title: Do stress, health behavior, and sleep mediate the association between loneliness and adverse health conditions among older people?
abstract: BACKGROUND
  Prior research has established an association between loneliness and a variety of negative health conditions among older people. However, little is known about the mechanisms underlying this association.
  
  
  OBJECTIVE
  Building on the Loneliness Model, Hawkley and Cacioppo (2010) identified possible pathways through which loneliness may affect the development of adverse health conditions. The present study was designed to test the pathways proposed by Hawkley and Cacioppo.
  
  
  METHODS
  The sample consisted of 8593 elderly ranging from 65 to 102 years of age participating in the 2013 Public Health Survey "How are you?".
  
  
  RESULTS
  Findings show that loneliness was significantly associated with cardiovascular disease, diabetes, and migraine. In addition high perceived stress, physical inactivity, daily smoking, and poor sleep mediated the association between loneliness and adverse health conditions. Moreover, findings demonstrate several gender differences in the association between loneliness and various adverse condition and the indirect mechanisms affecting these associations.
  
  
  CONCLUSIONS
  The findings largely support the pathways proposed by Hawkley and Cacioppo.
authors: Public Health and Quality Improvement, Central Denmark Region, Olof Palmes Allé 15, 8200, Aarhus N, Denmark; Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. Electronic address: julie.christiansen@stab.rm.dk.
authors: Julie
authors: J
authors: Christiansen
authors: Public Health and Quality Improvement, Central Denmark Region, Olof Palmes Allé 15, 8200, Aarhus N, Denmark. Electronic address: finn.breinholt@stab.rm.dk.
authors: Finn Breinholt
authors: FB
authors: Larsen
authors: Public Health and Quality Improvement, Central Denmark Region, Olof Palmes Allé 15, 8200, Aarhus N, Denmark; Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. Electronic address: mathias.lasgaard@stab.rm.dk.
authors: Mathias
authors: M
authors: Lasgaard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008132:Loneliness / Q000523:psychology*; D008297:Male; D012737:Sex Factors; D012890:Sleep; D013315:Stress, Psychological / Q000523:psychology*
keywords: Cardiovascular disease; Diabetes; Health behavior; Loneliness; Migraine; Sleep; Stress