Older adult loneliness: myths and realities

Loneliness among older adults in Europe: The relative importance of early and later life conditions

The aim of this paper is to study the association between childhood circumstances and loneliness in older adults in Europe. Based on rich information collected by the Survey on Health, Ageing, and Retirement in Europe (SHARE) on childhood characteristics and individual characteristics at age 50+, the study is able to control for personality traits, socioeconomic and demographic factors, social support and health in later life, and country-specific characteristics. The analyses show strong correlations between life circumstances in childhood and feeling lonely in older age; these correlations remain significant after adjusting for covariates. While ill health is the main factor correlated with loneliness at 50+, as expected, the analysis of the relative importance of the determinants reveals that personality traits account for more than 10% of the explained variance and that life circumstances during childhood account for 7%. Social support at older ages is the second highest category of factors, accounting for 27%-with, interestingly, support at home and social network characteristics contributing about 10% each, engaging in activities and computer skills accounting for 7% of the explained variance. Demographic and socioeconomic factors account for 6% and country-level characteristics contribute 5%. This paper points out the relevance of early life interventions to tackling loneliness in older age, and it shows that early interventions and interventions aiming at increasing social support in later life need to be adapted to all personality types. Thus, the role of childhood circumstances and the mechanisms explaining the association between loneliness in childhood and loneliness in later life deserve more attention in future research.

Social Isolation and Loneliness among Near-Centenarians and Centenarians: Results from the Fordham Centenarian Study

Social isolation and loneliness have been recognized as problems older people face due to their adverse effects on health and mortality, but very few researchers have analyzed their co-occurrence, which might be particularly prevalent and critical among the very old. In this study, we investigated the prevalence of combinations of social isolation and loneliness among near-centenarians and centenarians. We used data collected from 94 individuals aged 95-107 from the Fordham Centenarian Study. We built a four-group typology and explored associations with individual characteristics in various domains (demographic, socioeconomics, social, health, care, and psychological) with multinomial logistic regression models. Considering their combinations, the most prevalent groups were "isolated and lonely" and "neither isolated nor lonely" (29.8% and 28.7%, respectively). The "lonely but not isolated" (20.2%) and "isolated but not lonely" (21.3%) groups were also notably large. The likelihood of belonging to each group varied according to various individual characteristics, such as education, health, and personality. Social isolation and loneliness are distinct phenomena among centenarians. The consideration of their varied combination can help better assess life conditions at very old ages. Taking into account the differences between groups can facilitate the design of tailored interventions to improve the lives of near-centenarians and centenarians.

Self-Identity and Meaning in Life as Enablers for Older Adults to Self-Manage Depression

Depression is the most common mental illness in older adults and is a leading cause of global disability. Generally, those who have a stronger sense of self-identity and find meaning in their lives tend to manage the symptoms of depression better than those who do not. Little is known about the association between self-identity, meaning in life and self-management of depression in older adults. The aim of this grounded theory study was to explicate how older adults with depression attempted to reclaim self-identity in ways that facilitated self-management. Data collection and analysis were informed by Corbin and Strauss' approach to grounded theory. Thirty-two older adults with a formal diagnosis of moderate depression participated in in-depth, semi-structured interviews. The core problem for participants related to their sense that they were not treated as individuals as they sought to receive and adapt to a depression diagnosis. This challenge was conceptualised as Struggling to maintain personal identity as an older adult with depression. By empowering themselves and striving for a meaningful existence, participants strived to master their current circumstances in ways that strengthened their sense of personal identity. This, in turn, supported their efforts to effectively manage their symptoms of depression and employ adaptive coping strategies that optimise well-being. Our findings identify the need for recovery-oriented models of interdisciplinary practice that enhance self-identity and meaning in life in older adults, in ways that support self-management of depression.

COVID-19 and the Elderly's Mental Illness: The Role of Risk Perception, Social Isolation, Loneliness and Ageism

For almost two years, populations around the globe faced precariousness and uncertainty as a result of the COVID-19 pandemic. Older adults were highly affected by the virus, and the policies meant to protect them have often resulted in ageist stereotypes and discrimination. For example, the public discourse around older adults had a paternalistic tone framing all older adults as "vulnerable". This study aimed to measure the extent to which perceived age discrimination in the context of the COVID-19 pandemic, as well as the sense of loneliness and social isolation, fear and perception of COVID-19 risks, had a negative effect on older adults' mental illness. To do so, a self-report questionnaire was administered to 1301 participants (average age: 77.25 years old, SD = 5.46; 56.10% females, 43.90% males). Descriptive and correlational analyses were performed, along with structural equation modelling. Results showed that perceived age discrimination in the context of the COVID-19 pandemic positively predicts loneliness and also indirectly predicts mental illness. In addition, loneliness is the strongest predictor of mental illness together with fear of COVID-19 and social isolation. Such results highlight the importance of implementing public policies and discourses that are non-discriminating, and that favour the inclusion of older people.

Association between Sense of Belonging and Loneliness among the Migrant Elderly Following Children in Jinan, Shandong Province, China: The Moderating Effect of Migration Pattern

BACKGROUND

Driven by accelerating population aging and migration, the number of older migrants has increased rapidly in China. Those who moved to cities to look after grandchildren were referred to as the migrant elderly following children (MEFC). This study aims to examine the relationship between sense of belonging and loneliness and explore the moderating effect of migration pattern among the MEFC in China.

METHODS

The study included 656 MEFC aged 60 years and above. Loneliness was evaluated by the eight-item University of California Los Angeles Loneliness Scale (ULS-8). Sense of belonging and migration pattern were measured using a self-designed questionnaire. Hierarchical multiple regression was conducted to test the proposed association and moderating effect. A margins plot was introduced to illustrate this effect.

RESULTS

The average ULS-8 score was 12.82 ± 4.05, revealing a low level of loneliness. A weak sense of belonging was related with a higher level of loneliness (β = 0.096, p = 0.014). Migration pattern was found to exacerbate this association (β = 0.138, p = 0.026), especially for the elderly who migrated across provinces.

CONCLUSIONS

Sense of belonging was correlated with loneliness, and the moderating role of migration pattern was established. Both policymakers and the adult children of inter-provincial migrant elderly should focus on this special subgroup.

Life Conditions as Mediators of Welfare State Effect on Mental Wellbeing among Oldest Old in Europe

BACKGROUND

Mental wellbeing is formed by our daily environments, which are, in turn, influenced by public policies, such as the welfare state. This paper looks at how different aspects of life conditions may mediate the welfare state effect on mental wellbeing in oldest old age.

METHODS

Data were extracted from Round 6 of the European Social Survey (2012). The dataset comprised of 2058 people aged 80 years and older from 24 countries. Mediation analyses determined possible links between the welfare state, including eleven intervening variables representing life conditions and five mental wellbeing dimensions.

