Older migrants and loneliness: scanning the field and looking forward

Sociodemographic and Health Determinants of Loneliness in Older Immigrants in Canada: A Cross-Sectional Study

The COVID pandemic brought to light the pressing issues of social isolation and loneliness for older adults. Immigrant older adults' experience of loneliness is even more exacerbated by factors, such as, language barriers, and the loss of cultural community. Key determinants of loneliness in older immigrants are not clear in the literature. A cross-sectional study was conducted in nine cities across Canada to: describe the experience of emotional, social and overall loneliness; and examine the determinants of loneliness among Punjabi, Mandarin, and Arabic-speaking older immigrants. A total of 647 older immigrants participated in the study. Descriptive statistics were used to describe their experience of loneliness, and multiple regression analysis was performed to examine the determinants of loneliness. Most participants had a post-secondary education, were married, and had been in Canada for about 16 years. On average, the participants reported good physical and mental health, and moderate levels of emotional, social, and overall loneliness. Ethnocultural group, emotional wellbeing, and depression were associated with emotional loneliness. Social loneliness was associated with education, depression, psychological distress, age, and ethnocultural group. Determinants of overall loneliness were age, gender, ethnocultural group, self-rated mental health, emotional wellbeing, depression, and psychological distress. Community based interventions that target these key factors must be designed to address loneliness experienced by older immigrants.

Midlife dementia risk scores in a multi-ethnic population in the Netherlands: the HELIUS study

BACKGROUND

Migrant populations in the Netherlands may face greater dementia risk factor burden than Dutch natives.

OBJECTIVES

To study whether midlife dementia risk scores differ by ethnicity.

METHODS

We calculated three validated dementia risk scores in participants aged 40-70 years of Dutch (n = 2978), South-Asian Surinamese (n = 2084), African Surinamese (n = 3135), Ghanaian (n = 1699), Turkish (n = 2000), and Moroccan (n = 2025) background, from the HELIUS study (Amsterdam, the Netherlands): Cardiovascular Risk Factors, Aging and Incidence of Dementia (CAIDE), LIfestyle for BRAin Health (LIBRA), and Australian National University-Alzheimer's Disease Risk Index (ANU-ADRI). We cross-sectionally compared scores between ethnicities using linear regression.

RESULTS

Ethnic minority groups had higher risk scores than those with a Dutch background (CAIDE: +0.66-1.35; LIBRA: +0.66-1.43; ANU-ADRI: +2.75-7.25). CAIDE estimated an absolute 20-year incident dementia risk of 2.6% for Dutch, 3.4% for South-Asian Surinamese, 3.6% for Turkish, 3.7% for Moroccan, 3.7% for African Surinamese and 4.5% for Ghanaian populations. Differences were greater when removing age from scores (CAIDE +0.89-2.22; ANU-ADRI +3.03-8.20), implying that this higher risk score is independent of age.

CONCLUSION

Migrant populations had higher dementia risk scores than Dutch natives. Validation of these scores in migrant populations is warranted. If replicated, ethnicity should be considered when estimating dementia risk and developing preventive strategies for high-risk populations.

Social support and depressive symptoms among migrant elderly following children: the chain mediating role of resilience and loneliness

BACKGROUND

Migrant elderly following children (MEFC) is an emerging special elderly mobile migrant population in China. MEFC face multiple dilemmas of distress, which makes their depressive symptoms more prominent. To explore ways to alleviate depressive symptoms, this study aimed to investigate the chain mediating effects of resilience and loneliness on the relationship between social support and depressive symptoms among MEFC.

METHODS

A cross-sectional study was conducted using purposive sampling from Changsha, Hunan Province, China, and 298 MEFC were included. The 15-item Geriatric Depression Scale, Social Support Rating Scale, University of California Los Angeles Loneliness Scale, and Connor-Davidson Resilience Scale were used to measure depressive symptoms, social support, loneliness, and resilience, respectively. Pearson's correlation analysis was conducted to clarify the association between the variables. The PROCESS macro model 6 was applied to analyze the multiple mediating effects.

RESULTS

The prevalence of depressive symptoms among MEFC was 29.86%. Social support (r = -0.354, P < 0.001), resilience (r = -0.373, P < 0.001), and loneliness (r = 0.483, P < 0.001) were significantly associated with depressive symptoms. Social support not only had a direct negative effect (Effect= -0.086, 95% CI: -0.149 to -0.023) on depressive symptoms, but also had an indirect effect on depressive symptoms through resilience (Effect= -0.045, 95% CI: -0.076 to -0.015), loneliness (Effect= -0.053, 95% CI: -0.091 to -0.020), and the chain mediating effects of resilience and loneliness (Effect= -0.019, 95% CI: -0.037 to -0.007), respectively.

CONCLUSIONS

The prevalence of depressive symptoms was relatively high. Resilience and loneliness partially mediated the association between social support and depressive symptoms. In the future, interventions could focus on increasing social support to enhance resilience and reduce loneliness, thereby reducing depressive symptoms in MEFC.

