Predictors of loneliness in elderly Korean immigrant women living in the United States of America

Systematic review of factors influencing loneliness in older-adult migrants

OBJECTIVES

Older-adult migrants constitute a proportion of the global population, and loneliness hinders their adaptation to host areas. However, review studies on risk factors for loneliness target general older-adults without focusing on older-adult migrants. Therefore, this study systematically reviews and synthesizes the factors influencing the loneliness of older-adult migrants.

METHOD

Five databases were searched and screened for quantitative studies investigating the relationship between risk factors and loneliness among older-adult migrants (over age 50). Finally, 35 articles were included.

RESULTS

Factors related to loneliness in older-adult migrants were synthesized into sociodemographic, physical health, psychological, interpersonal, and acculturation-related factors. Consistent significant relationships with loneliness were found for a few risk factors, including not having spouses, low subjective financial status, poor self-rated health, poor psychological status, few non-kin ties, low quality of kin and non-kin ties, and a weak sense of belonging to either one's ethnic group or that of the host areas.

CONCLUSION

This review discusses the unique findings on the risk factors for loneliness in older-adult migrants. Additionally, the current literature on loneliness in older-adult migrants has some research gaps, calling for longitudinal studies with a rigorous design.

Loneliness and Functional Decline in Aging: A Systematic Review

Loneliness is prevalent in adults aged ≥65 years in the United States and is associated with functional decline. The purpose of the current review was to synthesize evidence on the relationship between loneliness and functional decline using Roy's Adaptation Model as a theoretical framework. A comprehensive review of PubMed, Medline, and Embase databases was performed. Inclusion criteria were samples including adults primarily aged >60 years, peer-reviewed, published in the English language, and included a measure for loneliness and function. A total of 47 studies were analyzed. Most studies examined correlates, risk factors, and predictors of loneliness, rather than the relationship between loneliness and function. Evidence suggests there is bidirectionality in the relationship between loneliness and functional decline. Loneliness is associated with functional decline in aging via multiple possible pathways. Further studies are needed to determine causality and biological mechanisms underlying the relationship. [Research in Gerontological Nursing, 16(4), 202-212.].

Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources

BACKGROUND

Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community.

OBJECTIVE

This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults.

METHODS

A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources.

RESULTS

The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services.

CONCLUSIONS

A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.

Gender Differences in Correlates of Loneliness among Community-Dwelling Older Koreans

Background: Despite a relatively large number of studies exploring late-life loneliness, few studies have compared gender differences in the correlates of loneliness of older adults. Thus, we examined the gender differences in correlates of loneliness among community-dwelling older adults. Methods: This study was a secondary analysis of data from a parent study conducted among community-dwelling Koreans 65 years of age or older. Loneliness was measured by the 20-item Revised University of California Los Angeles Loneliness Scale. As potential correlates, demographic, health-related, and social variables were included. Multivariate hierarchical regression analyses were performed separately by gender. Results: Men were more likely to be lonely than women, after controlling for demographic, health-related, and social variables. A social network of family ties and being married were found to be inversely correlated with loneliness in men but not in women. A social network of friendship ties and participation in a variety of community activities were inversely correlated with loneliness in both men and women. Conclusions: A social network of family ties and being married may help reduce late-life loneliness, particularly among men. This study highlights the importance of considering gender differences in the design of strategies for preventing and alleviating late-life loneliness.

Systematic review of psychometric properties and cross-cultural adaptation of the University of California and Los Angeles loneliness scale in adults

This systematic review assessed the psychometric properties and the cross-cultural adaptation of the University of California and Los Angeles Loneliness scale (UCLA-LS) in adults. A systematic search of four electronic databases (PubMed, EMBASE, Scopus, and PsycINFO) was conducted from inception until March 2021. We followed the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines for data extraction and evidence synthesis. Eighty-one studies assessed the validity and reliability of the UCLA-LS, translated into many languages, and applied across several countries/societies. Three versions of the 20-item and nine short versions of the UCLA-LS with 3 to 20 questions were identified. High-quality evidence supported the internal structure of the UCLAs: 4, 6, 7 and 10, while low-to moderate-quality evidence supported the construct validity of the UCLAs: 3, 4, 6, 8, 16 and 20. Moderate-quality evidence supported the test-retest reliability of version 3 UCLA-20 with excellent interclass coefficients values of 0.76-0.93. The UCLAs: 4, 6, 7 and 10 had the most robust internal structure and may therefore be the most useful for informing clinicians and social psychologists engaged in assisting those with loneliness.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-021-02494-w.

