Public health

Mendelian randomization study of loneliness, subjective well-being, and frailty index

  • Aikeremu Aierken ,
  • Chen Xingjuan ,
  • Niu Yueyue
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  • 1.Chinese and Western Medicine Collaborative Diagnosis and Treatment Medical Center, People′s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830054, China
    2.Cadres Health Protection Department, Guang′anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
First author contact:Aierken Aikeremu was responsible for the research design and the statistical analysis, and drafted the initial manuscript. Chen Xingjuan was responsible for data collection. Niu Yueyue reviewed and revised the manuscript. All authors have read the final version of manuscript and consented to its submission.
Niu Yueyue, E-mail: 952830794@qq.com.

Received date: 2025-05-16

  Accepted date: 2025-10-20

  Online published: 2026-01-30

Supported by

High Level Chinese Medical Hospital Promotion Project(HLCMHPP2023079)

Abstract

Objective ·To employ a two-sample Mendelian randomization (MR) design to examine whether the associations between loneliness, subjective well-being, and the frailty index reflect causal relationships. Methods ·Summary data from published genome-wide association studies (GWAS) were utilized, and an MR approach was employed to analyze the causal relationships between loneliness, subjective well-being, and the frailty index (as a surrogate measure of frailty). Data on loneliness were derived from a study comprising 445 024 individuals of European ancestry, including 80 134 cases and 364 890 controls. Data for subjective well-being were obtained from 298 420 participants of European ancestry. Summary statistics for frailty were sourced from a meta-analysis of GWAS conducted within the UK Biobank and the Swedish TwinGene cohort, which included 175 226 individuals of European ancestry. The inverse variance weighted (IVW) method served as the primary MR analytical approach to derive causal estimates, with the weighted median estimator (WME) used as a supplementary approach. Cochran′s Q test was applied to assess heterogeneity in the IVW estimates. The presence of horizontal pleiotropy was evaluated using the MR-Egger intercept test. When significant heterogeneity was detected, the MR-PRESSO global test was utilized to identify and subsequently remove outlier variants. MR analyses were then repeated. A Leave-One-Out sensitivity analysis was conducted to evaluate whether the overall estimates were unduly influenced by any single nucleotide polymorphism (SNP). To ensure data consistency and analytical reliability during effect allele harmonization between exposure and outcome datasets, palindromic SNPs (for which the effect allele direction could not be definitively determined) were excluded. Results ·The IVW method revealed a significant positive association between loneliness and the frailty index, with an OR of 3.87 (95% CI 2.33‒6.46, P<0.001). This result was further confirmed by the WME, yielding an OR of 2.81 (95% CI 1.49‒5.29, P<0.001). Subjective well-being showed a significant negative association with the frailty index (OR=0.80, 95% CI 0.69‒0.94, P=0.005). The WME demonstrated a consistent direction of effect, though with borderline significance (OR=0.86, 95% CI 0.74‒1.01, P=0.065). The analysis revealed no significant heterogeneity (Cochran′s Q test, P=0.054 and P=0.074) or horizontal pleiotropy (MR-Egger intercept test, P=0.470 and P=0.260). Conclusion ·This study, supported by the MR methodology, indicates that loneliness is associated with an increased risk of frailty, while subjective well-being serves as a protective factor against frailty.

Cite this article

Aikeremu Aierken , Chen Xingjuan , Niu Yueyue . Mendelian randomization study of loneliness, subjective well-being, and frailty index[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026 , 46(1) : 75 -81 . DOI: 10.3969/j.issn.1674-8115.2026.01.009

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