RESULTS

Our study confirms that the higher the level of welfare state, the better mental wellbeing, irrespective of dimension. Although several life conditions were found to mediate the welfare state effect on mental wellbeing, subjective general health, coping with income and place in society were the most important intervening variables.

CONCLUSIONS

All three variables centre around supporting autonomy in the oldest old age. By teasing out how the welfare state influences mental wellbeing in the oldest old, we can better understand the many drivers of wellbeing and enable evidence informed age-friendly policy making.

Effect of Perceived Social Support on Self-care Agency and Loneliness Among Elderly Muslim People

This study was conducted to investigate the effect of perceived social support on self-care agency and loneliness among elderly Muslim people. This study used a cross-sectional design and included 965 elderly individuals who met the inclusion criteria. There was a positive correlation between perceived social support and self-care agency and a negative correlation between perceived social support and loneliness in elderly muslim individuals (p < 0.05). It is recommended that psychiatric nurses should activate the social support mechanisms of elderly individuals, and necessary follow-ups to increase self-care agencies must be conducted.

Association of Loneliness With 10-Year Dementia Risk and Early Markers of Vulnerability for Neurocognitive Decline

BACKGROUND AND OBJECTIVES

Loneliness is common, and its prevalence is rising. The relationship of loneliness with subsequent dementia and the early preclinical course of Alzheimer disease and related dementia (ADRD) remains unclear. Thus, the primary objective of this study was to determine the association of loneliness with 10-year all-cause dementia risk and early cognitive and neuroanatomic imaging markers of ADRD vulnerability.

METHODS

This was a retrospective analysis of prospectively collected data from the population-based Framingham Study cohorts (September 9, 1948-December 31, 2018). Eligible participants had loneliness assessed and were dementia-free at baseline. Loneliness was recorded with the Center for Epidemiologic Studies Depression Scale, defined conservatively as feeling lonely ≥3 days in the past week. The main outcomes were incident dementia over a 10-year period, cognition, and MRI brain volumes and white matter injury.

RESULTS

Of 2,308 participants (mean age 73 [SD 9] years, 56% women) who met eligibility in the dementia sample, 14% (329 of 2,308) developed dementia and 6% (144 of 2,308) were lonely. Lonely (versus not lonely) adults had higher 10-year dementia risk (age-, sex-, and education-adjusted hazard ratio 1.54, 95% CI 1.06-2.24). Lonely participants <80 years of age without APOE ε4 alleles had a 3-fold greater risk (adjusted hazard ratio 3.03, 95% CI, 1.63-5.62). Among 1,875 persons without dementia who met eligibility in the cognition sample (mean age 62 [SD 9] years, 54% women), loneliness associated with poorer executive function, lower total cerebral volume, and greater white matter injury.

DISCUSSION

Over 10 years of close clinical dementia surveillance in this cohort study, loneliness was associated with increased dementia risk; this tripled in adults whose baseline risk would otherwise be relatively low on the basis of age and genetic risk, representing a majority of the US population. Loneliness was also associated with worse neurocognitive markers of ADRD vulnerability, suggesting an early pathogenic role. These findings may have important clinical and public health implications given observed loneliness trends.

CLASSIFICATION OF EVIDENCE

This study provides Class I evidence that loneliness increases the 10-year risk of developing dementia.

Social Capital as a Mediator and Moderator in the Association between Loneliness and Health, Israel as a Case Study

Loneliness has been associated with poor health. Social capital (SC) could possibly prevent the ill effects of loneliness. The study aims to assess the association of loneliness with physical and mental health in four different communities in Israel and study the impact of structural and cognitive SC on that association. A cross-sectional face-to-face survey with 4620 adults in four towns was conducted. The questionnaire included self-rated health (SRH), mental health (MH), loneliness, cognitive and structural SC and socioeconomic characteristics. Logistic regression analysis and mediation and moderation effects were calculated. Loneliness was associated with worse SRH (OR = 0.4–0.5) and worse MH (OR = 2.0–10). Both SC variables were associated with health. However, towns differ in these associations. Structural SC serves as a significant mediator between loneliness and SRH in all towns and is a mediator between loneliness and MH in two towns. Cognitive social capital was a moderator between loneliness and MH in two towns. This study suggests that increasing SC could possibly compensate for loneliness and buffer its effect on health. The study reinforces the need for the performance of separate health profiles to assess possible interventions for each community, as not always can we generalize these results to all communities.

A perspective on the sense of loneliness and its determinants in Iranian older people

BACKGROUND

The sense of loneliness is one of the common problems of older people and their quality of life, and is affected by many factors such as personal resources, gender, health condition, and age. This study investigates the determinants of the sense of loneliness between older men and women in Birjand.

METHODS

This study was a part of the community-based prospective cohort study of the Birjand Longitudinal Aging Study (BLAS). Individuals over 60 years of age and their families (selected by random cluster sampling) were assessed through structured interviews with questionnaires such as Patient Health Questionnaire, Short-Form-12, Longitudinal Aging Study Amsterdam Physical Activity Questionnaire, loneliness, and social support questions.

RESULTS

The mean age of the participants in the study was 68.59 ± 6.72, and 53.2% were women. Based on the findings of pathway analysis, the most critical determinants of loneliness in older men and women were the number of children (total effect = -0.112, P = 0.006) and mood, respectively (total effect = 0.142, P < 0.001). According to results, older people with fewer children feel lonelier.

CONCLUSION

Compared with men, emotional loneliness is more common in older women. Older women, who lost their husbands, suffer from loneliness, mental health disorders, and low quality of life.

Young adults' coping strategies against loneliness during the COVID-19-related quarantine in Greece

COVID-19 and the related quarantine disrupted young adults' academic and professional life, daily routine and socio-emotional well-being. This cross-sectional study focused on the emotional and behavioural responses of a young adult population during the COVID-19-related quarantine in April 2020, in Greece. The study was conducted through an online survey. A total of 1559 young adults, aged 18-30 years, completed Steele's Social Responsibility Motivation Scale and the De Jong Gierveld Loneliness Scale, and answered questions about compliance with instructions, quarantine-related behaviours and coping strategies. According to the results, participants displayed a relatively high sense of social responsibility (M = 16.09, SD = 2.13) and a trend towards moderate feeling of loneliness (M = 2.65, SD = 1.62); young women reported significantly higher levels of loneliness than men. The majority complied with instructions often (46.4%) or always (44.8%). Significantly more women created a new social media account and used the social media longer than 5 h/day, compared with men. Resorting to religion, practicing sports and sharing thoughts and feelings about COVID-19 with others predicted higher levels of social responsibility; humour, practicing sports and sharing thoughts and feelings about COVID-19 with others predicted lower levels of loneliness. Conclusively, COVID-19 is expected to have a significant psychological impact on young adults. Currently, Greece is going through the second quarantine period. This study raises awareness about loneliness in young adults during the COVID-19-related quarantine and highlights the importance of developing online programmes, attractive to younger people, to nurture adaptive coping strategies against loneliness.

