Background/Purpose: Loneliness in adults is a growing phenomenon across the Western world. It is associated with increased mortality, depression, coronary heart disease and stroke. Moreover, over the last 2 decades, physicians have increasingly prescribed opioids to address chronic pain from osteoarthritis (OA) resulting in increased hospital stays associated with narcotic-analgesic overuse in people aged above 85 years. Our study evaluated whether presence of OA is associated with higher loneliness and if there is a difference in loneliness score among narcotic analgesic, non-narcotic and non-analgesic groups.

Methods:

Data from wave 2 (2010-2011) of National Social Life, Health and Aging Project (NSHAP) were analyzed. Data were collected via in-home face-to-face interviews as well as leave-behind respondent administered questionnaires. The study was comprised of community residing adults born between 1920 and 1947, and their co-resident partners, with an oversampling of African-Americans and Hispanics and other key subgroups. Respondents were categorized as narcotic-analgesic, non-narcotic-analgesic or non-analgesic users based on medication logs obtained by interviewers, and as having or not having osteoarthritis if they specified it as a medical problem. Physical function was assessed by self-reported ability to walk one block and gait speed measured by 3-meter timed walk. Loneliness was measured with the 3-item UCLA loneliness scale in which ratings were summed to produce a loneliness score ranging from 0 to 9, with a higher score indicating greater loneliness. Ordinal logistic regression analyses were performed; survey weights were applied.

Results:

Among adults with OA (n=624 out of 2572), 70 % were female, 86 % were non-Hispanic white and the mean age was 72.7 years (±9.06 y). 12 % of those with OA reported taking narcotic-analgesics, which was higher than the rate among those without OA (6%, p<0.001). Those with OA tended to be lonelier than those without OA (mean 3.3 vs. 3.1; p=0.008). Among older adults with OA, those taking non-narcotic-analgesics were lonelier than those taking no analgesics, and this association persisted when adjusting for pain and walking difficulty (p=0.043). In the OA group, the pain levels were higher in the narcotic-analgesic users as 92 % of them had at least moderate pain levels compared to 65 % and 61% in non-narcotic-analgesic and non-analgesic users (p<0.001). There was no difference between pain levels in non-narcotic-analgesic users and those in non-analgesic users. Pain levels did not correlate with loneliness in those with OA. Both narcotic and non-narcotic-analgesic groups reported greater difficulty walking a block compared to non-analgesic users even after the analysis was adjusted for pain, age and gender (p=0.004).

Conclusion: People with OA were found to be lonelier than those without OA. In the OA group, those taking non-narcotic-analgesics were found to be lonelier. Due to higher degree of loneliness in people with OA, devising strategies to reduce loneliness is important for quality of life and wellbeing. Future research should explore associations between analgesic medication classes, physical function and loneliness in people with OA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-relationship-between-loneliness-and-osteoarthritis-in-us-adults-from-a-nationally-representative-survey/