Loneliness Trajectories Predict Risks of Cardiovascular Diseases in Chinese Middle-Aged and Older Adults

Abstract

Objectives: Loneliness is considered a risk factor for cardiovascular diseases (CVD), but related evidence is mixed. Examining trajectories of loneliness over time, as compared to the assessment of loneliness at a single time point, can be useful to better understand the risks for CVD. The present study aimed to examine loneliness trajectories and their impacts on CVD in Chinese middle-aged and older adults.

Methods: The sample included 9,235 adults aged 45 years and older from 4 waves of the China Health and Retirement Longitudinal Survey from 2011 to 2018. Loneliness was assessed by a single-item question with a 4-point scale. CVD events were measured by self-reports of heart diseases and strokes in 2018.

Results: Group-based trajectory modeling showed that 3 loneliness trajectories emerged: stable low, moderate increasing, and high increasing loneliness. Binary logistic regression showed that loneliness trajectories were significantly associated with the risk of having CVD after controlling for all covariates. Specifically, compared to the group with stable low loneliness, people with moderate increasing loneliness had a higher risk of having stroke, and people with high increasing loneliness had higher risks of having both heart diseases and stroke. In contrast, loneliness at a single time point was not independently associated with the risk of having CVD.

Discussion: The present study identified groups of people vulnerable to CVD from the perspective of social connections in terms of loneliness trajectories. Middle-aged and older adults showing increasing loneliness may need social and emotional support to protect their cardiovascular health.

Keywords: China Health and Retirement Longitudinal Survey (CHARLS); Group-based trajectory modeling; Heart diseases; Stroke; Trajectories of loneliness.