Cognitive health risks posed by social isolation and loneliness in older Korean Americans

BACKGROUND

This study examines associations among social isolation, loneliness, and cognitive health risks in older Korean Americans, focusing on the mediating role of loneliness in the relationship between social isolation and objective and subjective measures of cognitive impairment.

METHODS

Data are from 2061 participants in the Study of Older Korean Americans, a multi-state survey of Korean immigrants age 60 and older (Mage = 73.2, SD = 7.93). Social isolation was indexed with the Lubben Social Network Scale- 6; loneliness, with the short-form UCLA Loneliness Scale. Objective and subjective measures of cognitive impairment included the Mini-Mental State Examination and a single-item self-rating of cognitive health.

RESULTS

In the logistic regression model for objective cognitive impairment, social isolation was significantly associated, but loneliness was not. In the model for subjective cognitive impairment, both social isolation and loneliness were significant factors. However, the effect of social isolation became non-significant when loneliness was considered, suggesting a potential mediating role of loneliness. The subsequent mediation analysis confirmed that the indirect effect of social isolation on subjective cognitive impairment through loneliness was significant (B = .20, SE = .03, 95% CI = .12, .28).

CONCLUSION

Our analyses provide evidence for the proposed mediating effect of loneliness in the relationship between social isolation and subjective cognitive impairment. Intervention efforts should focus on reducing feelings of loneliness experienced by older immigrants, possibly by engaging them in socially meaningful and cognitively stimulating activities.

Loneliness among Elderly People: Can Food and Meals Change this Situation?

In a relationship, it is natural that one person lives longer than the other, leading to many challenges, including the possibility of loneliness. This article focuses on how food and meals can help reduce loneliness among the elderly. There are many reasons for loneliness or emptiness, including being a widow or a widower, illness, and poverty. As the number of elderly people is greatly increasing in all welfare states, meals are an important function that should be maintained throughout life. This study used CurroCus® group interviews, or fast focus groups. Nine CurroCus® groups were conducted, lasting for 37–56 min (average = 45 min). Altogether, 76 persons participated, ranging in age from 60 to 87 years; participants were predominantly female (> 80%). The collected empirical data were recorded, transcribed, and entered into NVivo 11.0. Interviews were analysed using a grounded theory approach. The main findings of this article fall into two main categories: togetherness and life action. Based on the interpretation of respondents’ answers, elderly people make both conscious and unconscious choices that help reduce loneliness. They also gather around food and meals to experience more togetherness. In future research, loneliness strategies carried out unknowingly should be investigated more closely. In addition, elderly participants should self-report on meal activities throughout the day.

"Living happily despite having an illness": Perceptions of healthy aging among Korean American, Vietnamese American, and Latino older adults

BACKGROUND/OBJECTIVE

The growingly diverse aging population presents a challenge for the geriatric workforce, particularly its capacity to effectively respond to the sociocultural and linguistic needs of ethnic minority older adults. Informed by research on the importance of culturally-competent care in reducing racial and ethnic health disparities, this study sought to understand the meaning of healthy aging from the perspectives of Korean American, Vietnamese American, and Latino older adults.

METHODS

Interviews were conducted with 30 participants recruited from community-based organizations in Southern California.

RESULTS

Several dimensions emerged in the participants' understanding of healthy aging: (1) having good physical and mental health (2) optimism and acceptance; (3) social connectedness; (4) taking charge of one's health; and (5) independence and self-worth.

