Does having someone to confide in affect mortality in older adults? a prospective cohort study from 2008 to 2018

Objectives: Our study investigated the association between confidant networks and mortality among older Chinese adults, focusing on the impact of the absence, types, and size of the networks. Methods: A prospective cohort study included 11,930 participants aged over 65 from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. Cox proportional hazards models were employed for analysis, supplemented by subgroup and interaction analyses. Results: Participants without confidant networks had higher mortality (HR=1.194, 95% CI 1.097–1.300) after adjusting for confounders. A dose-response relationship was observed between the size of confidant networks and mortality. Notably, having a spouse as a confidant was strongly associated with decreased mortality (HR=0.765, 95% CI 0.677–0.865), whereas having formal helpers as confidants did not significantly affect mortality (HR=0.813, 95% CI 0.636–1.040). Conclusion: Identifying and supporting older adults without confidant networks is crucial for enabling them to benefit from these networks and potentially enhance their longevity.