Creating a social movement to engage communities in physical activity: A mixed methods study of motivations to engagement

Throughout the world social isolation and loneliness are common and both have several adverse impacts on health and wellbeing. We are designed to live in close-knit communities and we thrive in close co-operation, however, modern life isolates us from others. To reduce the burden of loneliness and social isolation we need to find strategies to reconnect people to each other, their place and provide a common purpose. Social movements aim to create healthier communities by connecting people to each other and giving people a common purpose. Interventions which create a social movement appear to be effective at engaging substantial portions of a community, however, it remains unclear why individuals are attracted to these initiatives, and if such reasons differ by sociodemographic characteristics. This study combined qualitative and quantitative methods to understand what motivated (different) people to take part in a social movement based intervention. This study suggests that it is not one but a combination of reasons people engage in interventions of this nature. This diversity needs to be acknowledged when promoting and communicating these interventions to potential participants to maximise engagement. Promoting an end reward or health/fitness may not be the most effective way to promote interventions to a large proportion of people. Instead, communications should be centred around what people value (i.e., being with their friends, doing what they enjoy and are good at).

Correlates of emotional and social loneliness among community dwelling older adults in Rotterdam, the Netherlands

OBJECTIVES

Loneliness is seen as an important problem, contributing to serious health problems. As a baseline measurement for the evaluation of a community project aimed at reducing loneliness in Rotterdam, loneliness was measured, as well as potential correlates. This article describes models of social and emotional loneliness among older adults.

METHODS

This study was conducted among 3,821 randomly selected community dwelling citizens of 65 years and older. Loneliness was measured by using the Jong-Gierveld loneliness questionnaire/scale. As potential correlates demographic, health and psychological and social variables were included. Data were subjected to multiple hierarchically regression analysis.

RESULTS

Emotional loneliness was reported by 60% and social loneliness by 47% of the sample. Women were more emotionally lonely than men , while men reported more social loneliness than women. Emotional social support and quality of life were strongest in predicting emotional loneliness and social capital in the neighbourhood, companionship and instrumental support were strongest predictors for social loneliness. Demographic variables predicted variability in emotional loneliness.

CONCLUSIONS

The strength of the correlates differed between the two dimensions of loneliness. In the design of interventions to prevent and reduce loneliness among older adults, strategies should be developed aimed at the specific dimensions of loneliness.

Managing Perceived Loneliness and Social-Isolation Levels for Older Adults: A Survey with Focus on Wearables-Based Solutions

As an inevitable process, the number of older adults is increasing in many countries worldwide. Two of the main problems that society is being confronted with more and more, in this respect, are the inter-related aspects of feelings of loneliness and social isolation among older adults. In particular, the ongoing COVID-19 crisis and its associated restrictions have exacerbated the loneliness and social-isolation problems. This paper is first and foremost a comprehensive survey of loneliness monitoring and management solutions, from the multidisciplinary perspective of technology, gerontology, socio-psychology, and urban built environment. In addition, our paper also investigates machine learning-based technological solutions with wearable-sensor data, suitable to measure, monitor, manage, and/or diminish the levels of loneliness and social isolation, when one also considers the constraints and characteristics coming from social science, gerontology, and architecture/urban built environments points of view. Compared to the existing state of the art, our work is unique from the cross-disciplinary point of view, because our authors' team combines the expertise from four distinct domains, i.e., gerontology, social psychology, architecture, and wireless technology in addressing the two inter-related problems of loneliness and social isolation in older adults. This work combines a cross-disciplinary survey of the literature in the four aforementioned domains with a proposed wearable-based technological solution, introduced first as a generic framework and, then, exemplified through a simple proof of concept with dummy data. As the main findings, we provide a comprehensive view on challenges and solutions in utilizing various technologies, particularly those carried by users, also known as wearables, to measure, manage, and/or diminish the social isolation and the perceived loneliness among older adults. In addition, we also summarize the identified solutions which can be used for measuring and monitoring various loneliness- and social isolation-related metrics, and we present and validate, through a simple proof-of-concept mechanism, an approach based on machine learning for predicting and estimating loneliness levels. Open research issues in this field are also discussed.

Listening to the voice of older people: dimensions of loneliness in long-term care facilities

Loneliness has proved to be common in long-term care facilities (LTCF) and is associated with adverse health outcomes. Although older residents have expressed their experiences of loneliness in previous studies in various ways, researchers have rarely distinguished or explored the three dimensions of loneliness: social, emotional and existential. Furthermore, descriptions of existential loneliness in LTCF is still a neglected area of research. The aim of this study was to explore how the experiences of loneliness of older people in LTCF are manifested and divided into these dimensions. We used an ethnographic multi-method approach. The analysis leaned on abductive reasoning. In terms of social loneliness, the respondents missed company and lacked peer support, but also felt lonely in a crowd. Emotional loneliness felt miserable and could not be shared with anyone. It was related to a feeling of meaninglessness of life and a lack of meaningful others. Existential loneliness was characterised by waiting and a feeling of emptiness. It reflected the fundamental issues of humanity. The present study is one of the first to explore the dimensions of the experiences of loneliness among frail and cognitively impaired older people in LTCF. According to the voices of the lonely respondents, loneliness has many social, emotional and existential aspects. These features of loneliness should be recognised in studies, care practices and interventions.

Retrospective feelings of loneliness during the COVID-19 pandemic among residents of long-term care facilities

The novel coronavirus disease (COVID-19) has had an incisive effect on residents living in long-term care facilities (LTCFs). Local governments have introduced restrictive measures because of the danger posed by this virus. One increasing negative effect of these implementations among residents living in LTCFs is their subjective feelings of loneliness. This study assumed that these measures weighed heavily particularly on residents living in LTCFs, as this group of older people could not decide for themselves whether or how they should be implemented. Thus, this study investigated the retrospectively reported subjective loneliness of residents living in LTCFs. On a large-scale Swiss survey (N = 828; mean age: 87.78, 75% female), residents of 22 LTCFs filled out a questionnaire on their subjective feelings of loneliness during the pandemic. The retrospective loneliness scores of the residents living in LTCFs were found to exceed those reported in other studies focusing on community-dwelling older people. Multivariate regression analyses showed that females, individuals with lower values of joy in life and life satisfaction, and individuals who were not satisfied with the manner in which their care home coped with the COVID-19 measures significantly felt lonelier. Therefore, the subjective feelings of loneliness of residents in LTCFs should be monitored very carefully. As the measures have still not been completely lifted, residents of LTCFs are assumed to still experience social isolation and be at high risk of encountering prolonged feelings of loneliness, which can be detrimental to their mental health and well-being.