CONCLUSIONS

Results could inform the development of a culturally-responsive geriatric healthcare system that takes into account older adults' beliefs, preferences, and needs to promote successful aging.

Lonely ageing in a foreign land: Social isolation and loneliness among older Asian migrants in New Zealand

Ageing does not reduce people's need to connect with family members, friends, and acquaintances, and neither does migration. For those older migrants living in a foreign land, connectedness with others plays a particularly important role in achieving a sense of belonging and sustaining their health and well-being. This paper explores the issues of social isolation and loneliness among older Asian migrants in New Zealand. Data were collected from in-depth semi-structured interviews with Chinese- or Korean-speaking migrants aged between 75 and 84 years (n = 10: all females), and from three focus groups consisting of Chinese- and Korean-speaking migrants (n = 10: 7 females, 3 males) and Chinese professionals (n = 5: 3 females, 2 males) between June 2016 and December 2016. The qualitative data obtained were analysed applying a thematic analysis approach using NVivo software for group analysis by a multidisciplinary research team. The findings from the study show that older Asian migrants experienced high levels of isolation and loneliness at least at some points in their migrant lives. Most participants in this study were living alone or with only their spouse, and this living arrangement was likely to provide fertile ground for isolation and loneliness to grow in the context of later-life migration. It was also observed that their lonely ageing ironically resulted from their efforts to preserve family relationships through avoiding being a burden, while allowing them a sort of space to maintain now barely connected lives. The participants revealed multiple ways of coping with lonely and isolated experiences in their limited social network, and these individual strategies allow us to make suggestions about how best to reduce older migrants' social isolation and loneliness in the New Zealand context and beyond.

The Role of Cultural and Family Values on Social Connectedness and Loneliness among Ethnic Minority Elders

OBJECTIVES

Ethnic minority elders have high levels of social isolation and loneliness. Assumptions about the family providing enough social support exist in the literature, contradicting ethnic minority elders' reported levels of isolation and loneliness. While structural barriers influence feelings of isolation and loneliness, limited information exists about the role of cultural factors such as acculturation and family values. Accordingly, this study investigated the roles of acculturation and family values on loneliness and social isolation among ethnic minority elders.

METHODS

Ethnic minority elders (N = 123) completed a questionnaire that assessed their social connectedness, measured by social network and levels of loneliness, and structural factors such as income. Additionally, cultural and family values were assessed by acculturation and the 'family as referents' dimension of familism, which refers to the belief that family members' behaviour should meet with familial expectations.

RESULTS

Statistical analysis using hierarchical regression indicated that 'family as referents' and acculturation predicted loneliness, but not social network.

CONCLUSIONS

This study raises the importance of considering cultural values when investigating predictors of loneliness among ethnic minority elders.

CLINICAL IMPLICATIONS

Findings highlight the importance of addressing familial expectations in programs aimed at alleviating loneliness among ethnic minority elders.

The relation between living alone and depressive symptoms in older Korean Americans: do feelings of loneliness mediate?

OBJECTIVES

As the opposite end of the continuum from social integration, social isolation may put individuals at a greater risk of poor mental health. Conceptualizing living alone as an objective and structural indicator of social isolation and loneliness as subjective perceptions of social isolation, the present study hypothesized that the relation between living alone and depressive symptoms would be mediated by the feelings of loneliness. Using older Korean Americans as the target population, the mediation model was examined in consideration of the contextual factors such as demographics (age, gender, education, perceived income, and length of stay in the USA), health (chronic conditions and functional disability), and general social integration (size of social network and community social cohesion).

METHOD

Date were drawn from surveys with 209 older Korean Americans in Central Texas (M_age = 69.6, SD = 7.5). Multivariate regression models of depressive symptoms were entered in the following order: (1) demographics, (2) health, (3) living alone, (4) social network/community social cohesion, and (5) loneliness. The mediation effect of loneliness in the relationship between living alone and depressive symptoms was separately examined using the bootstrapping method.

