The Influence of Loneliness on the Smoking and Physical Activity of Community-Dwelling Older Adults: Results from the Health and Retirement Study

Purpose: To use the loneliness model in examining the influence of loneliness on the number cigarettes smoked per day and the different intensity levels of physical activity among community-dwelling older Americans in the United States. Design, setting, sample: This study analyzed a nationally representative sample of older adults aged 65+ in two waves (2010 and 2012) of data from the Health and Retirement Study. Response rates for the two waves were 81% and 89.1%. The sample size for smoking model was 199, and for physical activity models was 3018. Measures: Outcomes included number of cigarettes smoked per day and physical activity at three intensity levels: light, moderate, and vigorous. Independent variable was the UCLA loneliness scale. Analysis: A lagged dependent approach for modeling longitudinal data was adopted. Models controlled for outcomes at the first timepoint (Wave 1), health/physical functioning, and demographic variables. Results: Loneliness was associated with an increased number of cigarettes smoked per day (β = 2.93, P <.05) and decreased engagement in moderate and vigorous physical activity for older adults (β =.12, P <.05; β =.12, P <. 05), after controlling for these behaviors at baseline and other covariates. Conclusion: The findings call for smoking reduction and physical activity enhancement interventions targeting older adults who have high levels of loneliness. Efforts to enhance social support will be crucial to eradicating the harmful health impact of loneliness. Critical limitations include self-reported measures and unobserved confounders.