Loneliness and mortality: The moderating effect of positive affect

Although the adverse association of loneliness with health and mortality are well documented, less is known about moderating factors of this relationship. According to the "buffering theory," it is argued that positive affect moderates the negative associations of stressors with health. The current study contributes to the literature by asking: Does positive affect also moderate the relationship between loneliness and mortality? A large population-based sample of middle-aged and older adults in Germany from 2008 was used (N = 4442). Mortality was monitored up to 2020, resulting in a maximum follow-up period of observation of 12 years, in which mortality events could be observed. Loneliness was measured using an adapted German version of the De Jong Gierveld Loneliness Scale, while positive affect was measured with an adapted German version of the Positive and Negative Affect Schedule. Using Cox survival regression, it was found that loneliness significantly predicted increased mortality risk (HR = 1.20; p = .029); conversely, positive affect significantly predicted decreased mortality risk (HR = 0.63; p < .001). Furthermore, a significant interaction emerged between loneliness and positive affect in predicting mortality (HR = 0.70; p = .001): The strength of the association of loneliness with mortality decreased with increasing levels of positive affect. Positive affect attenuates the association between loneliness and mortality, supporting previous empirical research and theories on the buffering effect of positive affect. If replicated in further studies, interventions that promote positive affect might be beneficial to mitigate the negative associations of loneliness with health.