Older adult loneliness: myths and realities

Changes in prevalence of loneliness among home-dwelling older adults over three decades and associated factors

BACKGROUND

Studies examining loneliness trends over several decades among comparable cohorts of older people are rare.

OBJECTIVE

We evaluated how the prevalence of self-reported loneliness has changed over three decades among home-dwelling older people (75+ years), and factors associated with loneliness.

METHODS

We used data from four waves of the Helsinki Aging Study (1989-present), a repeated cross-sectional cohort study. The data had been collected using a postal questionnaire. The sample sizes were: 1989 (n = 660), 1999 (n = 2598), 2009 (n = 1637), 2019 (n = 1758). Based on responses to the question "Do you suffer from loneliness?", we categorized the respondents into lonely ('always or often', 'sometimes') and not lonely ('seldom or never'). The associations between various characteristics and loneliness were explored.

RESULTS

The prevalence of loneliness among older people decreased slightly between 1989 and 2019, from 34 % to 30 %. Loneliness decreased among both sexes. In the multivariable forward stepwise regression model, factors associated with loneliness were widowhood (OR 2.18, 95 % CI 1.91-2.49), needing help daily (OR 1.83, 95 % CI 1.56-2.16), feeling depressed (OR 5.26, 95 % CI 3.56-7.77), comorbidities (OR 1.07, 95 % CI 1.03-1.11), feeling useful (OR 0.36, 95 % CI 0.31-0.41), meeting friends (OR 0.65, 95 % CI 0.57-0.74), and male sex (OR 0.69, 95 % CI 0.59-0.80).

CONCLUSIONS

Loneliness among both older men and women has decreased over the past three decades. Several factors were found to be associated with loneliness. Given the detrimental impact of loneliness on health of individuals, policies and health strategies aimed at alleviating loneliness among older people should be a top priority.

Comprehensive geriatric assessment for older adults admitted to the hospital as emergencies: a meta-analysis of randomized controlled trials

OBJECTIVE

To evaluate the effects of comprehensive geriatric assessment (CGA) on mortality, readmission, activities of daily living (ADL) improvement, and length of hospital stay in acutely hospitalized older patients.

METHODS

In accordance with the guidelines from the Cochrane recommendations and PRISMA guidelines, we conducted a search of seven databases: PubMed, Web of Science, Embase, CINAHL, ProQuest, ScienceDirect, and Cochrane Library, aiming to identify eligible studies published from the time of database inception up to February 23, 2024. The quality of the included studies was assessed using the Cochrane Risk of Bias (RoB) 2.0. Following the literature search, two researchers independently performed data extraction and quality assessment, and conducted meta-analysis using Review Manager 5.4 software, pooling risk ratios (RR) and 95 % confidence intervals (CI). Heterogeneity among studies was evaluated using the I2 statistic.

RESULTS

Twenty-three trials involving 9,477 participants were identified. The final meta-analysis showed that CGA did not significantly reduce mortality overall. However, subgroup analyses revealed that older patients living alone who underwent CGA had a lower risk of mortality at 6 months (RR 0.43, 95 % CI 0.21 to 0.90; P = 0.03). At six months post-discharge, CGA reduced readmission rates (RR 0.49, 95 % CI 0.36 to 0.68; P < 0.0001), and improved ADL outcomes in targeted populations (RR 3.04, 95 % CI 1.05 to 8.79; p = 0.04), though no differences were observed in length of stay (MD 0.50, 95 % CI -1.98 to 2.98; P = 0.69).

CONCLUSION

CGA may improve short-term survival and reduce rates of readmission following acute hospitalization. These findings highlight CGA's potential to enhance geriatric nursing practice through comprehensive evaluations addressing both functional status and social vulnerabilities. Further research is needed to explore multicenter, standardized CGA frameworks with long-term follow-up, which are essential for establishing evidence-based clinical guidelines to facilitate seamless integration of CGA into routine geriatric care pathways.

[A panel model of the relationships between loneliness and depression in older adults]

ANTECEDENTS AND OBJECTIVE

The declining birth rate and increasing life expectancy have led to an aging population, causing challenges at the economic, social and healthcare levels. Ensuring and maintaining high levels of well-being and mental health in older adults is crucial for successful aging. Given that previous literature indicates that perceived loneliness and depressive symptoms constitute significant obstacles to their quality of life, the aim of this study is to examine how perceived loneliness and depression intertwined in community-dwelling older adults over time.

METHODOLOGY

For this purpose, we conducted a longitudinal research study with a total of 46,317 European older adults (57.40% women), using the SHARE database (Survey of Health, Ageing and Retirement in Europe), at waves 6, 7, and 8, spanning a recent four-year period from 2016 to 2020. Several cross-lagged panel models were estimated using the structural equation modeling package Mplus.

RESULTS

The results show that loneliness and depression are bidirectionally related, which is difficult to combat because of their feedback and stability over time.

CONCLUSIONS

We discuss the practical implications of these findings concerning the potential double-edged sword of these reciprocal relationships on treatment and preventive interventions, as well as the study's limitations and future research directions.

Womanhood bound to motherhood: Choosing childlessness in Türkiye

This article aims to evaluate the subjective experiences of voluntarily childless Turkish women, and based on the data collected through in-depth interviews where [a] what it means for them to be a childless woman, [b] what the motivations behind choosing a childless life are, and [c] how they negotiate their childless identity in a pronatalist society are explored. A total of 18 women were interviewed, and three meta-themes [negotiating identity and agency in a pronatalist society, the emotional landscape of childlessness, pathways and motivations for remaining childless] were generated through main themes and subthemes based on the data. All participating women reported some degree of emotional and social distress arising from the stigma they feel within their environmental contexts. Many of them tapped into the "felt outsiderness" among people following traditional gender roles ascribed by Turkish society. All of them felt comfortable with their decision to choose and remain childless despite some difficulties it might bring as a result of living in a society that equates womanhood with motherhood. They presented a variety of individual, familial, and social factors that impact their choice of pursuing a childless life. The article argues that the decision to remain childless is not merely a personal preference but a complex, multi-layered process shaped by sociocultural expectations, gender norms, and individual agency. It highlights how voluntarily childless women actively negotiate their identities within a pronatalist society, challenge traditional narratives surrounding womanhood, and construct meaningful lives that do not conform to dominant reproductive expectations.

Reversed loneliness development after age 65 for men and women: Modeling of the age trajectories of loneliness using national cohorts in Taiwan and Japan

AIM

This study depicts the age trajectories of loneliness and gender differences among older adults in Taiwan and Japan.

METHODS

Two nationally representative data sets for older adults in Taiwan and Japan were obtained from the Taiwan Longitudinal Study on Aging (TLSA, 1996-2011) and the National Survey of the Japanese Elderly (NSJE, 1996-2012), respectively. The analytic sample included 3037 and 1974 older adults aged 65 and over at baseline in Taiwan and Japan, respectively.

RESULTS

The prevalence rate of loneliness for adults aged 65+ living in the community was 23.64% in Taiwan and 17.03% in Japan. Higher average levels (βTaiwan = 0.1508, P < 0.001) and rates of increment (βTaiwan*age = 0.0068, P < 0.05) in loneliness development were found in Taiwan as compared with Japan. In addition, although women reported higher levels of loneliness compared with men at age 65 (29.0% vs. 19.4% in Taiwan, and 19.3% vs. 13.9% in Japan), a soaring development of loneliness with accelerated rates of increment after age 65 was observed in men in both countries.

CONCLUSIONS

Lonliness in old age is very different between men and women. Women's loneliness curve shows an inverted U state: Although they feel more lonely than men during midlife, it has a downward trend as they get older. On the contrary, men's loneliness curve shows an upward U-shaped curve: After retirement, both Japanese and Taiwanese men continue to rise. Geriatr Gerontol Int 2025; 25: 620-627.

A qualitative study to examine hidden care burden for older adults with overweight and obesity in England

OBJECTIVES

The study aimed to explore the phenomena related to formal and informal social care needs among overweight and obese older adults living in England.

BACKGROUND

Despite the rising prevalence of obesity among older adults, its impact on social care needs remains underexplored. Existing research highlights significant unmet social care needs among older adults, yet the specific challenges faced by those who are overweight or obese have received limited attention. This study addresses this gap by exploring and understanding the social care experiences and needs of older adults in England who are overweight or obese.

