Cumulative loneliness and social isolation are associated with incident glaucoma in Chinese and US cohorts

Abstract

Abstract To investigate the association of cumulative loneliness and social isolation with glaucoma risk among middle-aged and older adults in Chinese and American populations, we conducted an observational cohort study using data from the China Health and Retirement Longitudinal Study (CHARLS; n  = 7,098 for loneliness and n  = 8,481 for social isolation) and the Health and Retirement Study (HRS; n  = 6,982 for loneliness and n  = 5,011 for social isolation). Cumulative exposure was defined as reporting loneliness or social isolation at two time points (0, 1, or 2 times). In CHARLS (median follow-up: loneliness 4.90 years, social isolation 4.89 years; incident glaucoma cases: loneliness 185, social isolation 221), one-time loneliness (HR 1.49; 95% CI 1.01–2.20) and two-time loneliness (HR 1.99; 95% CI 1.39–2.86) were associated with a higher risk of self-reported incident glaucoma. Similar associations were observed for one-time social isolation (HR 1.47; 95% CI 1.01–2.15) and two-time social isolation (HR 1.77; 95% CI 1.14–2.76). In HRS (median follow-up: loneliness 4.86 years, social isolation 5.09 years; incident glaucoma cases: loneliness 566, social isolation 347), only two-time cumulative exposure was significantly associated with a higher risk of self-reported incident glaucoma: loneliness (HR 1.38; 95% CI 1.05–1.83) and social isolation (HR 1.30; 95% CI 1.01–1.66). These observational findings suggest that cumulative loneliness and social isolation may be relevant psychosocial markers for future eye-health research and should be interpreted as associative and hypothesis-generating.