Loneliness in individuals older than 60 appears to be associated with increased risk of functional decline and death, according to a study.

Carla M. Perissinotto, MD, MHS, of the University of California, San Francisco, and colleagues examined data from 1,604 participants in the Health and Retirement Study. The participants (average age 71) were asked if they felt left out, isolated or a lack of companionship. Of the participants, 43.2% reported feeling lonely, which was defined as reporting one of the loneliness items at least some of the time.

Loneliness was associated with an increased risk of death over the six-year follow-up period (22.8% vs. 14.2%), according to results of the study, which appeared June 18 on the website of the Archives of Internal Medicine.

Loneliness also was associated with functional decline, including an increased likelihood of experiencing decline in activities of daily living (24.8% vs. 12.5%) and developing difficulties with upper extremity tasks (41.5% vs. 28.3%) and stair climbing (40.8% vs. 27.9%).

"Loneliness is a common source of suffering in older persons," the authors wrote. "We demonstrated that it is also a risk factor for poor health outcomes including death and multiple measures of functional decline," the authors wrote.

The authors concluded their study could have important public health implications: "Assessment of loneliness is not routine in clinical practice and it may be viewed as beyond the scope of medical practice. However, loneliness may be as an important of a predictor of adverse health outcomes as many traditional medical risk factors.

"Our results suggest that questioning older persons about loneliness may be a useful way of identifying elderly persons at risk of disability and poor health outcomes."

To read the study, visit http://bit.ly/Nbdbs2.

Living solo and cardiovascular death

In another study, also appearing on the website of the Archives of Internal Medicine, living alone was associated with an increased risk of overall death and cardiovascular death among a cohort of stable outpatients at risk of or with arterial vascular disease.

Social isolation may be associated with poor health consequences, and the risk associated with living alone is relevant because about one in seven American adults lives alone, according to background information in the study. Epidemiological evidence suggests that social isolation may alter neurohormonal-mediated emotional stress, influence health behavior and affect access to healthcare, which may result in association with or acquisition of cardiovascular risk..

Jacob A. Udell, MD, MPH, of Brigham and Women’s Hospital and Harvard Medical School in Boston, and colleagues examined whether living alone was associated with increased mortality and cardiovascular risk in the global REduction of Atherothrombosis for Continued Health (REACH) Registry. Among 44,573 REACH participants, 8,594 (19%) lived alone.

Living alone was associated with higher four-year mortality (14.1% vs. 11.1%) and cardiovascular death (8.6% vs. 6.8%), the researchers found.

Based on age, living alone was associated with an increased risk of death among patients 45 to 65 compared with those living with others (7.7% vs. 5.7%), and among participants 66 to 80 (13.2% vs. 12.3%). However, among patients older than 80, living alone was not associated with an increased risk of mortality compared with those living with others (24.6% vs. 28.4%).

The authors concluded that "living alone was independently associated with an increased risk of mortality and CV death in an international cohort of stable middle-aged outpatients with or at risk of artherothrombosis.

"Younger individuals who live alone may have a less favorable course than all but the most elderly individuals following development of CV disease, and this observation warrants confirmation in further studies."

To read the study, visit http://bit.ly/Lxpa13.