ArticleJournal of the American Geriatrics Society2020
The Relationship of Loneliness to End-of-Life Experience in Older Americans: A Cohort Study.
Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Loneliness among adults at the end of life: A systematic review of prevalence and correlates.Palliative medicine · 2026Pooled it
- Trajectories of Social Activity Engagement and Physical and Cognitive Function During the Last Years of Life.Journal of the American Geriatrics Society · 2026Article
- Culture matters? Family norms, living arrangements, and loneliness in China.SSM - population health · 2026Article
- Quality over Quantity: The Association Between Daily Social Interactions and Loneliness.International journal of environmental research and public health · 2025Article
- Loneliness and Social Isolation in the Care of the Seriously Ill Older Adult.Clinics in geriatric medicine · 2025Review
- [Loneliness at the end of life].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2024Review
- Automated Detection of In-Home Activities with Ultra-Wideband Sensors.Sensors (Basel, Switzerland) · 2024Article
- Social connection and end-of-life outcomes among older people in 19 countries: a population-based longitudinal study.The lancet. Healthy longevity · 2024Article
- Understanding Social and Emotional Loneliness among Black Older Adults: A Scoping Review.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2022Article
- A paradigm shift-Loneliness as a root cause of symptom distress among older adults.Journal of the American Geriatrics Society · 2022Article
- The epidemiology of social isolation and loneliness among older adults during the last years of life.Journal of the American Geriatrics Society · 2021Article
- Existential Suffering in Palliative Care: An Existential Positive Psychology Perspective.Medicina (Kaunas, Lithuania) · 2021Review
- Social Isolation and Loneliness Among San Francisco Bay Area Older Adults During the COVID-19 Shelter-in-Place Orders.Journal of the American Geriatrics Society · 2021Article
- Loneliness and Isolation in Long-term Care and the COVID-19 Pandemic.Journal of the American Medical Directors Association · 2020Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 2 countries.
Funding
Abstract
objectivesLittle is known about the relationship between loneliness and end-of-life (EOL) experience including symptom burden, intensity of care, and advance care planning among older adults.
designSecondary analysis of the Health and Retirement Study (HRS).
settingPopulation based.
participantsDecedents older than 50 years who died between 2004 and 2014 (n = 8700). Exclusions included those who were ineligible for surveys assessing loneliness (n = 2932) or had missing or incomplete loneliness or symptom data (n = 2872). MEASUREMENTS: Individuals were characterized as lonely based on responses to the three-item Revised University of California, Los Angeles Loneliness Scale in the most recent HRS survey before death. Outcomes were proxy reports of total EOL symptom burden, intensity of EOL care (eg, late hospice enrollment, place of death, hospitalizations, use of life support), and advance care planning. Results were expressed as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).
resultsOne-third of 2896 decedents (n = 942) were lonely. After adjusting for demographics, socioeconomic status, multimorbidity, depressive symptoms, family and friends, and social support, loneliness was independently associated with increased total symptom burden at EOL (ß = .13; P = .004). Compared with nonlonely individuals, lonely decedents were more likely to use life support in the last 2 years of life (35.5% vs 29.4%; aOR = 1.36; 95% CI = 1.08-1.71) and more likely to die in a nursing home (18.4% vs 14.2%; aOR = 1.78; 95% CI = 1.30-2.42). No significant differences in other measures of intense care (late hospice enrollment, number of hospitalizations, or dialysis use) or likelihood of advance care planning were observed.
conclusionLonely older people may be burdened by more symptoms and may be exposed to more intense EOL care compared with nonlonely people. Interventions aiming to screen for, prevent, and mitigate loneliness during the vulnerable EOL period are necessary. J Am Geriatr Soc 68:1064-1071, 2020.
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