Loneliness As an Independent Factor for Health and Disability Regardless of Alcohol Habit, Smoking Habit, and Social Relationships: A Questionnaire-Based Cross-Sectional Study in a Rural Area of Japan / 日本農村医学会雑誌

ABSTRACT

We conducted a questionnaire survey to examine the association between loneliness and health with consideration of lifestyle and social relationships in a mountainous rural area of Japan. We used the Japanese versions of the short-form University of California, Los Angeles Loneliness Scale (UCLA score 3-9 points) and the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS score 12-48 points). Among 108 respondents (47 men, 61 women), mean age was 74.1 years, 30 (28%) were obese, 40 (37%) had a smoking habit, and 38 (35.1%) had an alcohol habit. Negative social relationships were reported by5 (4.6%) respondents. Mean UCLA score was 4.08 ± 1.34 and mean WHODAS score was 7.68 ± 8.84. Respondents were classified into the loneliness group if the UCLA score was greater than 4 points (58/108, 53,7%) and into the healthy group if the WHODAS score was 7 points or less (66/108, 61.1%). In univariable analysis, lower health status was significantly associated with age > 75 years (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.11-0.73, p = 0.003), female sex (OR 2.82, 95%CI 1.15-7.09, p = 0.01), living alone (OR 0.44, 95%CI 0.14-1.33, p = 0.01), divorce, separation, or bereavement (OR 0.24, 95%CI 0.09-0.60, p < 0.001), ≤ 9 years of education (OR 0.18, 95%CI 0.07-0.46, p < 0.001), unemployed/looking for work (OR 0.9, 95%CI 0.26-0.27, p < 0.001), no alcohol habit (OR 2.66, 95%CI 1.05-7.05, p = 0.02), and loneliness (OR 0.29, 95%CI 0.11-0.72, p = 0.003). On multivariable analysis, loneliness was identified as an independent risk factor for poorer health status (OR 0.11, 95%CI 0.02-0.43, p =0.002) after adjusting for the other significant items on univariable analysis.