{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T15:16:07Z","timestamp":1761491767697,"version":"build-2065373602"},"reference-count":74,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Functionality is crucial for older adults\u2019 autonomy, and loneliness has emerged as a potential risk factor for chronic diseases. However, its role in functional limitations remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study was to analyze the association between loneliness and limitations in 1 or more basic activities of daily living (BADL) and instrumental activities of daily living (IADL) in individuals who were 80\u00a0years old or older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a cross-sectional study using data from wave 8 of the Survey of Health, Ageing and Retirement in Europe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted in 26 European countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Participants were 7434 community-dwelling adults who were 80\u00a0years old or older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Loneliness was assessed using the 3-item loneliness scale, covering companionship, exclusion, and isolation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome and Measures<\/jats:title>\n                    <jats:p>Functional limitations were defined as difficulty in 1 or more BADL (dressing, walking, bathing, eating, bed transfer, and toileting), IADL (map use, preparing a hot meal, shopping, phone use, medication management, housework, finances, transportation, and laundry), or in both types of activities (BADL and IADL). Sociodemographic and health-related variables were considered. Logistic regression and multivariate analyses were applied, using the odds ratio (OR) as the effect measure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean age was 84.4 (SD\u2009=\u20093.8) years; 58.2% of participants were women; and 52.5% had a low educational level. Loneliness affected 56% of participants, and 66% reported limitations in BADL\/IADL. Loneliness was significantly associated with functional limitation in BADL\/IADL in both univariate (OR\u2009=\u20092.18 [95% CI\u2009=\u20091.98\u20132.39]) and multivariate (OR\u2009=\u20091.50 [95% CI\u2009=\u20091.34\u20131.67]) models, even after adjustment for covariates, with an area under the receiver operating characteristic curve of 76%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Loneliness is significantly and independently associated with limitations in BADL\/IADL among the oldest-old.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance<\/jats:title>\n                    <jats:p>These findings highlight the importance of assessing psychosocial factors, such as loneliness, when evaluating functional health in the oldest-old.<\/jats:p>\n                  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