Older adult loneliness: myths and realities

Coping with loneliness: what do older adults suggest?

OBJECTIVES

A limited amount of information is available on how older adults cope with loneliness. Two ways of coping are distinguished here, i.e., active coping by improving relationships and regulative coping by lowering expectations about relationships. We explore how often older adults suggest these options to their lonely peers in various situations and to what extent individual resources influence their suggestions.

METHOD

After introducing them to four vignettes of lonely individuals, discriminating with regard to age, partner status, and health, 1187 respondents aged 62-100 from the Longitudinal Aging Study Amsterdam were asked whether this loneliness can be alleviated by using various ways of coping.

RESULTS

In general, both ways of coping were often suggested. However, regression analyses revealed that active coping was suggested less often to people who are older, in poor health, or lonely and by older adults who were employed in midlife and have high self-esteem. Regulative coping was suggested more often to people who are older and by older adults with a low educational level and with low mastery.

CONCLUSIONS

Coping with loneliness by actively removing the stressor is less often seen as an option for and by the people who could benefit most from it. This underlines the difficulty of combating loneliness.

Effects of a physical activity governmental health programme on the quality of life of elderly people

Background:

The population ageing occurring worldwide resulted in multiple researches on sedentary ageing and quality of life.

Purpose:

To verify the effects of a physical activity programme on the quality of life (QOL) of elderly individuals served by a governmental health programme.

Design:

Descriptive inquiry research.

Methods:

Randomly distributing 70 elderly individuals in a control group ( n=35; mean±SD 69.80±8.05 years) and an experimental group ( n=35; 68.66±5.93 years) plus QOL evaluation via WHOQOL-Old.

Results:

The experimental group showed significant best results on the post-test by repeated-measures ANOVA on sensorial functioning (Δ%=0.022%, p=0. 0001), social participation (Δ%=0.012%, p=0.013), perceptions of death and dying (Δ%=0.04%, p=0.009), intimacy (Δ%=0.059%, p=0.05), and total score (Δ%=0.001, p=0.000).

Conclusions:

Sensorial functioning, social participation, perceptions of death and dying, and intimacy play an important role in the positive relationship between physical activity and QOL.

Insights and principles for supporting social engagement in rural older people

Staying socially engaged is known to improve health and longevity in older people. As the population ages, maintaining levels of social engagement among older people becomes increasingly important. Nevertheless, advancing age brings with it many challenges to social engagement, especially in rural areas. A three-year Australian Research Council Linkage Project sought to improve understandings of age-related triggers to social disengagement in six Tasmanian communities that are representative of rural Australian experience, and thus of wider salience. A collaboration between academics and health and social professionals, the project investigated design solutions for service frameworks that may be useful before ageing individuals become isolated and dependent, and that may support those individuals to actively contribute to and benefit from social life. The purpose of this paper is to report on perspectives about diminishing levels of social engagement held by older rural participants and service providers, and to advance a number of key insights on ways in which to nurture social engagement and improve the experience of ageing.

Loneliness and emotional intelligence

The possible associations of loneliness with Emotional Intelligence (EI), 2 of its correlates (life satisfaction and a sense of meaning), and several background variables were tested on a sample of 134 young adults attending college in northern Israel. Structural Equation Modeling (SEM) analysis provided support for the model, suggesting that the presence of meaning, EI, and size and availability of an individual's social network are the strongest correlates of loneliness. EI therefore emerges as a potentially important factor in our understanding of loneliness, and the model provides a framework for future studies. The results are discussed vis-à-vis existing findings in the literature and possible directions for approaching loneliness as a theoretical concept and a social phenomenon.