METHODS

Participants were recruited from a local National Health Service (NHS) health centre in London England using a purposive sampling strategy to the point of analytical saturation. A total of 45 participants were invited and of these 33 participants were eligible to take part. All participants in this study are either of British origin or immigrants to the UK from various nationalities. A semi-structured interview was conducted, and a qualitative structural narrative analysis was undertaken.

RESULTS

The study found that older adults, who are overweight or obese, were more likely to have physical health problems and problems with mobility. They were more likely to have informal voluntary care and support rather than formal social care support. They also had a weaker social support network, were more isolated and frustrated, lacked housing adaptations, felt unsafe, felt they were a burden to their families and felt discriminated against by the wider community. Care and support needs if not met, then these are likely to generate or widen health inequalities over time.

CONCLUSIONS

This study provides a unique perspective on unmet care needs among overweight and obese older adults in England. It highlights the compounded challenges faced by this population, emphasising the importance of holistic social care approaches that address both health and psychosocial needs. Findings suggest that minimal yet targeted interventions, such as accessible support networks and public health policies promoting social engagement, could significantly improve wellbeing and reduce long-term health inequalities.

Trajectories of loneliness in later life - Evidence from a 10-year English panel study

The prevalence of loneliness is higher among older people; however, few studies have examined its longitudinal patterns and associated risk factors, particularly social network resources. Using data from six waves of the English Longitudinal Study of Ageing (2008/09 to 2018/19, N = 4740) and group-based trajectory modelling (GBTM), we identified five groups of loneliness trajectories: three with stable levels (37% "stable low"; 26% "stable medium"; 9% "stable high") and two with time-varying scores of loneliness (8% "increasing"; 20% "decreasing"). Multinomial regression models and GBTM were used to examine baseline and time-varying factors associated with these trajectories. We created composite measures to capture the presence and key facets of social network resources (including size, support, closeness, and frequency of contact) for four different social relationship domains (partner, children, immediate family, and friends). Our results show that, among those with family or friends, older people with higher social network resources and those who maintained or improved them over time reported lower levels of loneliness. Findings also suggest that all social relationship domains contributed to feelings of loneliness in later life. Also, we find that respondents in poor health and depressed, as well as those whose health deteriorated over time, were more likely to have stable high or increasing levels of loneliness. The study highlights the need to investigate loneliness from a life course perspective, account for the complexity of social relationships in later life beyond their mere presence or absence, and include their quality and quantity as well as multiple domains of family and intergenerational relationships.

Study on the impact of learning engagement on the subjective wellbeing of empty nesters in rural China

With the rapid development of China's socio-economic landscape and shifts in population structure, rural empty nesters have increasingly become a focal point of social concern. Compared to their urban counterparts, rural empty nesters face more life challenges and psychological stress, making their subjective wellbeing a significant issue. This study explores the impact of learning engagement on the subjective wellbeing of rural empty nesters in China, aiming to provide theoretical support and policy recommendations to enhance their wellbeing. Using a random sampling method, the study focused on elderly learners aged 50 and above from counties within Z Province, N City, where elderly learning is relatively concentrated. Data were processed using SPSS 27.0 software. The findings indicate that there is a significant difference in subjective wellbeing between rural empty nesters and rural non-empty nesters, with rural empty nesters exhibiting lower subjective wellbeing and more passive involvement in learning activities. Learning engagement has a significant effect on improving the subjective wellbeing of rural empty nesters, with a notable positive correlation between learning engagement dimensions and subjective wellbeing. Compared to rural non-empty nesters, learning engagement has a more pronounced positive effect on the subjective wellbeing of rural empty nesters.

Toward a National Profile of Loneliness in Old-Age China: Prevalence and Lonely Life Expectancy

OBJECTIVES

Loneliness presents a significant challenge for many older adults in China. Understanding the national scale and patterns of loneliness is critical to inform and guide policy interventions. This study builds a national profile of loneliness among Chinese adults aged 55 and above, illustrating the prevalence of loneliness and the average years expected to feel lonely, and examining how these measures vary by urban/rural residence and gender.

METHODS

This study uses the China Health and Retirement Longitudinal Study (2011-2018, N = 25,563) to estimate the loneliness prevalence across different gender and urban/rural residences. Drawing on Sullivan's method for calculating Healthy Life Expectancy, the author estimate the Lonely Life Expectancy (LLE), which quantifies the expected years an individual will live with loneliness.

RESULTS

Approximately 30% of older Chinese aged 55 and above reported experiencing loneliness during 2011-2018. At age 55, Chinese adults anticipate spending about 7-10 years feeling lonely, representing over one-third of their remaining lifespan. By age 75, this proportion may increase to more than half. Estimates of prevalence and LLE exhibit marked disparities with respect to gender and urban/rural residency. Rural women emerged as the most disadvantaged, facing the highest prevalence and largest proportion of remaining lifetime feeling lonely.

DISCUSSION

Older adults in China spend a significant proportion of their remaining lives feeling lonely. Marked disparities in LLEs underscore the potential role of loneliness in perpetuating health inequalities across different gender and urban/rural residences. These results highlight the urgent need for targeted interventions to mitigate the consequences of prolonged loneliness.

Prevalence and associated factors of loneliness among in-school adolescents in three South Asian countries

Objective: We aimed to determine the prevalence and factors associated with loneliness among adolescent students in three South Asian countries.Methods: We used data from the latest Global School-Based Health Survey of Afghanistan, Bangladesh, and Pakistan. A two-stage cluster sampling design was used to collect the cross-sectional survey data. Data from 8 089 in-school adolescents were analysed using STATA 14.0.Results: Among all the participants, the prevalence of loneliness was 14.9%. The prevalence of loneliness was significantly higher in females (19.7%), Afghan adolescents (35.5%), participants having anxiety-induced sleep disturbance (51.4%), often experiencing bullying (28.9%), feeling hungry often or always (23.9%), suffering parental emotional neglect (21.2%), and spending ≥ 8 hours/day leisure time (35.8%), than their counterparts. The final adjusted model of multiple logistic regression showed that females (OR = 1.36, 95% CI: 1.02 -1.80), having no close friends (OR = 2.00, 95% CI: 1.30 - 3.10), having an anxiety-induced sleep disturbance (OR = 5.25, 95% CI: 3.75 - 7.34), being bullied 1 to 2 days in the past month (OR = 2.13, 95% CI: 1.60 - 2.84), being physically attacked 2 or more times in the past year (OR = 1.69, 95% CI: 1.26 - 2.26), suffering parental emotional neglect (OR = 1.67, 95% CI: 1.18-2.34), and current tobacco user (OR = 2.70, 95% CI: 1.39 - 5.25) had significantly higher odds of having loneliness.Conclusion: We found a higher prevalence of loneliness and identified several risk factors among in-school adolescents in three South Asian countries. To reduce loneliness among in-school adolescents, target-oriented interventions, such as peer, parental, and counselling support, are needed at schools.

Social Robots and Sensors for Enhanced Aging at Home: Mixed Methods Study With a Focus on Mobility and Socioeconomic Factors

BACKGROUND

Population aging affects society, with a profound impact on daily activities for those of a low socioeconomic status and with motor impairments. Social assistive robots (SARs) and monitoring technologies can improve older adults' well-being by assisting with and monitoring home activities.

OBJECTIVE

This study explored the opinions and needs of older adults, including those with motor difficulties and of a low socioeconomic status, regarding SARs and monitoring technologies at home to promote daily activities and reduce sedentary behaviors.

METHODS

A mixed methods approach was used, with 31 older adults divided into 3 groups: those of a low socioeconomic status, those with motor difficulties, and healthy individuals. Focus groups were conducted, and they were analyzed using thematic analysis. Perceived mental and physical well-being were assessed using the 12-Item Short Form Health Survey, and attitudes toward robots were evaluated using the Multidimensional Robot Attitude Scale.

RESULTS

The results identified 14 themes in four key areas: (1) technology use for supporting daily activities and reducing sedentary behaviors, (2) perceived barriers, (3) suggestions and preferences, and (4) actual home technology use. Lower perceived physical well-being was associated with higher levels of familiarity, interest, perceived utility, and control related to SARs. Lower perceived psychological well-being was linked to a more negative attitude, increased concerns about environmental fit, and a preference for less variety. Notably, older adults from the low-socioeconomic status group perceived less control over SARs, whereas older adults with motor difficulties expressed higher perceived utility compared to other groups, as well as higher familiarity and interest compared to the low-socioeconomic status group.

