School of Nursing, The University of Texas at Austin, Austin, TX, USA.
Psychol Health Med. 2024 Sep;29(8):1548-1563. doi: 10.1080/13548506.2023.2299665. Epub 2024 Jan 5.
This scoping review aimed to explore and synthesize existing research on predictors of loneliness, and the impact of loneliness on physiological and psychological health outcomes and health behaviors in older adults with diabetes. Results from 12 studies showed that low education, being unmarried/divorced/separated, having diabetes-related complications, being physically inactive, having diabetes distress, being of a certain race/ethnicity, being female, having depressive symptoms, and being younger age were consistently identified as predictors of loneliness. In addition, loneliness was found to affect both psychological (depressive symptoms and negative perceptions of diabetes) and physiological health outcomes (increased postprandial blood glucose and A1C levels, decreased cortisol levels, increased MCP-1 levels, slower gait speed, and weaker hand grip) and health behaviors (decreased engagement in physical activity, increased disability in activities of daily living and instrumental activities of daily living, and increased likelihood of antidepressant use). The results of this scoping review suggest that loneliness is a complex issue for older adults with diabetes and its effects are far-reaching. Therefore, further research should be conducted to explore the potential causal relationships between loneliness and physiological and psychological health outcomes and to identify the best interventions to reduce loneliness in older adults with diabetes. For healthcare providers, it is important to recognize that loneliness is an appropriate risk factor for older adults with diabetes that may affect psychological and physiological health outcomes and health behaviors and to address it through interventions such as social support programs, group therapy, or psychosocial counseling.
本范围综述旨在探索和综合现有研究,以了解预测老年人孤独感的因素,以及孤独感对糖尿病老年患者生理和心理健康结果及健康行为的影响。12 项研究的结果表明,低教育程度、未婚/离婚/分居、有糖尿病相关并发症、身体活动不足、有糖尿病困扰、特定种族/族裔、女性、有抑郁症状和年龄较小,这些因素与孤独感密切相关。此外,孤独感不仅影响心理(抑郁症状和对糖尿病的负面认知)和生理健康结果(餐后血糖和 A1C 水平升高、皮质醇水平降低、MCP-1 水平升高、步态速度减慢、握力减弱),还影响健康行为(体力活动参与度降低、日常生活活动和工具性日常生活活动能力下降、抗抑郁药使用可能性增加)。本范围综述的结果表明,孤独感是糖尿病老年患者面临的一个复杂问题,其影响深远。因此,应进一步开展研究,探索孤独感与生理和心理健康结果之间的潜在因果关系,并确定减少糖尿病老年患者孤独感的最佳干预措施。对于医疗保健提供者而言,重要的是认识到孤独感是糖尿病老年患者的一个适当的风险因素,可能会影响他们的心理和生理健康结果及健康行为,并通过社会支持计划、团体治疗或心理社会咨询等干预措施来解决这一问题。