Prevention & lipidsCohort study
Loneliness, unhealthy lifestyle, and incident cardiometabolic disease among middle-aged and older adults across 33 countries: a multicohort study
- Prospective cohort study
- multicohort
- 6 cohorts across 33 countries
- time-varying Cox mixed-effects regression
Authors' conclusion
Building on prior evidence that has largely come from single-cohort studies, our findings highlighted loneliness as a global risk factor in predicting the incident CMD, particularly cardiometabolic multimorbidity. The greatest risk was observed among socioeconomically disadvantaged individuals with multiple unhealthy lifestyles.
Study context
- Population
- Adults aged ≥45 years in six ageing cohorts (China Health and Retirement Longitudinal Study (CHARLS), English Longitudinal Study of Ageing (ELSA), Health and Retirement Study (HRS), SHARE, Korean Longitudinal Study of Aging (KLoSA), Mexican Health and Aging Study (MHAS)) across 33 countries15,750 developed cardiometabolic disease (CMD)
- Participants
- 81,978 adults
- Exposure
- Loneliness vs no loneliness
- Outcome
- Incident cardiometabolic disease (CMD)
- Follow-up
- Median five years
Main finding
Any CMD
Adjusted hazard ratio
1.23
95% CI 1.20–1.26
Loneliness vs No loneliness
aHR 1.23 (95% CI 1.20–1.26)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aHR (CI) | |
|---|---|---|
| Cardiometabolic multimorbidity vs single CMD — Loneliness vs No loneliness · multimorbidity | 1.48 (1.37–1.60) | |
| Cardiometabolic multimorbidity vs single CMD — Loneliness vs No loneliness · single CMD | 1.18 (1.15–1.22) | |
| 0.512Adjusted hazard ratio (log scale) |
Mediation by unhealthy lifestyles (any CMD)
- Proportion mediated by unhealthy lifestyles
- 5.19% (95% CI: 3.06, 7.64)
Joint effect: low socioeconomic status (SES) + multiple unhealthy lifestyle factors + loneliness
- Greatest CMD risk, adjusted HR
- 1.89, 1.76, 2.02
Original publication
Loneliness, unhealthy lifestyle, and incident cardiometabolic disease among middle-aged and older adults across 33 countries: a multicohort study. Eur J Prev Cardiol. Published 22 June 2026. doi:10.1093/eurjpc/zwag330
Summarised from the published abstract; every number is checked against it