An 80-Year-Old Man Comes to the Office for Routine Follow-Up

An 80-year-old man comes to the office for routine follow-up.  He lives alone and is independent in his activities of daily living.  He still drives infrequently but has his groceries delivered.  His spouse of 50 years died 2 years ago.  The patient denies feeling down and is still interested in music and playing golf but remarks that he is not going out as much as he once did.  He admits to lacking companionship and feeling lonely.  He has hypertension, hyperlipidemia, benign prostatic hyperplasia, and osteoarthritis of the knees.  The patient takes 5 medications daily and is adherent with his medical regimen.  He drinks 1 or 2 glasses of wine a day.
On physical examination, the patient is well dressed and groomed.  Blood pressure is 130/84 mm Hg and pulse is 80/min.  BMI is 25 kg/m².  Mini-Mental Status Examination score is 27/30.  He has slight tenderness to palpation of the joint line of his left knee but has full range of motion.  The rest of the examination is within normal limits.
Which of the following is the strongest risk factor for functional decline and increased mortality in this patient?

A) Alcohol use
B) Hypertension
C) Loneliness
D) Masked depression
E) Osteoarthritis

Correct Answer:

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