Risk factors for loneliness among older people in a Nordic regional context – a longitudinal study

The aim of this study was to examine the prevalence of loneliness among older people and to identify risk factors for loneliness in a Nordic regional context over a six-year period. Longitudinal data from the Gerontological Regional Database (GERDA) study of 4,269 older adults living in northern Sweden and western Finland, aged 65, 70, 75 and 80 at baseline in 2010, were analysed. Logistic regressions were used to analyse socio-demographic, social and health-related risk factors at baseline and changes in these for experiences of loneliness at follow-up. The results showed that most older adults (85%) did not experience loneliness at baseline or at follow-up in our study region. However, 3 per cent of the sample reported loneliness in both study years, indicating enduring and chronic loneliness. Analyses revealed that being widowed and becoming a widow/er as well as poor self-rated health at baseline and the onset of depression were risk factors for loneliness. Finally, the risk of loneliness was higher in older people living in Sweden. Further work is needed to explore changes and stability in loneliness as well as to increase our understanding of between-country differences in loneliness.

Social support moderates suicidal ideation among Chinese nursing home residents with limited activities of daily living and loneliness

Rare studies are available exploring the impact of limited activities of daily living (ADL), loneliness on suicidal ideation, and protective effect of social support on their relationships in nursing home residents. This study aims to examine these links in a sample of older adults from nursing homes. A stratified random sampling was adopted to recruit 538 respondents from 37 nursing homes in Jinan. Suicidal ideation, limited ADL, social support and loneliness were assessed through instruments of Beck Suicidal Ideation Scale, ADL scale, Perceived Social Support Scale and UCLA Loneliness Scale. Relationships of latent variables were tested using Path Analysis in this cross-sectional study. The mediating effect of loneliness was significant on the association between limited ADL and suicidal ideation, and the mediation model was multiply moderated by social support with significant coefficients and acceptable model fitness. This study demonstrated the multiple moderating role of social support in the effect of limited ADL and loneliness on suicidal ideation among nursing home residents. More efforts are suggested in providing more available external resources to seniors' mental health for reducing risk of influencing factors of suicidal ideation.

Aging-related fears and their associations with ideal life expectancy

Fears regarding various aspects tend to stimulate individuals to escape or to avoid the sources of the threat. We concluded that fears associated with the future aging process, like the fear of aging-related diseases, the fear of loneliness in old age, and the fear of death, would stimulate patterns of avoidance when it comes to ideal life expectancy. We expected fear of aging-related diseases and fear of loneliness in old age to be related to lower ideal life expectancies. We expected fear of death to be related to higher ideal life expectancies. In two adult lifespan samples [N₁ = 1065 and N₂ = 591; ages ranging from 18 to 95 years, M (SD)₁ = 58.1 (17.2) years, M (SD)₂ = 52.6 (18.1) years], we were able to support our hypothesis regarding fear of death. We furthermore found significant interactions among the fears, indicating that individuals fearing diseases or loneliness but being unafraid of death opted for the shortest lives. Our results indicate that fears regarding life in very old age might be associated with the wish to avoid this age period; the fear of death was however associated with the wish for particularly long lives, and thus, with distancing oneself from the dreaded event of death. We conclude that fears seem to be associated with how individuals approach old age and with what they wish for in their own future as aged people.

The Sociability Argument for the Burqa Ban: A Qualified Defence

Over the past decade, countries such as France, Belgium, Denmark, Austria, Latvia, and Bulgaria have banned face-coverings from public spaces. These bans are popularly known as 'burqa bans' as they seem to have been drafted with the aim of preventing people from wearing burqas and niqabs specifically. The scholarly response to these bans has been overwhelmingly negative, with several lawyers and philosophers arguing that they violate the human right to freedom of religion. While this article shares some of the concerns that have been raised, it argues that banning face-coverings in public is morally justified under certain conditions with the exception of facemasks that are necessary for the containment of infectious diseases, such as COVID-19. The reason for this is that those who publicly cover their face make it very difficult for other members of society to socially interact with them, especially for those who are deaf or hard-of-hearing, which is problematic in an age where many people are chronically lonely or at risk of becoming chronically lonely. As such, this article can be understood as a more elaborate, and arguably more sophisticated, defence of the justification that France offered for its face-covering ban before the European Court of Human Rights, namely that covering one's face undermines the conditions for 'living together'.

Loneliness and mental health among the elderly in Poland during the COVID-19 pandemic

Background

The unexpected changes caused by the COVID-19 pandemic related to the fear of developing the disease, and the need for social distancing and isolation have had an effect on people’s mental health. These drastic changes can result in the development of anxiety, depressive symptoms and sense of loneliness. Elderly and chronically ill individuals are at a particularly high risk of developing COVID-19, suffering severe illness and dying as a result of it.

Aim of the study

The aim of the study was to assess the prevalence of anxiety, depressive symptoms, irritability and loneliness in the elderly aged 60 years and older as a group exposed to the negative impact of the COVID-19 pandemic, and to analyze the relationships between loneliness and mental health of the respondents and sociodemographic variables and chronic diseases.

Materials and methods

The study was conducted in Poland among 221 individuals aged 60+. The study material was collected using a sociodemographic questionnaire, Hospital Anxiety and Depression Scale (HADS-M) and a revised University of California Los Angeles loneliness scale (R-UCLA). Women accounted for 47.51% and men for 52.49% of study participants; the mean age was 65.18 (SD = 4.06).

Results

In total, according to HADS-M, depressive symptoms were present in 19.15% of the participants and borderline states in 14.18% of them. Based on R-UCLA, moderate and moderately high sense of loneliness was present in 58.83% of the participants. Sense of loneliness was significantly correlated with the prevalence of depressive symptoms (p < 0.001).

Conclusions

In this study, one in five participants experienced anxiety and depressive symptoms. Two out of three participants experienced a moderate sense of loneliness. Individuals who displayed a higher level of loneliness also had a higher severity of anxiety level depressive symptoms and irritability. Elderly individuals should be under special care due to their high risk of experiencing physical and mental effects of the COVID-19 pandemic.

The role of oxytocin in regulating loneliness in old age

Loneliness is prevalent in old age and is associated with reduced positive social interactions. Building on studies showing that oxytocin (OT) levels rise during social interactions, we hypothesized that following participation in positive social interaction involving synchronized movements, OT levels would increase, while state loneliness levels would diminish. A total of 63 older adults (aged M = 78.93, SD = 9.99; Range = 65-101) participated in the study. Participants completed emotional and social loneliness scales and provided saliva samples pre- and post-participation in the "mirror game", which requires movement synchronization and is known to promote connectedness and closeness. Results indicate a reduced state of loneliness following the mirror game. Importantly, the change in OT levels predicted the change in social loneliness, defined as the absence of social interactions with people in the social network. On the other hand, emotional loneliness, marked by deficient emotional contact, only decreased among participants who experienced high levels of closeness with their partner in the mirror game. Findings suggest that context-dependent change in endogenous OT may serve as biomarker for the social effects of oxytocin on loneliness in old age and can help in the development of targeted interventions for treating loneliness in old age.

