Loneliness, social network size and mortality in older adults: a meta-analysis

An intergenerational service-learning approach to improve hand function in older adults

Homebound older adults are at greater risk for functional impairments, social isolation, and loss of independence. Adequate hand function is needed to perform many daily activities, yet is understudied, particularly in the homebound population. The purpose of this study was to pilot test an intergenerational program in which pre-health college students were trained to deliver hand exercises to homebound older adults receiving Meals on Wheels (MOW) services. Eight MOW clients (mean age: 80.1 ± 12.9y) and 17 students completed the program. Students visited clients 2×/week for 6 weeks and engaged in hand exercises and meaningful conversations. Measures of hand strength, dexterity, self-reported function, self-efficacy, depression, and social isolation were taken before and after the program. Clients and students also completed a post-program experience survey. Significant improvements in pinch strength were observed, and 75% of clients reported better upper limb mobility after training. Survey feedback was positive with clients saying they enjoyed interacting with college students, while students praised the hands-on nature of the program and engagement with older adults. Results from this pilot study demonstrate an intergenerational approach to deliver hand training is feasible and underscores the value of using such models to increase access to care for homebound older adults.

Social coaching: applying Keyes' Model of Social Wellbeing to audiological support for older adults with hearing loss

OBJECTIVE

To propose the application of Keyes's Model of Social Wellbeing to guide hearing care professionals (HCPs) in providing social coaching to address the impact of hearing loss on social wellbeing in older adults.

DESIGN

A discussion paper introducing Keyes's Model of Social Wellbeing and its application in enhancing the social wellbeing of older adults with hearing loss. Qualitative insights and evidence from various studies are provided to support the application of the proposed model. Examples of how HCPs can use social coaching to help address the effects of hearing loss on social coherence, integration, acceptance, contribution, and actualisation are provided.

STUDY SAMPLE

N/A.

RESULTS

Hearing loss significantly impacts all five constructs of Keyes's Model of Social Wellbeing, leading to challenges in social coherence, integration, acceptance, contribution, and actualisation. Effective social coaching by HCPs can mitigate these impacts by providing tailored support, enhancing communication skills, and fostering a sense of belonging and purpose.

CONCLUSIONS

Integrating social coaching into audiology practice and policy, guided by Keyes's Model, can improve social wellbeing for older adults with hearing loss. This person-centred approach requires HCPs to understand the social implications of hearing loss and deliver targeted interventions to support their clients' social and emotional needs.

Loneliness, social isolation, and living alone: a comprehensive systematic review, meta-analysis, and meta-regression of mortality risks in older adults

Loneliness, social isolation, and living alone are significant risk factors for mortality, particularly in older adults. This systematic review and meta-analysis aimed to quantify their associations with all-cause and cause-specific mortality in older adults, broadening previous research by including more social factors. Comprehensive searches were conducted in PubMed, APA PsycINFO, and CINAHL until December 31, 2023, following PRISMA 2020 and MOOSE guidelines. Studies included were prospective cohort or longitudinal studies examining the relationship between loneliness, social isolation, living alone, and mortality. Quality was assessed using the Newcastle-Ottawa Scale. Meta-analyses used random-effects models with the Restricted Maximum Likelihood method. Subgroup and meta-regression analyses explored the relationships further. Of 11,964 identified studies, 86 met the inclusion criteria. Loneliness was associated with increased all-cause mortality (HR 1.14, 95% CI 1.10-1.18), with substantial heterogeneity (I² = 84.0%). Similar associations were found for social isolation (HR 1.35, 95% CI 1.27-1.43) and living alone (HR 1.21, 95% CI 1.13-1.30). Subgroup analyses revealed variations based on factors like sex, age, region, chronic diseases, and study quality. Meta-regression identified longer follow-up, female sex, validated social network indices, adjustments for cognitive function, and study quality as significant predictors of mortality risks. These findings highlight the need for public health interventions to address these social factors and improve health outcomes in older adults. However, further research is needed due to variability and heterogeneity across studies. Also studying the cumulative effect of these factors on mortality risks will be of considerable interest.