CONCLUSIONS

Participants indicated that SARs and monitoring technologies could help reduce sedentary behaviors by assisting in the management of daily activities. The results are discussed in the context of these outcomes and the implementation of SARs and monitoring technologies at home. This study highlights the importance of considering the functional and socioeconomic characteristics of older adults as future users of SARs and monitoring technologies to promote widespread adoption and improve well-being within this population.

Impact of remote social interaction during the COVID-19 pandemic on the cognitive and psychological status of older adults with and without cognitive impairment: A randomized controlled study

BACKGROUND

Social isolation and loneliness have both been associated with psychological health and cognitive decline in older adults. This study investigated the impact of social interaction through remote communication technologies during the COVID-19 pandemic on the cognitive and psychological status of older adults with and without cognitive impairment.

METHODS

Participants were recruited from Boston (USA) and Chieti (Italy). The study used a randomized single-blinded controlled crossover design with an intervention (remote social conversations with research staff over 20-minute video or telephone calls three times per week) and a passive control condition, each one of 4-weeks duration. The primary outcome was a composite cognitive score change from baseline to week 4. Secondary outcomes included scales for mood, anxiety, and loneliness.

RESULTS

Out of 196 participants recruited from April 2020 to April 2021, 17% dropped out. Based on the blind MoCA, 52% had cognitive impairment, and 25% were at risk of social isolation according to the Lubben social network scale. We observed that larger social networks were linked to better cognitive status and lower depression and anxiety levels, while loneliness was directly associated to depression severity. Older adults with cognitive impairment exhibited higher levels of depression and anxiety and were at greater risk for social isolation. In terms of the intervention, 91% preferred telephone over video calls. The intervention did not lead to improvements in cognitive or psychological scores.

CONCLUSIONS

More work is needed to assess the utility of this intervention for the support of a heterogenous cross-cultural sample of older adults at-risk for social isolation, including individuals with cognitive impairment. Future research should explore longer intervention periods, categorize participants by call type, and target those meeting social isolation criteria.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04480112.

National trends in loneliness and social isolation in older adults: an examination of subgroup trends over three decades in Sweden

Introduction

Loneliness and social isolation are public health concerns. This study aimed to examine levels and trends in loneliness and social isolation among older adults (77+ years) in Sweden, assess subgroup variations, and determine associations between loneliness and social isolation.

Methods

The 1992, 2002, 2004, 2011, 2014 and 2021 waves of the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) were analysed through ordered logistic and linear regressions.

Results

On average, 12.5 percent of the participants experienced loneliness often/nearly always, while 6 percent were categorised as severely isolated. Loneliness and social isolation were more common in women, those aged 85+, and persons with basic education, in psychological distress or with mobility limitations. Loneliness was also associated with living alone. No increases in loneliness or isolation were identified; instead, loneliness tended to decrease in groups already experiencing lower levels of loneliness. Loneliness and social isolation were moderately associated each survey year.

Discussion

This study challenges perceptions of high and increasing levels of loneliness and social isolation. Given the impact on health and wellbeing and the ageing of populations, policy and practice should still address these issues and target vulnerable groups. Subgroup analyses in trends are scarce and should be explored further in future research.

Estimating risk of loneliness in adulthood using survey-based prediction models: A cohort study

It is widely accepted that loneliness is associated with health problems, but less is known about the predictors of loneliness. In this study, we constructed a model to predict individual risk of loneliness during adulthood. Data were from the prospective population-based FinHealth cohort study with 3444 participants (mean age 55.5 years, 53.4% women) who responded to a 81-item self-administered questionnaire and reported not to be lonely at baseline in 2017. The outcome was self-reported loneliness at follow-up in 2020. Predictive models were constructed using bootstrap enhanced LASSO regression (bolasso). The C-index from the final model including 11 predictors from the best bolasso -models varied between 0.65 (95% CI 0.61 to 0.70) and 0.71 (95% CI 0.67 to 0.75) the pooled C -index being 0.68 (95% CI 0.61 to 0.75). Although survey-based individualised prediction models for loneliness achieved a reasonable C-index, their predictive value was limited. High detection rates were associated with high false positive rates, while lower false positive rates were associated with low detection rates. These findings suggest that incident loneliness during adulthood. may be difficult to predict with standard survey data.

Frailty Assessment and Its Impact on Loneliness among Older Adults Receiving Home-Based Healthcare during the COVID-19 Pandemic

The purpose of this study was to identify the effect of frailty on loneliness among older adults receiving home care, in correlation to their socioeconomic and homebound statuses. This cross-sectional study recruited 218 individuals aged ≥65 years receiving home-based health services from the "Help at Home" program in the Region of Evrytania, Greece through an open invitation from the municipality authorities from March to June 2022. The Tilburg Frailty Indicator (TFI) was used for the evaluation of frailty, the UCLA Loneliness Scale version 3 was used for loneliness, and social isolation was accessed through five questions (living alone, frequency of interaction with children, relatives, friends, and participation in social organizations). The mean age of the participants was 81.48 ± 9.06, 61.9% were female, 54.1% experienced high levels of loneliness (UCLA-3 mean 45.76 ± 11.10 [range 20-68]), and 46.3% of the participants were found to be socially isolated. Also, 58.3% of the individuals were identified as frail (TFI mean 5.95 ± 3.07) [TFI range 0-13], with 57.3% experiencing physical frailty, 43.6% experiencing psychological frailty, and 27.1% experiencing social frailty. An analysis of covariance (ANCOVA) using UCLA-3 as the dependent variable revealed that loneliness across all domains of TFI was significantly higher in participants with frailty (total frailty [Yes] 49.27 vs. [No] 40,87 p < 0.001) (physical frailty [Yes] = 48.99 vs. [No] = 41.42, p < 0.001, psychological: 48.60 vs. 43.57 p < 0.001, and social: 53.38 vs. 42.94 p < 0.001), particularly compared to non-frail individuals, even after adjusting for potential confounding effects (covariates: gender, age, marital status, family status, living status, educational level, annual income, chronic diseases, homebound status, and social isolation). Our findings indicate that frail older adults experienced higher levels of loneliness, suggesting that frailty and loneliness are independently associated among older adults who receive home-based healthcare.

Loneliness Trajectories and Chronic Loneliness Around the World

OBJECTIVES

We examine cross-national variation in (a) loneliness trajectories and (b) the association between common social risk factors and chronic loneliness in middle and older adulthood.

METHODS

Using longitudinal data, we assess the country-level prevalence of loneliness trajectories (chronic, transitory, and no loneliness) and the extent of common social risk factors for loneliness (living alone, widowhood, divorce, no grandchildren, having chronic conditions, and never working) among adults 50 and older in 20 countries covering 47% of the global population in this age bracket. Additionally, we compare how the associations between social risk factors and chronic loneliness vary across countries.

RESULTS

We find considerable variation in the prevalence of chronic loneliness cross-nationally, ranging between 4% (Denmark) and 15% (Greece) of adults 50 and older. Living arrangements have the most consistent association with the likelihood of chronic loneliness across countries, with those ever living alone having an 8% higher likelihood of chronic loneliness on average across countries, with a range of 2%-25%. Additionally, those who never report working and those with chronic conditions have a higher likelihood of chronic loneliness across more than a third of the countries.

DISCUSSION

These results suggest that policies and interventions targeted to middle age and older adults living alone and with limited work histories or with chronic conditions are critical in reducing the public health challenges of chronic loneliness.

Interventions for loneliness in older adults: a systematic review of reviews

Loneliness in older persons is a major risk factor for adverse health outcomes. Before the COVID-19 pandemic led to unprecedented isolation and hampered programs aimed at preventing or reducing loneliness, many interventions were developed and evaluated. However, previous reviews provide limited or conflicting summaries of intervention effectiveness. This systematic review aimed to assess previous review quality and bias, as well as to summarize key findings into an overarching narrative on intervention efficacy. The authors searched nine electronic databases and indices to identify systematic reviews of interventions to reduce loneliness in older people prior to the COVID-19 pandemic; 6,925 records were found initially. Of these, 19 reviews met inclusion criteria; these encompassed 101 unique primary intervention studies that varied in research design, sample size, intervention setting, and measures of loneliness across 21 nations. While 42% of reviews had minimal risk of bias, only 8% of primary studies appraised similarly. Among the 101 unique articles reviewed, 63% of tested interventions were deemed by article author(s) as effective or partially effective. Generally, interventions that included animals, psychological therapies, and skill-building activities were more successful than interventions focused on social facilitation or health promotion. However, interventions that targeted multiple objectives aimed at reducing loneliness (e.g., improving social skills, enhancing social support, increasing social opportunities, and changing maladaptive social cognition) were more effective than single-objective interventions. Future programs should incorporate multiple approaches, and these interventions should be rigorously tested.

