From social structural factors to perceptions of relationship quality and loneliness: the Chicago health, aging, and social relations study

Social isolation and loneliness in non-communicable chronic diseases: Impact of COVID-19 pandemic, population aging and technological progress

AIMS

Social isolation and loneliness have increasingly emerged as closely linked to onset and progression of non-communicable chronic diseases (NCDs). The aim of this review is to highlight the importance of addressing social isolation in the prevention and management of NCDs such as obesity, type 2 diabetes, and cardiovascular diseases in order to hinder their development and improve their outcomes.

DATA SYNTHESIS

Social isolation and loneliness affect a significant portion of the older adult population, due to decrease in social interactions, chronic illnesses and sensory impairments. However, many other vulnerable populations may experience social isolation because of psychiatric or disabling health conditions, substances abuse, low socioeconomic status, unemployment and belonging to ethnic or marginalized minorities. The unprecedented COVID-19-related social distancing can be taken as a proof-of-concept of the detrimental role of poor interactions in NCDs prevention and management not only at individual level but also in a public health perspective. Indeed, social isolation has been linked to unhealthy lifestyle choices, disrupted sleep quality, low utilization of healthcare, preventive services and adherence to treatments. Underlying mechanisms like inflammation and stress responses may also play a role in the association between social isolation and worse NCDs outcomes.

CONCLUSIONS

Social isolation negatively impacts on the development, progression and management of NCDs. Effective interventions for social isolation should address both societal factors and healthcare-related needs. To counteract the detrimental effects of social distancing during COVID-19 pandemic, the use of telemedicine was implemented. However, telemedicine is not always available, and legislative and age-related barriers persist.

Exploring the Role of Workaholism and Social Support in Social Anxiety and Loneliness. Findings and Implications From a Cross-Sectional Study in a Romanian Sample

The aim of the present cross-sectional study was to address a gap in the literature regarding the potential role of workaholism and social support in the development of social anxiety and loneliness. This study involved 338 individuals from Romania, with 53.8% females and 45.9% males, ranging in age from 18 to 45 (M = 24.79, SD = 4.75). Participants completed instruments assessing workaholism, social anxiety, loneliness, social support, and socio-demographic data. Our findings showed that workaholism and social support predicted social anxiety and loneliness. This study may contribute to the existing body of knowledge on key constructs related to workaholism, while highlighting its potential negative impact on mental health. Theoretical and practical implications are discussed, along with recommendations, while acknowledging the limitations of the research design and the inability to infer causal relationships from the data.

The Influence of Loneliness, Social Support and Income on Mental Well-Being

Mental well-being is a multifaceted concept that reflects emotional stability, psychological resilience and social connectedness. This study examines how demographic factors, perceived loneliness, and social support influence mental well-being in Spain. Participants were surveyed online and provided personal information along with responses to the University of California, Los Angeles (UCLA) Loneliness Scale, the Medical Outcomes Study Social Support Survey (MOS-SSS), and the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). Our findings support previous research on mental well-being in Spain and again show significant associations between income, loneliness, social support and overall mental health. In particular, perceived loneliness was found to be a strong predictor of mental well-being. Furthermore, income and social support were found to partially mediate the relationship between loneliness and mental well-being. These findings highlight the critical role of social connections and financial stability in promoting mental health. Overall, this research contributes to the growing understanding of the factors influencing mental well-being and provides valuable insights for improving mental health outcomes.

Associated Factors of Worrying About Loneliness Before Death

Human beings' welfare is closely related to their social relationships, and lack of that relationship could result in social isolation and loneliness. Various types of loneliness have been discussed in the literature, but a sense of loneliness before death has received no attention. Thus, this study is conducted to better understand the mechanism and nature of that type of loneliness. The response of this study was "Do you worry that you may be alone when you are dying?". After highlighting the most important features, to examine the true associations between various factors and a sense of loneliness, the pairwise interactions across various variables were considered. It was found, for instance, while attending religious service, having higher subjective life condition, and being older are negatively associated with the response, belief that success depends on God and higher income are positively associated with that feeling. Also, while married people are less worried about loneliness before death, this interacts with a myriad of factors. Similarly, positive associations were found across responses and a higher concern that those close with us won't be with us, or those who we care about might not remember us after death.

Racial and ethnic differences in loneliness among older adults: evidence from California

OBJECTIVES

Loneliness is a common experience in older adulthood and is associated with mortality. However, it is still unclear how demographic and health characteristics associated with loneliness vary between racial/ethnic groups. This study aims to understand the intra- and intergroup racial/ethnic differences in the characteristics associated with loneliness in a sample of older adults from a California Department of Aging program.

