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

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.