Prevalence and predictors of loneliness and its association with health-seeking behaviors among the elderly population, Gujarat, A community-based cross-sectional study

Objectives

To determine the prevalence and predictors of loneliness and its associations with health behaviors among elderly adults in Gujarat, India.

Methodology

This community-based cross-sectional study included 250 participants aged ≥60 years. Loneliness was measured using the UCLA Loneliness Scale. Associations with socio-demographic, health, and social factors were explored through regression models. Health behaviors were compared between lonely and non-lonely groups.

Results

The prevalence of moderate and severe loneliness was 24% (n = 60) and 16% (n = 40), respectively. 40% (n = 100) were found to be lonely. Widowhood (55/125, OR 3.67), living alone (75/125, OR 1.85), social isolation (90/125, OR 2.38), recent bereavement (68/125, OR 1.69), depression (85/125, OR 6.52), and disability (70/125, OR 6.35) were significant predictors of loneliness (P < 0.05). Lonely elders had poorer diet, exercise, sleep, increased smoking, screen time, reduced medical checkups, and social engagements versus non-lonely peers (P < 0.05).

Conclusion

Loneliness was highly prevalent among 40% of elderly Indians and strongly linked to adverse health behaviors. Interventions promoting social connectedness, counseling, and peer support are recommended.

The mediating roles of optimism, loneliness, and psychological distress in the association between a sense of community and meaning in life among older adults

A sense of community is known to be a protective factor for the well-being of older adults and meaning in life associated with positive mental outcomes. Nevertheless, there is a need to expand the knowledge of the role of a sense of community in meaning in life, particularly among older adults. Intending to broaden the empirical understanding from this perspective, the current study examined the mediating roles of optimism, loneliness, and psychological distress in the association between a sense of community and meaning in life. Participants included 740 community dwelling Israeli older adults (M = 71.96; SD = 5.81). Participants completed questionnaires on a sense of community, optimism, loneliness, psychological distress, meaning in life, and sociodemographic characteristics. A positive association was found between a sense of community with optimism, and a negative association with loneliness. A negative association between optimism with psychological distress and a positive link between loneliness with psychological distress was found, while a higher level of psychological distress was associated with a lower level of meaning in life. Practitioners should focus interventions with older adults on developing a sense of community, with the aim to promote optimism and, at the same time, reduce loneliness and thus decrease psychological distress while strengthening meaning in life.

Attitudes towards Technology: Insights on Rarely Discussed Influences on Older Adults' Willingness to Adopt Active Assisted Living (AAL)

BACKGROUND

European research policy promotes active assisted living (AAL) to alleviate costs and reach new markets. The main argument for massive investments in AAL is its potential to raise older adults' Quality of Life and enhance their freedom, autonomy, mobility, social integration, and communication. However, AAL is less widely spread in older adults' households than expected.

RESEARCH AIM

We investigate how the variable "technology acceptance" is connected to socio-economic-, social, health, "personal attitude towards ageing", and "Quality of life" variables.

METHOD

We conducted a study in Vienna between 2018 and 2020, questioning 245 older adults (M = 74, SD = 6.654) living in private homes. We calculated multivariate models regressing technology acceptance on the various exploratory and confounding variables.

RESULTS

Experiencing an event that made the person perceive their age differently changed the attitude towards using an assistive technological system. Participants perceived technology that is directly associated with another human being (e.g., the use of technology to communicate with a physician) more positively.

CONCLUSION

Older adults' attitudes towards technology may change throughout their lives. Using major events in life as potential entry points for technology requires awareness to avoid reducing the lives of older adults to these events. Secondly, a certain human preference for "human technology" may facilitate abuse if technology is given a white coat, two eyes, a nose, and a mouth that may falsely be associated with a natural person. This aspect raises the ethical issue of accurate information as a significant precondition for informed consent.

Age-Specific Changes in the Effects of Social Connectedness and Loneliness on Depressive Symptoms: Evidence From the Korean Longitudinal Study of Ageing Before and During the COVID-19 Pandemic

OBJECTIVE

This study investigates the longitudinal effects of changes in the associations between two distinct aspects of social connections-i.e., social connectedness and loneliness-on depressive symptoms among community-dwelling Korean adults. This study also examines whether these associations vary across three age groups (45-64, 65-74, and 75 or above).

METHODS

Using data from the Korean Longitudinal Study of Ageing collected between 2014 and 2020 (n=3,642 individuals), fixed effects models were used to examine the age-specific associations between the two distinct aspects of social connections and depressive symptoms (Center for Epidemiologic Studies-Depression Scale) while, accounting for time-invariant individual heterogeneity. Social connectedness is measured by asking the frequency of interactions with friends, relatives, or neighbors.

RESULTS

The findings indicate that the impact of loneliness on depressive symptoms outweighs that of social disconnectedness. Notably, this study unveils age-specific patterns concerning the impact of the coronavirus disease-2019 pandemic on depressive symptoms and changes in the association between loneliness and depressive symptoms. Specifically, middle-aged individuals reported higher levels of depressive symptoms and loneliness along with a heightened impact of loneliness on depressive symptoms, despite maintaining stable social connections. Conversely, the oldest adults experienced reductions in both depressive symptoms and loneliness, despite a significant decrease in socializing.

CONCLUSION

These findings shed light on the differential effects of loneliness on depressive symptoms within distinct age groups before and during the pandemic. The implications of these findings are discussed with a focus on informing the development of targeted policy interventions tailored to the specific needs of different age groups.

Perceived Loneliness, Social Isolation, and Social Support Resources of Frail Older People Ageing in Place Alone in Italy

This paper presents some findings from the IN-AGE ("Inclusive ageing in place") study, which the authors carried out in 2019 in Italy. It explores the available social support resources for frail older people with functional limitations ageing in place alone, and possible links between their social isolation and perceived loneliness. The authors conducted qualitative/semi-structured interviews involving 120 participants aged 65 years and over, and used a mixed-methods analysis (quantitative/qualitative). The main results show the family as the main help resource for daily activities, but also for intimate confidences against social isolation, especially when said relatives live close. Family confidants are less present when seniors are supported by friends/neighbours or/and public services. Moreover, the family is valuable for decreasing loneliness, although not always. However, some older people feel particularly alone when they are supported by public services. Such a complex context draws attention on the need of support for frail seniors living alone and could provide insights for policymakers on adequate policies for preventing and managing loneliness and social isolation in later life. This is especially relevant when family (and other) resources are not available or scarce, also considering the opportunities offered by technology, which can help seniors remain socially connected to relatives, friends and their overall community.

Redefining Age-Friendly Neighbourhoods: Translating the Promises of Blue Zones for Contemporary Urban Environments

The longevity and healthy ageing observed in Blue Zones offer valuable insights for contemporary urban neighbourhood planning and design. This paper reviews the age-friendly features of the built environment in Blue Zones, aiming to translate these insights into actionable strategies for urban neighbourhood development. Employing a systematic literature review and Convolutional Neural Networks (CNNs) analysis of Google Street View imagery, this study assesses the built environments in Blue Zones, including housing, public spaces, and transportation systems. Key findings highlight the presence of adaptable housing, building designs that foster a connection with nature, and semi-public spaces that encourage social interaction and physical activity. A notable emphasis on walkability and limited public transport access was observed. The CNN analysis corroborated these findings, providing a quantitative view of age-friendly features. This research contributes to the academic discourse in urban planning and design by providing practical insights for developing age-friendly neighbourhoods, inspired by Blue Zones. It concludes by offering policy advice and future research directions for creating sustainable and inclusive urban environments conducive to ageing populations.

COVID-19 restrictions promoted the newly occurring loneliness in older people - a prospective study in a memory clinic population

Introduction

A high burden and many negative outcomes for older people were associated with the COVID-19 pandemic. Social isolation and loneliness are prevalent health problems impacting well-being and quality of life and may have increased due to pandemic-related restrictions. Methods: This study investigate the influence of the COVID-19 pandemic on loneliness in people visiting a mem40ory clinic between March 2020 and September 2022. We conducted a prospective, single-center, questionnaire-based observational follow-up study to assess potential predictors of newly occurring, pandemic-related loneliness. Next to a newly developed COVID-19 questionnaire, a comprehensive neuropsychological test battery, the Neuropsychiatric Inventory and the Geriatric Depression Scale were used.

