Social Isolation, Loneliness, and Health Behaviors at Older Ages: Longitudinal Cohort Study

Ann Behav Med. 2018 May 31;52(7):582-593. doi: 10.1093/abm/kax033.


Background: The prospective associations between social isolation, loneliness, and health behaviors are uncertain, despite the potential importance of these relationships over time for outcomes including mortality.

Purpose: To examine the associations between baseline social isolation, baseline loneliness, and engagement in health behaviors over 10 years among older adults.

Methods: Data were from 3,392 men and women aged ≥52 years in the English Longitudinal Study of Ageing from 2004/2005 to 2014/2015. Modified Poisson regression was specified to estimate relative risks (RRs) and 95% confidence intervals for the associations between baseline social isolation, baseline loneliness, and consistent weekly moderate-to-vigorous physical activity, consistent five daily fruit and vegetable servings, daily alcohol drinking at any time point, smoking at any time point, and a consistently overweight/obese body mass index over the follow-up (all yes vs. no). Models were population weighted and adjusted for sociodemographic factors, health indicators, and depressive symptoms, with mutual adjustment for social isolation and loneliness.

Results: Socially isolated participants were less likely than non-isolated participants to consistently report weekly moderate-to-vigorous physical activity (RR = 0.86; 0.77-0.97) or five daily fruit and vegetable servings (RR = 0.81; 0.63-1.04). They were less likely to be consistently overweight or obese (RR = 0.86; 0.77-0.97) and more likely to smoke at any time point (RR = 1.46; 1.17-1.82). Loneliness was not associated with health behaviors or body mass index in adjusted models. Among smokers, loneliness was negatively associated with successful smoking cessation over the follow-up (RR = 0.31; 0.11-0.90).

Conclusions: Social isolation was associated with a range of health-related behaviors, and loneliness was associated with smoking cessation over a 10 year follow-up in older English adults.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / epidemiology
  • Alcohol Drinking / psychology
  • Body Mass Index
  • Diet, Healthy / psychology
  • Exercise / psychology
  • Female
  • Health Behavior*
  • Humans
  • Loneliness* / psychology
  • Longitudinal Studies
  • Male
  • Marital Status
  • Middle Aged
  • Poisson Distribution
  • Risk
  • Sex Factors
  • Social Isolation* / psychology