Unwelcome Companions: Loneliness Associates with the Cluster of PainFatigue and Depression in Older Adults

摘要

Objective: Pain, fatigue, and depression commonly co-occur as asymptom cluster in pathological inflammatory states. Psychosocial stressors suchas loneliness may lead to similar states through shared mechanisms. Weinvestigated the association of loneliness with pain, fatigue, and depression inolder adults. Methods: Using Health and Retirement Study data(N = 11,766), we measured cross-sectional prevalence offrequent, moderate to severe pain; severe fatigue; depressive symptoms; andco-occurrence of symptoms surpassing threshold levels (i.e., symptom cluster).Logistic regression models evaluated associations with loneliness.Results: Pain, fatigue, and depression were reported in 19.2%,20.0%, and 15.3% of the total sample, respectively. The symptom cluster was seenin 4.9% overall; prevalence in lonely individuals was significantly increased(11.6% vs. 2.3%, p < .0001). After adjusting for demographicvariables, loneliness associated with the symptom cluster (adjusted OR = 3.39,95% CI = 2.91, 3.95) and each symptom (pain adjusted OR = 1.61, 95% CI = 1.48,1.76; fatigue adjusted OR = 2.02, 95% CI = 1.85, 2.20; depression adjustedOR = 4.34, 95% CI = 3.93, 4.79). Discussion: Loneliness stronglyassociates with the symptom cluster of pain, fatigue, and depression. Furtherresearch should examine causal relationships and investigate whetherinterventions targeting loneliness mitigate pain, fatigue, and depression.