Living alone, socioeconomic status, and mortality among older adults: a population-based cohort study.
11 affiliations
- 1Public Healthcare Center, Home Healthcare Clinic, Seoul National University Hospital, Seoul, Republic of Korea.
- 2Department of Family Medicine, Health Promotion Center, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 03080, Republic of Korea.
- 3Medical Social Work Team, Public Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea.
- 4Department of Social Welfare, Sungkyunkwan University, Seoul, Republic of Korea.
- 5Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
- 6Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Republic of Korea.
- 7Department of Pediatrics, Seoul National University Hospital, Seoul, Republic of Korea.
- 8Public Healthcare Center, Home Healthcare Clinic, Seoul National University Hospital, Seoul, Republic of Korea. [email protected].
- 9Department of Family Medicine, Health Promotion Center, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 03080, Republic of Korea. [email protected].
- 10Institute on Aging, Seoul National University College of Medicine, Seoul, Republic of Korea. [email protected].
- 11Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. [email protected].
Abstract
Background
This study examined the association between living alone, socioeconomic status, and mortality among community-dwelling older adults.Methods
We analyzed mortality outcomes among 3,771 participants aged ≥ 60 years enrolled in the Korean Longitudinal Study of Aging (KLoSA) beginning in 2006. Participants were followed until the date of death or December 31, 2020, whichever occurred first. All-cause, cancer, and cardio-cerebrovascular (CCV) mortality were compared between individuals living alone and those living with others using Cox proportional hazards models and inverse probability of treatment weighting (IPTW). Subgroup analyses were conducted to assess cause-specific mortality according to various social and functional factors.Results
In the weighted model, the mean age was 70.0 ± 7.5 years for those living with others and 70.2 ± 6.7 years for those living alone. Living alone was associated with higher all-cause, cancer, and CCV mortality after adjustment for demographic and behavioral factors (adjusted hazard ratio [aHR], 95% confidence interval [CI]: 1.49 [1.30-1.70], 1.81 [1.32-2.47], and 1.92 [1.46-2.53], respectively). However, after IPTW adjustment for socioeconomic factors, these associations were no longer statistically significant, suggesting that living alone may not be an independent causal factor but rather a proxy for underlying socioeconomic vulnerability. Among older adults living alone, those in the low-income subgroup had significantly higher all-cause and CCV mortality (aHR 1.33, 95% CI 1.04-1.68; and aHR 1.68, 95% CI 1.06-2.66, respectively). Living alone with close contact at least once per week was not associated with increased mortality, whereas those meeting close contacts between once per year and once per week showed a borderline increase in CCV mortality (aHR 2.72, 95% CI 0.95-7.77). Notably, individuals with no close social relationships over the past year exhibited a significantly increased risk of CCV mortality (aHR 3.41, 95% CI 1.20-9.69).Conclusions
We found that although living alone is associated with mortality, adjustment for social and functional factors may attenuate this association. However, specific subgroups with low income, and scarce social relation lead to increased CCV mortality. Further study with a larger sample size is necessary to confirm this finding.
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BibTeX
@article{kim2026living,
title = {{Living alone, socioeconomic status, and mortality among older adults: a population-based cohort study.}},
author = {Kyae Hyung Kim and Daehee Jung and Sun Young Lee and Shin Hye Yoo and In-Young Hwang and Woohyeon Cho and Seonyoung Jeong and Min Sun Kim and Belong Cho},
journal = {BMC geriatrics},
year = {2026},
month = aug,
doi = {10.1186/s12877-026-07946-1},
url = {https://europepmc.org/article/MED/42958090},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Living alone, socioeconomic status, and mortality among older adults: a population-based cohort study.
AU - Kyae Hyung Kim
AU - Daehee Jung
AU - Sun Young Lee
AU - Shin Hye Yoo
AU - In-Young Hwang
AU - Woohyeon Cho
AU - Seonyoung Jeong
AU - Min Sun Kim
AU - Belong Cho
PY - 2026
DA - 2026/08/03
JO - BMC geriatrics
DO - 10.1186/s12877-026-07946-1
UR - https://europepmc.org/article/MED/42958090
AB - Background This study examined the association between living alone, socioeconomic status, and mortality among community-dwelling older adults.Methods We analyzed mortality outcomes among 3,771 participants aged ≥ 60 years enrolled in the Korean Longitudinal Study of Aging (KLoSA) beginning in 2006. Participants were followed until the date of death or December 31, 2020, whichever occurred first. All-cause, cancer, and cardio-cerebrovascular (CCV) mortality were compared between individuals living alone and those living with others using Cox proportional hazards models and inverse probability of treatment weighting (IPTW). Subgroup analyses were conducted to assess cause-specific mortality according to various social and functional factors.Results In the weighted model, the mean age was 70.0 ± 7.5 years for those living with others and 70.2 ± 6.7 years for those living alone. Living alone was associated with higher all-cause, cancer, and CCV mortality after adjustment for demographic and behavioral factors (adjusted hazard ratio [aHR], 95% confidence interval [CI]: 1.49 [1.30-1.70], 1.81 [1.32-2.47], and 1.92 [1.46-2.53], respectively). However, after IPTW adjustment for socioeconomic factors, these associations were no longer statistically significant, suggesting that living alone may not be an independent causal factor but rather a proxy for underlying socioeconomic vulnerability. Among older adults living alone, those in the low-income subgroup had significantly higher all-cause and CCV mortality (aHR 1.33, 95% CI 1.04-1.68; and aHR 1.68, 95% CI 1.06-2.66, respectively). Living alone with close contact at least once per week was not associated with increased mortality, whereas those meeting close contacts between once per year and once per week showed a borderline increase in CCV mortality (aHR 2.72, 95% CI 0.95-7.77). Notably, individuals with no close social relationships over the past year exhibited a significantly increased risk of CCV mortality (aHR 3.41, 95% CI 1.20-9.69).Conclusions We found that although living alone is associated with mortality, adjustment for social and functional factors may attenuate this association. However, specific subgroups with low income, and scarce social relation lead to increased CCV mortality. Further study with a larger sample size is necessary to confirm this finding.
SN - 1471-2318
ER -