The epidemiology of social isolation and loneliness among older adults during the last years of life

Social isolation and loneliness are critical to the health of older adults, but they have not been well-described at the end of life. To determine the prevalence and correlates of social isolation and loneliness among older adults in the last years of life. Nationally representative, cross-sectional survey. Health and Retirement Study, 2006-2016 data. Adults age > 50 interviewed once in the last 4 years of life (n = 3613). We defined social isolation using a 15-item scale measuring household contacts, social network interaction, and community engagement, and frequent loneliness using the 3-item UCLA Loneliness Scale. We used multivariable logistic regression to determine their adjusted prevalence by time prior-to-death and by subgroups of interest. Approximately 19% experienced social isolation, 18% loneliness, and 5% both in the last 4 years of life (correlation = 0.11). The adjusted prevalence of social isolation was higher for individuals nearer to death (4 years: 18% vs 0-3 months: 27%, p = 0.05) and there was no significant change in loneliness (4 years: 19% vs 0-3 months: 23%, p = 0.13). Risk factors for both isolation and loneliness included (p