Effectiveness of a community-based integrated service model for older adults living alone: A nonrandomized prospective study

OBJECTIVE

Older adults living alone face physical, emotional, and social health problems, and prefer to age in place (AIP) in their homes. A community-based integrated model for AIP is needed and few studies have identified its impact on older adults living alone.

METHODS

This was a non-randomized prospective study. Participants were 877 community-dwelling older adults living alone, aged above 65 years, in S* city in South Korea. The intervention group (n = 331) received a community-based integrated service (CBIS) model based on AIP for six months from October 2019 to April 2020.

RESULTS

Scores on frailty (β = -0.377, p < .001), loneliness (β = -1.897, p = .018), and health-related quality of life (β = 4.299, p = .021) significantly improved in the intervention group. Among the intervention group, loneliness scores significantly improved among participants aged under 80 years than those aged over 80 years.

CONCLUSION

The CBIS model improved frailty, loneliness, and quality of life in community-dwelling older adults living alone.

Social vulnerability and aging of elderly people in the United States

We use 7 waves of the Health and Retirement Study and construct a social vulnerability index (SVI) for elderly U.S. Americans (born 1913–1966). We show that the SVI is mildly larger for men than for women and increases in age from above age 60 onwards for both genders. Social vulnerability of men (but not of women) is lower in the West and Midwest than in other regions and higher income mildly reduces the SVI for men (but not for women). In cohort analysis we find an increase of the SVI for individuals born in the late 1940s or later, which is, however, statistically significant only for women. In order to investigate the nexus between social vulnerability and aging, we construct a frailty index from the same data. We find that socially vulnerable persons display more health deficits at any age. Using the initial SVI (at first interview) we find that social vulnerability exerts a significant impact on subsequent accumulation of health deficits, which is of about the same size for men and women. A one standard deviation increase in the initial SVI leads to a 20 percent increase of the frailty index at any age.

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Panel study of social vulnerability and aging in the U.S.

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Social vulnerability index (SVI) increases for women born after 1940.

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Strong impact of initial SVI on subsequent accumulation of health deficits.

Death Anxiety and Loneliness among Older Adults: Role of Parental Self-Efficacy

Death anxiety and loneliness are major issues for older people. The present study aimed to broaden the understanding of factors that are linked with increased loneliness in old age by examining the association between death anxiety and loneliness, and the role of an unexplored variable among older adults, namely, parental self-efficacy. A convenience sample of 362 Israeli parents over the age of 65 was recruited through means of social media. Participants completed self-reported questionnaires, which included background characteristics, death anxiety, parental self-efficacy, and loneliness measures. The findings showed that death anxiety was positively associated with loneliness among older adults. The findings also confirmed that parental self-efficacy moderated this association in this population. We concluded that the combination of death anxiety and low parental self-efficacy identified a group of older adults that are at higher risk of developing increased loneliness levels. Mental health professionals should consider intergenerational relationships as a fundamental component of older adults' daily lives, focusing on parental self-efficacy in old age, as this appears to be a resilience resource.

Reducing loneliness in older adults: looking at locals and migrants in a Swiss case study

Older adults are at a high risk for loneliness, and community-based interventions can help reduce loneliness for all older adults in a community, regardless of their migration status. However, little research has investigated how older adults, including locals and migrants (in this case, internal newcomers and international expats) participate in these interventions. The "Neighbourhoods in Solidarity" (NS) are a series of community-based interventions that aim to increase social connectedness and reduce loneliness in older adults (55+) in the canton of Vaud, Switzerland. This longitudinal embedded mixed-methods study aimed to understand whether older adults (distinguishing between locals, newcomers, and expats) were aware of and participated in the NS, to assess whether participation was associated with changes in loneliness, and to identify relevant processes that could explain a reduction in loneliness. We combined a longitudinal pre/post survey (235 respondents) with ethnographic observations and informal interviews. Quantitative findings showed that individuals who participated in the NS did not have significant changes in loneliness. Qualitative findings showed that perceived migration played an important role in who participated, and that the community distinguished between two types of migrants: newcomers who spoke French fluently, and expats who did not. Individuals were only 'local' if they had ancestors from the town. Some newcomers and some locals used the NS as a platform to build a new sense of community within the NS, whereas expats rarely participated. This was due to linguistic and cultural determinants, institutional constraints, interpersonal relationships, and personal preferences.

Physical distancing is related to fewer electronic and in-person contacts and to increased loneliness during the COVID-19 pandemic among older Europeans

PURPOSE

During the COVID-19 pandemic older adults are asked to maintain physical distancing, which can be linked to loneliness. While older people are encouraged to use electronic communication to stay socially connected, it remains an open question whether electronic contacts are related to lower loneliness during the pandemic. This study examined the associations of physical distancing during the pandemic with loneliness and the role of in-person and electronic contacts with children and non-kin as explaining these associations across European regions.

METHODS

The study used data from Survey of Health, Ageing and Retirement in Europe (SHARE), collected during the COVID-19 pandemic in 2020. Mediation and moderation analyses tested the direct and indirect associations between physical distancing, contact frequency and loneliness, as well as the differences across European regions.

RESULTS

The results indicate that adults who reported higher frequency of physical distancing also felt lonelier during the pandemic. This association was partly explained by social contacts-those who practiced physical distancing maintained less in-person contact with children and non-kin and less electronic contact with non-kin, which were related to feeling lonelier. Adults in Southern European countries felt lonelier and reported more frequent contacts. The moderation analyses showed that the link between physical distancing and loneliness was found in the northern region, but not in the southern and eastern regions of Europe.

CONCLUSION

This study can indicate that attention should be paid to adults who may struggle to maintain social contacts in light of physical distancing guidelines.

Social support and loneliness among frail older adults attending daycare centers: A multicultural study in Israel

AIMS

To examine the link between intensity of use of formal support and loneliness among older adults, controlling for family support and covariates; and examine the moderating effect of contact frequency with family on this relationship.

METHODS

Cross-sectional data were collected from September 2016 - April 2017 through structured interviews with 360 older adults attending adult day care centers (ADCCs) and representing three different ethnic groups in Israel. Loneliness was assessed by the UCLA Loneliness Scale. Hierarchical regression was applied to the study variables with loneliness scores as dependent variable, and bootstrapping with resampling strategies tested a moderating effect.

RESULTS

Loneliness was linked negatively with contact frequency with the family network, frequency of ADCC attendance, and greater involvement in social activities at the ADCC. Significant negative correlation between ADCC attendance frequency and loneliness occurred only when family contact was at low-to-average frequency, but not in cases of high-contact frequency.

CONCLUSIONS

Frequent use of ADCCs emerged as a significant contributor beyond the contribution of family support for reducing loneliness in older age, particularly for those with insufficient family contact. Service providers should improve the accessibility and availability of formal community services for the older population.