Loneliness-associated factors among older adults: Focus on friendship type and number of friends

AIM

Loneliness among older people is prevalent. Few studies have examined the association of loneliness with the type of friendship and number of friends. This study aimed to clarify the loneliness-related factors among older adults by gender focusing on the type of friendship and number of friends.

METHODS

An anonymous, self-administered questionnaire survey was conducted on 1610 older adults in Japan. The questionnaire included basic characteristics, health status used by the self-administered dementia checklist, type of friendship and number of friends evaluated by the Lubben Social Network Scale, and loneliness evaluated using the University of California, Los Angeles Loneliness Scale. Univariate analysis was performed with loneliness as the dependent variable, and multiple logistic regression analysis was also performed.

RESULTS

A total of 1082 older adults were included for analysis. The loneliness rate was 16.8%. Regarding the type of friendship and number of friends, having <3 close friends to call on for help (tangible aid) was most associated with loneliness (men odds ratio [OR]: 2.88, women OR: 3.10). Higher awareness of the participants of subjective symptoms of dementia was proportionally related to loneliness (men, OR: 3.06; women, OR: 2.40). Among women, economic insecurity (OR: 1.68), subjective health (OR: 2.12), having <3 friends with whom they feel easy to talk about private matters (emotional support) were related to loneliness (OR: 2.38).

CONCLUSION

The results suggested that the type of friendship and number of friends, economic insecurity, and health status might be associated with loneliness among older adults. Several factors related to loneliness might differ by gender.

Loneliness and psychotic-like experiences in middle-aged and older adults: the mediating role of selective attention to threat and external attribution biases

OBJECTIVES

Loneliness has been associated with psychotic-like experiences (PLEs) in the general population, but the mechanisms underlying this association are poorly understood. Theoretical models, corroborated by empirical findings, signify the key role of biased cognition in both loneliness and psychosis. This study tested whether two cognitive biases - Selective Attention to Threat (ATB) and External Attribution Bias (EAB) - account for the association between loneliness and PLEs.

METHOD

A convenience sample (n = 357) of middle-aged and older adults (aged 40+) was recruited online from the UK population. The parallel mediation model with two the aforementioned cognitive biases as mediators was tested.

RESULTS

A mediation effect between loneliness and PLEs via ATB (ab1 = 0.441, 95% CI = [0.264, 0.646]) and EAB (ab2 = 0.354, 95% CI [0.124, 0.627] was established. This model remained significant after controlling for the current symptoms of anxiety and depression.

CONCLUSION

Greater loneliness was associated with a higher rate of PLEs in the sample of middle-aged and older adults. This association was fully explained by ATB and EAB, independent of the current symptoms of anxiety and depression.

Family is all that matters: Prospective associations between structure, function, and quality of social relations and self-rated health in the National Social Life, Health, and Aging Project (NSHAP)

We prospectively examined the association between structure, function, and quality of social relations and self-rated health (SRH) in U.S. adults followed over 10 years in the population-based National Social Life, Health, and Aging Project (NSHAP). Large social network and high positive/negative social support were measured at baseline and defined as the highest quartile. These three binary measures were reported from friends, family, and partner and combined into a multifactorial exposure variable. SRH was measured through a 5-point Likert scale and dichotomised. Odds ratios (OR) for poor SRH were estimated with covariate-adjusted logistic regression. In total, 1,592 participants were included. Based on the combined multifactorial exposure variable as well as independent exposure variables, only lower levels of negative social support were prospectively associated with better SRH (aOR = 0.65; 95%CI 0.44-0.98). From the different social ties, only family-related negative social support was associated with poor SRH (aOR = 0.59; 95%CI 0.39-0.90). This association was similar between genders, but only statistically significant among women. Sensitivity analysis with depressive symptoms as outcome supported the hypothesis that the findings for SRH may be partially driven by mental health (aOR = 0.65; 95%CI 0.48-0.90). Concluding, negative social support particularly from family is prospectively associated with poor SRH.