Results

In total 426 people (mean age: 76.48 years, 12.9% cognitively intact, 33.1% diagnosed with Mild Cognitive Impairment, 49.8% diagnosed with dementia, and 4.2% diagnosed with depression) completed the COVID-19 questionnaire at baseline and 166 at follow-up. Newly occurring loneliness was indicated by 22.3% of baseline participants and by 24.1% of follow-up participants. Results of logistic regression analysis showed that living alone (OR 5.452) and having less contact with friends (OR 2.771) were most predictive of the occurrence of loneliness. The use of digital communication media as an alternative strategy for social interaction was lowest in dementia patients (6-13%).

Discussion

In conclusion, personal contacts and a close friendship network appear to be more decisive to prevent loneliness in older people than does the use of digital communication media. However, promoting an intensified use of digital communication media may be useful to counteract loneliness, especially in dementia patients.

Exploring the impact of information and communication technologies on loneliness and social isolation in community-dwelling older adults: a scoping review of reviews

BACKGROUND

Recognizing the escalating public health concerns of loneliness and social isolation in aging populations, this study seeks to comprehensively explore the potential of information and communication technology (ICT)-based interventions to address these issues among older adults. This scoping review of reviews aims to map and synthesize existing evidence on the effectiveness and scope of ICT interventions targeting loneliness and social isolation in community-dwelling older adults, elucidating types of technology, impacts, facilitators, barriers, and research gaps.

METHODS

Following the Joanna Briggs Institute framework, we systematically searched eight diverse databases identifying relevant published reviews. We included English-written, peer-reviewed reviews of all types, with no limits regarding time of publication about ICTs targeting loneliness and/or social isolation for community-dwelling older adults. Eligible reviews were analysed and summarized, offering a holistic narrative of the reported types of ICTs and their impact, the identified facilitators and barriers influencing the implementation and adoption of ICT interventions, and the research gaps identified in the literature.

RESULTS

The review included 39 publications published between 2012 and 2024, spanning systematic, scoping, and reviews of reviews. Various ICTs were reported, primarily social media virtual communities, followed by video-mediated friendly visits, conversational agents, social robots, exergames and online gameplay. Predominantly positive impacts on mitigating social isolation and loneliness were evident for these ICTs, although methodological diversity and contradictory findings complicated definite conclusions. Facilitators and barriers encompassed individual competencies, access and usage, and intervention design and implementation. Research gaps involved targeting specific subgroups, exploring innovative technologies, incorporating diverse study designs, improving research methodologies, and addressing usability and accessibility. Future research should focus on identifying elderly individuals who can benefit the most from ICT use, exploring novel technologies, using a wider range of study designs, and enhancing usability and accessibility considerations.

CONCLUSIONS

This review sheds light on the diverse range of ICTs, their impact, and the facilitators and barriers associated with their use. Future investigations should prioritize refining outcome measures, addressing gender differences, and enhancing the usability and accessibility of interventions. The involvement of older adults in the design process and the exploration of technological training interventions hold promise in overcoming barriers.

Identifying characteristics of adolescents with persistent loneliness during COVID-19: A multi-country eight-wave longitudinal study

Background

Elevated loneliness experiences characterise young people. While loneliness at this developmental juncture may emerge from age-typical upheaval in social relationships, there is little data on the extent to which young people experience high and persistent levels of loneliness, and importantly, who is most vulnerable to these experiences. Using the widespread social restrictions associated with the COVID-19 pandemic, which precipitated loneliness in many, we aimed to examine adolescents' loneliness profiles across time and the demographic predictors (age, sex, and country) of more severe trajectories.

Methods

Participants aged 12-18 years, recruited into a multi-wave study (N = 1039) across three sites (UK, Israel, and India) completed a 3-item loneliness measure fortnightly across 8 timepoints during the pandemic.

Results

Latent class growth analysis suggested 5 distinct trajectories: (1) low stable (33%), (2) low increasing (19%), (3) moderate decreasing (17%), (4) moderate stable (23%), and (5) high increasing (8%). Females and older adolescents were more likely to experience persistently high loneliness.

Conclusions

These findings indicate a need for interventions to reduce loneliness in adolescents as we emerge from the pandemic, particularly for those groups identified as being at highest risk.

Social support, attitudes toward own aging, loneliness and psychological distress among older Chinese adults: a longitudinal mediation model

The current study aimed to explore the protective factors and underlying mechanisms associated with loneliness and psychological distress among older Chinese adults within the framework of a longitudinal design. This investigation specifically focused on the mediating role of attitudes toward own aging (ATOA) in the relationship between social support and the experience of loneliness and psychological distress (comprising depression, anxiety, and stress) amidst the backdrop of the COVID-19 pandemic. A cohort of 345 elderly individuals (mean age = 83.84 years, standard deviation = 8.49 years; 55.1% females) participated in this research endeavor. The participants were required to complete self-report instruments measuring their perceived levels of social support at Time 1 (T1), attitudes towards own aging, ATOA at Time 2 (T2), and their experiences of loneliness, and psychological distress (including depression, anxiety, and stress) at T1 and Time 3 (T3). The data collection timeline encompassed baseline data collection at T1 in September 2020, a subsequent six-month follow-up at T2 in March 2021, and a one-year follow up at T3 in September 2021. The findings of this investigation unveiled a negative predictive relationship between social support at T1 and psychological distress (encompassing depression, anxiety, and stress) at T3. Furthermore, it was discerned that ATOA at T2 acted as a mediating mechanism, elucidating the longitudinal association between social support at T1 and the manifestation of loneliness and psychological distress (including depression, anxiety, and stress) at T3. The discussion section of this paper delves into an exploration of the limitations and implications inherent in these conclusions, particularly concerning their relevance to potential intervention strategies.

Associations among loneliness, internal locus of control and subjective accelerated ageing in older adults who received the booster vaccination

BACKGROUND

A rise in loneliness among older adults since the COVID-19 outbreak, even after vaccination, has been highlighted. Loneliness has deleterious consequences, with specific effects on perceptions of the ageing process during the COVID-19 pandemic. Coping with stressful life events and the challenges of ageing may result in a perception of acceleration of this process.

AIM

Studies have shown a buffering effect of an internal locus of control in the relationship between COVID-19 stress and mental distress. The current study examined whether loneliness predicts subjective accelerated ageing and whether internal locus of control moderates this relationship.

METHOD

Two waves of community-dwelling older adults (M = 70.44, s.d. = 5.95; age range 61-88 years), vaccinated three times, were sampled by a web-survey company. Participants completed the questionnaire after the beginning of the third vaccination campaign and reported again 4 months later on loneliness, internal locus of control and subjective accelerated ageing level in the second wave.

RESULTS

Participants with higher levels of loneliness presented 4 months later with higher subjective accelerated ageing. Participants with a low level of internal locus of control presented 4 months later with high subjective accelerated ageing, regardless of their loneliness level. Participants with a high level of internal locus of control and a low level of loneliness presented with the lowest subjective accelerated ageing 4 months later.

CONCLUSIONS

The findings emphasise the deleterious effects of loneliness and low internal locus of control on older adults' perception of their ageing process. Practitioners should focus their interventions not only on loneliness but also on improving the sense of internal locus of control to improve subjective accelerated ageing.

The protective influence of family support on anxiety, depressive symptoms, and suicidal ideation among elderly Chinese nursing home residents: A study of serial mediation

In light of the aging demographic in China, heightened attention is warranted for the mental well-being of elderly individuals. Nevertheless, the prevalence of suicidal ideation among older residents in Chinese nursing homes and the nuanced impact of family support on this phenomenon, mediated by anxiety and depressive symptoms, remain unclear. A cohort of 506 Chinese elderly adults participated in the study. Psychosocial traits were assessed using the Perceived Social Support from Family scale (PSS-Fa) for family support, the 7-item Generalized Anxiety Disorder scale (GAD-7) for anxiety symptoms, the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms, and suicidal ideation. A structural equation model (SEM) was employed to execute a serial mediation model. The analysis of 506 elderly adults revealed that 8.1% reported varying levels of suicidal ideation within Chinese nursing homes. The pathway from family support to anxiety symptoms (standardized beta = -0.025, P = .241), family support to depressive symptoms (standardized beta = -0.072, P < .05), and family support to suicidal ideation (standardized beta = -0.082, P < .05) were explored. Additionally, pathways from anxiety symptoms to suicidal ideation (standardized beta = 0.364, P < .001), anxiety symptoms to depressive symptoms (standardized beta = 0.647, P < .001), and depressive symptoms to suicidal ideation (standardized beta = 0.369, P < .001) were examined. This study elucidated the underlying mechanisms connecting family support to suicidal ideation, with depressive symptoms partially mediating this association. Additionally, our discoveries shed light on the partial mediation of anxiety symptoms by depressive factors when it came to the realm of suicidal ideation.

