Feelings of isolation and being ignored associated with functional dependence beyond traditional risk factors among older adults in Mexico

Studies conducted in community-dwelling populations have shown that age, depression and comorbidities are associated with functional dependence; defined as the inability to independently perform basic (BADL) or instrumental (IADL) activities of daily living. Likewise, subjective experiences, though highly modifiable, such as loneliness, isolation and feeling ignored have been associated with deteriorating health status. However, their relationship with dependency beyond traditional risk factors remains limited. We evaluated the effects of loneliness, isolation and feeling ignored on functional dependency beyond traditional risk factors in older Mexican adults. A cross-sectional analysis of 9,368 individuals in the 2021 Mexican National Health and Aging Study (ENASEM) was studied. We estimated the prevalence of both the exposure (feelings of loneliness, isolation and being ignored) and of the outcome (dependence in BADL and IADL) along with their 95% confidence intervals. We ran sequential logistic regression models to assess the effect of loneliness, isolation and feeling ignored on BADL and IADL beyond traditional risk factors. The prevalence of feelings of loneliness, isolation, and being ignored as well as functional dependence increased with age and was higher among women than among men at any given age. The effect of isolation, and feelings of being ignored on functional dependence remained significant in fully adjusted models that accounted for traditional risk factors such as age, educational level, socioeconomic factors, lifestyle factors, and relevant chronic diseases. Improving feelings related to social well-being in older adults is important for reducing functional dependence in Mexico.Author summary: Social support networks play an important role in the aging process when it comes to preventing dependency. In this study, we analyzed 9,500 older adults in Mexico. We examined whether they experienced feelings of isolation, loneliness, and a sense of being ignored. We then studied how these feelings relate to functional dependence. We found that the frequency of these feelings increases with age and that they are much more common among women. Furthermore, these feelings are associated with dependency even in the presence of other relevant factors, such as an unfavorable socioeconomic status, an unhealthy lifestyle (smoking, obesity), and other chronic conditions such as type 2 diabetes, hypertension, stroke, heart disease, lung disease, cancer, or even depression. The results of this study highlight the importance of social support during aging, as well as the participation of the elderly population in daily life and the need to prevent their exclusion or marginalization.