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Study Uncovers High Rates of Loneliness Among Older HIV-Positive People

June 4, 2018

  • San Francisco researchers studied quality of life for people with HIV over 50
  • 58% of study participants experienced some degree of loneliness
  • Previous research found associations between loneliness and poor health

Due to advances in treatment many HIV-positive people can have near-normal life expectancy and more of them are reaching their senior years. Therefore, researchers need to better understand the issues faced by this population.

A team of researchers in San Francisco enrolled 356 HIV-positive people in a study to assess different aspects of their health and well-being. Participants were in their mid-to-late 50s. Nearly 60% of participants experienced some degree of loneliness. Participants who were lonely were more likely to have the following:

  • symptoms of depression
  • use of alcohol and tobacco
  • low income
  • poor health-related quality of life

The researchers stated: "A comprehensive care approach, incorporating mental health and psychosocial assessments with more traditional clinical assessments, will be needed to improve health outcomes for the aging HIV-positive population."



Related: One Doc's Advice for Caring for Elderly Patients With HIV



Study Details

Researchers conducted an assessment of the health and well-being of participants at one point in time for the study. In particular, they assessed health-related quality of life, social support and the ability to carry out everyday activities. They used well-validated surveys and were also able to assess the results of blood tests.

In general, participants were in their mid-to-late 50s, 85% were men and 15% were women, and 57% were white. About 70% of participants were lesbian, gay or bisexual.


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Results

A total of 58% of participants reported some degree of loneliness, distributed as follows:

  • mild loneliness -- 24%
  • moderate loneliness -- 22%
  • severe loneliness -- 12%

Compared to people who were not lonely, participants who were lonely were more likely to have the following factors:

  • use tobacco
  • engage in problematic use of alcohol or other substances
  • symptoms of depression
  • poor health-related quality of life


Problems With Carrying Out Basic Everyday Activities

Researchers also assessed participants' ability to engage in activities of everyday life, including bathing, grooming, dressing, feeding themselves and so on. People who were lonely and who had problems carrying out basic everyday activities tended to have the following:

  • low income
  • symptoms of depression
  • other health problems such as kidney and liver injury


General Implications of Loneliness

In the present study, loneliness was common, reported by almost 60% of participants. Some studies among HIV-negative people have found that some lonely elderly people have greater chances of the following:

  • increased levels of inflammation
  • increased presence of unhealthy behaviours that heighten the risk for heart attack and stroke

However, due to issues related to their design, these studies in HIV-negative people cannot prove that loneliness caused these outcomes. Rather, it is possible that there are other factors -- smoking; insufficient physical activity; unrecognized, untreated or poorly managed mental health issues -- that are more common in people who are lonely that affected the findings of these studies. Still, being lonely is distressing and affects a person's quality of life and possibly their overall health and survival, and therefore it deserves further attention.


Bear in Mind

The overall rate of loneliness in the present study was high -- almost 60%. According to the researchers, other studies with HIV-positive people have reported rates of loneliness between 30% and 46%. A difference between the present study and those other studies is that the present study focused solely on people over the age of 50.                                    

Studies among HIV-negative people aged 65 and older have found rates of loneliness around 40%.

The present study captured data at one point in time and provides a foundation for planning future long-term studies. The researchers stated that such studies "should include a broader range of participants, including those from diverse geographic regions (both urban and rural areas), women and those who acquired HIV through non-MSM contact, to understand more about loneliness across a [broad range] of adults living with HIV." Such studies also need to find ways to foster interaction and friendship among older people.


CATIE Resources

Italian and U.S. researchers look to the future and explore aging-related issues -- CATIE News

Frailty, nerve injury and falls in middle-aged and older HIV-positive people -- CATIE News

Factors linked to falling in HIV-positive women -- TreatmentUpdate 218

Nerve pain and numbness from A Practical Guide to HIV Drug Side Effects

Unravelling the complexity of HIV and fatigue -- CATIE News

Alberta researchers warn about increasing costs of HIV care -- CATIE News

Emerging issues in older HIV-positive people -- TreatmentUpdate 214

Older people with HIV face different long-term health challenges -- CATIE News

Denmark -- unexpected trends in use of psychotropic medicines -- TreatmentUpdate 204

