The relationship of breathlessness with social isolation and loneliness: a nationally representative cohort study of older adults in England
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Introduction
Breathlessness is a common and distressing symptom impacting quality of life and limiting activities
of daily living. Social isolation and loneliness are associated with increased morbidity and mortality,
being problems in themselves and risk factors for poor health. Qualitive studies indicate
breathlessness impacts social health, however quantitative evaluation is limited. We aimed to assess
the relationship of breathlessness with social isolation and loneliness in adults.
Methods
Using a nationally representative sample of older adults aged ≥50years from the English Longitudinal
Study of Ageing (N=6,623). The sample had 44% males, mean age of 70years (SD=10). We examined
associations of baseline breathlessness (mMRC breathlessness scale) with loneliness (3-item UCLA
loneliness scale) and social isolation (low social contact, low community participation, living alone), at
baseline, and follow-up at 4- and 8-years later, using regression models adjusted for confounders.
Results
At baseline, breathlessness was associated with higher levels of loneliness (coef.=0.161, 95%CI 0.113
0.209), and social isolation, including low social contact (coef.=0.094, 95%CI 0.028-0.159), low
community participation (coef.=0.169, 95%CI 0.117-0.221), and living alone (OR 1.089, 95%CI 1.026
1.157). Longitudinally, breathlessness was associated increasing loneliness and reducing social contact
and community participation at 4 and 8-year follow-up. Breathlessness was not associated with
change in living alone. Findings were independent of identified confounders.
Conclusions
Breathlessness is related to increasing social isolation and loneliness, potentially due to limiting the
amount and quality of social interactions. These findings suggest important psychosocial impacts of
breathlessness requiring holistic management strategies.
Breathlessness is a common and distressing symptom impacting quality of life and limiting activities
of daily living. Social isolation and loneliness are associated with increased morbidity and mortality,
being problems in themselves and risk factors for poor health. Qualitive studies indicate
breathlessness impacts social health, however quantitative evaluation is limited. We aimed to assess
the relationship of breathlessness with social isolation and loneliness in adults.
Methods
Using a nationally representative sample of older adults aged ≥50years from the English Longitudinal
Study of Ageing (N=6,623). The sample had 44% males, mean age of 70years (SD=10). We examined
associations of baseline breathlessness (mMRC breathlessness scale) with loneliness (3-item UCLA
loneliness scale) and social isolation (low social contact, low community participation, living alone), at
baseline, and follow-up at 4- and 8-years later, using regression models adjusted for confounders.
Results
At baseline, breathlessness was associated with higher levels of loneliness (coef.=0.161, 95%CI 0.113
0.209), and social isolation, including low social contact (coef.=0.094, 95%CI 0.028-0.159), low
community participation (coef.=0.169, 95%CI 0.117-0.221), and living alone (OR 1.089, 95%CI 1.026
1.157). Longitudinally, breathlessness was associated increasing loneliness and reducing social contact
and community participation at 4 and 8-year follow-up. Breathlessness was not associated with
change in living alone. Findings were independent of identified confounders.
Conclusions
Breathlessness is related to increasing social isolation and loneliness, potentially due to limiting the
amount and quality of social interactions. These findings suggest important psychosocial impacts of
breathlessness requiring holistic management strategies.
Date Issued
2026-04-01
Date Acceptance
2026-05-07
Citation
BMJ Public Health, 2026, 4 (2)
ISSN
2753-4294
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Public Health
Volume
4
Issue
2
Copyright Statement
© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY- NC. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license.
License URL
Identifier
10.1136/bmjph-2025-004442
Publication Status
Published
Article Number
004442
Date Publish Online
2026-06-09