The Longevity Benefits of Homeownership: Evidence From Early Twentieth-Century U.S. Male Birth Cohorts

Owning a home has long been touted as a key component of the idealized "American Dream." Homeownership is associated with greater wealth and better health, but the causal impact of homeownership on health remains unclear. Using linked complete-count census and Social Security mortality records, I document Black-White disparities in homeownership rates and produce the first U.S.-based estimates of the association between homeownership in early adulthood and longevity. I then use a sibling-based identification strategy to estimate the causal effect of homeownership on longevity for cohorts born in the first two decades of the twentieth century. The results indicate that homeownership has a significant positive impact on longevity, which I estimate at approximately 4 months.

Prevention of frailty in relation with social out-of-home activities in older adults: results from the Survey of Health, Ageing, and Retirement in Europe

Out-of-home mobility and social participation have been identified as resources to postpone frailty. We aim to examine the mediating role and specific contribution of social out-of-home activities in frailty prevention. Data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) waves six (w6), seven (w7), and eight (w8) were used. Frailty was measured with the SHARE version of the Edmonton Frail Scale (EFS) with frailty states fit, pre-fail and frail. First, a mediation model with 13,456 fit participants aged ≥ 50 years in w6 was specified with social network size, loneliness (UCLA 3-Item Loneliness Scale), and lack of motivation (EURO-D) as predictors and number of performed social out-of-home activities in w7 as mediator variable on EFS-scores in w8. Age, education, gender, cohabitation, widowhood, urban environment, and country served as covariates. Second, we investigated the association of increasing social out-of-home activities from w6 to w7 with change in EFS-score from w6 to w8 using a linear mixed model with 17,439 participants in all frailty states. Direct effects of loneliness (w6) and lack of motivation (w6) on EFS-scores (w8) were partially mediated by social out-of-home activities (loneliness ß = 0.005; 95% CI = 0.003-0.008) and (lack of motivation ß = 0.014; 95% CI = 0.009-0.019). The linear mixed model revealed a significant effect of increasing social out-of-home activities (w6-w7) on reduction of EFS-scores (w8) (ß = - 0.21; 95% CI = - 0.29-0.04; p < 0.001). Social out-of-home activities appear to play a crucial role in frailty prevention, which could be used for future interventions.

The status quo and influencing factors of intrinsic capacity among community-dwelling older adults from the perspective of Ecological Systems Theory: A cross-sectional study

BACKGROUND

As intrinsic capacity (IC) declines, older adults are at a significantly increased risk of frailty, care dependency, and death. Currently, the research on IC among older adults in China was still insufficient. We aimed to identify the status quo and influencing factors among community-dwelling older adults in China and explore the relationship between IC, external environment, and social network.

METHODS

A convenience sampling method was used to collect 312 older people from May 2023 to February 2024 in five communities in Chengdu, Sichuan Province. Data were collected using the general information questionnaire, Integrated Care of the Elderly (ICOPE) screening tool, World Health Organization Quality of live scale (WHOQOL-100), and Social Network Scale (LSNS-6).

RESULTS

The IC score among Chinese community-dwelling older adults was 3.39 ± 1.60, and the prevalence of IC decline was 86.9%. Marital status, age, number of chronic diseases, social network, and external environment were influencing factors of IC, which explained 35.7% of the total variance. External environment and social network were positively correlated with IC.

CONCLUSIONS

Chinese community-dwelling older adults had low IC scores and a high prevalence of IC decline. The government should focus on IC for older adults, especially those who are older, not married or widowed, and suffering from multiple chronic diseases. In addition, the richer the external resources available to older adults, the more social support they received, and the better the IC. These findings could provide a theoretical basis for managing and improving IC in older adults.

