TOPLINE: 

In the last year of life among adults older than age 50, psychological and physical symptoms such as depression and agitation were associated with loneliness, and physical symptoms such as difficulty breathing and persistent cough were linked to social isolation.

METHODOLOGY: 

• Researchers used nationally representative data from the Health and Retirement Study (2006-2018) to assess the association between medical symptoms and loneliness.
• They included 2385 adults over age 50 in their last year of life (mean age at last interview, 76.1 years) who had exit interviews completed after death by a proxy, typically next of kin.
• Loneliness was assessed using a validated single-item question asking respondents whether they felt lonely much of the time during the past week.
• Social isolation was measured through a composite scale derived from the psychosocial Leave-Behind Questionnaire, evaluating household and core contacts, community engagement, and social network interaction in a subset of 800 participants.
• Proxies reported on end-of-life symptoms, including psychological (depression, agitation, and confusion) and physical (pain, fatigue, and poor appetite, among others).

TAKEAWAY: 

• Depression was associated with a higher adjusted probability of loneliness (35% vs 18%), as were agitation (38% vs 24%), pain (30% vs 20%), and fatigue (29% vs 22%) (P < .001 for all),
• Physical symptoms such as difficulty breathing (22% vs 14%), drowsiness (30% vs 17%), and persistent cough (24% vs 15%) were associated with a higher adjusted probability of social isolation.
• Physical symptoms including poor appetite, difficulty controlling limbs, and incontinence showed no significant association with the probabilities of social isolation. 

IN PRACTICE: 

"The presence of such symptoms could serve as a prompt for healthcare providers to explore loneliness and social isolation in their patients and subsequently provide appropriate referrals or interventions," the authors of the study wrote.

SOURCE: 

The study was led by Mara Rosenberg, MD, of the Division of Geriatrics at the University of California, San Francisco. It was published online on March 19 in the Journal of the American Geriatrics Society.

LIMITATIONS: 

Loneliness, social isolation, and symptoms may not have occurred simultaneously. A single-item measure of loneliness was used, rather than an extended scale. The cross-sectional study design restricted the ability to establish causal relationships between symptoms and outcomes.

DISCLOSURES: 

Various authors reported receiving support from the National Institute on Aging. One author disclosed personal consulting fees from Papa Inc.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.