Loneliness as a predictor of mortality in cancer patients, a cohort study

Abstract

Introduction. Some studies have indicated that loneliness may be associated with an increased risk of mortality in cancer patients, as it can weaken treatment response and the immune system, and promote harmful behaviors, worsening the prognosis and increasing the likelihood of death. Addressing loneliness in public health is essential to provide social support and improve outcomes in cancer patients. Objective. To obtain an estimator of the unwanted loneliness-mortality association. Materials and methods. We followed a prospective cohort of 400 patients for two years (exposure=loneliness levels; outcome=mortality; sociodemographic and clinical control variables were included). A parametric survival model (log normal) was used. Results. The cohort had a median survival of 20.2 months and a mortality rate of 3.2 deaths/100 patient-months (95% CI: 2.8 to 3.7). The survival model found the following time ratios (TR): moderate level/low level: TR=0.55; 95% CI: 0.39 to 0.77; moderately high level/low level: TR=0.62; 95% CI: 0.41 to 0.93; high level/low level: TR=1.17; 95% CI: 0.31 to 4.42. Conclusion. Compared to patients with low levels of loneliness, patients with moderate or moderately high levels reach death more quickly (statistically significant TRs, adjusted for the effect of other variables in the model); this highlights the need for interventions to mitigate loneliness and promote social support in patients having cancer.