Loneliness and mortality among older adults in China.

OBJECTIVES To examine the relationships between loneliness, social and health behaviors, health, and mortality among older adults in China. METHOD Data came from a nationally representative sample of 14,072 adults aged 65 and older from the 2002, 2005, and 2008 waves of the Chinese Longitudinal Healthy Longevity Survey. A cross-lagged model combined with survival analysis was used to assess the relationships between loneliness, behavioral and health outcomes, and risk of mortality. RESULTS About 28% of older Chinese adults reported feeling lonely, and lonely adults faced increased risks of dying over the subsequent years. Some of the effect was explained by social and health behaviors, but most of the effect was explained by health outcomes. Loneliness both affects and is affected by social activities, solitary leisure activities, physical exercise, emotional health, self-rated health, and functional limitations over a 3-year period. DISCUSSION Loneliness is part of a constellation of poor social, emotional, and health outcomes for Chinese older adults. Interventions to increase the social involvement of lonely individuals may improve well-being and lengthen life.