The prevalence of loneliness among adults: a case study of the United Kingdom

Within contemporary Western (post) modern societies, loneliness is seen as a problem that is particularly associated with old age. Much less attention has been given to examining variations in loneliness across age groups. We examine patterns of loneliness across adults aged 15 years and older in the United Kingdom using data from the European Social Survey. We first consider the prevalence of loneliness among the adult population; then the relationship between loneliness and a range of key risk factors, and finally the relationship with age for each of our risk factors. Loneliness demonstrates a nonlinear U-shaped distribution, with those aged under 25 years and those aged over 65 years demonstrating the highest levels of loneliness. Depression is associated with loneliness for all age groups. Poor physical health is associated with loneliness in young adult and midlife but not later life. For those in mid and later life, the quality of social engagement is protective against loneliness, while for young adults it is the quantity of social engagement. This indicates that different factors may endow vulnerability (or protect) against loneliness at different stages of life and suggests that preventative strategies or interventions that reflect these variations need to be developed.

Use of Direct Versus Indirect Approaches to Measure Loneliness in Later Life

The aim of the current investigation was to compare a direct versus an indirect approach for measuring loneliness by comparing the one-item Center for Epidemiologic Studies Depression Scale, representing the direct approach, with the shortened version of the Revised UCLA Loneliness Scale, representing the indirect approach, using approximately 2,000 observations from the 2002 Health and Retirement Study. The authors artificially identified a cut point of ≥6 on the three-item Revised UCLA Loneliness Scale to potentially yield the most similar results to the single-item scale and demonstrate the best sensitivity and specificity. Nonetheless, a high rate of respondents (57%) who reported being lonely on the direct item were classified as not lonely on the indirect scale. Inconsistency between the two approaches was also evident with regard to the associations between loneliness and age, as well as with education. These findings indicate that the different measures of loneliness provide a somewhat different picture of both the prevalence of loneliness and the characteristic of the people who suffer from it.

Experienced discrimination amongst European old citizens

This study analyses the experienced age discrimination of old European citizens and the factors related to this discrimination. Differences in experienced discrimination between old citizens of different European countries are explored. Data from the 2008 ESS survey are used. Old age is defined as being 62 years or older. The survey data come from 28 European countries and 14,364 old-age citizens. Their average age is 72 years. Factor analysis is used to construct the core variable 'experienced discrimination'. The influence of the independent variables on experienced discrimination is analysed using linear regression analysis. About one-quarter of old European citizens sometimes or frequently experience discrimination because of their age. Gender, education, income and belonging to a minority are related to experienced age discrimination. Satisfaction with life and subjective health are strongly associated with experienced age discrimination, as is trust in other people and the seriousness of age discrimination in the country. Large, significant differences in experienced discrimination due to old age exist between European countries. A north-west versus south-east European gradient is found in experienced discrimination due to old age. The socio-cultural context is important in explaining experienced age discrimination in old European citizens. Old-age discrimination is experienced less frequently in countries with social security arrangements. Further research is needed to understand the variation in (old) age discrimination between European countries. Measures recommended include increasing public awareness about the value of ageing for communities and changing public attitudes towards the old in a positive way.

Older people living alone at the end of life in the U.K.: research and policy challenges

Older people who live alone face particular challenges if they are to age and die well in the place and manner of their choosing. This discussion paper examines the experiences and needs of older people living alone towards the end of life. The paper focuses on the U.K., given recent policy and service development initiatives there which emphasize home as a place of support and care; the promotion of independence; ensuring choice and decision making; and equity. These initiatives do not acknowledge diversity in the older population and make little provision to meet the specific needs that older people living alone may have as they approach the end of life. We identify three broader social factors that influence whether older people who live alone can remain at home until the end of their lives. The first factor is the physical environment; the second concerns their material environment; and the third relates to their social environment and their access to informal and formal care services. In future, palliative care research of relevance to older people should consider living arrangements as an important variable and be cognisant of the way in which wider social issues constrain the quality of end-of-life care that those living alone in older age receive.

Affect and loneliness among centenarians and the oldest old: the role of individual and social resources

OBJECTIVES

Affect and loneliness are important indicators of mental health and well-being in older adulthood and are linked to significant outcomes including physical health and mortality. Given a large focus on young-old adults within gerontological research, the primary aim of this study was to examine the ability of individual and social resources in predicting affect and loneliness within a sample of oldest-old individuals including centenarians, an understudied population.