RESULTS

Loneliness was found to mediate the relation between living alone and depressive symptoms (indirect effect = 1.03, 95% CI = .05-2.08).

CONCLUSION

The results suggest that subjective perceptions of loneliness may explain the mechanism through which objective social isolation presents risks for depressive symptoms in older Korean Americans.

Interventions for alleviating loneliness among older persons: a critical review

OBJECTIVES

Loneliness is common among older persons and has been associated with health and mental health risks. This systematic review examines the utility of loneliness interventions among older persons.

DATA SOURCE

Thirty-four intervention studies were used. STUDY INCLUSION CRITERIA: The study was conducted between 1996 and 2011, included a sample of older adults, implemented an intervention affecting loneliness or identified a situation that directly affected loneliness, included in its outcome measures the effects of the intervention or situation on loneliness levels or on loneliness-related measures (e.g., social interaction), and included in its analysis pretest-posttest comparisons.

DATA EXTRACTION

Studies were accessed using the databases PsycINFO, MEDLINE, ScienceDirect, AgeLine, PsycBOOKS, and Google Scholar for the years 1996-2011.

DATA SYNTHESIS

Interventions were classified based on population, format, and content and were evaluated for quality of design and efficacy.

RESULTS

Twelve studies were effective in reducing loneliness according to the review criteria, and 15 were evaluated as potentially effective. The findings suggest that it is possible to reduce loneliness by using educational interventions focused on social networks maintenance and enhancement.

CONCLUSIONS

Multiple approaches show promise, although flawed design often prevents proper evaluation of efficacy. The value of specific therapy techniques in reducing loneliness is highlighted and warrants a wider investigation. Studies of special populations, such as the cognitively impaired, are also needed.

Association of social isolation and health across different racial and ethnic groups of older Americans

Social isolation is a social and public health problem that affects people of all ages, especially elders. Previous studies have found that social isolation across numerous industrialised countries is associated with negative health outcomes. However, it is unknown whether and how this association differs by race/ethnicity and age. To begin to address this gap, this study examines the association of social isolation and physical and mental health among Black, White and Hispanic elders in the United States of America. Building on Cornwell and Waite's perceived isolation and social disconnectedness dimension model of social isolation, the author used multi-stage survey data from a nationally representative sample of 3,005 community-residing adults aged 57-85 from the National Social Life, Health, and Aging Project. Tests for association were conducted on health by age, gender, marital status, education and race/ethnicity separately. Multivariate logistic regressions were used to test the association of social isolation and health exclusively and separately among these three groups. Results showed that social isolation is strongly associated with physical and mental health. Both perceived isolation and social disconnectedness had a significant negative association with physical and mental health among White elders. For Blacks, social disconnectedness is negatively associated with their physical health while perceived isolation had a negative association with mental health. Among Hispanic elders, there seemed to be no association between social isolation and physical health, but a significant negative association was found with their mental health. Despite various associated patterns, however, social isolation overall was associated with health outcomes that were similar across three elder groups. By identifying factors influencing social isolation and health among minority older Americans, this study has relevance to the development of culturally sensitive health-care practice and services, which may be applicable to minority elders in different countries.

The importance of culturally meaningful activity for health benefits among older Korean immigrant living in the United States

Research indicates that participation in culturally meaningful activity is beneficial for immigrants' health and well-being, yet older Korean immigrants struggle with accepting new cultural perspectives, which can negatively affect their health and well-being. Using in-depth interviews, this study was designed to capture the value of culturally meaningful activities for health among older Korean immigrants. Three themes were identified: (a) improved psychological well-being, (b) enhanced positive emotions and feelings, and (c) social connections developed with others. The findings suggest that by engaging in various culturally meaningful activities, older Korean immigrants gain a sense of social, cultural, and psychological significance in life. This study also provided evidence that older Korean immigrants maintain and develop their cultural identity through culturally meaningful activities.

