Transitions of loneliness and lonely life expectancy: A longitudinal study across 24 countries.

Abstract

Objective: This study aims to explore individual- and country-level factors associated with loneliness' transitions and estimate total life expectancy (TLE) and lonely life expectancy (LLE) at age 60 across 24 countries.

Design: This is a longitudinal study.

Setting: Data were drawn from five harmonized multinational cohorts.

Participants: This study included 61,511 older adults aged 60 and above MEASUREMENTS: A multistate Markov model was used to estimate the life expectancy of older adults in states of loneliness and non-loneliness, and factors associated with the state transition probabilities.

Results: Female, low education, multimorbidity, and psychological disorders were associated with higher risk of transitioning from "Not lonely" to "Lonely", while physical activity was linked to recovery. Beyond individual-level factors, high GDP, civil society participation, and accessible public transport were linked to lower loneliness risk. However, civil society participation and transport access had limited effects on mortality. TLE for older adults aged 60 was 23.14 years, with a LLE of 4.31 years. Older adults in high-GDP countries had a 1.25-year longer TLE and a 2.40-year shorter LLE. Greater civil society participation was linked to a 0.75-year increase in TLE and a 2.78-year reduction in LLE. In contrast, higher urbanization was associated with a slightly longer TLE but a higher LLE. Public transport accessibility correlated with a significantly reduced LLE by 1.97 years.

Conclusions: This study highlights the longitudinal associations between individual behaviors, socioeconomic factors and loneliness, offering valuable insights for promoting healthy aging globally.