The association between loneliness, social isolation, and sleep disturbances in older adults: A follow-up study from the Swedish good aging in Skåne project

Objectives

The aim of this follow-up study was to investigate whether loneliness and social isolation in a sample of older adults, mean age of 67.4 years at baseline examination, were associated with sleep disturbances at re-examination at a mean age of 76.4 years.

Methods

The study sample consisted of 2897 participants. Data on loneliness, social isolation, and sleep disturbances were collected through questionnaires and medical examinations. Logistic regression models were constructed to identify associations between levels of loneliness and social isolation at baseline and sleep disturbances at follow-up. Sociodemographic and health-related confounding factors were controlled for in the models.

Results

Sleep disturbances were reported by 25.6% (95% CI: 24.0%-27.2%) at baseline and 23.7% (95% CI: 22.1%-25.3%) at re-examination. Odds ratios for sleep disturbances at re-examination in relation to not being lonely or socially isolated were as follows: single occasions of loneliness (OR: 1.37, 95% CI: 1.05-1.78), recurring periods/constant loneliness (OR: 1.92, 95% CI: 1.01-1.99), less severe social isolation (OR: 1.18, 95% CI: 0.78-1.79), and severe social isolation (OR: 1.88, 95% CI: 1.01-3.49).

Discussion

Sleep disturbances are common among older adults and are associated with loneliness and social isolation. Healthcare professionals should be aware of the potential effects of loneliness and social isolation when investigating sleep disturbances in older adults.

Loneliness and sense of community are not two sides of the same coin: Identifying different determinants using the 2019 Nova Scotia Quality of Life data

The purpose of this study was to explore the relative importance of lifestyle factors and living conditions when predicting loneliness and sense of community (SOC) in a representative sample of 12,871 participants from Nova Scotia collected in 2019. Using multiple regression and measures of relative importance based on the Lindeman, Merenda and Gold (lmg) method, we identified which variables are most important to predicting measures of loneliness and SOC. Twenty-two predictors accounted for 46% of the variance in SOC and the top 10 predictors accounted for 36% of the variance: satisfaction with quality of the natural environment in the neighborhood (ri = 0.09), life satisfaction (ri = 0.05), number of neighbors one can rely on (ri = 0.05), confidence in institutions (ri = 0.05), feeling better off due to government policy or programming (ri = 0.04), feeling safe walking in neighborhood after dark (ri = 0.03), mental health (ri = 0.02), number of friends one can rely on (ri = 0.02), volunteering (ri = 0.02), and perceptions of time adequacy (ri = 0.02). Only six of these variables were also the top predictors of loneliness. These results show that both community- and individual-level variables are substantial predictors of social well-being. The effect sizes differ between models, which suggests that there may be important predictors of loneliness that we have not accounted for. This study may inform community-level programming and policy that seeks to promote social well-being for individuals and their communities.

Life Events and Loneliness Transitions Among Middle-Aged and Older Adults Around the World

OBJECTIVES

Adult loneliness is a substantial social problem and a growing point of concern for policymakers around the world. We assess whether the predictors of loneliness onset among middle-aged and older adults vary from country to country in a large array of settings across world regions. Taking a life course perspective, we focus on common life events in our focal age range, including changes in partnership, coresidence, work, and health, and we test whether changes in them have comparable prospective associations with loneliness onset in different countries.

METHODS

We draw on respondent-level data from a diversity of world regions surveyed in 7 harmonized cross-national studies in 20 countries, representing 47% of the global population over the age of 50. Our innovative longitudinal approach estimates prospective transition probability models that examine how each life event predicts the transition into loneliness.

RESULTS

Despite substantial variation in the prevalence of loneliness and life events across the range of countries in our sample, our results highlight consistency in the predictors of loneliness transitions. Family and household changes like divorce, coresidence, and especially widowhood are paramount predictors of loneliness transition across settings, with changes in work and health playing more minor and less universal roles.

DISCUSSION

The results demonstrate the importance that family and household connections play in determining loneliness at these ages. These findings suggest that addressing late-life loneliness may require a focus on key life events, especially those concerning changes in families and households.

What Drove Program Participants to Initially Attend Congregate Meals? Socialization, Health, and Other Reasons

The Congregate Nutrition Services support efforts to keep older Americans independent and engaged in their communities. We examined participants' self-reported reasons for initially attending the congregate meals program and whether reasons differed by participant characteristics. Descriptive statistics and tests of differences were used to compare participants (n = 1,072). Individuals attended congregate meals for several reasons, with the top two being socialization (36.3%) and age- or health-related reasons (18.7%). Those attending for socialization were less likely to be lower income, have food insecurity, or live with 3+ ADL limitations while participants who first attended due to age or health-related reasons were more likely to be low income, food insecure, and from historically marginalized populations. Health and social service professionals and community organizations could expand data collection on older adults in their communities and partner with congregate meal providers to encourage participation for individuals with unmet nutritional, health, and socialization needs.

Gender Differences in Loneliness Over Time: A 15-Year Longitudinal Study of Men and Women in the Second Part of Life

Evidence suggests that in old age, women are lonelier than men. Gender differences in loneliness are often explained by gender differences in longevity, social status and loss, health, and mobility-well-established predictors that may influence loneliness differently in "younger" (40-59 years) and "older" (60-80 years) groups of men and women in the second part of life. This study explores loneliness in men and women ages 40 to 80 years at baseline over a 15-year period using panel data from three waves of the Norwegian Life Course, Ageing and Generation Study (N = 2,315). Our analyses show that women were more lonely than men also in adjusted analyses. Logistic regression analyses indicated that loss of a partner and poor mental health are prospectively related to loneliness among men and women, whereas other factors like becoming a partner, stable singlehood, and poor physical health were related to loneliness among women but not men.

The association between loneliness or social isolation and food and eating behaviours: A scoping review

Loneliness or social isolation and food/eating behaviours have important health consequences and there are rationales for why they could interact. Loneliness and dietary behaviours are recognised as health determinants and targets for interventions at individual, group and population levels. However, there are currently no research reviews investigating associations between these areas. This scoping review synthesized evidence investigating loneliness or social isolation and food/eating behaviours in people aged over 16 years in high-income countries. A systematic search of five databases from 2000 was conducted using predetermined search terms. Dissertation database and backwards citation searches were also conducted. Full text screening of 254 articles/theses resulted in inclusion of three qualitative and 26 quantitative studies, with eight conducted in COVID-19 lockdowns. Almost all studies reported a relationship between loneliness/social isolation and eating behaviours usually considered harmful such as low fruit and vegetable intake and lower diet quality. Qualitative research also supports the detrimental influence of loneliness or social isolation on eating. Study quality was considered, and interpretation and comparison of results was complicated by use of varying methods. Better awareness and understanding of the relationship between these complex aspects of health is needed to inform the development of interventions and practice of nutrition and mental health practitioners, policymakers, researchers and end-users.

Adolescent loneliness across the world and its relation to school climate, national culture and academic performance

BACKGROUND

Loneliness during adolescence has adverse consequences for mental health, education and employment outcomes. Yet, we know little about common correlates of loneliness among adolescents, making intervention work difficult.

AIMS

In this study, we (1) explore individual-, school- and country-level correlates of loneliness to help identify potential intervention targets, and (2) examine the influence of loneliness on academic performance.

SAMPLE

A total of 518,210 students aged 15 years from 75 countries provided self-reported loneliness data.

RESULTS

Using multilevel modelling, we found individual-, school- and country-level correlates of self-reported school-based loneliness, and showed that loneliness negatively influenced academic performance.

