Loneliness and health-related quality of life by chronic disease: a nationally representative survey

BACKGROUND: Patients with chronic diseases may be vulnerable to loneliness, but previous studies are inconsistent. Furthermore, the impact of loneliness may differ depending on the type of chronic disease. However, previous studies have focused on single diseases. Thus, this study aims to evaluate the prevalence and impact on health-related quality of life (HRQoL) of different chronic diseases. METHODS: This is a cross-sectional study. We included from the Korean general population, participants with cardiovascular, musculoskeletal, respiratory, endocrine/metabolic, ear/eye, urologic/reproductive, gastrointestinal, mental, and cerebrovascular diseases, and cancer. Loneliness was assessed by using the third revised version of the UCLA Loneliness Scale. HRQoL was assessed by using the Patient-Reported Outcomes Measurement Information System Global Health v1.2. RESULTS: A total of 2699 participants were enrolled, of whom 1755 (65.0%) had at least one chronic disease. Participants with chronic conditions (27.5%) were more likely to experience high levels of loneliness than healthy individuals (22.1%). The highest levels of loneliness were found in mental disorders (57.4%), followed by cerebrovascular (36.7%) and ear/eye (35.8%) diseases. High levels of loneliness were associated with poor psychological health (prevalence ratio [PR] 3.55, 95% confidence interval [CI] 3.05, 4.13) and physical health (PR 1.73, 95% CI 1.55, 1.93). In participants with cancer, the PR for poor psychological health was 5.89 (95% CI 3.32, 10.46), but this estimate is imprecise and should be interpreted cautiously due to the small subgroup (n = 87). CONCLUSION: Participants with chronic conditions had higher loneliness than the general population, especially those with mental, cerebrovascular, and ear/eye diseases. Loneliness not only affects psychological health, but also has a significant impact on physical health.