Impressive gains in survival for older people with HIV but still less than general population -- CATIE News

Danish study raises questions about accelerated aging in HIV -- CATIE News

Long-term HIV infection and health-related quality of life -- CATIE News

Dutch doctors explore intersection of aging and HIV -- CATIE News

Geriatric syndromes found to be common among some people with HIV -- CATIE News

Strengthening the aging brain --TreatmentUpdate 203

Longer life expectancy for HIV-positive people in North America -- TreatmentUpdate 200

HIV and aging -- Healthy living tips for people 50 and over living with HIV

Mental Health from HIV in Canada: A primer for service providers


Non-CATIE Resources

HIV and Aging: State of Knowledge and Areas of Critical Need for Research. A Report to the NIH Office of AIDS Research by the HIV and Aging Working Group

Quantification of biological aging in young adults -- Proceedings of the National Academy of Science USA

Management of Human Immunodeficiency Virus Infection in Advanced Age -- Journal of the American Medical Association

"America's other drug problem: Giving the elderly too many prescriptions" -- Washington Post

The CIHR Comorbidity Agenda -- Canadian Institutes of Health Research (CIHR)

CIHR's HIV Comorbidity Research Agenda: Relevant Research Areas

Factsheets on HIV and aging in Canada -- Canadian AIDS Society

HIV & Aging: A 2013 Environmental Scan of Programs and Services in Canada -- Community Report -- realize (formerly the Canadian Working Group on HIV and Rehabilitation -- CWGHR)

Directory of Promising Programs and Services for Older People Living with HIV in Canada -- realize

Evidence-informed recommendations for rehabilitation with older adults living with HIV: a knowledge synthesis -- BMJ Open


References

  1. Greene M, Hessol NA, Perissinotto C, et al. Loneliness in older adults living with HIV. AIDS and Behavior. 2018 May;22(5):1475-1484.
  2. Finlay JM, Kobayashi LC. Social isolation and loneliness in later life: A parallel convergent mixed-methods case study of older adults and their residential contexts in the Minneapolis metropolitan area, USA. Social Science & Medicine. 2018 May 4;208:25-33.
  3. Nersesian PV, Han HR, Yenokyan G, et al. Loneliness in middle age and biomarkers of systemic inflammation: Findings from midlife in the United States. Social Science & Medicine. 2018; in press.
  4. Hakulinen C, Pulkki-Råback L, Virtanen M, et al. Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality: UK Biobank cohort study of 479 054 men and women. Heart. 2018; in press.
  5. Elovainio M, Hakulinen C, Pulkki-Råback L, et al. Contribution of risk factors to excess mortality in isolated and lonely individuals: an analysis of data from the UK Biobank cohort study. Lancet Public Health. 2017 May 4;2(6):e260-e266.
  6. Gale CR, Westbury L, Cooper C. Social isolation and loneliness as risk factors for the progression of frailty: the English longitudinal study of ageing. Age and Ageing. 2018 May 1;47(3):392-397.
  7. Rico-Uribe LA, Caballero FF, Martín-María N, et al. Association of loneliness with all-cause mortality: A meta-analysis. PLoS One. 2018 Jan 4;13(1):e0190033.
  8. Prince JD, Oyo A, Mora O, et al. Loneliness among persons with severe mental illness. Journal of Nervous and Mental Disease. 2018 Feb;206(2):136-141.
  9. Liu B, Floud S. Unravelling the associations between social isolation, loneliness, and mortality. Lancet Public Health. 2017 Jun;2(6):e248-e249.
  10. Jacobs JM, Hammerman-Rozenberg A, Stessman J. Frequency of leaving the house and mortality from age 70 to 95. Journal of the American Geriatrics Society. 2018 Jan;66(1):106-112.
  11. Rubin R. Loneliness might be a killer, but what's the best way to protect against it? JAMA. 2017 Nov 21;318(19):1853-1855.

[Note from TheBodyPRO: This article was originally published by CATIE on May 23, 2018. We have cross-posted it with their permission.]


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One Doc's Advice for Caring for Elderly Patients With HIV



This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication CATIE News. Visit CATIE's Web site to find out more about their activities, publications and services.
 

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