Loneliness in adults awaiting liver transplantation at 7 U.S. transplant centers

Kacey A. Berry; Dorothea Kent; Srilakshmi Seetharaman; Randi Wong; Yara Mohamad; Frederick Yao; Maria Nunez-Duarte; Sharad I. Wadhwani; Brian J. Boyarsky; Robert S. Rahimi; Andres Duarte-Rojo; Matthew R. Kappus; Michael L. Volk; Daniela P. Ladner; Dorry L. Segev; Mara McAdams-DeMarco; Elizabeth C. Verna; Daniel R. Ganger; Jennifer C. Lai

doi:10.1016/j.aohep.2022.100718

Loneliness in adults awaiting liver transplantation at 7 U.S. transplant centers

Kacey A. Berry, Dorothea Kent, Srilakshmi Seetharaman, Randi Wong, Yara Mohamad, Frederick Yao, Maria Nunez-Duarte, Sharad I. Wadhwani, Brian J. Boyarsky, Robert S. Rahimi, Andres Duarte-Rojo, Matthew R. Kappus, Michael L. Volk, Daniela P. Ladner, Dorry L. Segev, Mara McAdams-DeMarco, Elizabeth C. Verna, Daniel R. Ganger, Jennifer C. Lai^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Background: Loneliness, “a subjective feeling of being isolated”, is a strong predictor of adverse health. We characterized loneliness in patients with end-stage liver disease (ESLD) awaiting liver transplantation (LT). Methods: We surveyed loneliness in ambulatory ESLD adults awaiting LT at 7 U.S. sites using the validated UCLA Three-Item Loneliness Scale, May2020-Jan2021; “lonely”=total ≥5. Liver Frailty Index (LFI) assessed frailty; “frail”=LFI≥4.4. Logistic regression associated loneliness and co-variables. Results: Of 454 participants, median MELDNa was 14 (IQR 10-19) and 26% met criteria for “lonely”. Compared to those not lonely, those lonely were younger (57 v. 61y), more likely to be female (48% v. 31%) or frail (21 v. 11%), and less likely to be working (15% v. 26%) or in a committed partnership (52% v. 71%). After multivariable adjustment, frailty (OR=2.24, 95%CI=1.23-4.08), younger age (OR=1.19, 95%CI=1.07-1.34), female sex (OR=1.83, 95%CI=1.14-2.92), not working (OR=2.16, 95%CI=1.16-4.03), and not in a committed partnership (OR=2.07, 95%CI=1.29-3.32) remained significantly associated with higher odds of loneliness. Conclusion: Loneliness is prevalent in adults awaiting LT, and independently associated with younger age, female sex and physical frailty. These data lay the foundation to investigate the extent to which loneliness impacts health outcomes in LT, as in the general population.

Original language	English (US)
Article number	100718
Journal	Annals of Hepatology
Volume	27
Issue number	5
DOIs	https://doi.org/10.1016/j.aohep.2022.100718
State	Published - Sep 1 2022

Funding

This analysis was supported by TL1TR001871-05 (Berry), National Institute on Aging R01AG059183/K23AG048337 (Lai), NIH F32DK124941(Boyarsky), NIH K24DK101828 (Segev), NIH NCATS KL2TR001870 (Wadhwani), P30 DK026743 (UCSF Liver Center, Lai). The funding agencies played no role in the analysis of the data or the preparation of manuscript. The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Keywords

Cirrhosis
End-stage liver disease
Frailty
Mental health
Psychosocial
Quality of life
Social isolation
Social support

ASJC Scopus subject areas

Hepatology

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10.1016/j.aohep.2022.100718

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Berry, K. A., Kent, D., Seetharaman, S., Wong, R., Mohamad, Y., Yao, F., Nunez-Duarte, M., Wadhwani, S. I., Boyarsky, B. J., Rahimi, R. S., Duarte-Rojo, A., Kappus, M. R., Volk, M. L., Ladner, D. P., Segev, D. L., McAdams-DeMarco, M., Verna, E. C., Ganger, D. R., & Lai, J. C. (2022). Loneliness in adults awaiting liver transplantation at 7 U.S. transplant centers. Annals of Hepatology, 27(5), Article 100718. https://doi.org/10.1016/j.aohep.2022.100718

