Elderly and autonomy, the weight of loneliness

• Chronic loneliness, but not temporary loneliness, is an independent risk factor for declining autonomy in both sexes.
• Chronic loneliness increases the risk of declining autonomy in instrumental activities of daily living (IADL) in women, but not in men.
• To prevent functional disability, interventions are appropriate to prevent the loneliness of the elderly from becoming chronic, also taking into account gender differences. 

Why it matters

• The ageing of the population requires that everything possible be done to make the elderly «age well», thus avoiding excess morbidity and mortality and containing care costs.
• It is essential to identify the modifiable risk factors of ADL disability (inability to look after one’s own hygiene, use the bathroom independently, dress, feed and walk independently) and IADL (inability to self-manage activities not strictly essential for survival, but necessary for independence, such as shopping, preparing meals, managing drugs and finances).

How the study was conducted

• Data from the Health and Retirement Study on adults ≥50 years of age residing in the USA were analyzed.
• Participants were given a questionnaire every 4 years that included tools for assessing ADL/IADL and loneliness (3-item UCLA Loneliness Scale).
• Based on the answers obtained in two consecutive questionnaires, loneliness was classified as: temporary (only at T1), chronic (at both T1 and T2) or accident (only at T2).

Key results

• 30.7% of subjects included in the analysis (n=7,148) suffered from temporary (10.3%), accident (8.9%) or chronic (11.5%) loneliness.
• During follow-up (36,294 person-years), 18.16% and 17.63% of subjects, with normal functional abilities at baseline, developed disabilities, respectively, ADL and IADL.
• After adjusting for potential confounders, chronic loneliness was associated with a higher risk of ADL disability (HR 1.37 [95%CI 1.16-1.63]; p<0.001) and IADL (HR 1.25 [1.09-1.44]; p<0.002).
• There was no association between temporary loneliness and functional disability.
• Chronic loneliness was not associated with the risk of IADL disability in men.

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Source — https://www.univadis.it/viewarticle/anziani-e-autonomia-il-peso-della-solitudine-2023a1000589