CONCLUSIONS

Based on the findings, interventions that focus on enhancing social and emotional skills, increasing trust between teachers and students and changing school climate to be more inclusive are likely to be the most effective for adolescents; they should also be culturally sensitive.

Loneliness among Chilean indigenous women: Family, community, and socio-cultural integration as protective factors

This study examined the incidence of loneliness among Chilean indigenous older adult women (106 Aymara and 180 Mapuche) and how family, community and socio-cultural integration are associated with lower levels of loneliness. A cross-sectional study involving 800 older adults living in a rural context in Chile, of whom 35.8% were indigenous women. The De Jong Gierveld Loneliness Scale (DJGLS-6) were used to assess loneliness and a questionnaire about the maintenance of certain indigenous cultural practices was created. The descriptive findings indicate more loneliness among Mapuche women. Moreover, hierarchical regression models confirmed that women who did not live alone, who participated in social groups and who maintained cultural practices reported lower levels of loneliness, with notable transmission of indigenous knowledge to their children. While, taking part in the indigenous New Year, leading or organizing a ceremony and receiving attention with a health cultural agent were associated with more loneliness. These seemingly contradictory findings are discussed and may be explained by religious changes in indigenous communities; however, this study would confirm that social integration in different dimensions is a protective factor against loneliness.

Time trends in loneliness from 1984 to 2019 among 27,032 older adults in Norway: A HUNT study

The aging population and increasing evidence of the detrimental health impacts of loneliness emphasize the importance of studying and predicting changes in loneliness prevalence among older adults. To understand and project changes in loneliness over time, we examined 35-year trends in adults aged 70 and older, considering factors such as sex, age, and living situation. Cross-sectional data from 27,032 home-dwelling adults aged 70 years and older who participated in at least one of the four Norwegian HUNT surveys from 1984 to 2019, and Norwegian population data from Statistics Norway were used for the analyses. Loneliness was self-reported, and the prevalence of loneliness was standardized to the Norwegian population at the survey year by age and sex. The results showed that the prevalence of loneliness significantly decreased between each survey. The higher categories of loneliness (a good amount, very much) decreased, from 11.4% (1995-97), 6.7% (2006-08), and 5.8% (2017-19). Across surveys, loneliness was significantly more common among women, the oldest, and those living alone. The prevalence of loneliness among the oldest adults living alone increased from 2006 to 2019. The gradual decline in loneliness observed from 1995 to 2019 coincided with notable societal changes in Norway. We estimated that the number of older adults experiencing loneliness in Norway could rise from 184,000 in 2020 to 286,000 in 2035, and potentially reach 380,000 in 2050.

Risk factors for loneliness: A literature review

RATIONALE

Increasingly, loneliness is being recognised as a serious problem with detrimental effects on health, as well as on social cohesion and community trust. To effectively tackle this complex issue, a clear understanding of the phenomenon and its main drivers is needed. Over years of scientific research on loneliness, many potential risk factors have emerged and been tested empirically.

OBJECTIVE

This narrative review of 109 studies provides a concise summary of empirical evidence on the main potential risk factors for loneliness and presents an additional section dedicated to the COVID-19 pandemic.

METHOD

Given the very large number of existing studies, emphasis is placed on recent meta-analyses and systematic literature reviews as well as longitudinal studies. Similarly, given the large number of possible risk factors for loneliness, which may differ based on the geographical and cultural context, this review focuses on studies from Europe and North America.

RESULTS

The results show that demographic factors often correlate with loneliness, but in many cases the link becomes negligible when controlling for other factors. Often, physical and mental health problems are found to be associated with loneliness, and so are some psychological factors, such as neuroticism or extroversion. Loneliness also depends on the environment in which one lives, and possibly the broader socio-economic and socio-cultural contexts. Nevertheless, the review shows that ultimately everything comes down to the quantity and quality of social relationships. In particular, marital status, living arrangements and the characteristics of one's personal social network are quite consistently found to be among the strongest predictors of loneliness. These main findings about the risk factors for loneliness remained valid also during the COVID-19 pandemic.

POLICY IMPLICATIONS

The findings of this review have implications for policy, as understanding who the most vulnerable groups are is key for designing targeted policy solutions that tackle loneliness.

Equal Opportunities in Aging: Income Level Moderates the Relationship Between Infrequent Participation in Formal Social Activities and Loneliness Among Older Adults

Infrequent participation in formal social activities among older adults increases the risk of loneliness. We examined whether a higher income level moderates the relationship between infrequent participation and loneliness. Utilizing data from wave #6 of the European Health, Aging, and Retirement Survey, we included participants aged 65+ (i.e., older adults), non-participants in the labor force (N = 24 819). Loneliness was measured by the R-UCLA loneliness questionnaire, formal social activity by participation frequency in volunteer/charity activities, educational course/training, sports/social/other clubs, and political/community organizations. Hierarchical multiple regression models examined relationships between variables, controlled by country. Infrequent participation in formal social activity associated with higher risk of loneliness. However, income moderated the association between participation and loneliness; infrequently participating older adults with low-to-moderate income were more vulnerable to loneliness than higher income older adults, for whom infrequent participation did not increase loneliness. This reinforces the need to encourage formal social activity with subsidy for low-to-moderate income older adults.

Loneliness and Unmet Needs of Older Adults Living in Publicly Supported Housing

Guided by the RE-AIM framework, the current study sought to examine the relationship between perceived needs of older adults living in publicly supported housing and loneliness. Participants were males and females aged 70 to 83 years who identified as White or Chinese. Using the Camberwell Assessment of Need Short Appraisal Schedule and UCLA Loneliness Scale, the relationship between residents' needs and loneliness was assessed to guide the development of interventions. Results revealed residents self-reported 54% of their needs were met and rated their loneliness at a score of 36.5 (moderate level). Furthermore, there was a medium positive correlation between unmet needs and loneliness whereby high unmet needs were associated with higher loneliness scores. Findings suggest that these older adults living in publicly supported housing are vulnerable to the negative consequences of loneliness. Implementing equitable and inclusive interventions to address the impact of loneliness in the context of social determinants of health is warranted. [Research in Gerontological Nursing, 16(5), 217-223.].

Sense-Making of Loneliness and Exclusion From Social Relations Among Older Adults in Sweden

BACKGROUND AND OBJECTIVES

Loneliness and exclusion from social relations (ESR) are frequently addressed as public health issues for older adults. Public discourses potentially influence how loneliness and ESR are understood in society and experienced by the individual. The aim of this study was to analyze how older adults in different parts of Sweden use the discourses and concepts available to them to describe experiences of ESR and loneliness, and how these descriptions are used to construct a self-identity.

RESEARCH DESIGN AND METHODS

Qualitative semi-structured interviews were conducted with 30 individuals (14 men, 16 women) aged 67-87 years and living in Sweden. Emphasis was, in line with perspectives of discursive psychology, on how individuals draw on discourses to make sense of experiences. The empirical material was analyzed through an inductive process where we were open to finding concepts and themes.

RESULTS

Most participants emphasized the importance of not being lonely, considered achievable through maintaining an active lifestyle. "Othering" was taking place, where a general image of a "lonely" older adult was referred to when speaking about "others" loneliness. Those who expressed feelings of loneliness related these feelings to loss, being omitted, and other difficult life circumstances.

DISCUSSION AND IMPLICATIONS

States of ESR were discussed more comfortably than loneliness, whereas various linguistic resources were used to distance themselves from loneliness. These findings indicate the need for further studies elaborating on how older adults make sense of ESR and loneliness and what implications this has for older adults' well-being and identity making.

Factors associated with ICD-11 posttraumatic stress disorder and complex posttraumatic stress disorder among older adults during the COVID-19 pandemic

ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD have been understudied in the older population. The study focused on the associations between traumatic exposure before the pandemic, COVID-19 worries, depression, and loneliness with current PTSD and CPTSD among older adults. A random sample of five hundred and twelve Israeli older adults (Mage = 72.67 ± 3.81, range 68-87) was recruited using a Web-based survey company (Ipanel, Israel). Participants completed questionnaires of demographic details, self-rated health, COVID-19 worries, trauma exposure, depressive symptoms, level of loneliness, PTSD, and CPTSD. Univariate logistic regression revealed that trauma exposure, COVID-19 worries, depression, and loneliness were associated with PTSD. Multinomial regression revealed that only trauma exposure was associated with PTSD among older adults with PTSD compared with those not reaching the PTSD cutoff level. In the comparison between older adults suffering from CPTSD with those not reaching the PTSD cutoff level, being married, higher levels of trauma exposure, COVID-19 worries, depression, and loneliness were associated with a higher risk of CPTSD. Results suggest that specific factors may be significant psychological correlates of CPTSD symptoms among older adults during the COVID-19 pandemic. Identifying these factors could assist practitioners in tailoring more effective interventions.