@article{4b7fe128240f49ca94a68415ff4a5791,

title = "Loneliness in adults awaiting liver transplantation at 7 U.S. transplant centers",

abstract = "Background: Loneliness, “a subjective feeling of being isolated”, is a strong predictor of adverse health. We characterized loneliness in patients with end-stage liver disease (ESLD) awaiting liver transplantation (LT). Methods: We surveyed loneliness in ambulatory ESLD adults awaiting LT at 7 U.S. sites using the validated UCLA Three-Item Loneliness Scale, May2020-Jan2021; “lonely”=total ≥5. Liver Frailty Index (LFI) assessed frailty; “frail”=LFI≥4.4. Logistic regression associated loneliness and co-variables. Results: Of 454 participants, median MELDNa was 14 (IQR 10-19) and 26% met criteria for “lonely”. Compared to those not lonely, those lonely were younger (57 v. 61y), more likely to be female (48% v. 31%) or frail (21 v. 11%), and less likely to be working (15% v. 26%) or in a committed partnership (52% v. 71%). After multivariable adjustment, frailty (OR=2.24, 95%CI=1.23-4.08), younger age (OR=1.19, 95%CI=1.07-1.34), female sex (OR=1.83, 95%CI=1.14-2.92), not working (OR=2.16, 95%CI=1.16-4.03), and not in a committed partnership (OR=2.07, 95%CI=1.29-3.32) remained significantly associated with higher odds of loneliness. Conclusion: Loneliness is prevalent in adults awaiting LT, and independently associated with younger age, female sex and physical frailty. These data lay the foundation to investigate the extent to which loneliness impacts health outcomes in LT, as in the general population.",

keywords = "Cirrhosis, End-stage liver disease, Frailty, Mental health, Psychosocial, Quality of life, Social isolation, Social support",

author = "Berry, {Kacey A.} and Dorothea Kent and Srilakshmi Seetharaman and Randi Wong and Yara Mohamad and Frederick Yao and Maria Nunez-Duarte and Wadhwani, {Sharad I.} and Boyarsky, {Brian J.} and Rahimi, {Robert S.} and Andres Duarte-Rojo and Kappus, {Matthew R.} and Volk, {Michael L.} and Ladner, {Daniela P.} and Segev, {Dorry L.} and Mara McAdams-DeMarco and Verna, {Elizabeth C.} and Ganger, {Daniel R.} and Lai, {Jennifer C.}",

note = "Funding Information: This analysis was supported by TL1TR001871-05 (Berry), National Institute on Aging R01AG059183/K23AG048337 (Lai), NIH F32DK124941(Boyarsky), NIH K24DK101828 (Segev), NIH NCATS KL2TR001870 (Wadhwani), P30 DK026743 (UCSF Liver Center, Lai). The funding agencies played no role in the analysis of the data or the preparation of manuscript. The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Publisher Copyright: {\textcopyright} 2022 Fundaci{\'o}n Cl{\'i}nica M{\'e}dica Sur, A.C.",

year = "2022",

month = sep,

day = "1",

doi = "10.1016/j.aohep.2022.100718",

language = "English (US)",

volume = "27",

journal = "Annals of Hepatology",

issn = "1665-2681",

publisher = "Elsevier Espana S.L.U",

number = "5",

}

Berry, KA, Kent, D, Seetharaman, S, Wong, R, Mohamad, Y, Yao, F, Nunez-Duarte, M, Wadhwani, SI, Boyarsky, BJ, Rahimi, RS, Duarte-Rojo, A, Kappus, MR, Volk, ML, Ladner, DP, Segev, DL, McAdams-DeMarco, M, Verna, EC, Ganger, DR & Lai, JC 2022, 'Loneliness in adults awaiting liver transplantation at 7 U.S. transplant centers', Annals of Hepatology, vol. 27, no. 5, 100718. https://doi.org/10.1016/j.aohep.2022.100718

TY - JOUR

T1 - Loneliness in adults awaiting liver transplantation at 7 U.S. transplant centers

AU - Berry, Kacey A.

AU - Kent, Dorothea

AU - Seetharaman, Srilakshmi

AU - Wong, Randi

AU - Mohamad, Yara

AU - Yao, Frederick

AU - Nunez-Duarte, Maria

AU - Wadhwani, Sharad I.

AU - Boyarsky, Brian J.

AU - Rahimi, Robert S.

AU - Duarte-Rojo, Andres

AU - Kappus, Matthew R.

AU - Volk, Michael L.

AU - Ladner, Daniela P.

AU - Segev, Dorry L.