Loneliness and social support of older people in China: a systematic literature review

Loneliness is a serious problem for older people, which can be alleviated by social support. The dramatic population ageing together with social and economic change in China increases the likelihood of loneliness and the availability of different sources of social support of older people. The aim of this review was to identify the prevalence of loneliness and its related factors and sources of social support of older people in China. Electronic literature searches were conducted in September 2011 using Web of Science, PsycINFO, MEDLINE, PubMed, CINAHL, China Academic Journal and VIP Database for Chinese Technical Periodicals. Twenty-six papers were identified and reviewed. The prevalence of loneliness varied across the studies, reflecting the different measurements and samples. Marital status, gender, age, educational level, economic level, living arrangements, health status and social support were significant factors related to loneliness. The family was the most important source of social support followed by friends. The receipt of family support improved subjective well-being and mental health, but the effects of support from friends were inconsistent. Chinese older people received relatively little support from neighbours, governmental or other social organisations. Further well-designed studies are needed to identify additional factors related to loneliness and to understand the support from friends, neighbours, formal organisations and other sources.

The experience of acculturative stress-related growth from immigrants' perspectives

Previous literature has mainly focused on the positive effects of stress associated with disability and illness, called stress-related growth. Little research has explored positive changes as a result of acculturative stress among a group of immigrants. In particular, older Asian immigrants may experience a high level of stress related to acculturation because they may face more challenges to adapt to and navigate a new culture. This study was designed to capture the characteristics of stress-related growth associated with acculturative stress. Using in-depth interviews among 13 older Korean immigrants, three main themes associated with the stress-coping strategies were identified: (a) the development of mental toughness, (b) engagement in meaningful activities, and (c) promotion of cultural understanding. These themes indicate that by following the stressful acculturation process, participants developed a better understanding of the new culture, engaged in various leisure activities, and enhanced mental strength. This finding provides information on how immigrants deal with acculturative stress and have positive psychological changes, which results in a sense of happiness and psychological well-being.

Immigration and loneliness in later life

Although the loneliness of both older adults and immigrants is frequently asserted, knowledge regarding the implications of immigration for loneliness in later life is limited. In particular, little attention has been directed to the impact of factors that might differentiate individuals within the immigrant population. Using data from the 2007 General Social Survey (GSS-21) conducted by Statistics Canada, this study examined the effects of immigrant status as well as immigrant generation, length of residence in Canada and race/ethnicity on loneliness among adults aged 60 and over (N=10,553). Regression analyses (ordinary least squares) estimating both the general and age-specific effects of immigrant experience on loneliness, indicated that immigrants report higher levels of loneliness than native-born Canadians, that race/ethnicity influenced loneliness particularly among immigrants and that generational status as well as length of residence also had an impact, but one that differed across age groups. Immigration-related variables appeared less consequential for loneliness in the oldest-old (aged 80+) than in younger elderly age groups. These findings attest to the significance of immigrant status for an understanding of loneliness in later life but suggest a need to acknowledge the diversity of immigrant experiences associated with lifecourse and other factors.

Factors related to type of companion pet owned by older women

Although pets can be valuable companions for older adults, little is known about why older adults select a specific kind of pet. This study examined demographic (e.g., marital status, health status), health (i.e., well-being, loneliness), and environmental characteristics (i.e., living arrangement, type of housing) of 159 older women in terms of whether they had a companion dog or cat. Significantly more women who were married/partnered had dogs, whereas more single women had cats. Significantly more women who lived alone had cats, whereas more women who lived with someone had dogs. Women with companion dogs had significantly lower depressed mood and higher levels of general health, vitality, and total well-being than those with cats. Although loneliness was somewhat greater among women with cats, the difference was not statistically significant. More women living in 55-and-older communities had cats, whereas more women living in private homes had dogs. Practicing psychiatric nurses can use the information generated from this research to advocate for pet companionship in order to enhance well-being in older women.

The mediating role of loneliness in the relation between social engagement and depressive symptoms among older Korean Americans: do men and women differ?