Do middle-aged and older people underreport loneliness? experimental evidence from the Netherlands

Despite the growing acknowledgment of the importance of loneliness among older individuals, questionnaire length constraints may hinder the inclusion of common multi-item loneliness scales in surveys. Direct, single-item loneliness measures are a practical alternative, but scholars have expressed concerns that such measures may lead to underreporting. Our aim was to test whether such reservations are justified. We conducted a preregistered list experiment among 2,553 people aged 50 + who participated in the Dutch Longitudinal Internet studies for the Social Sciences (LISS) panel. The list experiment method has been developed to unobtrusively gather sensitive information. We compared the list experiment estimate of the prevalence of frequent loneliness with the corresponding direct question estimate to assess downward bias in the latter. Next to pooled models, we estimated models stratified by gender to assess whether loneliness underreporting differed between women and men. Relying on the direct question, we estimated that 5.9% of respondents frequently felt lonely. Our list experiment indicated that the prevalence of frequent loneliness was 13.1%. Although substantial in magnitude, the difference between both estimates was only marginally significant (Δb: 0.072, 95% CI: - 0.003;0.148, p = .06). No evidence of gender differences was found. Although we cannot be conclusive that loneliness estimates are biased downward when a direct question is used, our results call for caution with direct, single-item measures of loneliness if researchers want to avoid underreporting. Replications are needed to gain more precise insights into the extent to which direct, single-item loneliness measures are prone to downward reporting bias.

[Loneliness as health risk: a narrative review]

Loneliness is increasingly recognized as a significant health risk. This review provides an overview of current research on the impact of loneliness on mental and physical health. The findings indicate that loneliness is a significant risk factor of both mental and physical health. Previous reviews focusing on mental health effects reveal that loneliness is associated with the onset of depression, social anxiety, and cognitive decline. Furthermore, loneliness can impede recovery from mental disorders in general, which can be partly attributed to the bidirectional interplay between loneliness and mental health. Regarding physical health, consequences of loneliness have been mostly studied in relation to cardiovascular diseases. Loneliness predicts the onset of cardiovascular diseases and impedes recovery from them. Reviews also highlight that loneliness enhances the likelihood of suicidality and mortality. However, this article also points out the shortage of longitudinal studies, complicating the investigation into how loneliness causally affects future health problems. The health implications of loneliness outlined in this review, some of which are irreversible and can induce suffering and impairment, underscore the importance of interventions aimed at alleviating loneliness as a preventive strategy against both mental and physical illnesses.

Marital status, educational level, and mid-term mortality risk in 5924 patients after transcatheter aortic valve implantation

Aims

There is scarce knowledge about the association between social factors and mid-term outcome in older patients undergoing transaortic valve implantation (TAVI). Our aim in this study is to explore associations between marital status, educational level, and mortality risk in patients after TAVI.

Methods and results

Patients aged ≥65 who underwent TAVI in Sweden during 2014-2020 were identified from the SWEDEHEART registry. Social factors and comorbidities were collected from mandatory national registries. Cox regression models adjusted for baseline comorbidities, age, sex, year of TAVI, social factors, and smoking were used to estimate mortality risk. Median follow-up was 1.9 years (interquartile range: 0.9-3.3). Overall, 5924 patients were included (47.3% women), with a mean age of 82.1 years (standard deviation: 6.1). Of the 1410 (23.8%) deaths during follow-up, 721 (51.2%) were related to cardiovascular causes. Patients with low education (<10 years) had a higher risk of mortality than patients with the highest education level [>12 years; adjusted hazard ratio (aHR): 1.20, 95% confidence interval (CI): 1.03-1.41]. Never being married/cohabiting was associated with an increased risk of mortality in comparison with being married/cohabiting (aHR: 1.32, 95% CI: 1.05-1.65). A separate analysis of men and women showed an increased risk among never-married men (aHR: 1.63, 95% CI: 1.23-2.14) but not among never-married women (aHR: 0.85, 95% CI: 0.56-1.30).

Conclusion

Disadvantage in social factors was associated with an increased mortality risk after TAVI in older patients. These findings emphasize the importance of developing strategies to increase health literacy and social support after TAVI in older patients with unfavourable social factors.

The Relationship Between Loneliness and the Overuse of WeChat Among Chinese Elderly: The Chain Mediation Role of Sensation Seeking and Fear of Missing Out

Background

With the advent of new media technology, WeChat, as China's largest social networking platform, has significantly impacted people's lives. Growing concerns exist about social media usage, particularly regarding mental health issues stemming from problematic smartphone use. However, limited research has explored the relationship between social media usage and mental health among older adults in China, particularly the mechanisms influencing this relationship. This study addresses this gap by investigating the relationship between excessive WeChat use and loneliness among older adults, examining the mediating roles of sensation seeking and fear of missing out (FoMO).

