Evidence map›Paper›PMID 42736300›Full record

ArticleNature communications2026

Bidirectional associations between loneliness and physical multimorbidity and the mediating role of social inactivity.

Yaguan Zhou, Siqi Zhu, Julianne Holt-Lunstad, Mika Kivimäki, Xiaolin Xu

Abstract read
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Yaguan Zhou *School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Siqi Zhu *School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.ORCID http://orcid.org/0009-0008-8314-0557
Julianne Holt-LunstadDepartment of Psychology, Brigham Young University, Provo, UT, USA.
Mika KivimäkiBrain Sciences, University College London, London, UK.ORCID http://orcid.org/0000-0002-4699-5627
Xiaolin XuSchool of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. xiaolin.xu@zju.edu.cn.ORCID http://orcid.org/0000-0002-8203-9878

Funding

National Natural Science Foundation of China (National Science Foundation of China) 72474197
6 · The paper itself

Abstract

Physical multimorbidity and loneliness are increasingly recognised as public health concerns, but the nature of their potential relationships remains unclear. Here we report bidirectional associations between physical multimorbidity and loneliness in middle-aged and older adults and the mediating role of social inactivity. Longitudinal data from adults aged ≥45 years are analysed across 19 countries from five prospective cohorts: US Health and Retirement Study; English Longitudinal Study on Ageing; Survey of Health, Ageing and Retirement in Europe; China Health and Retirement Longitudinal Study; and Korean Longitudinal Study of Aging. Cox regression models suggest longitudinal associations between physical multimorbidity and loneliness in both directions (from physical multimorbidity to loneliness: adjusted hazard ratio (HR) = 1.25, 95% confidence interval (CI) = 1.20 to 1.30; from loneliness to physical multimorbidity: adjusted HR = 1.10, 95% CI = 1.05 to 1.17). Random-intercept cross-lagged panel models confirm significant association between T1 physical multimorbidity and T3 loneliness, with T2 social inactivity serving as a mediator. These findings suggest that physical multimorbidity and loneliness may create a vicious cycle where each condition exacerbates the other, with social inactivity mediating the direction from physical multimorbidity and loneliness.

Indexed as

LonelinessMultimorbiditySedentary BehaviorAgedAgingChinaEuropeFemaleHumansLongitudinal StudiesMaleMiddle AgedProportional Hazards ModelsProspective Studies

Identifiers

PMID42736300
PMCPMC13575247

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.