OBJECTIVES

This study conceptualized loneliness as a mediator in the relation between social engagement and depressive symptoms and explored gender differences in the mediation model. Various indices of social engagement were considered including living arrangement, social network, and activity participation.

METHOD

Using data from 674 community-dwelling Korean American older adults, we first examined the mediation effect of loneliness in the relation between each of 3 indices of social engagement (not living alone, social network, and activity participation) and depressive symptoms. Subsequently, gender differences in the mediation model were examined.

RESULTS

As hypothesized, loneliness was found to mediate the relation between each of the indices of social engagement and depressive symptoms in both men and women. We also observed gender differences in the strength of mediating effects; the effect of living alone was more likely to be mediated by loneliness among men, whereas women showed greater levels of mediation in the models with social network and activity participation.

DISCUSSION

Our findings suggest that loneliness may explain the mechanism by which deficits in social engagement exerts its effect on depressive symptoms and that gender differences should be considered in interventions targeting social engagement for mental health promotion.

Testing healthy immigrant effects among late life immigrants in the United States: using multiple indicators

OBJECTIVE

This study tested a healthy immigrant effect (HIE) and postimmigration health status changes among late life immigrants.

METHODS

Using three waves of the Second Longitudinal Study of Aging (1994-2000) and the linked mortality file through 2006, this study compared (a) chronic health conditions, (b) longitudinal trajectories of self-rated health, (c) longitudinal trajectories of functional impairments, and (d) mortality between three groups (age 70+): (i) late life immigrants with less than 15 years in the United States (n = 133), (ii) longer term immigrants (n = 672), and (iii) U.S.-born individuals (n = 8,642). Logistic and Poisson regression, hierarchical generalized linear modeling, and survival analyses were conducted.

RESULTS

Late life immigrants were less likely to suffer from cancer, had lower numbers of chronic conditions at baseline, and displayed lower hazards of mortality during the 12-year follow-up. However, their self-rated health and functional status were worse than those of their counterparts over time.

CONCLUSION

A HIE was only partially supported among older adults.

Loneliness, social networks, and mortality: 18 years of follow-up

We examined the influence of changes in loneliness and social support networks upon mortality during 18 years of follow-up among an elderly cohort and determined the gender-specific nature of this relationship. The study is based on data collected from the Jerusalem Longitudinal Study (1990-2008), which has followed a representative sample of 605 community-dwelling elderly people. Subjects were randomly selected from an age homogenous cohort born 1920-1921 and were aged 70, 78, and 85 when data were collected at baseline in 1990 and at follow-up in 1998 and 2005. All-cause mortality from age 70-88 was determined according to the National Death Registry. Sense of loneliness was found to be stable among the majority of the respondents. Loneliness among men was found in bivariate analyses to be a risk factor for mortality. Although multivariate analyses found that loneliness was not a significant predictor of mortality, nonetheless several social network factors (marital status at the baseline and living arrangements) were found to predict mortality among men. Loneliness and solitude among elderly men can be a risk factor of mortality. The findings imply that attention should be given to this high risk group.

Perception and negative effect of loneliness in a Chicago Chinese population of older adults

This qualitative study aims to investigate the cultural understandings of loneliness, identify the contexts of loneliness, and to examine its effect on the health and well-being of U.S. Chinese older adults. Despite loneliness is one of the main indicators of well-being, little attention has been paid to understanding loneliness among immigrant older adults. This study utilizes both survey questionnaires and semi-structured focus group methods to investigate the feelings of loneliness among U.S. Chinese older adults. Based on interviews with 78 community-dwelling Chinese older adults in Chicago Chinatown, this community-based participatory research study (CBPR) shows loneliness is common among U.S. Chinese older adults. It was frequently identified through emotional isolation and social isolation. Social, psychological and physical health factors could contribute to the experience of loneliness. In addition, the health of older adults with loneliness may be associated with worsening overall health, elder mistreatment, health behavior changes and increased healthcare utilizations. This study has implications for healthcare professionals, social services agencies and policy makers. Our findings point to the needs for healthcare professionals to be more alert of the association of loneliness and adverse health outcomes. Communities and social services agencies should collectively take a lead in reducing social isolation, improving intergenerational relationships, and increasing social networks and companionship for this group of vulnerable older adults.

