Loneliness as a gender-specific predictor of physical and mental health-related quality of life in older adults

Friederike H Boehlen,Beate Wild,Hans-Christoph Friederich,Ben Schoettker,Hermann Brenner,Imad Maatouk

doi:10.1007/s11136-021-03055-1

Abstract

PurposeHealth-related quality of life (HRQOL) in older persons is influenced by physical and mental health, as well as by their social contacts and social support. Older women and men have disparate types of social networks; they each value social ties differently and experience loneliness in unique and personal ways. The aim of this study is, therefore, to determine the longitudinal association between loneliness and social isolation with HRQOL in older people—separated by gender.MethodsData stem from the third and fourth follow-up of the ESTHER study—a population-based cohort study of the older population in Germany. A sample of 2171 older women and men (mean age: 69.3 years, range 57–84 years) were included in this study; HRQOL was assessed by using the Short Form-12 questionnaire (SF-12). Data on physical and mental health, loneliness, and social networks were examined in the course of comprehensive home visits by trained study doctors. Gender-specific linear regression analyses were performed to predict physical quality of life (measured by the PCS, physical component score of the SF-12) and mental quality of life (measured by the MCS, mental component score) after three years, adjusted by socioeconomic variables as well as physical, mental, and social well-being.ResultsAt baseline, PCS was 41.3 (SD: 10.0) in women and 42.2 (SD: 9.6) in men (p = .04). MCS was 47.0 (SD: 10.2) in women and 49.6 (SD: 8.6) in men (p < .001). In both genders, PCS and MCS were lower three years later. Loneliness at t0 was negatively associated with both PCS and MCS after three years (t1) among women, and with MCS but not PCS after three years among men. In both genders, the strongest predictor of PCS after three years was PCS at t0 (p < .001), while the strongest predictors of MCS after three years were MCS and PCS at t0.ConclusionHRQOL in elderly women and men is predicted by different biopsychosocial factors. Loneliness predicts decreased MCS after three years in both genders, but decreased PCS after three years only in women. Thus, a greater impact of loneliness on the health of older women can be surmised and should therefore be considered in the context of their medical care.

Highlights

Health-related quality of life (HRQOL) comprises the perception and evaluation of a person concerning his/her biopsychosocial well-being
We examined the association of loneliness and HRQOL over three years in a sample of more than 2000 older adults in Germany- separated by gender
At t0, data on loneliness and HRQOL was obtained from 3026 participants

Summary

Introduction

Health-related quality of life (HRQOL) comprises the perception and evaluation of a person concerning his/her biopsychosocial well-being. Other studies state that social relations, functional ability, and activities influence quality of life as much as the objective health status [6] In this context, loneliness has shown to be associated with decreased HRQOL in older persons as well as with a greater mortality risk [7, 8]. Hajian-Tilaki et al demonstrated that the adjustment for chronic disease conditions and sociodemographic factors partly explains the lower HRQOL in women, while gender differences still remain significant [11] In this context, Baladon et al [12] reported that anxiety and pain had an impact only on the HRQOL of women. Another recent publication emphasized that regarding quality of life, older women would benefit more from active social participation whereas men would benefit more from social networks and social support [13]

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