Digestive diseases linked to loneliness and depression among older adults

ANN ARBOR, Mich. — Older Americans are living longer than ever, which is great for life expectancies but not as stellar for digestive health. Estimates show that close to 40 percent of older Americans live with a stomach condition, such as Crohn’s disease and ulcerative colitis. Now, a team from the University of Michigan has found an association between digestive issues and higher rates of both loneliness and depression.

“Many people don’t realize that these conditions are very common in ambulatory care,” says Michigan Medicine gastroenterologist Shirley Ann Cohen-Mekelburg, M.D., who specializes in conditions like inflammatory bowel disease, Crohn’s disease and ulcerative colitis, in a university release. “Ultimately, this creates an excess in health care spending in the United States. Not only are these conditions debilitating for the millions of people living with them, but they’re also very expensive to treat.”

Researchers explain that recent years have seen a renewed effort among providers and scientists to better understand and hopefully detect why so many Americans are developing digestive diseases. However, Dr. Cohen-Mekelburg adds that current efforts usually fail to account for how psychosocial factors contribute to these conditions.

“As physicians, it’s important for us to pay attention to psychosocial factors involved in the lives of our patients, but they often go overlooked,” the study author explains. “These factors have the potential to significantly impact gastrointestinal health, and they also play a crucial role in the overall wellbeing of our patients.”

This idea inspired Dr. Cohen-Mekelburg and a team of gastroenterologists and hepatologists to analyze rates of loneliness, depression, and social isolation among older adults – both with and without various digestive diseases.

Dr. Cohen-Mekelburg adds that the research team “wanted to quantify these numbers with self-reported rates of poor health.”

“Our research involved analyzing data from 2008 to 2016 from the University of Michigan Health and Retirement Study. This is a longitudinal panel study that involves a representative sample of approximately 20,000 individuals in the U.S. who are 50 years and older, as well as their spouses,” she continues. “It’s important to note that loneliness refers to the subjective distressed feeling of being alone or lacking companionship. The correlation between loneliness and depression is well established.”

Sad, lonely elderly woman looking out window
(© De Visu – stock.adobe.com)

However, the study authors defined social isolation as the “objective physical separation from other people, which is independent of psychological well-being.”

“Therefore, there are people who live in isolation but are well-adapted, not lonely and report high psychological wellbeing. But on the other hand, there are also people who are socially connected, yet suffer from low psychological wellbeing and loneliness. This, despite having a strong social network,” Dr. Cohen-Mekelburg notes.

Among 7,110 participants, study authors found 56 percent had a digestive disease and 44 percent did not have any stomach ailments.

“Overall, 60.4% and 55.6% of respondents with and without digestive diseases reported loneliness, while 12.7% and 7.5% reported severe depression, and 8.9% and 8.7% reported social isolation, respectively,” Dr. Cohen-Mekelburg articulates. “We found that individuals with a digestive disease were more likely to report ‘poor-or-fair’ health when compared to those without one. And among patients with a digestive disease, loneliness, as well as moderate to severe depression, were associated with greater odds of self-reporting ‘poor-or-fair’ health.”

In summation, Dr. Cohen-Mekelburg says she hopes these findings eventually empower gastroenterologists to “screen patients for depression and loneliness,” besides the usual physical symptoms.

“By doing this, providers can better establish care pathways for mental health treatment for their patients, which is hugely important,” she concludes. “Our research shows that gastroenterologists are in a unique position to help their patients achieve good overall health. If you’re a clinician who also happens to treat older adults, even better. Being aware of the link between loneliness, depressive symptoms and digestive diseases can really benefit your patients from a holistic perspective.”

The study is published in the journal Clinical Gastroenterology and Hepatology.

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