Loneliness in elderly individuals, level of dependence in activities of daily living (ADL) and influential factors

This study has been carried out to investigate the level of loneliness, determine the level of dependence in the ADL and influential factors in the elderly people. This descriptive, cross-sectional study was conducted in 5 Family Healthcare Centers (FHC) located in central Erzincan, Turkey between March and June 2010. The data of the research was collected using a questionnaire that determined the descriptive and UCLA Loneliness Scale (UCLA-LS). Mean score of the UCLA-LS was determined as 51.59 ± 4.44. It was determined that 2% of the elderly ADL were completely dependent, 14.5% were semi-dependent. Factors such as being old, a widow/divorced, having a lower level of education and/or income, living alone, having a chronic disease, poor self-perceived health, lack of visits by relatives or acquaintances, dissatisfaction with the place of living, and being fully dependent while performing daily activities were determined as factors which increased the level of loneliness. Furthermore, factors such as being old, a female, a widow/divorced, living together with a daughter/son, having a chronic disease and poor self-perceived health were found to be influential in dependency. Elderly people who are alone and dependent in fulfilling their ADL should be monitored more closely.

Suffering from loneliness indicates significant mortality risk of older people

Background. The harmful associates of suffering from loneliness are still in dispute. Objective. To examine the association of feelings of loneliness with all-cause mortality in a general aged population. Methods. A postal questionnaire was sent to randomly selected community-dwelling of elderly people (>74 years) from the Finnish National Population Register. The questionnaire included demographic characteristics, living conditions, functioning, health, and need for help. Suffering from loneliness was assessed with one question and participants were categorized as lonely or not lonely. Total mortality was retrieved from the National Population Information System. Results. Of 3687 respondents, 39% suffered from loneliness. Lonely people were more likely to be deceased during the 57-month follow-up (31%) than subjects not feeling lonely (23%, P < .001). Excess mortality (HR = 1.38, 95% CI = 1.21-1.57) of lonely people increased over time. After controlling for age and gender, the mortality risk of the lonely individuals was 1.33 (95% CI = 1.17-1.51) and after further controlling for subjective health 1.17 (CI = 1.02-1.33). The excess mortality was consistent in all major subgroups. Conclusion. Suffering from loneliness is common and indicates significant mortality risk in old age.

Intergenerational acculturation conflict and Korean American parents' depression symptoms

This study examined the links between intergenerational acculturation conflict and depression symptoms in 176 Korean American parents of children between the ages of 5 and 10. Approximately, 29% of fathers and 28% of mothers reported increased depression symptoms, which were related to parent-child acculturation conflict. Specific situations related to parental depression symptoms included conflicts over the child's social life, comparing the child with others, expressions of love, the importance of saving face, and proper Korean child's behavior. These findings can be used to develop a family intervention program to decrease parental depression symptoms by reducing parent-child acculturation conflict.

Loneliness in old age: longitudinal changes and their determinants in an Israeli sample

BACKGROUND

There is a paucity of past research concerning longitudinal changes in loneliness in old age and in the factors that correlate with loneliness in older persons. This study examines (a) whether loneliness increases with age, (b) characteristics of the lonely older population, and (c) predictors of becoming lonely in old age.

METHODS

Data are from the Cross-Sectional and Longitudinal Aging Study, a national longitudinal study on the health, mental, and social status of people aged 75 and older living in Israel. Loneliness was measured as the frequency at which participants had felt lonely during the last month (range: 0-3). The analysis included two waves of data, with an average gap of 3.5 years between them, with 1147 participants at wave 1 and 588 participants at wave 2.

