Association between loneliness trajectories and chronic diseases as well as chronic comorbidities among middle - aged and elderly chinese: based on the group - based trajectory modeling method.

This study aims to investigate the associations between loneliness trajectories and chronic diseases and chronic comorbidities among middle aged and elderly Chinese individuals. This study included 8,935 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study (2011-2020). Loneliness was assessed using a single item 4 point scale. Group based trajectory modeling (GBTM) was applied to identify loneliness trajectories, and logistic regression was used to examine their associations with chronic diseases and comorbidities. Three distinct loneliness trajectories were identified: low (45.55%), moderate (18.15%), and high (36.30%). In the core model, loneliness trajectories were significantly associated with hypertension, chronic pulmonary disease, heart disease, stroke, kidney disease, digestive diseases, mental and neurological disorders, memory-related diseases, arthritis/rheumatism, and asthma. For chronic comorbidities, compared with the high loneliness group, the moderate and low loneliness groups showed significantly lower risks with OR (95%CI) of 0.74 (0.65-0.83) and 0.58 (0.53-0.64), respectively. Results from the extended model were similar. Loneliness trajectories are significantly associated with multiple chronic diseases and chronic comorbidities in middle aged and elderly Chinese adults. These findings highlight the important role of loneliness as a psychosocial factor in chronic disease burden and support its integration into public health strategies for healthy aging.