Immigrant Older Adults' Experiences of Aging in Place and Their Neighborhoods: A Qualitative Systematic Review

Engaging in one's neighborhood fosters independence, promotes social connectedness, improves quality of life, and increases life expectancy in older adults. There is a lack of evidence synthesis on immigrant older adults' neighborhood perceptions and experiences, essential for addressing neighborhood-level influences on aging in place. This study systematically synthesizes qualitative evidence on immigrant older adults' perceptions and experiences of their neighborhoods. A comprehensive search was conducted from inception to 5 April 2023, in multiple databases. This review considered studies including immigrant older adults aged ≥60 years, included studies from any country where the neighborhood was the focus, and only considered qualitative data while excluding review studies, theoretical publications, and protocols. Eligible studies were appraised using the JBI critical appraisal checklist for qualitative research. The Joanna Briggs Institute meta-aggregation approach was used to synthesize findings, and the ConQual approach established confidence in the synthesis. A total of 30 studies were included. Most studies were conducted in North America and explored phenomena such as aging in place, social capital, social cohesion, sense of community, and life satisfaction. Key contextual factors were walkable safe access to social spaces, accessible transportation to amenities, social cohesion with neighbors, and pre-migration neighborhood experiences. Immigrant older adults have varied experiences related to their sense of belonging and social cohesion. Factors such as racial discrimination, feeling unsafe, and social isolation contributed to negative perceptions. This review highlights the need for inclusive neighborhoods that align with the needs and values of immigrant older adults aging in place.

Gender Differences in Social Embeddedness Determinants of Loneliness Among Moroccan and Turkish Older Migrants

OBJECTIVES

Moroccan and Turkish migrants residing in Northwestern Europe have high loneliness levels. This study examines gender differences in loneliness within this migrant population. The migrants have gender-segregated social roles at home and in public, which might lead to gender differences in what aspects of social relationships can explain variation in loneliness.

METHODS

Respondents are from the Longitudinal Aging Study Amsterdam with 446 first-generation Moroccan and Turkish migrants in the Netherlands, aged between 55 and 66 years. We use interaction effects to test for gender differences in determinants of loneliness.

RESULTS

Men and women have a similar, moderate level of loneliness. Having a spouse and receiving care from children are more strongly related with lower loneliness levels in men than in women. Coethnic ties play an equally important role for men and women. In men, frequent mosque attendance is related with greater loneliness, but not in women.

DISCUSSION

Family ties are more protective against loneliness for older men than for older women, possibly indicating that migrant women's expectations regarding family go above and beyond having a spouse, receiving intergenerational care, or having frequent contact with children. In addition, migrant older men's higher expectations regarding a public social life could make their social life in the Netherlands less fulfilling, resulting in greater loneliness.

Loneliness and Psychological Distress Among Older Californians: The Moderating Roles of Citizenship Status and English Proficiency

OBJECTIVES

Guided by the theory of stress proliferation, our study examined whether loneliness, citizenship status, and English proficiency were associated with psychological distress among older adults, and if citizenship status and English proficiency moderated these relationships.

METHODS

Using the older adult subsample (65+ years) of the 2019-2020 California Health Interview Survey (N = 15,210), we assessed cross-sectional associations between loneliness, citizenship status, and English proficiency on psychological distress by conducting multivariable linear regression models. Interaction terms were included in subsequent models to determine if citizenship status and English proficiency moderated the relationship between loneliness and psychological distress.

RESULTS

In unadjusted models, greater loneliness was associated with higher distress. Both naturalized citizens and noncitizens, and those with limited English proficiency (LEP) exhibited greater distress than US born citizens and those who speak English only (EO). After adjusting for sociodemographic and health covariables, loneliness remained significant for distress although the relationships between citizenship status and English proficiency became attenuated. With the inclusion of interactions, the magnitude of the relationship between loneliness and distress was stronger for naturalized citizens and those with LEP than native-born citizens and those who speak EO, respectively.

DISCUSSION

Loneliness was the most consistent stressor affecting multiple life domains. However, our findings demonstrate that stress proliferation is occurring among older immigrant adults and the interplay between loneliness, citizenship status, and English proficiency is contributing to heightened distress. Further attention is needed in understanding the role of multiple stressors influencing mental health among immigrant older adults.

Loneliness Among Low-Income Older Immigrants Living in Subsidized Senior Housing: Does Perceived Social Cohesion Matter?

This study compared the level of loneliness among older immigrants residing in subsidized senior housing with that of non-immigrant residents. The study also sought to examine the differential influence of perceived social cohesion on loneliness among these groups. 231 study participants were recruited from subsidized senior housing in St. Louis and the Chicago area. Multiple regression analyses showed that there was a significant difference in loneliness between immigrants and non-immigrants (b = .3, SE = 0.150, p < .05). Also, perceived social cohesion was negatively associated with loneliness (b=-.102, SE = .022, p < .001). Furthermore, immigration status moderated the relationship (b=-.147, SE = .043, p < .01), showing immigrants may benefit more from higher perceived social cohesion in terms of loneliness. The results suggest that perceived social cohesion may act as an important community-level protective factor against loneliness, particularly for older immigrants residing in subsidized senior housing. Creating socially cohesive environments, particularly for this subgroup, could be a crucial strategy for mitigating loneliness.              .

