The association of loneliness with bone mineral density, osteoporosis, osteopenia, fall, and sarcopenia among older adults: results from Mr. and Ms. Os (Hong Kong) study.

PURPOSE: To assess the association between loneliness and musculoskeletal conditions, including bone mineral density (BMD), osteoporosis, osteopenia, falls, and sarcopenia among older adults.

METHODS

This longitudinal study utilized data from two follow-up assessments conducted four years apart among community-dwelling older Chinese adults in the Mr. OS and Ms. OS Hong Kong cohorts. Loneliness was assessed using the De Jong Gierveld Loneliness Scale. BMD was measured by dual-energy X-ray absorptiometry at baseline. Fall and fracture history was self-reported, and the SARC-F questionnaire was measured at baseline and follow-up. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 at baseline. Regression models were used to examine the associations between baseline loneliness and musculoskeletal outcomes, adjusted for demographic and health-related covariates.

RESULTS

In total, 1053 and 466 participants were included in the cross-sectional and longitudinal analyses. At baseline, after adjustment, compared to the absence of loneliness, severe loneliness was significantly associated with the lower hip (β = -0.031, 95% CI [-0.053, -0.008]) and femoral neck BMD (β = -0.027, 95% CI [-0.047, -0.006]), and increased odds of osteoporosis (OR = 3.278, 95% CI [1.187, 9.051]) and osteopenia (OR = 2.471, 95% CI [1.303, 4.684]) in reference to those without either condition. Each unit increase in emotional loneliness scores was associated with lower BMD in the hip and femoral neck, and increased odds of osteoporosis and osteopenia after adjustment (p < 0.05). After adjustment, loneliness was not cross-sectionally associated with falls or sarcopenia (p > 0.05). Longitudinally, severe loneliness (OR = 2.302, 95% CI [1.024, 5.177]) and higher social loneliness scores (OR = 1.340, 95% CI [1.076, 1.667]) at baseline predicted positive SARC-F (≥ 4) at follow-up after adjusting for baseline level and covariates. Loneliness did not significantly predict falls at follow-up after full adjustment (p < 0.05).

CONCLUSION

Healthcare professionals should consider psychological factors, such as loneliness, when working with older adults who have these musculoskeletal conditions.