Methods

To clarify the intermediary role of sensation seeking and FoMO in the relationship between elderly loneliness and problematic phone use, this study employed the loneliness scale, brief sensation seeking scale, the scale of FoMO and WeChat overuse scale in a questionnaire survey on the Chinese elderly aged 55 to 89 (N=913). A chained mediation model was constructed, with descriptive statistics, Pearson correlation analysis, and mediation effect tests performed.

Results

The results indicate that the relationship between loneliness and excessive WeChat use among Chinese elderly is mediated by sensation seeking and FoMO.

Conclusion

The findings reveal that loneliness, sensation seeking and FoMO and problematic mobile phone use (WeChat) are interconnected; (ii) sensation seeking and FoMO are the two important intermediary mechanisms between loneliness and problematic mobile phone use; and (iii) sensation seeking and FoMO can act as mediators in the relationship between loneliness and problematic mobile phone use among the elderly. In the difference test of demographic variables, it was found that women had more WeChat overuse behavior than men, and urban residents demonstrated significantly higher levels of overuse than their township residents. The study has revealed the psychological mechanism between loneliness and problematic mobile phone use among the elderly, which provides guiding suggestions for the prevention and intervention of such behaviors in the elderly.

Social network and related factors in older people with sensory impairment in the community: Using principal component analysis

AIM

Older people with sensory impairment are more likely to have smaller and weaker social network due to their reduced ability, which lowers their quality of life. However, there is little research on the social network in older people with sensory impairment, especially the related factors. The aim of the study was to explore the related factors of social network and to provide evidence for the improvement of social network to promote successful aging in older people with sensory impairment.

METHODS

A cross-sectional study was conducted among 374 participants for hearing and vision assessment and questionnaire survey in a community, Beijing. Data were collected and analyzed by principal component analysis (PCA) and multiple logistic regression using IBM SPSS 25.0 software.

RESULTS

PCA showed that there were six risk factors whose eigenvalues >1 were extracted, with a total variance of 56.555%. Multiple logistic regression analysis of principal component indicated that five factors including physical health factor, social interaction factor, psychological status factor, lifestyle factor, and family condition factor, were statistically significant (p < 0.05).

CONCLUSIONS

The social network of older people with sensory impairment is relatively poor. Physical health factor, social interaction factor, psychological status factor, lifestyle factor, and family condition factor may be related factors. Medical staff should pay attention to physical, psychological and social characteristics of older people, especially with sensory impairment, to carry out necessary measures to improve social network and avoid social isolation.

Predictive factors and risk and protection groups for loneliness in older adults: a population-based study

BACKGROUND

Loneliness is considered a public health problem, particularly among older adults. Although risk factors for loneliness have been studied extensively, fewer studies have focused on the protected and risk groups that these factors configure. Our objective is to analyze the variables and latent factors that predict loneliness in older adults and that enable risk and protected groups to be configured.

METHODS

We employed an epidemiological, cross-sectional survey that was carried out on a random sample of 2060 people over 65 years extracted from the census. A structured telephone interview was used to assess mental and physical health, habits, quality of life, and loneliness, applying the COOP-Wonca, Goldberg General Health (GHQ-12), and Barber Questionnaires.

RESULTS

Predictors of loneliness were: mental health, living alone, quality of life, depressive symptoms, low educational level, and some deficiency situations such as having no one to turn to for help. The factors extracted (Factorial Analysis) were: a subjective experience of poor health, objective isolation, and psychological isolation. We established at risk and protected groups ("Decision Tree" procedure), and loneliness was referred to by 73.2% of the people living alone and with poor mental health and quality of life (risk group). By contrast, only 0.8% of people living with others, with good mental health and good quality of life felt loneliness (protected group).

CONCLUSION

In a well-developed city, subjective and objective factors are associated with loneliness. These factors, especially those associated with at risk or protected groups, must be considered to develop strategies that address loneliness.

