Original Study| Volume 22, ISSUE 8, P1720-1725.e5, August 2021

Do Loneliness and Perceived Social Isolation Reduce Expected Longevity and Increase the Frequency of Dealing with Death and Dying? Longitudinal Findings based on a Nationally Representative Sample

  • André Hajek
    Address correspondence to André Hajek, PhD, PD, Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52 20246 Hamburg, Germany.
    Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Hans-Helmut König
    Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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      Loneliness and social isolation are important factors for morbidity and mortality. However, little is known about whether increases in loneliness and perceived social isolation contribute to decreased expectations of longevity and an increased frequency of dealing with death and dying. Consequently, our aim was to clarify these relationships.


      Longitudinal data were derived from a nationally representative sample of individuals ≥40 years (analytical sample, n=7952 observations).

      Setting and Participants

      Community-dwelling individuals aged ≥40 years.


      Loneliness and perceived social isolation were both measured using well-established tools. In accordance with other large cohort studies, the expectations of longevity were assessed using the question “What age do you think you will live to?” Moreover, the frequency of dealing with death and dying (from 1 = never to 5 = very often) served as outcome measure. In regression analysis, it was adjusted for several sociodemographic and health-related factors.


      Fixed effects regressions showed that both increases in loneliness (β = –0.99, P < .001) and in perceived social isolation (β = –0.59, P < .05) were associated with decreases in expectations of longevity. Furthermore, both loneliness [incidence rate ratio (IRR) = 1.02, P < .05] and perceived social isolation (IRR = 1.02, P < .05) were associated with increases in the frequency of dealing with death and dying.

      Conclusions and Implications

      Beyond the impact of various covariates, findings still point to a longitudinal association between both perceived social isolation and loneliness and lower expectations of longevity as well as an increased frequency of dealing with death and dying. Efforts in reducing loneliness and perceived social isolation can contribute to increased expected longevity and a decreased frequency of dealing with death and dying which ultimately can contribute to longevity in older age.


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