Loneliness and health expectancy among older adults: A longitudinal population-based study

BACKGROUND

The population health impact of loneliness remains unknown. We quantified the impact of loneliness on total life expectancy (TLE) and health expectancy (the duration of remaining life lived in different health states) among older adults, aged ≥60 years.

DESIGN

Multistate life table analysis of a nationally representative longitudinal survey.

SETTING

Singapore.

PARTICIPANTS

Survey participants (n = 3449) interviewed in 2009, 2011-12, and 2015.

MEASUREMENTS

Health states were defined using self-rated health (SRH) status and activity of daily living (ADL)/instrumental ADL (IADL) status. Participants with somewhat or very unhealthy SRH were considered as unhealthy. Those reporting health-related difficulty with any ADL/IADL were considered to have limitation in ADLs/IADLs. TLE and health expectancy (healthy and unhealthy life expectancy (HLE and UHLE) in the context of SRH, and active and inactive life expectancy (ALE and IALE) in the context of ADLs/IADLs) were estimated using the multistate life table method with a microsimulation approach, considering loneliness as time varying.

RESULTS

At age 60, 70, and 80, those sometimes lonely or mostly lonely generally had shorter TLE, HLE and ALE, similar UHLE and IALE, and a higher proportion of remaining life with unhealthy SRH or with ADL/IADL limitations versus those never lonely. For example, at the age of 60, those sometimes lonely versus never lonely had shorter TLE (by 5.4 [95% Confidence Interval: 3.4-7.9] years), shorter HLE (by 5.9 [4.1-8.6] years), similar UHLE (difference: 0.6 [-0.7-1.7] years), and higher proportion of remaining life with unhealthy SRH (by 6.2 [1.2-10.8] percentage points). For those mostly lonely versus never lonely, TLE was shorter by 3.6 (0.7-6.6) years, HLE was shorter by 4.8 (2.3-8.2) years, UHLE was similar (difference: 1.2 [-0.1-4.0] years), and proportion of remaining life with unhealthy SRH was higher by 7.2 (2.1-18.1) percentage points.

CONCLUSION

Identification and management of loneliness may increase years of life with healthy SRH and without limitation in ADLs/IADLs among older adults.

Lonely in the City-Sociodemographic Status and Somatic Morbidities as Predictors of Loneliness and Depression among Seniors-Preliminary Results

Up to a third of the population of older adults has been estimated to suffer from feelings of loneliness, which is considered a risk factor of depression. The aim of this paper is to compare the perceived level of loneliness and depression in seniors living in the country and in the cities and assess somatic morbidity and sociodemographic status as predictors of loneliness and depressiveness. n = 92 older adults in primary care units filled out a set of questionnaires: authors' survey on sociodemographic data and morbidities, Beck Depression Inventory II (BDI, to measure depressiveness) and De Jong Gierveld Loneliness Scale (DJGLS, to assess loneliness). There was a strong, positive and statistically significant correlation between the BDI and DJGLS scores (R = 0.855, p < 0.001). City residents had on average higher BDI and DJGLS scores. Linear regression models were constructed to predict BDI and DJGLS scores. The set of statistically significant predictors were similar for BDI and DJGLS. Sociodemographic status and somatic morbidities accounted for around 90% of variance of depressiveness and loneliness scores in the studied group. Living alone was found to be the strongest relative predictor of both loneliness and depressiveness in the studied sample of the older adults. Our current results suggest that there might be a need to improve social support in the late adulthood as an intervention to diminish the sense of loneliness and depressiveness.

The protective effect of self-esteem on suicidal ideation among nursing home residents with limited social support in China: A cross-sectional study

Aim

This cross‐sectional study aimed to assess the impact of limited social support and loneliness on suicidal ideation, under the influence of self‐esteem, an important inner resource for quality living.

Design

An observational cross‐sectional study conducted from September 2018–April 2019.

Methods

The participants comprised 538 nursing home residents selected by a stratified sampling method from all seven administrative districts in a capital city of eastern China. All the participants completed the survey that constituted the measurement of suicidal ideation, self‐esteem, social support and loneliness. Path analysis was performed using the structural equation modelling method.

Results

A moderating effect, with satisfactory model fit indices and significant path coefficients, was detected between self‐esteem and suicidal ideation through limited social support and loneliness, revealing the multiple protective mechanisms of this psychological characteristic on the change of suicidal ideation.

"Not Alone in Loneliness": A Qualitative Evaluation of a Program Promoting Social Capital among Lonely Older People in Primary Health Care

The weekly group-based program "Paths: from loneliness to participation" was conducted face-to-face over 15 sessions by nurses, social workers and volunteers in primary care in Catalonia (Spain) to alleviate loneliness among older people by promoting peer support and participation in community assets. We aimed at exploring participants' experiences of loneliness and participation prior to the program and its perceived benefits. The qualitative design was descriptive-interpretative. Data were collected through three focus groups and 41 interviews applying a semistructured topic guide involving 26 older participants, six professionals and nine volunteers. Participant-observation of all sessions involved the 38 older people who started the program. A thematic content analysis was applied. Older persons with diverse profiles of loneliness and participation explained different degrees of decrease in loneliness, an increase in participation in local community assets, companionship, peer support and friendship, and an empowerment process. Successful cases reported improvements in mental wellbeing and recovering the sense that life was worth living. Loneliness persisted among some widowed participants and vulnerabilities hampered some benefits. Participants, professionals and volunteers reported different degrees of success in older people to alleviate loneliness by enhancing social relationships and activities through complex processes interrelated with health and socioeconomic factors.

Adult children's gender, number and proximity and older parents’ moves to institutions: evidence from Sweden

Older people's ability to thrive independently of their adult children is an important feature of a universalistic welfare system. However, population ageing puts this notion under stress. In separate multinomial logistic regression models for older men and women, we examined whether adult children's gender, number and proximity were associated with older parents’ relocations into residential care facilities, and whether the effects of these children's characteristics on older parents’ institutionalisation vary by parents’ severe health problems, operationalised as closeness to death – specifically, dying within the two-year observation period. Analyses were based on the Swedish register data between 2014 and 2016 (N = 696,007 person-years). Older parents with at least one co-resident child were less likely to move or become institutionalised than those without a co-resident child. We did not find a relationship between older adults’ institutionalisation and the closest child's gender. The negative effect of having a non-resident child living nearby on the likelihood of becoming institutionalised was more pronounced for mothers than fathers. Having a child nearby decreased the likelihood of moving to an institution more for mothers who had severe health problems than for those in better health. We found no evidence of a relationship between number of children and likelihood of institutionalisation.

