This study examined the relationship between loneliness, health, and mortality using
a U.S. nationally representative sample of 2101 adults aged 50 years and over from
the 2002 to 2008 waves of the Health and Retirement Study. We estimated the effect
of loneliness at one point on mortality over the subsequent six years, and investigated
social relationships, health behaviors, and health outcomes as potential mechanisms
through which loneliness affects mortality risk among older Americans. We operationalized
health outcomes as depressive symptoms, self-rated health, and functional limitations,
and we conceptualized the relationships between loneliness and each health outcome
as reciprocal and dynamic. We found that feelings of loneliness were associated with
increased mortality risk over a 6-year period, and that this effect was not explained
by social relationships or health behaviors but was modestly explained by health outcomes.
In cross-lagged panel models that tested the reciprocal prospective effects of loneliness
and health, loneliness both affected and was affected by depressive symptoms and functional
limitations over time, and had marginal effects on later self-rated health. These
population-based data contribute to a growing literature indicating that loneliness
is a risk factor for morbidity and mortality and point to potential mechanisms through
which this process works.
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