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This is a Cross-Sectional Study study.

September 23, 2025

Loneliness is Independently Associated With Functioning in the Oldest Old: A Cross-Sectional Study Using Data From the Survey of Health, Ageing and Retirement in Europe.

KBKarina BertoldiPontifícia Universidade Católica do Paraná AHAriele Barreto HaagsmaNewcastle upon Tyne Hospitals NHS Foundation Trust RBRafaella Stradiotto BernardelliPontifícia Universidade Católica do Paraná

Key Points

Loneliness significantly correlates with limitations in basic and instrumental activities of daily living among older adults.
About 56% of participants reported feelings of loneliness, and 66% experienced functional limitations in daily activities.
Logistic regression analysis indicated a strong association, with an odds ratio of 1.50 for loneliness affecting functional abilities.
This cross-sectional analysis emphasizes the importance of considering psychosocial factors in evaluating health among the oldest-old.

Abstract

Functionality is crucial for older adults' autonomy, and loneliness has emerged as a potential risk factor for chronic diseases. However, its role in functional limitations remains unclear. The objective of this study was to analyze the association between loneliness and limitations in 1 or more basic activities of daily living (BADL) and instrumental activities of daily living (IADL) in individuals who were 80 years old or older. This was a cross-sectional study using data from wave 8 of the Survey of Health, Ageing and Retirement in Europe. The study was conducted in 26 European countries. Participants were 7434 community-dwelling adults who were 80 years old or older. Loneliness was assessed using the Three-Item Loneliness Scale, covering companionship, exclusion, and isolation. Functional limitations were defined as difficulty in 1 or more BADL (dressing, walking, bathing, eating, bed transfer, toileting), IADL (map use, preparing a hot meal, shopping, phone use, medication management, housework, finances, transportation, laundry), or in both types of activities (BADL and IADL). Sociodemographic and health-related variables were considered. Logistic regression and multivariate analyses were applied, using the odds ratio (OR) as the effect measure. The mean age was 84.4 (SD = 3.8) years; 58.2% of participants were women, and 52.5% had a low educational level. Loneliness affected 56% of participants, and 66% reported limitations in BADL/IADL. Loneliness was significantly associated with functional limitation in BADL/IADL in both univariate (OR = 2.18 95% CI = 1.98-2.39) and multivariate (OR = 1.50 95% CI = 1.34-1.67) models, even after adjustment for covariates, with an area under the receiver operating characteristic curve of 76%. Loneliness is significantly and independently associated with limitations in BADL/IADL among the oldest-old. These findings highlight the importance of assessing psychosocial factors, such as loneliness, when evaluating functional health in the oldest-old.

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