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Social isolation and loneliness are associated with increased morbidity and mortality, being problems in themselves and risk factors for poor health. Qualitative studies indicate breathlessness impacts social health; however, quantitative evaluation is limited. We aimed to assess the relationship of breathlessness with social isolation and loneliness in adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a nationally representative sample of older adults aged \u226550\u2009years from the English Longitudinal Study of Ageing (N=6623). The sample had 44% males, mean age of 70\u2009years (SD=10). We examined associations of baseline breathlessness (modified Medical Research Council (mMRC) breathlessness scale) with loneliness (3-item University of California and Los Angeles (UCLA) loneliness scale) and social isolation (low social contact, low community participation, living alone) at baseline and follow-up at 4 and 8\u2009years later, using regression models adjusted for confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At baseline, breathlessness was associated with higher levels of loneliness (coef.=0.161, 95%\u2009CI 0.113 to 0.209) and social isolation, including low social contact (coef.=0.094, 95%\u2009CI 0.028 to 0.159), low community participation (coef.=0.169, 95%\u2009CI 0.117 to 0.221) and living alone (OR 1.089, 95%\u2009CI 1.026 to 1.157). Longitudinally, breathlessness was associated with increasing loneliness and reducing social contact and community participation at 4-year and 8-year follow-up. Breathlessness was not associated with a change in living alone. Findings were independent of identified confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Breathlessness is related to increasing social isolation and loneliness, potentially due to limiting the amount and quality of social interactions. These findings suggest important psychosocial impacts of breathlessness requiring holistic management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004442","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T11:56:20Z","timestamp":1781006180000},"page":"e004442","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Relationship of breathlessness with social isolation and loneliness: a nationally representative cohort study of older adults in England"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9614-3580","authenticated-orcid":false,"given":"Keir E J","family":"Philip","sequence":"first","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, UK"},{"name":"NIHR Imperial Biomedical Research Centre, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-3768","authenticated-orcid":false,"given":"Feifei","family":"Bu","sequence":"additional","affiliation":[{"name":"Behavioural Science and Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara C","family":"Buttery","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, UK"},{"name":"NIHR Imperial Biomedical Research Centre, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0516-0102","authenticated-orcid":false,"given":"Lisa Jane","family":"Brighton","sequence":"additional","affiliation":[{"name":"Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael I","family":"Polkey","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, London, UK"},{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3235-0454","authenticated-orcid":false,"given":"Nicholas S","family":"Hopkinson","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, UK"},{"name":"NIHR Imperial Biomedical Research Centre, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisy","family":"Fancourt","sequence":"additional","affiliation":[{"name":"Behavioural Science and Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"2026060904552343000_4.2.e004442.1","doi-asserted-by":"crossref","first-page":"107379","DOI":"10.1016\/j.rmed.2023.107379","article-title":"Prevalence of dyspnea in general adult populations: A systematic review and meta-analysis","volume":"218","author":"M\u00fcller","year":"2023","journal-title":"Respir Med"},{"key":"2026060904552343000_4.2.e004442.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmjresp-2020-000643","article-title":"Underlying contributing conditions to breathlessness among middle-aged individuals in the general population: a cross-sectional study","volume":"7","author":"Sandberg","year":"2020","journal-title":"BMJ Open Respir Res"},{"key":"2026060904552343000_4.2.e004442.3","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu001"},{"key":"2026060904552343000_4.2.e004442.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2006.01631.x"},{"key":"2026060904552343000_4.2.e004442.5","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/30.2.155"},{"key":"2026060904552343000_4.2.e004442.6","first-page":"166","article-title":"Activities Forgone because of Chronic Breathlessness: A Cross-Sectional Population Prevalence Study","volume":"1","author":"Kochovska","year":"2020","journal-title":"Palliat Med Rep"},{"key":"2026060904552343000_4.2.e004442.7","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1017\/S1478951507000454","article-title":"Experiences of breathlessness: a systematic review of the qualitative literature","volume":"5","author":"Gysels","year":"2007","journal-title":"Palliat Support Care"},{"key":"2026060904552343000_4.2.e004442.8","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01477-2017"},{"key":"2026060904552343000_4.2.e004442.9","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.jpainsymman.2018.09.021","article-title":"Control and Context Are Central for People With Advanced Illness Experiencing Breathlessness: A Systematic Review and Thematic Synthesis","volume":"57","author":"Lovell","year":"2019","journal-title":"J Pain Symptom Manage"},{"key":"2026060904552343000_4.2.e004442.10","doi-asserted-by":"crossref","unstructured":"Jong Gierveld J , Tilburg T , Dykstra PA . 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