ABSTRACT:
Loneliness affects approximately one quarter of older adults globally, yet remains an overlooked health concern, particularly in collectivist societies like Egypt, where family-centered culture may mask its prevalence. Recent evidence demonstrates loneliness is associated with 32% increased diabetes risk and elevated cardiovascular disease incidence through multiple pathways, including systemic inflammation and compromised health behaviors. Loneliness reduces motivation for meal preparation and dietary quality, creating nutritional vulnerabilities that contribute to chronic disease development. However, whether poor nutritional status mediates the loneliness-chronic disease relationship remains unexplored in Egyptian older adults. The objectives of this study are to: (1) examine whether nutritional status mediates the association between loneliness and nutrition-related chronic diseases (diabetes, hypertension, cardiovascular disease) in Egyptian older adults, and (2) determine whether this relationship differs by gender. Data will be collected from 200 participants aged 60 years and above recruited from Ain Shams University clinics. Loneliness will be assessed using the UCLA Loneliness Scale, nutritional status through the Mini Nutritional Assessment, and chronic disease presence through self-reported medical history. Mediation analysis will test whether nutritional status mediates the loneliness-chronic disease association, controlling for depression, age, marital status, socioeconomic status, and physical functionality. We hypothesize that loneliness is associated with poorer nutritional status, which in turn is associated with higher chronic disease burden. This cross-sectional research will provide the first evidence on the loneliness-nutrition-disease pathway in Egyptian older adults, generating hypotheses for future longitudinal research and informing nutritional intervention strategies under Egypt's Elderly Law.