Evidence map›Paper›PMID 39836319›Full record

SynthesisAging clinical and experimental research2025

Loneliness, social isolation, and living alone: a comprehensive systematic review, meta-analysis, and meta-regression of mortality risks in older adults.

Agni Nakou, Elena Dragioti, Nikolaos-Stefanos Bastas, Nektaria Zagorianakou, Varvara Kakaidi, Dimitrios Tsartsalis, Stefanos Mantzoukas, Fotios Tatsis, Nicola Veronese, Marco Solmi and 1 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Aging clinical and experimental research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
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  4. Trial
  5. System-Specific Epigenetic Aging Signatures in Autistic Adults.bioRxiv : the preprint server for biology · 2026
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  6. Review
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  11. Chronic disease and social isolation among Canadians: evidence from the 2022 Mental Health and Access to Care Survey.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Agni NakouResearch Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Elena DragiotiResearch Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Nikolaos-Stefanos BastasResearch Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Nektaria ZagorianakouResearch Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Varvara KakaidiResearch Laboratory Integrated Care, Health & Well-being, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Dimitrios TsartsalisResearch Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Stefanos MantzoukasResearch Laboratory Integrated Care, Health & Well-being, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Fotios TatsisFaculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Nicola VeroneseUnit of Geriatrics, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
Marco Solmi *SCIENCES lab, Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada. msolmi@toh.ca.
Mary Gouva *Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Loneliness, social isolation, and living alone are significant risk factors for mortality, particularly in older adults. This systematic review and meta-analysis aimed to quantify their associations with all-cause and cause-specific mortality in older adults, broadening previous research by including more social factors. Comprehensive searches were conducted in PubMed, APA PsycINFO, and CINAHL until December 31, 2023, following PRISMA 2020 and MOOSE guidelines. Studies included were prospective cohort or longitudinal studies examining the relationship between loneliness, social isolation, living alone, and mortality. Quality was assessed using the Newcastle-Ottawa Scale. Meta-analyses used random-effects models with the Restricted Maximum Likelihood method. Subgroup and meta-regression analyses explored the relationships further. Of 11,964 identified studies, 86 met the inclusion criteria. Loneliness was associated with increased all-cause mortality (HR 1.14, 95% CI 1.10-1.18), with substantial heterogeneity (I² = 84.0%). Similar associations were found for social isolation (HR 1.35, 95% CI 1.27-1.43) and living alone (HR 1.21, 95% CI 1.13-1.30). Subgroup analyses revealed variations based on factors like sex, age, region, chronic diseases, and study quality. Meta-regression identified longer follow-up, female sex, validated social network indices, adjustments for cognitive function, and study quality as significant predictors of mortality risks. These findings highlight the need for public health interventions to address these social factors and improve health outcomes in older adults. However, further research is needed due to variability and heterogeneity across studies. Also studying the cumulative effect of these factors on mortality risks will be of considerable interest.

Indexed as

LonelinessMortalitySocial IsolationAgedAged, 80 and overFemaleHumansMaleRisk FactorsLonelinessMeta-analysisMortalityOlder adultsSocial isolationSystematic review

Identifiers

PMID39836319
PMCPMC11750934

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.