Longitudinal associations among loneliness and physical and psychological well-being in older cancer survivors.

PURPOSE: Approximately 30-50% of adult cancer survivors experience moderate to severe loneliness. Less is known about the persistence of loneliness over time and its prospective associations with later physical and psychological well-being. The purpose of this study is (a) to examine the stability of loneliness over time among adult cancer survivors aged 55 years and older, (b) to assess whether loneliness predicts subsequent physical well-being (perceived health, ADL/IADL) and psychological well-being (perceived stress, life satisfaction) over time using two waves of data from the Health and Retirement Study, a national longitudinal panel survey study. And (c) to evaluate whether these longitudinal associations differed between individuals with and without a history of cancer.

METHODS: We examined the prevalence of loneliness over a four-year period and its prospective associations with subsequent physical and psychological well-being among cancer survivors. Structural equation modeling was used to estimate associations between baseline loneliness and follow-up loneliness, perceived health, life satisfaction, and perceived stress. Multigroup analyses were additionally conducted to compare longitudinal associations between individuals with and without a history of cancer.

RESULTS: Loneliness showed stability over time, with baseline loneliness strongly associated with loneliness over time in older cancer survivors. The model showed good overall fit. Higher loneliness in 2018 was prospectively associated with poorer perceived health, greater stress, and lower life satisfaction in 2022. Overall, the longitudinal associations was similar among both cancer survivors and individuals without a history of cancer.

CONCLUSIONS: Loneliness is a persistent psychosocial experience and is prospectively linked to later well-being. Early identification through routine screening and sustained efforts to address loneliness, especially among older cancer survivors, may be important for improving long-term outcomes.

IMPLICATIONS FOR CANCER SURVIVORS: Addressing loneliness may represent an important opportunity to improve survivorship outcomes. Integrating loneliness screening and supportive resources into survivorship care plans could help promote better psychosocial and physical health among cancer survivors.