Living arrangement modifies the associations of loneliness with adverse health outcomes in older adults: evidence from the CLHLS

Table 3 Modification of the Effect of Loneliness on Cognitive Impairment by Living Arrangement

	No Loneliness		Loneliness		Odds Ratio (95% CI) for the Association Between Loneliness and Cognitive Impairment Within Each Stratum of Living Arrangement
	N With/Without Cognitive Impairment	Odds Ratio (95% CI)	N With/Without Cognitive Impairment	Odds Ratio (95% CI)
Cross-sectional Analyses ^a
Total Sample ^c	1405/7745	1.0 (reference)	1185/3373	1.22 (1.07–1.38) P = 0.003	–
NLA	1241/6799	1.0 (reference)	978/2372	1.32 (1.15–1.52) P < 0.001	1.32 (1.15–1.52) P < 0.001
LA	164/946	1.13 (0.87–1.47) P = 0.348	207/1001	0.94 (0.73–1.20) P = 0.604	0.80 (0.58–1.09) P = 0.156
Longitudinal Analyses ^b
Total Sample ^c	776/4088	1.0 (reference)	394/1371	1.01 (0.81–1.27) P = 0.926	–
NLA	675/3626	1.0 (reference)	290/910	1.04 (0.81–1.34) P = 0.748	1.04 (0.80–1.34) P = 0.783
LA	101/462	1.04 (0.69–1.57) P = 0.844	104/461	0.94 (0.63–1.43) P = 0.787	0.91 (0.52–1.61) P = 0.757

Note. NLA, not living alone; LA, living alone
^a Measure of effect modification on multiplicative scale: OR (95% CI) = 0.63 (0.45–0.87), P = 0.005. Adjusted for age, gender, race, marital status, residence, occupation, BMI, smoking, alcohol drinking, living preference, socioeconomic status, dietary habits, social/leisure activity score, physical exercise, poor self-rated health, poor interviewer-rated health, comorbidities (≥2), hypertension, diabetes, heart disease, stroke, serious illness in the past 2 years, hearing problem, visual impairment, functional limitation, and frailty. Education was not adjusted as we used education-adjusted criteria to define “cognitive impairment”
^b Measure of effect modification on multiplicative scale: OR (95% CI) = 0.87 (0.51–1.48), P = 0.607. For 11,118 participants without cognitive impairment at baseline. Adjusted for age, gender, race, occupation, hypertension, diabetes, heart disease, stroke, and changes in marital status, residence, BMI, smoking, alcohol drinking, socioeconomic status, dietary habits, social/leisure activity score, physical exercise, self-rated health, interviewer-rated health, comorbidity number, serious illness in the past 2 years, hearing problem, visual impairment, functional limitation, and frailty from 2008/2009 to 2011/2012
^c Living arrangements were also adjusted

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