(Letter to the Editor)

Loneliness and depression are both major public health concerns, particularly among older adults. Extensive evidence indicates that loneliness and depression adversely affect similar health outcomes in older adults, including cognitive impairment, diabetes, cardiovascular diseases, hypertension, compromised immunity, metabolic syndrome, suicide, and early mortality. Furthermore, both states are also positively associated with obesity and harmful health behaviors, particularly smoking and physical inactivity. Relatedly, men and women have been shown to have different susceptibility to risk of depression, owing to their distinct health profiles and risk behaviors. However, little is known about the extent to which loneliness and depression contribute to excess mortality risk in Asian older adults. Specifically, the extent to which there are gender differences in these relationships is unclear.

Our study thus examines the following: (1) Are loneliness and depression associated with a higher likelihood of all-cause mortality to the same degree in Asian older adults? (2) Does severe loneliness confer a higher mortality risk than moderate loneliness? (3) To what extent do the effects of either loneliness or depression on mortality vary by gender? and (4) whether the relationships are found to be significant even after comprehensively accounting for confounders.