%) studies discussed user privacy concerns regarding data collection and access. A total of 4 (27%) studies explored user knowledge of data collection purposes, 7 (47%) studies featured risk-related concerns such as data breaches and third-party misuse alongside benefits such as convenience, and 9 (60%) studies reported user enthusiasm about the potential for home safety.ConclusionsDue to the growing size of aging populations and advances in technological capabilities, regulators and designers should focus on user concerns by supporting higher levels of agency regarding data collection, use, and disclosure and by bolstering organizational accountability. This way, relevant privacy regulation and SHT design can better support user safety while diminishing potential risks to privacy, security, autonomy, or discriminatory outcomes.

Project description:BACKGROUND: The associations between depressive symptoms and alcohol-related disorders, drinking patterns and other characteristics of alcohol use are important public health issues worldwide. This study aims to study these associations in an upper middle-income country, Brazil, and search for related socio-demographic correlations in men and women. METHODS: A cross-sectional study was conducted between November 2005 and April 2006. The sample of 3,007 participants, selected using a multistage probabilistic sampling method, represents the Brazilian population aged 14 and older. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale and alcohol dependence was assessed using the Composite International Diagnostic Interview. Associations assessed using bi-variate analysis were tested using Rao-Scott measures. Gender specific multinomial logistic regression models were developed. RESULTS: Among the participants with alcohol dependence, 46% had depressive symptoms (17.2% mild/moderate and 28.8% major/severe; p?<?0.01); 35.8% (p?=?0.08) of those with alcohol abuse and 23.9% (p?<?0.01) of those with a binge-drinking pattern also had depressive symptoms. Alcohol abstainers and infrequent drinkers had the highest prevalence of major/severe depressive symptoms, whereas frequent heavy drinkers had the lowest prevalence of major/severe depressive symptoms. In women, alcohol dependence and the presence of one or more problems related to alcohol consumption were associated with higher risks of major/severe depressive symptoms. Among men, alcohol dependence and being ?45 years old were associated with higher risks of major/severe depressive symptoms. CONCLUSIONS: In Brazil, the prevalence of depressive symptoms is strongly related to alcohol dependence; the strongest association was between major/severe depressive symptoms and alcohol dependence in women. This survey supports the possible association of biopsychosocial distress, alcohol consumption and the prevalence of depressive symptoms in Brazil. Investing in education, social programs, and care for those with alcohol dependence and major/severe depressive symptoms, especially for such women, and the development of alcohol prevention policies may be components of a strategic plan to reduce the prevalence of depression and alcohol problems in Brazil. Such a plan may also promote the socio-economic development of Brazil and other middle-income countries.