Love songs and serenades: a theoretical review of music and romantic relationships

In this theoretical review, we examine how the roles of music in mate choice and social bonding are expressed in romantic relationships. Darwin's Descent of Man originally proposed the idea that musicality might have evolved as a sexually selected trait. This proposition, coupled with the portrayal of popular musicians as sex symbols and the prevalence of love-themed lyrics in music, suggests a possible link between music and attraction. However, recent scientific exploration of the evolutionary functions of music has predominantly focused on theories of social bonding and group signaling, with limited research addressing the sexual selection hypothesis. We identify two distinct types of music-making for these different functions: music for attraction, which would be virtuosic in nature to display physical and cognitive fitness to potential mates; and music for connection, which would facilitate synchrony between partners and likely engage the same reward mechanisms seen in the general synchrony-bonding effect, enhancing perceived interpersonal intimacy as a facet of love. Linking these two musical functions to social psychological theories of relationship development and the components of love, we present a model that outlines the potential roles of music in romantic relationships, from initial attraction to ongoing relationship maintenance. In addition to synthesizing the existing literature, our model serves as a roadmap for empirical research aimed at rigorously investigating the possible functions of music for romantic relationships.

Loneliness, Dementia Status, and Their Association with All-Cause Mortality Among Older US Adults

Background

Loneliness, dementia, and mortality are interconnected.

Objective

We aimed at understanding mediating pathways and interactions between loneliness and dementia in relation to mortality risk.

Methods

The study tested bi-directional relationships between dementia, loneliness, and mortality, by examining both interactions and mediating effects in a large sample of older US adults participating in the nationally representative Health and Retirement Study. Out of≤6,468 older participants selected in 2010, with mean baseline age of 78.3 years and a follow-up time up to the end of 2020, 3,298 died at a rate of 64 per 1,000 person-years (P-Y). Cox proportional hazards and four-way decomposition models were used.

Results

Algorithmically defined dementia status (yes versus no) was consistently linked with a more than two-fold increase in mortality risk. Dementia status and Ln(odds of dementia) were strongly related with mortality risk across tertiles of loneliness score. Loneliness z-score was also linked to an elevated risk of all-cause mortality regardless of age, sex, or race or ethnicity, and its total effect (TE) on mortality was partially mediated by Ln(odds of dementia), z-scored, (≤40% of the TE was a pure indirect effect). Conversely, a small proportion (<5%) of the TE of Ln(odds of dementia), z-scored, on mortality risk was explained by the loneliness z-score.

Conclusions

In sum, dementia was positively associated with all-cause mortality risk, in similar fashion across loneliness score tertiles, while loneliness was associated with mortality risk. TE of loneliness on mortality risk was partially mediated by dementia odds in reduced models.

Social connection and mortality in UK Biobank: a prospective cohort analysis

BACKGROUND

Components of social connection are associated with mortality, but research examining their independent and combined effects in the same dataset is lacking. This study aimed to examine the independent and combined associations between functional and structural components of social connection and mortality.

METHODS

Analysis of 458,146 participants with full data from the UK Biobank cohort linked to mortality registers. Social connection was assessed using two functional (frequency of ability to confide in someone close and often feeling lonely) and three structural (frequency of friends/family visits, weekly group activities, and living alone) component measures. Cox proportional hazard models were used to examine the associations with all-cause and cardiovascular disease (CVD) mortality.

RESULTS

Over a median of 12.6 years (IQR 11.9-13.3) follow-up, 33,135 (7.2%) participants died, including 5112 (1.1%) CVD deaths. All social connection measures were independently associated with both outcomes. Friends/family visit frequencies < monthly were associated with a higher risk of mortality indicating a threshold effect. There were interactions between living alone and friends/family visits and between living alone and weekly group activity. For example, compared with daily friends/family visits-not living alone, there was higher all-cause mortality for daily visits-living alone (HR 1.19 [95% CI 1.12-1.26]), for never having visits-not living alone (1.33 [1.22-1.46]), and for never having visits-living alone (1.77 [1.61-1.95]). Never having friends/family visits whilst living alone potentially counteracted benefits from other components as mortality risks were highest for those reporting both never having visits and living alone regardless of weekly group activity or functional components. When all measures were combined into overall functional and structural components, there was an interaction between components: compared with participants defined as not isolated by both components, those considered isolated by both components had higher CVD mortality (HR 1.63 [1.51-1.76]) than each component alone (functional isolation 1.17 [1.06-1.29]; structural isolation 1.27 [1.18-1.36]).

