Abstract
BackgroundLiving alone is increasingly common and has been depicted as an important cause of mortality. We examined the association between living alone and mortality risks among older men and women in northern Sweden, by linking two unique longitudinal datasets.MethodsWe used the Linnaeus database, which links several population registers on socioeconomic and health. This register-based study included 22,226 men and 23,390 women aged 50 and 60 years in Västerbotten County who had participated in the Västerbotten Intervention Program (VIP) during 1990–2006, with a total of 445,823 person-years of observation. We conducted Cox-proportional hazard regression to assess the risk of living alone on the mortality that was observed between 1990 and 2015, controlling for socio-demographic factors, chronic disease risk factors and access to social capital.ResultsOlder men and women who lived alone with no children at home were at a significantly higher risk of death compared to married/cohabiting couples with children at home (with an adjusted hazard ratio of 1.38, 95% CI of 1.26–1.50 in men and 1.27, 95% CI of 1.13–1.42 in women). Living alone was an even stronger factor than the well-established chronic disease risk factors and a lack of access to social capital.ConclusionsA significant association between living alone and mortality among the older adult population in Sweden was observed. Providing good social support for older people is important in preventing the negative health impact of living alone.
Highlights
Living alone is becoming increasingly common in highincome countries, due to for instance trends of longevity, high divorce rates, low rates of intergenerational coresidence, and high rates of widowhood [1,2,3]
This study provides a novel contribution to the literature by linking data from the comprehensive data of the Västerbotten Intervention Programme (VIP) with Swedish national register data that allow a longitudinal follow-up of survival among the Swedish older population
As the VIP data is linked to the population register data in the Linnaeus database, we obtained their socioeconomic and living arrangement data in the same year as when the individuals participated in the VIP examination, as well as death date for those who died
Summary
Study design and population We used the longitudinal information from the Linnaeus database, which links the Swedish population register, socio-economic data, hospitalisation and the Swedish death register at national level with the comprehensive VIP data (see below) during the years 1990–2006. The respondents were asked if they participated in any leisure-time activity or volunteer organisation during the last year, and if so, how often They were asked the number of people: (i) who they know and interact with; (ii) who can come to their house anytime and feel at home; and (iii) who were family or friends with whom they can speak their mind openly. We conducted a similar analysis for all population age 50 and over who lived in the Västerbotten County in 1990 and followed them until death or censored in October 2015 For this analysis, we did not control for chronic disease risk factors and access to social capital as this information were not available in the register data. All analyses were conducted in Stata 15 (Stata Corp Texas, 2017)
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