Early life adversities and discrimination, social activity, and loneliness among older adults in Europe: a moderated mediation analysis

OBJECTIVE

The present study explores how and when lifetime discriminatory experience moderates the mediation effect of early life adversities and social activity on loneliness among older European adults over eight years.

METHOD

The study analyzed 13,699 respondents aged 50 years and over who were interviewed in 2009 and re-interviewed in 2017 in the European Survey of Health, Ageing, Retirement. Conditional process analysis using the PROCESS model 15 was applied to examine the moderated mediation effect of lifetime discriminatory experience in 2009 (W) on early life adversities in 2009 (X) and social activity at 2017 (M) to loneliness in 2017 (Y).

RESULTS

Our moderated mediation models found that early life adversities (X) are associated with loneliness (Y) (Coeff X→Y=-0.0501, p<.001), but social activity (M) reduces its effect on loneliness (Y) (Coeff X→M→Y=-1.6391, p<.001). However, lifetime discriminatory experience (W) hampers social activity (Coeff M*W→Y = 0.0955, p<.05) and increases loneliness (Coeff X*M→Y = 0.6069, p<.05).

CONCLUSION

Older adults experiencing early life adversities may not necessarily develop later life loneliness. However, lifetime discriminatory experience due to political beliefs, religion, ethnicity, sexual orientation/background etc. may reverse the positive effect of social engagement on the relationship between early life adversities and loneliness. Early interventions should address discrimination and social inequalities and increase social participation across the life course to prevent the development of later-life loneliness among older adults.

Understanding and Addressing Older Adults' Loneliness: The Social Relationship Expectations Framework

Loneliness is an experience resulting from a perceived discrepancy between expected and actual social relationships. Although this discrepancy is widely considered the "core mechanism" of loneliness, previous research and interventions have not sufficiently addressed what older adults specifically expect from their social relationships. To address this gap and to help situate research on older adults' loneliness within broader life span developmental theories, we propose a theoretical framework that outlines six key social relationship expectations of older adults based on research from psychology, gerontology, and anthropology: availability of social contacts, receiving care and support, intimacy and understanding, enjoyment and shared interests, generativity and contribution, and being respected and valued. We further argue that a complete understanding of loneliness across the life span requires attention to the powerful impacts of contextual factors (e.g., culture, functional limitations, social network changes) on the expression and fulfillment of older adults' universal and age-specific relationship expectations. The proposed Social Relationship Expectations Framework may fruitfully inform future loneliness research and interventions for a heterogeneous aging population.

The relationships between loneliness and mental and physical health are moderated by the tendency for interpersonal victimhood: A study of young adult cancer patients

OBJECTIVES

To assess whether loneliness is inversely related to young adult cancer patients' subjective reports of mental and physical health, and to explore whether such inverse relationships are moderated by young adult cancer patients' tendency for interpersonal victimhood.

METHODS

Young adult cancer patients (N = 140) ranging in age from 19-39 years completed two questionnaires distributed three months apart. Patients reported loneliness, their tendency for interpersonal victimhood, and mental and physical health. Hypotheses were tested using the PROCESS macro for SPSS, which tests for main effects and moderation effects.

FINDINGS

Loneliness was inversely related to mental health, but there was no main effect of loneliness on physical health. Tendency for interpersonal victimhood significantly moderated the relationships between loneliness and both mental and physical health, such that a greater tendency for interpersonal victimhood strengthened the inverse relationships between loneliness and both mental and physical health.

CONCLUSION

Loneliness continues to be an important predictor of mental health for young adult cancer patients, and this relationship is strengthened when a patient has a greater tendency for interpersonal victimhood. Health care providers, family members, and other supporters should monitor the quantity and quality of patients' relationships with others and also facilitate conversations that can address aspects of the tendency for interpersonal victimhood, such as rumination or the need for recognition.

Multimorbidity and Quality of Life: The Mediating Role of ADL, IADL, Loneliness, and Depressive Symptoms

Background and Objectives

The ubiquity of multimorbidity makes it crucial to examine the intermediary factors linking it with quality of life (QoL). The objective was to examine to what extent the association between multimorbidity and QoL was mediated by functional and emotional/mental health and how these mediation pathways differed by sociodemographic factors (age, gender, education, and financial strain).

Research Design and Methods

Data from Waves 4 to 8 of 36,908 individuals from the Survey of Health, Aging, and Retirement in Europe (SHARE) were included. Multimorbidity (exposure) was defined as having 2 or more chronic conditions. Mediators included limitations with (instrumental) activities of daily living (ADL and IADL), loneliness, and depressive symptoms. QoL (outcome) was assessed with the CASP-12 scale. Longitudinal model-based causal mediation analyses were performed to decompose the total association between multimorbidity and QoL into direct and indirect effects. Moderated mediation analyses tested for differences in mediation pathways by sociodemographic factors.

Results

Multimorbidity was significantly associated with lower QoL (direct effect: b = -0.66). This association was mediated by ADL limitations (percentage mediated 0.97%), IADL limitations (3.24%), and depressive symptoms (16.70%), but not by loneliness. The mediation pathways were moderated by age, education, financial strain, and gender.

Discussion and Implications

ADL, IADL, and depressive symptoms are crucial intermediary factors between multimorbidity and QoL in older European adults, with changing importance according to age, education, financial strain, and gender. The findings may help to increase the QoL of individuals with multimorbidity and redirect care efforts to these factors.

Differences in Loneliness and Social Isolation among Community-Dwelling Older Adults by Household Type: A Nationwide Survey in Japan

(1) Background: Social isolation and loneliness are determinants of healthy longevity. However, previous research has focused on either social isolation or loneliness and has not considered household types. This study sought to clarify loneliness and social isolation among older adults using single-person (ST) or multi-person (MT) household types. (2) Methods: We administered a national, anonymous, self-administered survey to 5351 Japanese older adults aged 65 years or older. The survey included subjects' demographic characteristics and scores for loneliness (University of California Los Angeles (UCLA) Loneliness Scale version 3 (Cronbach's α = 0.790)), social isolation (Lubben Social Network Scale (LSNS-6) (Cronbach's α = 0.82)), and self-efficacy (GSES). (3) Results: After adjusting for age and gender, ST individuals had significantly lower LSNS-6 and significantly higher UCLA scores than MT individuals (p < 0.001). Lower LSNS-6 and higher UCLA scores were significantly associated with lower GSES scores, and the effect of GSES was greater for ST than for MT (LSNS-6, ST (β = 0.358, p < 0.001); MT (β = 0.295, p < 0.001)) (UCLA, ST (β = -0.476, p < 0.001); MT (β = -0.381, p < 0.001)). (4) Conclusions: Specific healthcare systems and programs based on self-efficacy should be developed by household type to reduce both social isolation and loneliness.

Fluctuations in loneliness due to changes in frequency of social interactions among older adults: a weekly based diary study

OBJECTIVES

Loneliness functionally varies and is determined by the degree of interaction with others. We examined weekly fluctuations in reported loneliness as a function of frequency of social interactions in old age. We hypothesized that emotional and social components of loneliness would be related to different types of social relationships.

DESIGN

Participants reported their feeling of loneliness and their social interaction quantity (frequency of meetings) via a weekly based diary, over 6 weeks.

SETTING

Diary study.

PARTICIPANTS

The study included 55 older adults with different dwelling arrangements (M = 73.4, SD = 6.97).

MEASUREMENTS

Measures of Loneliness (the De Jong-Gierveld Loneliness Scale), Social Interaction and Contact, and sociodemographic parameters were used.

RESULTS

Social and emotional loneliness fluctuated over the course of the 6-week study. Frequency of meeting friends was related to emotional loneliness and total feelings of loneliness. Frequency of meeting close/trusted figures was related to emotional loneliness which appeared the following week. Other variables were not associated with either changes in loneliness or its dimensions.

CONCLUSIONS

Loneliness in old age is changeable. The emotional component of loneliness seems to be dominant in determining overall feelings of loneliness and is more sensitive to externally chosen social interaction.