A longitudinal analysis of loneliness, social isolation and falls amongst older people in England

Feifei Bu,Daisy Fancourt,Paola Zaninotto,Jessica Abell

doi:10.1038/s41598-020-77104-z

Abstract

Loneliness and social isolation have been identified as important predictors of various health outcomes, but little research has investigated their influence on falls. This study aimed to investigate the longitudinal association between loneliness, social isolation and falls amongst older adults in England, looking at both self-reported falls and falls that require hospital admissions. This study drew on large scale, nationally representative data from the English Longitudinal Study of Ageing linked with Hospital Episode Statistics. Data were analysed using survival analysis, with self-reported falls (total sample = 4013) and falls require hospital admission being modelled separately (total sample = 9285). There was a 5% increase in the hazard of self-reported falls relative to one point increase in loneliness independent of socio-demographic factors (HR: 1.05, 95% CI: 1.02–1.08), but the association was explained away by individual differences in health and life-style measures (HR: 1.03, 95% CI: 1.00–1.07). Both living alone (HR: 1.18, 95% CI: 1.07–1.32) and low social contact (HR: 1.04, 95% CI: 1.01–1.07) were associated with a greater hazard of self-reported falls even after controlling for socio-demographic, health and life-style differences. Similar results were also found for hospital admissions following a fall. Our findings were robust to a variety of model specifications.

Highlights

Loneliness and social isolation have been identified as important predictors of various health outcomes, but little research has investigated their influence on falls
Following Cornwell and Waite’s34 suggestion, this study considered loneliness and social isolation as distinct concepts and explored if they were differentially associated with the risk of falls
We examined different aspects of social isolation which might be related to the risk of falls through different mechanisms

Summary

Introduction

Loneliness and social isolation have been identified as important predictors of various health outcomes, but little research has investigated their influence on falls. Little research work has been carried out to systematically investigate the relationship between falls and social factors This is surprising given that social factors, in particular loneliness and social isolation, have long been recognised as important predictors of various health outcomes of older people, such as increased risk of all-cause mortality[21,22], cardiovascular functioning[23,24], cognitive impairment[25,26], and d epression[27,28]. This study examined both self-reported falls (SR falls) and falls requiring hospital admission (HA falls) derived from administrative hospital records This allowed us to explore whether loneliness and social isolation affected both the risk of fall itself and the activation of a specific clinical pathway involved in the treatment of a fall

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Results

Conclusion