METHODS

Participants were assessed during the most recent cross-sectional data collection of the Georgia Centenarian Study. The eligible sample included 55 octogenarians (M = 83.70 years, SD = 2.68; range = 81-90) and 77 centenarians (M = 99.78 years, SD = 1.64; range = 98-109). Subjects scored 17 or greater on the Mini-Mental Status Exam and completed mental health assessments.

RESULTS

Hierarchical regression analyses were conducted to examine the relation of affect and loneliness with demographic characteristics, physical and social functioning, cognition, and personality. Within this sample of cognitively intact oldest old, measures of executive control and cognitive functioning demonstrated limited association with mental health. Personality, specifically neuroticism, was strongly related to mental health indicators for both age groups and social relations were particularly important associates of centenarians' mental health.

DISCUSSION

Findings indicate the distinctiveness of mental health indicators and the need to distinguish differential roles of individual and social resources in determining these outcomes among octogenarians and centenarians.

Strength and vulnerability integration: a model of emotional well-being across adulthood

The following article presents the theoretical model of strength and vulnerability integration (SAVI) to explain factors that influence emotion regulation and emotional well-being across adulthood. The model posits that trajectories of adult development are marked by age-related enhancement in the use of strategies that serve to avoid or limit exposure to negative stimuli but by age-related vulnerabilities in situations that elicit high levels of sustained emotional arousal. When older adults avoid or reduce exposure to emotional distress, they often respond better than younger adults; when they experience high levels of sustained emotional arousal, however, age-related advantages in emotional well-being are attenuated, and older adults are hypothesized to have greater difficulties returning to homeostasis. SAVI provides a testable model to understand the literature on emotion and aging and to predict trajectories of emotional experience across the adult life span.

Elderly quality of life impacted by traditional Chinese medicine techniques

BACKGROUND

The shift in age structure is having a profound impact, suggesting that the aged should be consulted as reporters on the quality of their own lives.

OBJECTIVES

The aim of this research was to establish the possible impact of traditional Chinese medicine (TCM) techniques on the quality of life (QOL) of the elderly.

SAMPLE

Two non-selected, volunteer groups of Rio de Janeiro municipality inhabitants: a control group (36 individuals), not using TCM, and an experimental group (28 individuals), using TCM at ABACO/Sohaku-in Institute, Brazil.

METHODS

A questionnaire on elderly QOL devised by the World Health Organization, the WHOQOL-Old, was adopted and descriptive statistical techniques were used: mean and standard deviation. The Shapiro-Wilk test checked the normality of the distribution. Furthermore, based on its normality distribution for the intergroup comparison, the Student t test was applied to facets 2, 4, 5, 6, and total score, and the Mann-Whitney U rank test to facets 1 and 3, both tests aiming to analyze the P value between experimental and control groups. The significance level utilized was 95% (P < 0.05).

RESULTS

The experimental group reported the highest QOL for every facet and the total score.

CONCLUSIONS

The results suggest that TCM raises the level of QOL.

Factors Associated With Loneliness of Noninstitutionalized and Institutionalized Older Adults

Objectives: First, to seek if sociodemographic and health factors contribute differentially to the explanation of loneliness in institutionalized and noninstitutionalized older adults; and second, to analyze the influence of institutionalization on loneliness. Method: This work was based on two surveys of older adults aged 60 years or more in Spain. A group of 234 community-dwelling people and 234 nursing homes residents were selected ( n = 468). Logistic regression models were applied using the six-item De Jong Gierveld Loneliness Scale as dependent variable. Results: Depression was associated with loneliness in both populations. Sex and marital status contributed to explain loneliness among those living at home, whereas gathering with family, friends, and neighbors showed a significant effect in the institutionalized group. Institutionalization per se showed a strong effect on loneliness. Discussion: Findings have potential implications for targeting older adults at risk for loneliness.

[Loneliness among the elderly in Spain and Sweden: context and culture]

OBJECTIVES

Older people in Spain and other Southern European countries are reported to feel lonelier than the older people in the North of Europe. Data from the 1970s and onwards consistently show this. The present study explores feelings of loneliness as a product of both cultural and situational determining factors, by comparing survey data for Spain and Sweden.

