Age-related patterns of loneliness during early cancer survivorship, risk factors, and associated health outcomes.

BACKGROUND

Loneliness can have profound health consequences for cancer patients, yet age-related patterns of loneliness remain inconsistent and mainly cross-sectional. We describe loneliness in young (<40 years), middle-aged (40-65 years), and older (≥65 years) patients over time during early cancer survivorship, identify biopsychosocial risk factors for loneliness, and examine its impact on health outcomes across age groups.

METHODS

This multicenter prospective longitudinal study included cancer patients within two months of diagnosis and at 6-, 12-, and 18-month follow-ups. Loneliness was measured using the UCLA loneliness scale. Generalized-linear-mixed-models examined changes over time. Mixed-effects regression models identified risk factors for loneliness and examined the predictive value of loneliness on physical and mental health outcomes over time.

RESULTS

In total, 994 patients (53% men, 60.5 years) were included in this analysis. Older patients reported lowest and most stable loneliness over time (15-20%), whereas middle-aged (19-31%) and young (25-38%) patients reported higher loneliness values, particularly shortly after diagnosis. Risk factors for being lonely included lower social support, absence of a partner, lower socioeconomic status, advanced disease, and greater comorbidity burden (all p < 0.05). Higher loneliness at diagnosis predicted mental disorders and psychosocial care needs at follow-ups, in addition to distinct age-specific relationships of reduced physical and mental QoL for middle-aged, and non-adherence for older patients (all p < 0.05).

CONCLUSION

Loneliness is common during early cancer survivorship, particularly among young and middle-aged patients shortly after cancer diagnosis. Age-related mechanisms, vulnerabilities and consequences of loneliness may inform clinical communication, e.g. about non-adherence or recommendation of tailored psychosocial support.

TRIAL REGISTRATION: This study was registered in the International Clinical Trials Registry (NCT04620564, https://clinicaltrials.gov/).