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University Ave. Maryland Ave. Loneliness is a prevalent social problem with serious physiological and health implications. However, much of the research to date is based on cross-sectional data, including our own earlier finding that loneliness was associated with elevated blood pressure. In this study, we tested the hypothesis that the effect of loneliness accumulates to produce greater increases in SBP over a four-year period than are observed in less lonely individuals. A population-based sample of 50—68 year-old White, Black, and Hispanic men and women in the Chicago Health, Aging, and Social Relations Study was tested annually for each of five consecutive years.
These increases were cumulative such that higher initial levels of loneliness were associated with greater increases in SBP over a 4-year period. Socially isolated individuals tend to feel lonely, but loneliness is not synonymous with being socially isolated.
At the biological level, loneliness is associated with increased vascular resistance Cacioppo, Hawkley, Crawford et al. Evidence is mounting that feelings of loneliness have serious physiological and health implications, but much of the research to date is based on cross-sectional data, including our own earlier finding that loneliness was associated with elevated blood pressure in a population-based sample of 50—68 year-old adults Cacioppo, Hawkley, Crawford et al. In the present study, we use longitudinal data to examine the degree to which loneliness explains increases in blood pressure over a four-year follow-up period in the same sample of aging adults.
We posit a potentially causal role for loneliness because an experimental and an observational field study among young adults indicated that loneliness was associated with chronically elevated total peripheral resistance TPR Cacioppo, Hawkley, Crawford et al. TPR levels behaved like a trait that varied as a function of individual differences in loneliness. Moreover, the association between loneliness and SBP was greater in older than younger individuals in this cohort Hawkley et al. In the present study, we used longitudinal data to formally test the hypothesis that the effect of loneliness on blood pressure accumulates to produce greater increases in SBP over a four-year period in 50—68 year-old adults.
In our examination of the cross-sectional association between loneliness and SBP, we observed a sizeable relationship an increase of one standard deviation in loneliness was associated with a Lonely senior search latinas date mm Hg increase in SBP that was net of Lonely senior search latinas date i. We also found that depressive symptoms, perceived stress, hostility, and low social support--psychosocial risk factors that are related to loneliness and have been associated with cardiovascular disease and hypertension Orth-Gomer et al.
Loneliness behaved as though it is a unique health risk factor in its own right. In testing the role of loneliness in predicting increases in blood pressure over a four-year period, we examine the degree to which the prospective association is unique to loneliness net of demographic characteristics, traditional cardiovascular risk factors, cardiovascular medications, depressive symptoms, perceived stress, hostility, and social support. The sample was selected using a multistage probability de in which the first stage involved identifying a subset of households estimated to have high probability of containing at least one adult aged 50—65 years 24 percent of the total frame.
A stratified, equal-probability-of-selection sample was drawn from this subset. The three strata were 1 households from census tracts in which at least 80 percent of the residents were African American, 2 households for which the associated surname was identified by the U. Census Department as "Hispanic", and 3 all remaining households. The final sample consisted of individuals who ranged from 50—68 years of age on the first testing occasion. The study was approved by the Institutional Review Board of the University of Chicago, and all participants gave informed consent.
The distribution of our sample on a of characteristics compares quite closely to that obtained from the national population-based Health and Retirement Survey HRS. In the U. Sample attrition over the course of the 5-year study averaged 7. Attriters over this time period had fewer years of education and more chronic health conditions at study onset, and were more likely to be Black or Hispanic than White. Attriters and non-attriters did not differ in age, gender, marital status, household income, religious participation, of voluntary group memberships, SBP, BMI, cardiovascular or antihyperlipidemia medications, smoking, alcohol ingestion, probability and duration of physical activity, loneliness, depressive symptoms, perceived stress, hostility, or social support.
For each of five annual visits to our laboratory, participants arrived between and a. All psychological measures reported in this paper, including loneliness, were obtained in the first survey packet of the day. During the health interview, participants were asked whether they had ever been diagnosed with a series of twenty health conditions, including heart attack, congestive heart failure, stroke, chronic obstructive pulmonary disease, ulcers, diabetes, and kidney disease.
Participants were asked to bring their medications with them to the laboratory, and experimenters recorded drug name, dosage, and frequency for subsequent coding. Height and weight were obtained using a standard medical scale.
Cardiovascular measures were obtained prior to lunch for all participants. Sensors for electrocardiograph, impedance cardiograph, and blood pressure recording were attached to participants. Participants were then seated in a comfortable padded chair. During a minute adaptation period, participants completed questionnaires while experimenters established good al quality.
