Living Alone Strong Predictor of All-Cause Mortality Among Older Adults

Living alone is a significant predictor of all-cause mortality among those younger than 75 years, independent of self-perceived health status and socioeconomic and medical covariates, according to a research correspondence published on Jan. 14 in JAMA Internal Medicine.
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The authors looked at 3,486 patients from the Blue Mountain Eye Study (BMES), and found that among participants younger than 75 years, living alone was associated with a 36 percent increased risk of all-cause mortality (15.0 percent vs. 11.4 percent; multivariate-adjusted hazard ratio, 1.36 [95 percent CI, 1.04-1.79]). In those 75 years or older, living alone was not found to be associated with both total mortality and CVD mortality (P=.48).

The authors note that their observations confirm previous studies, and that "lack of social support, whether it be measured objectively (living arrangements) or subjectively (feelings of loneliness), has a negative impact on health." They add that this topic should be addressed in future intervention studies.

In a related comment, Kenneth E. Covinsky, MD, MPH, notes that physicians should identify what is going on with their older patients who live alone: "How good is their social support structure? Is there someone who could help them if they need care? Do they feel that they have someone they can discuss concerns with? And are they developing any difficulties with basic activities of daily living such as taking a bath or shower, getting dressed, or getting out of bed or a chair?" He adds that "living alone has a differential diagnosis, just like any important sign or symptom in a patient."

Keywords: Risk, Social Support, Residence Characteristics, Health Status, Diagnosis, Differential

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