RESULTS

Data showed an increase in the mean level of loneliness over time, rising from 0.62 to 0.80, p<0.001. The strongest correlate of being lonely at wave 1 was unmarried status. Different variables predicted loneliness in the married and the unmarried. Among the married, lonelier persons tended to have experienced more traumatic events, had more doctor's visits, and manifested less cognitive vitality. In contrast, among the unmarried, loneliness was higher in those with financial difficulties, poor health, and less social network support. The longitudinal transition to becoming lonely was more likely in women, those with insufficient financial resources, and people with poorer health.

CONCLUSIONS

Results highlight the following implications for the development of preventive programs: (a) helping older persons maintain and develop social networks for preventing increased loneliness, (b) taking demographic factors, health factors, and previous trauma into account when designing interventions, and (c) targeting unmarried women for interventions.

Predictors of loneliness in U.S. adults over age sixty-five

The purpose of this study was to examine sociodemographic and health-related risks for loneliness among older adults using Health and Retirement Study Data. Overall prevalence of loneliness was 19.3%. Marital status, self-report of health, number of chronic illnesses, gross motor impairment, fine motor impairment, and living alone were predictors of loneliness. Age, female gender, use of home care, and frequency of healthcare visits were not predictive. Loneliness is a prevalent problem for older adults in the United States with its own health-related risks. Future research of interventions targeting identified risks would enhance the evidence base for nursing and the problem of loneliness.

Assessing the loneliness of older people with cerebral palsy

PURPOSE

To use the University of California Los Angeles Loneliness Scale Version 3 to (a) explore and compare the levels of loneliness experienced between two groups of older adults (aged 40 years and over) with cerebral palsy, a group who use natural speech to communicate and a group who use augmentative and alternative communication (AAC) and (b) to test the reliability of the UCLA Loneliness Scale (Version 3) when used with the older adults with cerebral palsy who use a variety of communication modes.

METHOD

The UCLA Loneliness Scale (Version 3) was administered twice to two groups of older participants with cerebral palsy. Group 1 consisted of 11 participants who used natural speech and Group 2 consisted of nine participants who used augmentative and alternative communication systems. The scores from the second assessment were used to calculate test retest reliability.

RESULTS

The mean loneliness scores for the two groups indicated that older people with cerebral palsy experience more loneliness than older adults without disability. There was no significant difference between the scores of Groups 1 and 2. The UCLA Loneliness Scale (Version 3) is a reliable tool for use with people who communicate using a variety of communication modes.

CONCLUSIONS

The UCLA Loneliness Scale (Version 3) items are pertinent to participants' perceived satisfaction with the quantity and quality of their relationships with others. Policy makers, service providers and the general community have a responsibility to ensure that older people with cerebral palsy are given the support they need to achieve satisfactory relationships and thus facilitate a good quality of life as they age.

Loneliness: a concept analysis

TOPIC

Loneliness is a universal human experience recognized since the dawn of time, yet it is unique for every individual. Loneliness can lead to both depression and low self-esteem.

PURPOSE

This article explicates the concept of loneliness through the examination of its conceptual definition and uses, defining attributes, related concepts, and empirical referents.

SOURCES OF INFORMATION

Literature review using hand search and database were used as sources of information.

CONCLUSION

Because loneliness is commonly encountered in nursing situations, the information provided will serve as a framework for assessment, planning, intervention, and evaluation of clients.

Addressing loneliness in later life

OBJECTIVES

Social and solitary pastimes with the potential to ameliorate the experience of loneliness among older individuals were investigated for the purpose of informing future interventions designed to reduce the negative consequences of social isolation.

METHOD

Nineteen individual interviews with Australians aged 65 years and older.

RESULTS

Several pastimes were described by interviewees as instrumental in determining whether the increasing social isolation they experience in older age results in feelings of emotional isolation and thus of loneliness.

CONCLUSION

The specific behaviours that were found to ameliorate loneliness included utilizing friends and family as an emotional resource, engaging in eating and drinking rituals as a means of maintaining social contacts, and spending time constructively by reading and gardening. Specific recommendations are provided for interventions designed to prevent and treat loneliness among older people.