Association of diabetes mellitus and social isolation with loneliness among older Japanese adults: a cross-sectional study

Abstract

Purpose: To clarify whether the combination of diabetes mellitus (DM) and social isolation is associated with loneliness among community-dwelling older adults.

Methods: Data of community-dwelling older adults aged 60 years and older without initial long-term care needs from the Japanese National Center for Geriatrics and Gerontology Study of Geriatric Syndromes were analyzed. Loneliness was measured using the University of California Los Angeles Loneliness Scale. Social isolation was assessed based on four categories: lack of conversation, lack of passive support, lack of support provided to others, and lack of social participation. DM status was determined by assessing patients' medical histories. Modified Poisson regression models were employed to assess relationships between DM, social isolation, and loneliness, including interactions according to sex.

Results: Data from 5876 participants (54.2% women) aged 68-77 years were included. The prevalence rates of loneliness, social isolation, and DM were 35.9%, 46.5%, and 13.1%, respectively. Among women, DM and social isolation were associated with loneliness (DM, prevalence ratio [PR]: 1.35, 95% confidence interval [CI]: 1.02-1.78; social isolation, PR: 1.98, 95% CI: 1.33-2.94). Among men, only social isolation was associated with loneliness (PR: 1.41, 95% CI: 1.09-1.84). No interaction was observed between DM and social isolation for either sex.

Conclusions: Social isolation was associated with loneliness in men and women. DM was associated in women but not in men. The findings of this study may help develop strategies to maintain the mental health of older adults.

Keywords: Diabetes mellitus; Loneliness; Mental health; Older adults; Social isolation; Social support.