Loneliness — the unpleasant feeling of emptiness or desolation — can creep in and cause suffering to people at any age. But it can be especially debilitating to older adults and may predict serious health problems and even death, according to a new study by UCSF researchers.

The team analyzed data in the Health and Retirement Study, a nationally representative study by the National Institute on Aging conducted on 1,604 older adults between 2002 and 2008. The research, published today in the Archives of Internal Medicine, focused specifically on the question of loneliness and its impact.

Carla Perissinotto, MD, MHS Carla Perissinotto, MD, MHS

“In our typical medical model, we don’t think of subjective feelings as affecting health,” said first author Carla Perissinotto, MD, MHS, assistant professor in the UCSF Division of Geriatrics. “It’s intriguing to find that loneliness is independently associated with an increased rate of death and functional decline.”

One of the top such programs in the nation, the UCSF Division of Geriatrics seeks to improve the care of older persons through teaching, discovery, and the care of patients. Physicians care for patients in their homes and in hospitals, clinics, and long-term care settings, teach medical students, resident physicians, physicians in practice, and train the next generation of leaders of geriatric medicine. As scientists, they seek to understand the causes and outcomes of illness in older persons, and to improve their health and well-being.

Lonely Without Being Alone

One of the more surprising findings of the team’s analysis is that loneliness does not necessarily correlate with living alone. The study found 43 percent of surveyed older adults felt lonely, yet only 18 percent lived alone.

“We are interested in identifying the different factors that cause adults to become functionally impaired and ultimately at risk for nursing home admission,” Perissinotto said. “The aging of our population and the greater odds of institutionalization make it important for us to think about all the factors that are putting elders in danger, including social and environmental risks.”

Researchers at UCSF focused on death and a decrease in the ability to perform daily activities such as upper extremity tasks, climbing stairs, and walking.

People who identified themselves as lonely had an adjusted risk ratio of 1.59 or a statistically significant 59 percent greater risk of decline. For death, the hazard ratio was 1.45 or 45 percent greater risk of death.

“This is one of those outcomes you don’t want to see because it was terrible to find out it was actually true,” Perissinotto said. “We went into the analysis thinking that there was a risk we could find nothing, but there actually was a strong correlation.”

Depression vs. Loneliness

Perissinotto and her colleagues believe the impact of loneliness on an elderly patient is different from the effects of depression. While depression is linked with a lack enjoyment, energy and motivation, loneliness can be felt in people who are fully functional but feel empty or desolate.