The Intersection of Physical and Social Frailty in Older Adults

Frailty, a vulnerability to stressors, has been increasingly woven into the clinical understanding of older people who are unable to respond to the impact of diseases, disability, and age-related decline. While the literature has focused on physical frailty, social frailty has been conceptualized within the domains of social needs (social and emotional support, loneliness), resources (income, food, housing, medical care, etc), social fulfillment (engagement in work and activities), and self-management (cognitive function, mental health, advance planning). This review outlines the assessment of the four domains of social frailty within the structure of clinical visits, particularly annual wellness and advance care planning. Increasing connectivity with the community, health system, and government support is the primary recommended intervention. On a policy level, expanding opportunities to connect socially frail people with resources may help mitigate the vulnerability of physical frailty.

Loneliness and symptom burden in oncology patients during the COVID-19 pandemic

BACKGROUND

Loneliness and social isolation are significant public health problems that are being exacerbated during the coronavirus disease 2019 pandemic. Little is known about the associations between loneliness and symptom burden in oncology patients before and during the pandemic. Study purposes include determining the prevalence of loneliness in a sample of oncology patients; evaluating for differences in demographic, clinical, and symptom characteristics between lonely and nonlonely patients; and determining which demographic, clinical, and symptom characteristics were associated with membership in the lonely group.

METHODS

A convenience sample (n = 606) completed online surveys that evaluated the severity of loneliness, social isolation, and common symptoms (ie, anxiety, depression, fatigue, sleep disturbance, cognitive dysfunction, and pain) in oncology patients. Parametric and nonparametric tests were used to evaluate for differences in scores between the lonely and nonlonely groups. Logistic regression analysis was used to determine risk factors for membership in the loneliness group.

RESULTS

Of the 606 patients, 53.0% were categorized in the lonely group. The lonely group reported higher levels of social isolation, as well as higher symptom severity scores for all of the symptoms evaluated. In the multivariate model, being unmarried, having higher levels of social isolation, as well as higher levels of anxiety and depressive symptoms were associated with membership in the lonely group.

CONCLUSIONS

Study findings suggest that a significant number of oncology patients are experiencing loneliness, most likely as a result of mandate social distancing and isolation procedures. The symptom burden of these patients is extremely high and warrants clinical evaluation and interventions.

Profiles of Loneliness and Social Isolation in Physically Active and Inactive Older Adults in Rural England

Objective: Loneliness and social isolation are associated with higher risk of morbidity and mortality and physical inactivity in older age. This study explored the socioecological context in which both physically active and inactive older adults experience loneliness and/or social isolation in a UK rural setting. Design: A mixed-methods design employed semi structured interviews and accelerometer-measured moderate-to-vigorous physical activity (MVPA). Interviews explored the personal, social and environmental factors influencing engagement with physical activities, guided by an adapted-socioecological model of physical activity behaviour. Findings: Twenty-four older adults (Mean Age = 73 (5.8 SD); 12 women) were interviewed. Transcripts were thematically analysed and seven profiles of physical activity, social isolation and loneliness were identified. The high-MVPA group had established PA habits, reported several sources of social contact and evaluated their physical environment as activity friendly. The low MVPA group had diverse experiences of past engagement in social activities. Similar to the high MVPA, they reported a range of sources of social contact but they did not perceive the physical environment as activity friendly. Conclusions: Loneliness and/or social isolation was reported by both physically active and inactive older adults. There is wide diversity and complexity in types and intensity of PA, loneliness and social isolation profiles and personal, social and environmental contexts.

Older working adults in the HEAF study are more likely to report loneliness after two years of follow-up if they have negative perceptions of their work quality

BACKGROUND

Loneliness is an important public health issue associated with mortality and morbidity. Often researched amongst older people, less is known about risk factors for loneliness among adults aged 50-64 years who are in work. We investigated (a) if exit from the workforce increases the odds of loneliness; (b) whether adverse psychosocial work factors are associated with increased odds of loneliness over 2 years of follow-up; and (c) whether the association is stronger among subjects still working compared with those who have exited the workforce.

METHODS

Data came from the Health and Employment After Fifty (HEAF) study, a large population cohort who provided questionnaire information about work and health at baseline and 2 annual follow-ups. Logistic regression was used to explore the association between psychosocial risk factors and loneliness at follow-up 2, with adjustment for loneliness at baseline, sex, age, self-rated health, living alone, and mental health diagnosis.

RESULTS

Of the initial 8134 participants, 4521 were working at baseline and provided data for this analysis. Of those, 507 (11.2%) were defined as lonely at 2 years' follow-up. Exiting the workforce was not significantly associated with loneliness (OR = 1.1, 95%CI: 0.7-1.7). However, negative psychosocial work factors predicted loneliness at follow-up. After mutual adjustment, lack of choice at work (OR: 1.5, 95%CI: 1.1-1.9), often lying awake worrying about work (OR: 1.4, 95%CI: 1.0-1.9) and perceived not coping with physical demands of the job (OR: 1.3, 95%CI: 1.0-1.7) were independent predictors, with associations robust to adjustment for demographic factors and health. Associations were only slightly altered when we restricted the sample to those who remained in work until the end of follow-up.

CONCLUSIONS

Loneliness amongst middle-aged working adults is not predicted by permanent work exit but is predicted by individuals' perceptions about their work. Provision of good-quality work, matched to the capacity of the older worker, could prevent loneliness.

Worry about debt is related to social loneliness in older adults in the Netherlands

The amount of financial debt held by older adults has grown substantially over the past two decades in Europe. This study examines the association of objective and subjective debt burden with social and emotional loneliness among 1,606 older adults in the Netherlands. Objective debt burden is based on financial terms, such as debt-to-income ratio; whereas subjective debt burden measures the psychological distress caused by financial debt. Data are from the 2015/2016 wave of the Longitudinal Aging Study Amsterdam. First, we use means-comparison tests to examine whether older adults who experience social and emotional loneliness differ from older adults who do not experience loneliness regarding their subjective and objective debt burdens. Subsequently, using linear regression models we address two questions: whether social loneliness and emotional loneliness are associated with objective and subjective debt burden; and whether social participation, social network size, anxiety and depression mediate these relationships. We find that subjective debt burden (i.e. the worry related to debt) is a significant predictor of social loneliness, above and beyond the role of social and psychological measures. Objective debt burden, in contrast, is unrelated to social and emotional loneliness. Social participation, social network size, anxiety and depression do not mediate the debt-burden-to-loneliness relationships. The results point to the importance of subjective debt burden in understanding social loneliness and designing interventions.

Conversations in Times of Isolation: Exploring Rural-Dwelling Older Adults' Experiences of Isolation and Loneliness during the COVID-19 Pandemic in Manitoba, Canada

Older adults have been described as a vulnerable group in the current context of the COVID-19 pandemic. In Canada, where this study took place, older adults have been encouraged to self-isolate while the rest of the population has been cautioned against in-person contact with them. Prior to COVID-19, social isolation and loneliness among older adults was considered a serious public health concern. Using a series of semi-structured interviews with 26 community-dwelling older adults (65+) living in rural Manitoba, we explore older adults' experiences of isolation and loneliness in the initial stages of the pandemic between the months of May and July 2020. Participants identified a loss of autonomy, loss of activities and social spaces (e.g., having coffee or eating out, volunteering, and going to church), and lack of meaningful connection at home as factors influencing their sense of isolation and loneliness. Although these loses initially influenced participants' self-reported isolation and loneliness, the majority developed strategies to mitigate isolation and loneliness, such as drawing on past experiences of isolation, engaging in physically distanced visits, connecting remotely, and "keeping busy." Our findings call attention to the role of different environments and resources in supporting older adults social and emotional wellbeing, particularly as they adapt to changes in social contact over time.

