title: Loneliness and All-Cause, Cardiovascular, and Noncardiovascular Mortality in Older Men: The Zutphen Elderly Study.
abstract: Loneliness, defined as the discrepancy between one's desired and actual relationships, is prevalent in the elderly and can be both emotional and social loneliness. We aimed to determine whether loneliness is independently related to higher all-cause, cardiovascular, and noncardiovascular mortality in elderly men.
  
  
  
  Using a population-based cohort study with 25 years of follow-up from 1985, the Zutphen Study, 719 of 939 men (76.2%; age range: 64-84 years) who had complete data on loneliness at baseline and at least 2 years of survival were studied. Loneliness was assessed using a validated 11-item questionnaire in 1985, 1990, 1995, and 2000. Time-dependent Cox proportional hazards models were adjusted for sociodemographic characteristics and cardiovascular risk factors.
  
  
  
  At baseline, point prevalence of moderate and severe loneliness was, respectively, 38.8% (N = 279) and 3.2% (N = 23). Loneliness, especially emotional loneliness, did significantly increase over 15 years with an overall reliability coefficient of 0.50. All-cause, cardiovascular, and noncardiovascular mortality were not higher among moderately lonely participants (hazard ratio [HR]: 1.00; 95% confidence interval [CI]: 0.84-1.17; HR: 0.99; 95% CI: 0.78-1.25; and HR: 0.99; 95% CI: 0.79-1.24, respectively) and severely lonely participants (HR: 1.40; 95% CI: 0.85-2.31; HR: 1.18; 95% CI: 0.58-2.39; and HR: 1.63; 95% CIH 0.80-3.31, respectively).
  
  
  
  Loneliness is common and increases during aging, due to the increase in its component emotional loneliness over time. No independent associations with risks of all-cause, cardiovascular, and noncardiovascular death were found.
authors.affiliation: Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands. Electronic address: jjpsyex@gmail.com.
authors.forename: Jolien E
authors.initials: JE
authors.lastname: Julsing
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Daan
authors.initials: D
authors.lastname: Kromhout
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Geleijnse
authors.affiliation: Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Giltay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D004644:Emotions; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008132:Loneliness / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Aged; Cardiovascular death; Cohort studies; Loneliness; Mortality