Participants then sat quietly for an additional five minutes prior to recording of baseline cardiovascular activity. For the purposes of the present study, only blood pressure measurements are reported. The Colin Monitor records a pulse wave tonometrically by partial occlusion of the radial artery against the radius at the wrist, allowing for beat-to-beat measurement of blood pressure. The tonometer was calibrated against an initial blood pressure reading obtained using an oscillometric cuff and was periodically recalibrated either automatically or on experimenter initiation.
Systolic blood pressure was defined as the mean SBP during a four-minute seated, resting baseline. As we did in our earlier cross-sectional study Hawkley et al. According to Franklin et al. Thus, with less blood remaining in the aorta at the beginning of diastole, and with diminished elastic recoil, diastolic pressure decreases with increased steepness of diastolic decay.
After reverse scoring appropriate items, loneliness scores are calculated by summing all items. The range of possible scores is 20 to 80, with higher scores ifying greater loneliness. Following as closely as possible the procedures described by Berkman Berkman,we collapsed the 12 possible social network scores into four : low, medium, medium-high, and high. Smoking and alcohol consumption were dummy-coded to contrast current smokers and drinkers with non-smokers and non-drinkers respectively the reference.
Cardiovascular medications were coded using a standardized scheme available from www.
The Multum database permits coding of generic and brand name drugs by pharmacologic and therapeutic. For the present study, two medication —anti-hyperlipidemia agents e. Chronic conditions e. Although we asked subjects whether they had ever been told by a physician that they had hypertension or high blood pressure, hypertension is not included in the Charlson index.
In a final model, we added depressive symptoms, perceived stress, hostility, and social support as covariates to assess whether reciprocal lagged relationships between loneliness and SBP were independent of the lagged effects of these related psychosocial variables on SBP. Loneliness is associated with, and plays a causal role in, depressive symptoms, perceived stress, hostility, and perceptions of poor social support Cacioppo, Hawkley, et al. Nevertheless, loneliness is conceptually distinct from these related psychosocial variables. Perceived stress is a percept that the strain of life circumstances requires more time and energy than one is prepared or able to give.
Perceived social support is the percept that others are or will be available to provide instrumental, tangible, or emotional support in times of need. Feelings of loneliness extend beyond perceptions of available support and color social cognitions about social relationships past, present, and future Cacioppo, Hawkley et al. Analyses were conducted using a cross-lagged panel model approach Curran, to simultaneously address reciprocal influences on loneliness and SBP. The substantive research question under investigation in the present study is the degree to which loneliness has long- and short-term effects on SBP independent of any reciprocal effects of SBP on loneliness.
Cross-lagged panel analysis is the most practical analytic solution for this question because it allows modeling of chronic and transient effects of loneliness. For short-term effects, we examined the degree to which loneliness explained changes in SBP over a one-year period holding constant prior year loneliness and SBP.
In other words, we asked whether changes in loneliness over a one-year period predicted changes in SBP over the subsequent one-year period. For long-term effects, we examined the degree to which a stable aspect of loneliness explained changes in SBP over a two- three- and four-year period. We posited that short-term changes in loneliness Lonely senior search latinas date not exert a noticeable influence on SBP, but that a chronic trait-like component of loneliness would influence SBP over a longer time interval independent of any short-term effects.
Specifically, we tested long-term effects by examining the degree to which annual changes in SBP were predicted by initial loneliness levels that had been measured two, three, or four years earlier. We report unstandardized regression coefficients B and correlations robtained as standardized regression coefficientswith an alpha level of. Accordingly, we employed a directional one-tailed test of ificance for this effect. A cross-lagged panel model was specified to examine reciprocal relationships between SBP and loneliness over the course of the five-year study.
The model is depicted in Figure 1. Our theoretical model holds that the one-year autoregressive paths i. This model was specified by allowing the autoregressive paths single-headed arrows from a given variable at one time point to the same variable at the next time point and one-year lagged effects diagonal single-headed arrows of Year 1 predictors and covariates to be freely estimated.
For subsequent years, we applied equality constraints to the autoregressive paths and one-year lagged paths. In addition, long-lagged pathways from loneliness in Year 1 to SBP in Years 3, 4, and 5 were constrained to equality. The application of equality constraints imposes stationarity on the relationships among variables in the model and the resulting model fit can be compared to a model in which these relationships are freely estimated. Demographic characteristics at study onset were treated as covariates predicting only Year 2 UCLA-R and SBP, under the assumption that any subsequent influence of these static individual differences operates through their association with intervening covariates in the model.Lonely senior search latinas date
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