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Title: Loneliness in the oldest old
Author: Wang, Hanyuying
Awarding Body: University of Cambridge
Current Institution: University of Cambridge
Date of Award: 2019
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The importance of social relationships for health in later life has been explored over the past decades. Loneliness has been found to be an adversity associated with ageing. People who feel lonely are at greater risk of experiencing increased morbidity and mortality. However, the existing evidence on the determinants of loneliness as well as the effects of loneliness on health are exclusively based on relatively young-old people (65 years and over) with the oldest old (80 years and over) under-represented. Compared to the young-old people, the oldest old are more likely to experience health problems and have fewer ties or contacts with others; therefore, they might be more likely to suffer from loneliness. This thesis aims to investigate loneliness in the oldest old. Specific thesis objectives are (1) exploring the individual-level determinants of loneliness, identifying how patterns of loneliness change with age and the individual-level factors associated with loneliness transitions; (2) investigating the effects of loneliness on health (i.e. all-cause mortality and cognitive decline); and (3) examining the relationship between loneliness and health service and social care utilisation. In order to investigate the objectives, data from the Cambridge City over 75s Cohort (CC75C) study were used. The CC75C study is a population-based study of the very old. It started in 1985, surveying a representative sample of men and women aged 75 years or older living in Cambridge. Partial proportional odds model and multi-state modelling were used to explore the determinants of loneliness, identify the changing patterns of loneliness as well as examine the risk factors associated with loneliness transitions. Cox regression models and generalized estimating equations (GEE) were used to explore the effects of loneliness on all-cause mortality, cognitive decline, and health service and social care utilisation, respectively. The findings reveal clear associations between loneliness and all-cause mortality, cognitive function, as well as health and social care service use of the oldest old, possible mechanisms and the importance of developing societal approaches to alleviate loneliness.
Supervisor: Brayne, Carol Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
Keywords: Loneliness ; oldest old ; risk factors ; health outcomes