Loneliness and social isolation among middle-aged and older adults with SLE: a single centre cross-sectional study.

Abstract

Loneliness and social isolation are associated with adverse health outcomes in older adults and may affect those with SLE disproportionately. We sought to understand the impact of loneliness, social isolation and social support on health-related quality of life (HRQoL) in middle-aged and older adults with SLE. Adults ≥50 years with validated SLE took part in a cross-sectional survey. We used self-reported instruments to elicit social measures (i.e. loneliness, social isolation and social support) and patient-reported outcome (PRO) measures of HRQoL, including pain interference, depression and disability, as well as frailty status. We evaluated relationships between social measures using Pearson correlations. We assessed for associations between social measures and PROs using linear or logistic regression, adjusting for age, race, ethnicity, disease activity and organ damage. Among participants (N = 80), loneliness and social isolation were common. Social measures were significantly correlated (r -0.89 to 0.66, all P < 0.01). Greater loneliness and social isolation were independently associated with greater pain, depression, disability and frailty (P = 0.04 to P < 0.01). Conversely, greater social support was associated with less pain, depression, disability and frailty after covariate adjustment (P = 0.04 to P < 0.01). Lack of social connectedness is associated with decreased HRQoL in middle-aged and older adults with SLE. With ageing of the SLE population, strategies to mitigate loneliness and social isolation and enhance social support may complement traditional disease-directed therapeutic pathways to optimize HRQoL.