MATERIAL AND METHOD

Data derived from several national surveys of the older people in Spain and Sweden with questions about loneliness. For closer analysis we use the Spanish 2006 Encuesta de Condiciones de Vida (Living conditions Questionnaire), and the Swedish 2002-2003 Survey of Living Conditions.

RESULTS

On average, 24% of older people in Spain and 10% of elderly Swedish people expressed sentiments of loneliness in the surveys used here (2006 and 2002-03 respectively). Living arrangements and perceived health are related with factors of loneliness in both countries, although levels differ. For example, people in good health who live alone are five times more likely to feel lonely in Spain (45%) than in Sweden (9%) and two-three times more likely when living alone in poor health (82% and 32% respectively). People in good health who live with their spouse/partner only are equally unlikely in both Spain and Sweden to express loneliness (4-5%). It often seems--when it occurs--to be due to caring for a spouse/partner, or problems in the relationship.

CONCLUSIONS

Results highlight the importance of contextual features--health and living arrangements--and cultural expectations in interpreting reported loneliness.

The older, the lonelier? Risk factors for social loneliness in old age

Loneliness is often associated with old age, but many studies have shown that the relationship is not straightforward. This paper seeks a better understanding of the impact of social isolation on feelings of loneliness among older people, by building on the theoretical and actual distinction between social and emotional loneliness. Social loneliness refers to a lack of feelings of social integration; emotional loneliness emerges in the absence of an attachment figure. This paper focuses on social loneliness and has two aims, first to disentangle the direct and intermediate effects of both the number and the quality of social relationships on social loneliness in old age, and second to detect the groups at risk of social loneliness by identifying which personal features correspond with which relational deficits and therefore indirectly increase the risk on social loneliness. Data are analysed for a sample of 1,414 respondents aged 55 or more years drawn from the Panel Study of Belgian Households conducted in 2000. The results confirm that improved understanding is gained by decomposing the interrelation between age and other background features, on the one hand, and the social relational features, on the other, as indirect and direct predictors of social loneliness. Generally, this approach promotes a correct identification of the groups at risk of social loneliness in old age.

The De Jong Gierveld short scales for emotional and social loneliness: tested on data from 7 countries in the UN generations and gender surveys

Loneliness concerns the subjective evaluation of the situation individuals are involved in, characterized either by a number of relationships with friends and colleagues which is smaller than is considered desirable (social loneliness), as well as situations where the intimacy in confidant relationships one wishes for has not been realized (emotional loneliness). To identify people who are lonely direct questions are not sufficient; loneliness scales are preferred. In this article, the quality of the three-item scale for emotional loneliness and the three-item scale for social loneliness has been investigated for use in the following countries participating in the United Nations “Generations and Gender Surveys”: France, Germany, the Netherlands, Russia, Bulgaria, Georgia, and Japan. Sample sizes for the 7 countries varied between 8,158 and 12,828. Translations of the De Jong Gierveld loneliness scale have been tested using reliability and validity tests including a confirmatory factor analysis to test the two-dimensional structure of loneliness. Test outcomes indicated for each of the countries under investigation reliable and valid scales for emotional and social loneliness, respectively.

Loneliness among older Europeans

More than two decades of research has consistently indicated that feelings of loneliness among older people are more common in southern Europe than in its northern parts, with the lowest rates in Denmark and Sweden. Our analyses based on analysis of 2004-2006 data from 8,787 individuals aged 65 years or older in the SHARE project replicate, update, and extend these findings. We found, similar to previous studies, that the prevalence of feelings of loneliness was more common in the Mediterranean countries than in Northern Europe. Living together with a spouse/partner was consistently associated with the lower prevalence of loneliness across countries. The combination of living alone and having bad health was associated with 10 times higher odds of feeling lonely as compared with living together with someone and having good health. With regard to gender and health, we found signs of differences between countries in how these factors were related to loneliness. Our results indicate the importance of both contextual features and cultural expectations in interpreting reported loneliness, that is, loneliness across Europe has both nomothetic and idiographic features.