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How Much Does Loneliness Influence Depression in Older Adults?

Loneliness is responsible for up to 18% of cases of depression among people over 50 years in England, suggests a new UK study published in Lancet Psychiatry.

Irrespective of other social experiences, higher loneliness scores at baseline were associated with higher depression symptom severity scores during the study's 12 years of follow-up, highlighting the potential benefits of loneliness intervention strategies in older people.

The researchers investigated the association between loneliness and depressive symptoms using data from a nationally representative cohort of adults (4211 participants of the English Longitudinal Study of Ageing, aged 52 years and over) who answered questions at regular intervals over a 12-year period about their experiences of loneliness, social engagement and social support, as well as depressive symptoms.

Participants were asked three questions about lacking companionship, feeling left out and feeling isolated, and their answers combined into a loneliness score on a seven-point scale. Each one-point increase on the loneliness scale corresponded to a doubling of the odds of depression (based on a clinical threshold of depressive symptoms rather than a diagnosis).

After all adjustments, a one-point increase in the 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).

They estimated a population attributable fraction for depression associated with loneliness of 18 per cent (95% CI, 12-24%) at one year of follow-up and 11 per cent (3-19%) at the final follow-up, suggesting that 11-18 per cent of cases of depression could potentially be prevented if loneliness were eliminated.

First author Siu Long Lee said: “Health professionals working with older people who report being lonely should know that they are at risk of depression. Interventions such as social prescribing, social skills training, and psychological therapies that target negative feelings of loneliness, may be important for the mental health of lonely older adults.”

Lee SL, Pearce E, Ajnakina O, Johnson S, Lewis G, Mann F, Pitman A, Solmi F, Sommerlad A, Steptoe A, Tymoszuk U, Lewis G. The association between loneliness and depressive symptoms among adults aged 50 years and older: a 12-year population-based cohort study. Lancet Psychiatry. 2020 Nov 9 [Epub ahead of print]. doi: 10.1016/S2215-0366(20)30383-7. View full text

This article originally appeared on Univadis, part of the Medscape Professional Network.

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