Einsamkeit als Sterberisiko: Was die neuen Zahlen aussagen – und was nicht

<h4>Importance</h4>Loneliness affects more than half of US adults and has been declared a public health epidemic, yet whether clinically documented loneliness independently predicts mortality across diverse populations remains unclear.<h4>Objective</h4>To examine the association between clinically documented loneliness and all-cause mortality at 1, 3, and 5 years, overall and by sex, race and ethnicity, and age.<h4>Methods</h4>We conducted a propensity score-matched retrospective cohort study using the TriNetX US Collaborative Network, comprising electronic health record data from 65 health care organizations. Adults aged 18-90 years with at least one clinical encounter between January 1, 2016, and December 31, 2022, were eligible. Patients with a clinically documented diagnosis of loneliness were matched 1:1 (n = 28,944 per group) on age, sex, race and ethnicity, and 12 comorbidity domains to comparison patients with outpatient engagement and no loneliness diagnosis. The primary outcome was all-cause mortality at 1, 3, and 5 years. Between-group differences were assessed using risk differences, Kaplan-Meier survival analysis, and Cox proportional hazards models, overall and across prespecified subgroups.<h4>Results</h4>Among 57,888 matched adults (mean age, 55.4 years; 62.9% female), loneliness was associated with increased mortality at every horizon: 1-year hazard ratio (HR), 1.52 (95% CI, 1.40-1.66); 3-year HR, 1.35 (95% CI, 1.27-1.43); and 5-year HR, 1.29 (95% CI, 1.22-1.

<h4>Background</h4>Social isolation and loneliness are associated with mortality, but their impact on cause-specific mortality in cancer survivors remains unclear.<h4>Methods</h4>This cohort study enrolled UK Biobank participants with cancer at baseline, followed up from March 2006 to September 2024. Social isolation and loneliness were assessed by self-reported questionnaires. Outcomes included all-cause, cancer-specific, and cardiovascular disease (CVD)-related mortality. Associations were evaluated using Cox proportional hazards models.<h4>Results</h4>A total of 32,524 participants were included in this study (60.2% women; mean age, 60.3 years). During a median 15.7-year follow-up, 5,945 deaths occurred. Social isolation was significantly associated with increased all-cause (HR, 1.22; 95%CI, 1.12-1.32), cancer-specific (HR, 1.16; 95%CI, 1.04-1.28), and CVD-related (HR, 1.32; 95%CI, 1.07-1.63) mortality. Loneliness was not associated with all-cause mortality (HR, 0.98; 95%CI, 0.93-1.04), but independently associated with increased CVD-related mortality (HR, 1.26; 95%CI, 1.08-1.47). Exploratory analyses identified distinct prognostic impacts of specific isolation measures: living alone was linked to higher all-cause and non-cancer mortality across most cancer types, while weekly social activities and monthly family/friends visits were protective.<h4>Conclusions</h4>Social isolation was associated with increased risks of all-cause, cancer-specific, and CVD-related mortality.

<h4>Background</h4>Cardiac disease is the leading cause of morbidity and mortality among older adults, yet the psychosocial pathways through which it accelerates functional decline remain poorly characterized. Social isolation and loneliness are plausible mediators, but their longitudinal roles in the cardiac disease-disability-mortality cascade have not been examined in an integrated framework.<h4>Methods</h4>We analyzed 5,654 US Medicare beneficiaries aged ≥65 from the National Health and Aging Trends Study (NHATS) followed across Rounds 7-14 (2017-2024). Cardiac disease was ascertained at baseline via self-reported physician diagnosis. Social isolation was measured via a validated composite index; loneliness was assessed with a single-item measure. Disability outcomes included Nagi physical function, mobility limitation, activities of daily living (ADL) impairment, and instrumental activities of daily living (IADL) impairment. We estimated group differences using generalized estimating equations (GEE), mortality using Kaplan-Meier and Cox proportional-hazards models, and mediation using the counterfactual framework.<h4>Results</h4>At baseline, 1,361 participants (24.1%) had cardiac disease. The CD group exhibited higher social isolation prevalence (19.2% vs 16.8%, p=0.048), lower Nagi scores (7.1 vs 8.5, p<0.001), and greater comorbidity burden (2.9 vs 2.1 conditions, p<0.001). Over follow-up, CD was associated with persistently worse physical function (Round 14 Nagi: 7.1

Social disconnection, including loneliness and social isolation, is increasingly recognized as an important social determinant of adult health, but its relationship with chronic disease-related outcomes remains dispersed across disease areas and study designs. This systematic review aimed to synthesize evidence on the associations of loneliness and social isolation with chronic disease-related outcomes among adults in community, primary care, outpatient, registry-based, and population-based settings. PubMed/MEDLINE, Scopus, Web of Science, Web of Science East Mediterranean Region, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, the Cochrane Library, Google Scholar, and reference lists were searched from database inception to May 10, 2026, for original studies reporting loneliness or social isolation in relation to cardiovascular, metabolic, respiratory, renal, frailty-related, behavioral, biological, functional, quality-of-life, morbidity, or mortality outcomes. Thirty-one studies were included and synthesized narratively because of heterogeneity in populations, exposure measures, outcomes, study designs, follow-up periods, adjustment strategies, and reported effect estimates. The included evidence was mainly observational and suggested associations between loneliness, social isolation, and a broad range of adverse chronic disease-related outcomes, with more consistent associations reported for cardiovascular disease, cardiometabolic condi