Why visiting one's ageing mother is not enough: on filial duties to prevent and alleviate parental loneliness

As people grow old, many risk becoming chronically lonely which is associated with e.g. depression, dementia, and increased mortality. Whoever else should help to protect them from this risk, various philosophers have argued that any children that they might have will often be among them. Proceeding on this assumption, this article considers what filial duties to protect ageing parents from loneliness consist of, or might consist of. I develop my answer by showing that a view that may be intuitively plausible, namely that they simply require children to visit their ageing parents regularly when they can do so at reasonable cost and call, text, and/or email them from time to time, is defective in three respects. First, it ignores children's potential responsibilities to encourage and/or facilitate social interaction between their parents and third parties. Second, it ignores their potential responsibilities to help provide their parents with non-human companionship. Third, it elides over their duties to coordinate their efforts to offer loneliness protection with others. What I end up proposing instead, then, is an approach for protecting ageing parents from loneliness that is multi-faceted.

[Position paper of the Austrian Alzheimer Association (Österreichische Alzheimer Gesellschaft, ÖAG) : Effects of the COVID-19 pandemic in Austria on people with dementia and their care environment-problem areas, recommendations, and strategies]

Older adults are particularly affected by the current COVID-19 (SARS-CoV-2) pandemic. The risk of dying from COVID-19 increases with age and is often associated with pre-existing health conditions. Globally, more than 50 million-in Austria currently approximately 140,000 people-suffer from dementia. The co-occurrence of dementia as a "pandemic of old age" together with the COVID-19 pandemic has a double impact on persons living with dementia and their caregivers. The COVID-19 pandemic poses major challenges for individuals with dementia and their caregivers: (1) People with dementia have limited access to information on COVID-19, may have difficulties with protective measures such as wearing masks and in remembering safety regulations. (2) People with dementia live alone or with their family, or are institutionalized. To reduce the chance of infection among older people in nursing homes, Austrian local authorities have banned visitors to nursing homes and long-term care facilities and implemented strict social-distancing measures. As a result, older people lost face-to-face contact with their family members, became isolated and social activities stopped. Consequently, anxiety, stress and serious concerns about infections among staff in nursing homes increased and they developed signs of exhaustion and burnout during the full lockdown of the facilities. Thus, due to the emerging COVID-19 crisis, the Austrian Alzheimer Association (Österreichische Alzheimer Gesellschaft, ÖAG) and international societies developed recommendations to support people living with dementia and their caregivers on various issues of physical and mental health.

Loneliness and social isolation is associated with sleep problems among older community dwelling women and men with complex needs

Sleep problems, loneliness and social isolation often increase with age, significantly impacting older adults’ health and wellbeing. Yet general population health empirical evidence is surprisingly scant. Using the largest national database to date, cross-sectional and longitudinal analyses was undertaken on 140,423 assessments from 95,045 (women: 61.0%) community living older adults aged ≥ 65 years having standardised home care assessments between 1 July 2012 and 31 May 2018 to establish the prevalence and relationships between insufficient sleep, excessive sleep, loneliness and social isolation. At first assessment, insufficient sleep (women: 12.4%, men: 12.7%) was more commonly reported than excessive sleep (women: 4.7%, men: 7.6%). Overall, 23.6% of women and 18.9% of men reported feeling lonely, while 53.8% women and 33.8% men were living alone. In adjusted longitudinal analyses, those who were lonely and socially isolated were more likely to experience insufficient sleep. Respondents with excessive sleep were more likely to live with others. Both loneliness and social isolation contributed to insufficient sleep, synergistically. Loneliness, social isolation and health-concerns may affect the restorative properties of sleep over and above the effects of ageing. Further research is warranted.

Risk and Protective Factors of Loneliness among Older Adults: The Significance of Social Isolation and Quality and Type of Contact

Loneliness has a significant impact on the health and well-being of older people, including an increased risk of mortality. This cross-sectional study explored possible risk and protective factors that can help explain loneliness and emotional and social loneliness in a sample of community-dwelling older adults (N = 477). The survey incorporated a standardized scale of loneliness and items to assess type and quality of contact with others, community support, social isolation, physical health, cognitive health, and functional ability. Bivariate and multivariate analyses explored the factors that contributed to loneliness, emotional loneliness, and social loneliness. Results indicated overall quality of contact with others, use of phone contact, and social isolation was significant in all three regressions; other significant variables were different for each analysis. The findings support social work and public health recommendations for addressing loneliness, particularly within the current climate of "social distancing" under the COVID-19 pandemic.

Validation of the De Jong Gierveld Loneliness Scale, 6-item version, in a multiethnic population of Chilean older adults

OBJECTIVE

To analyse the psychometric properties of the De Jong Gierveld Loneliness Scale, 6-item version (DJGLS-6), in a multiethnic sample of older Chilean adults.

METHODS

A cross-sectional study was designed using a sample of 800 older people, and 71% were self-declared indigenous. Data quality and acceptability, internal consistency, and construct and structural validity of DJGLS-6 were analysed. The scale was also analysed according to the Rasch model.

RESULTS

The DJGLS-6 scored higher for the non-indigenous group than for Aymara and Mapuche (P < .001). KR-20 coefficients (internal consistency) for emotional loneliness subscale reached 0.44 for Aymara and Mapuche and 0.62 for non-indigenous, and from 0.73 (non-indigenous) to 0.86 (Aymara) for social loneliness subscale. The confirmatory factor analysis identified one dimension. None of the two subscales fit the Rasch model.

CONCLUSION

The results indicate that DJGLS-6 is a reliable and adequate scale for non-indigenous Chilean older people. However, it should be culturally adapted to indigenous ethnic minorities.

Loneliness around the world: Age, gender, and cultural differences in loneliness

The BBC Loneliness Experiment provided a unique opportunity to examine differences in the experience of lonelines across cultures, age, and gender, and the interaction between these factors. Using those data, we analysed the frequency of loneliness reported by 46,054 participants aged 16-99 years, living across 237 countries, islands, and territories, representing the full range of individualism-collectivism cultures, as defined by Hofstede (1997). Findings showed that loneliness increased with individualism, decreased with age, and was greater in men than in women. We also found that age, gender, and culture interacted to predict loneliness, although those interactions did not qualify the main effects, and simply accentuated them. We found the most vulnerable to loneliness were younger men living in individualistic cultures.