AU - McAdams-DeMarco, Mara

AU - Verna, Elizabeth C.

AU - Ganger, Daniel R.

AU - Lai, Jennifer C.

N1 - Funding Information: This analysis was supported by TL1TR001871-05 (Berry), National Institute on Aging R01AG059183/K23AG048337 (Lai), NIH F32DK124941(Boyarsky), NIH K24DK101828 (Segev), NIH NCATS KL2TR001870 (Wadhwani), P30 DK026743 (UCSF Liver Center, Lai). The funding agencies played no role in the analysis of the data or the preparation of manuscript. The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Publisher Copyright: © 2022 Fundación Clínica Médica Sur, A.C.

PY - 2022/9/1

Y1 - 2022/9/1

N2 - Background: Loneliness, “a subjective feeling of being isolated”, is a strong predictor of adverse health. We characterized loneliness in patients with end-stage liver disease (ESLD) awaiting liver transplantation (LT). Methods: We surveyed loneliness in ambulatory ESLD adults awaiting LT at 7 U.S. sites using the validated UCLA Three-Item Loneliness Scale, May2020-Jan2021; “lonely”=total ≥5. Liver Frailty Index (LFI) assessed frailty; “frail”=LFI≥4.4. Logistic regression associated loneliness and co-variables. Results: Of 454 participants, median MELDNa was 14 (IQR 10-19) and 26% met criteria for “lonely”. Compared to those not lonely, those lonely were younger (57 v. 61y), more likely to be female (48% v. 31%) or frail (21 v. 11%), and less likely to be working (15% v. 26%) or in a committed partnership (52% v. 71%). After multivariable adjustment, frailty (OR=2.24, 95%CI=1.23-4.08), younger age (OR=1.19, 95%CI=1.07-1.34), female sex (OR=1.83, 95%CI=1.14-2.92), not working (OR=2.16, 95%CI=1.16-4.03), and not in a committed partnership (OR=2.07, 95%CI=1.29-3.32) remained significantly associated with higher odds of loneliness. Conclusion: Loneliness is prevalent in adults awaiting LT, and independently associated with younger age, female sex and physical frailty. These data lay the foundation to investigate the extent to which loneliness impacts health outcomes in LT, as in the general population.

AB - Background: Loneliness, “a subjective feeling of being isolated”, is a strong predictor of adverse health. We characterized loneliness in patients with end-stage liver disease (ESLD) awaiting liver transplantation (LT). Methods: We surveyed loneliness in ambulatory ESLD adults awaiting LT at 7 U.S. sites using the validated UCLA Three-Item Loneliness Scale, May2020-Jan2021; “lonely”=total ≥5. Liver Frailty Index (LFI) assessed frailty; “frail”=LFI≥4.4. Logistic regression associated loneliness and co-variables. Results: Of 454 participants, median MELDNa was 14 (IQR 10-19) and 26% met criteria for “lonely”. Compared to those not lonely, those lonely were younger (57 v. 61y), more likely to be female (48% v. 31%) or frail (21 v. 11%), and less likely to be working (15% v. 26%) or in a committed partnership (52% v. 71%). After multivariable adjustment, frailty (OR=2.24, 95%CI=1.23-4.08), younger age (OR=1.19, 95%CI=1.07-1.34), female sex (OR=1.83, 95%CI=1.14-2.92), not working (OR=2.16, 95%CI=1.16-4.03), and not in a committed partnership (OR=2.07, 95%CI=1.29-3.32) remained significantly associated with higher odds of loneliness. Conclusion: Loneliness is prevalent in adults awaiting LT, and independently associated with younger age, female sex and physical frailty. These data lay the foundation to investigate the extent to which loneliness impacts health outcomes in LT, as in the general population.

KW - Cirrhosis

KW - End-stage liver disease

KW - Frailty

KW - Mental health

KW - Psychosocial

KW - Quality of life

KW - Social isolation

KW - Social support

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UR - http://www.scopus.com/inward/citedby.url?scp=85130609953&partnerID=8YFLogxK

U2 - 10.1016/j.aohep.2022.100718

DO - 10.1016/j.aohep.2022.100718

M3 - Article

C2 - 35460882

AN - SCOPUS:85130609953

SN - 1665-2681

VL - 27

JO - Annals of Hepatology

JF - Annals of Hepatology

IS - 5

M1 - 100718

ER -

Loneliness in adults awaiting liver transplantation at 7 U.S. transplant centers

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