Migration-related inequalities in loneliness across age groups: a cross-national comparative study in Europe

This study aims to contribute to the growing interest in the consequences of migration for loneliness by investigating the role of generational status across various age groups in countries with differing integration policies and attitudes towards immigrants. Using data from rounds 5, 6 and 7 of the European Social Survey, I conducted logistic multilevel models on a sample of 121,835 respondents aged 18 years and older, residing in 26 countries. Loneliness was assessed based on a single-item item question from the Center for Epidemiologic Studies of Depression scale. The findings suggest that individuals with a migration background are more likely to experience loneliness than those without. Within this group, I found that first-generation immigrants who arrived after the age of 18 are more vulnerable to loneliness than those who arrived earlier, although the latter still reported more loneliness than second-generation immigrants. Furthermore, migration-related inequalities in loneliness were greater among the youngest age group (18-34 years) and in countries with a more positive public stance towards immigrants. In sum, this study highlights the persistent challenges that migration poses for loneliness across generations and age groups, and emphasizes the need to extend research in this area beyond older adults. Moreover, it suggests that promoting a welcoming culture towards immigrants may have unintended consequences for loneliness gaps, but further research is needed to explain this observation.

Factors associated with loneliness in immigrant and Canadian-born older adults in Ontario, Canada: a population-based study

BACKGROUND

While loneliness is common in older adults, some immigrant groups are at higher risk. To inform tailored interventions, we identified factors associated with loneliness among immigrant and Canadian-born older adults living in Ontario, Canada.

METHODS

We conducted a cross-sectional analysis of 2008/09 data from the Canadian Community Health Survey (Healthy Aging Cycle) and linked health administrative data for respondents 65 years and older residing in Ontario, Canada. Loneliness was measured using the Three-Item Loneliness Scale, with individuals categorized as 'lonely' if they had an overall score of 4 or greater. For immigrant and Canadian-born older adults, we developed separate multivariable logistic regression models to assess individual, relationship and community-level factors associated with loneliness.

RESULTS

In a sample of 968 immigrant and 1703 Canadian-born older adults, we found a high prevalence of loneliness (30.8% and 34.0%, respectively). Shared correlates of loneliness included low positive social interaction and wanting to participate more in social, recreational or group activities. In older immigrants, unique correlates included: widowhood, poor health (i.e., physical, mental and social well-being), less time in Canada, and lower neighborhood-level ethnic diversity and income. Among Canadian-born older adults, unique correlates were: female sex, poor mental health, weak sense of community belonging and living alone. Older immigrant females, compared to older immigrant males, had greater prevalence (39.1% vs. 21.9%) of loneliness.

CONCLUSIONS

Although both groups had shared correlates of loneliness, community-level factors were more strongly associated with loneliness in immigrants. These findings enhance our understanding of loneliness and can inform policy and practice tailored to immigrants.

Neighbourhood Ethnic Density, Local Language Skills, and Loneliness among Older Migrants-A Population-Based Study on Russian Speakers in Finland

So far, little attention has been paid to contextual factors shaping loneliness and their interaction with individual characteristics. Moreover, the few existing studies have not included older migrants, identified as a group who are vulnerable to loneliness. This study examined the association between neighbourhood ethnic density (the proportion of own-group residents and the proportion of other ethnic residents in an area) and loneliness among older migrants. Furthermore, we investigated whether local language skills moderated this association. A population-based representative survey (The CHARM study, n = 1082, 57% men, mean age 63.2 years) and postal code area statistics were used to study Russian-speaking migrants aged 50 or older in Finland. The study design and data are hierarchical, with individuals nested in postcode areas. We accounted for this by estimating corresponding mixed models. We used a linear outcome specification and conducted logistic and ordinal robustness checks. After controlling for covariates, we found that ethnic density variables (measured as the proportion of Russian speakers and the proportion of other foreign speakers) were not associated with loneliness. Our interaction results showed that increased own-group ethnic density was associated with a higher level of loneliness among those with good local language skills but not among those with weaker skills. Good local language skills may indicate a stronger orientation towards the mainstream destination society and living in a neighbourhood with a higher concentration of own-language speakers may feel alienating for those who wish to be more included in mainstream society.

Conducting Empirical Research with Older Migrants: Methodological and Ethical Issues

This special section brings together a set of four articles containing novel quantitative and qualitative research on older migrants in Europe. Detailed reporting and reflection is presented on fieldwork decisions and how certain challenges were tackled, and their implications. This introductory article aims to lay the groundwork for a better understanding and awareness of methodological and ethical challenges researchers face when designing and conducting empirical studies involving older migrants. Highlighted are the main methodological issues and ethical dilemmas we observe in studying older migrants, which can serve as a wake-up call for researchers to be more critical throughout the process. We end with a plea for more collaboration between researchers in the field of older migrants, by sharing their data despite potential methodological and ethical problems.