CONCLUSIONS

This work suggests (1) a potential threshold effect for friends/family visits, (2) that those who live alone with additional concurrent markers of structural isolation may represent a high-risk population, (3) that beneficial associations for some types of social connection might not be felt when other types of social connection are absent, and (4) considering both functional and structural components of social connection may help to identify the most isolated in society.

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.

Association between Sense of Loneliness and Quality of Life in Older Adults with Multimorbidity

BACKGROUND

Multimorbidity has been associated with adverse health outcomes, such as reduced physical function, poor quality-of-life (QoL), poor self-rated health.

OBJECTIVE

The association between quality of life, social support, sense of loneliness and sex and age in older adult patients affected by two or more chronic diseases (multimorbidity) was evaluated.

METHODS

Patients n. 162 with multimorbidity and living with family members.

TESTS

MMSE-Mini-Mental-State-Examination; ADL-Activities of Daily Living; Social Schedule: demographic variables; Loneliness Scale -de Jong Gierveld; Quality-of-Life-FACT-G; WHOQOL-BRIEF Social relationships.

STATISTICAL ANALYSIS

Multivariate Regression Analysis.

RESULTS

The patients with three or more diseases have worse dimensions of FACT-G total score (p = 0.029), QoL Physical-well-being (p = 0.003), Social well-being (p = 0.003), Emotional-well-being (p = 0.012), Functional-well-being (p < 0.001), than those with two. Multiple linear regression QoL: FACT_G total score, PWB, SWB, EWB, FWB as dependent variables. In the presence of multimorbidity with an increase in the patient's age FACT-G total score (B = -0.004, p = 0.482), PWB (B = -0.024, p = 0.014), SWB (B = -0.022, p = 0.051), EWB (B = -0.001, p = 0.939), FWB (B = -0.023, p = 0.013) decrease by an average of 0.1, and as the sense of solitude increases FACT-G total score (B = -0.285, p < 0.000), PWB (B = -0.435, p < 0.000), SWB(B = -0.401, p < 0.000), EWB(B = -0.494, p < 0.000), FWB(B = -0.429, p < 0.000) decrease by 0.4.

CONCLUSIONS

A sense of loneliness and advancing age are associated with bad quality-of life in self-sufficient elderly patients with multimorbidity.

IMPLICATIONS FOR PRACTICE

Demonstrating that loneliness, as well as in the presence of interpersonal relations, is predictive of worse quality of life in patients with multimorbidity helps identify people most at risk for common symptoms and lays the groundwork for research concerning both diagnosis and treatment.

Loneliness in Relation to Social Factors and Self-Reported Health Among Older Adults: A Cross-Sectional Study

BACKGROUND

Loneliness is described as a public health problem and can be both a consequence of aging and a cause of ill health. Lonely older adults tend to have difficulties making new social connections, essential in reducing loneliness. Loneliness often varies over time, but established loneliness tends to persist. Maintaining good health is fundamental throughout the life course. Social connections change with aging, which can contribute to loneliness.

AIM

This study aimed to investigate loneliness in relation to social factors and self-reported health among older adults.

METHOD

A cross-sectional research design was used based on data from the Swedish National Study on Aging and Care, Blekinge (SNAC-B), from February 2019 to April 2021. Statistical analysis consisted of descriptive and inferential analysis.

RESULTS

Of n = 394 participants, 31.7% (n = 125) stated loneliness. Close emotional connections were necessary for less loneliness. Loneliness was more common among those who did not live with their spouse or partner and met more rarely. Furthermore, seeing grandchildren and neighbors less often increased loneliness, and a more extensive social network decreased loneliness.

CONCLUSION

This study underlined the importance of social connections and having someone to share a close, emotional connection with to reduce loneliness.