Addiction (Abingdon, England) · 2026
Drinking at least weekly, loneliness and social isolation over time: Bidirectional within-person associations in an Australian prospective cohort study.
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Wu Qingqing, Ding Ding, Farnbach Sara, Hagani Neta, Miller Mia, Owen Katherine B, Clare Philip J
Аннотация
BACKGROUND AND AIMS: Past research has shown a link between alcohol consumption and loneliness/social isolation; however, the nature of the relationship remains unclear. We aimed (1) to estimate bidirectional longitudinal associations between drinking at least weekly, loneliness and social isolation; and (2) to distinguish within-person change from stable between-person differences.
DESIGN: Prospective cohort study using ten annual outcome waves (2014-2023), with wave 13 (2013) providing descriptive context and time-constant baseline socio-demographic covariates. Random-intercept cross-lagged panel models (RI-CLPMs) were primary, dynamic panel models (DPMs) assessed robustness and conventional cross-lagged panel models were sensitivity analyses. Models were unadjusted, partially adjusted for baseline socio-demographic covariates and fully adjusted for additional time-varying covariates. RI-CLPMs separated deviations around participants' expected levels from relatively time-invariant differences in their average levels.
SETTING: Australia; the Household, Income and Labour Dynamics in Australia (HILDA) Survey is a nationally representative household panel, although analyses were unweighted.
PARTICIPANTS: Unbalanced panel of 33 835 Australians aged 15+. Former-drinker person-wave observations were excluded. Across waves 13-23, 87.8%-93.3% of individual-interview respondents completed the self-completion questionnaire.
MEASUREMENTS: Time-constant baseline covariates were measured at wave 13, and outcomes were measured at waves 14-23. Drinking at least weekly (≥1 day/week) was derived from an annually administered drinking-frequency item. Loneliness was derived from three 7-point items and social isolation was operationalised as low perceived social support using four 7-point items; responses ranged from 1 (strongly disagree) to 7 (strongly agree). Median scores ≥4 were classified as lonely and scores <4 as socially isolated, following prior HILDA operationalisations.
RESULTS: Among observed wave 13 responses, 6719/14 019 (47.9%) reported drinking at least weekly, 3884/14 076 (27.6%) were classified as lonely and 812/14 082 (5.8%) as socially isolated; participants were 50.9% female and had a mean age of 36.0 years (standard deviation = 22.8). In fully adjusted RI-CLPMs, loneliness predicted subsequent social isolation [pooled unstandardised coefficient (b) = 0.020, 95% confidence interval (CI) = 0.002-0.037 and social isolation predicted subsequent loneliness (b = 0.028, 95% CI = 0.007-0.049). Drinking at least weekly was autoregressive (b = 0.151, 95% CI = 0.135-0.168) but had no clear prospective association with either social measure. DPM conclusions were consistent with RI-CLPM conclusions.
SUMMARY: Loneliness and social isolation appeared to reinforce each other over time within individuals in this Australian cohort. Drinking at least weekly was not consistently associated with within-person changes in social connection at annual intervals.
DESIGN: Prospective cohort study using ten annual outcome waves (2014-2023), with wave 13 (2013) providing descriptive context and time-constant baseline socio-demographic covariates. Random-intercept cross-lagged panel models (RI-CLPMs) were primary, dynamic panel models (DPMs) assessed robustness and conventional cross-lagged panel models were sensitivity analyses. Models were unadjusted, partially adjusted for baseline socio-demographic covariates and fully adjusted for additional time-varying covariates. RI-CLPMs separated deviations around participants' expected levels from relatively time-invariant differences in their average levels.
SETTING: Australia; the Household, Income and Labour Dynamics in Australia (HILDA) Survey is a nationally representative household panel, although analyses were unweighted.
PARTICIPANTS: Unbalanced panel of 33 835 Australians aged 15+. Former-drinker person-wave observations were excluded. Across waves 13-23, 87.8%-93.3% of individual-interview respondents completed the self-completion questionnaire.
MEASUREMENTS: Time-constant baseline covariates were measured at wave 13, and outcomes were measured at waves 14-23. Drinking at least weekly (≥1 day/week) was derived from an annually administered drinking-frequency item. Loneliness was derived from three 7-point items and social isolation was operationalised as low perceived social support using four 7-point items; responses ranged from 1 (strongly disagree) to 7 (strongly agree). Median scores ≥4 were classified as lonely and scores <4 as socially isolated, following prior HILDA operationalisations.
RESULTS: Among observed wave 13 responses, 6719/14 019 (47.9%) reported drinking at least weekly, 3884/14 076 (27.6%) were classified as lonely and 812/14 082 (5.8%) as socially isolated; participants were 50.9% female and had a mean age of 36.0 years (standard deviation = 22.8). In fully adjusted RI-CLPMs, loneliness predicted subsequent social isolation [pooled unstandardised coefficient (b) = 0.020, 95% confidence interval (CI) = 0.002-0.037 and social isolation predicted subsequent loneliness (b = 0.028, 95% CI = 0.007-0.049). Drinking at least weekly was autoregressive (b = 0.151, 95% CI = 0.135-0.168) but had no clear prospective association with either social measure. DPM conclusions were consistent with RI-CLPM conclusions.
SUMMARY: Loneliness and social isolation appeared to reinforce each other over time within individuals in this Australian cohort. Drinking at least weekly was not consistently associated with within-person changes in social connection at annual intervals.