ArticleBMJ public health2026
Relationship of breathlessness with social isolation and loneliness: a nationally representative cohort study of older adults in England.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Breathlessness is a common and distressing symptom impacting quality of life and limiting activities of daily living. Social isolation and loneliness are associated with increased morbidity and mortality, being problems in themselves and risk factors for poor health. Qualitative studies indicate breathlessness impacts social health; however, quantitative evaluation is limited. We aimed to assess the relationship of breathlessness with social isolation and loneliness in adults. Methods: Using a nationally representative sample of older adults aged ≥50 years from the English Longitudinal Study of Ageing (N=6623). The sample had 44% males, mean age of 70 years (SD=10). We examined associations of baseline breathlessness (modified Medical Research Council (mMRC) breathlessness scale) with loneliness (3-item University of California and Los Angeles (UCLA) loneliness scale) and social isolation (low social contact, low community participation, living alone) at baseline and follow-up at 4 and 8 years later, using regression models adjusted for confounders. Results: At baseline, breathlessness was associated with higher levels of loneliness (coef.=0.161, 95% CI 0.113 to 0.209) and social isolation, including low social contact (coef.=0.094, 95% CI 0.028 to 0.159), low community participation (coef.=0.169, 95% CI 0.117 to 0.221) and living alone (OR 1.089, 95% CI 1.026 to 1.157). Longitudinally, breathlessness was associated with increasing loneliness and reducing social contact and community participation at 4-year and 8-year follow-up. Breathlessness was not associated with a change in living alone. Findings were independent of identified confounders. Conclusions: Breathlessness is related to increasing social isolation and loneliness, potentially due to limiting the amount and quality of social interactions. These findings suggest important psychosocial impacts of breathlessness requiring holistic management strategies.
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