METHOD

Pooled and stratified descriptive statistics and stratified logistic regression models with multiple imputation (N = 1436).

RESULTS

Non-Hispanic White older adults reported the highest percentage of loneliness (38.0%) while Asian American/Pacific Islander older adults reported the lowest percentage of loneliness (18.0%). Self-rated health was associated with lower likelihood of loneliness among non-Hispanic Black (OR = 0.37, p = 0.001) and Asian American/Pacific Islander (OR = 0.50, p = 0.030) older adults. Depression symptoms were associated with higher likelihood of loneliness among non-Hispanic White (OR = 2.40, p = 0.007), Hispanic/Latino (OR = 2.24, p = 0.004), and Asian American/Pacific Islander (OR = 5.64, p = 0.001) older adults.

CONCLUSION

Although there are some similarities in characteristics associated with loneliness among racially/ethnically diverse groups of older adults, there are notable differences including self-rated health, depression symptoms, and anxiety symptoms.

Perceived social support and relationship quality predict loneliness in older adults: a social network approach

OBJECTIVES

Loneliness negatively impacts older adults' mental and physical health. Though loneliness is associated with perceived social support, its relationship to received support is unclear. This might be because received support has been defined sparsely, overlooking types of support and overall relationship quality. The current study addressed this gap.

METHOD

Older adults recruited from the community (N = 142) and the Indiana Alzheimer's Disease Research Center (ADRC) (N = 176) completed an expanded PhenX social network interview to identify social network size, types of received support (emotional, instrumental), and relationship quality (network closeness, contact frequency). They also completed well-validated measures of loneliness and perceived social support. Data were analyzed with hierarchical linear regressions.

RESULTS

In both samples, loneliness was negatively related to perceived social support but was not related to either received support type. Contact frequency predicted loneliness in both samples, but network closeness predicted loneliness in the ADRC sample only. Dementia status did not affect results.

CONCLUSION

Social network size, emotional received support, and instrumental received support were not related to loneliness, but perceived social support and relationship quality were. These findings suggest that loneliness is influenced by perceived social support and some types of received support.

The prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study

BACKGROUND

Loneliness is a recognized risk factor for anxiety and depression, yet research on its interaction with low resilience remains sparse, particularly across the adolescent-to-adult transition. This study investigates how adolescent loneliness, both independently and in interaction with low resilience, influences anxiety and depression in young adulthood.

METHODS

This study utilized longitudinal data from The Trøndelag Health Study (HUNT) to track adolescents (13-19 years) from Young-HUNT3 (2006-08) through to HUNT4 (2017-19). Loneliness was assessed via a single-item measure, while resilience was estimated using the Resilience Scale for Adolescents. Anxiety and depression outcomes at the 11-year follow-up were measured using the Hospital Anxiety and Depression Scale. Multivariable logistic regression analyses were done to analyze the associations. Moreover, interaction effects were evaluated using relative excess risk due to interaction (RERI).

RESULTS

Loneliness during adolescence independently predicted anxiety and depression in young adulthood. Adolescents experiencing both loneliness and low resilience showed notably higher risks compared to other groups (highly resilient adolescents without loneliness [reference], highly resilient adolescents with loneliness, and adolescents with low resilience and low loneliness). The combined effect of loneliness and low resilience exhibited a synergistic interaction on the additive scale, although it was not statistically significant (RERI 0.13, 95% CI -2.39-2.65).

CONCLUSION

Adolescent loneliness and low resilience independently predict anxiety and depression in young adulthood. The interaction between loneliness and low resilience further heightens these risks. This underscores the importance of early interventions that focus on resilience-building during adolescence and reducing the impacts of loneliness on mental health.

Behind closed doors: Homeboundness and psychosocial outcomes. Evidence from a longitudinal study of middle-aged and older adults

OBJECTIVES

To examine how homeboundness is associated with psychosocial outcomes in terms of life satisfaction, positive affect, negative affect and loneliness among middle-aged and older adults.

METHODS

Longitudinal data were taken from the nationally representative sample German Ageing Survey (wave 1 to wave 4; n = 18,491 observations). This study included community-dwelling individuals aged 40 years and over in Germany. The mean age in the analytic sample was 62.3 years (SD: 11.8 years). Established tools were used to quantify the psychosocial outcomes. Spending six or more days per week at home was defined as homeboundness. It was adjusted for several time-varying covariates. An asymmetric linear FE regression model with cluster-robust standard errors was applied.

RESULTS

There was a robust association between the onset of homeboundness and an increase in loneliness. Among individuals aged 40 to 64 years, the onset of homeboundness was significantly associated with decreases in positive affect, whereas the end of homeboundness was significantly associated with decreases in negative affect. In contrast, changes in homeboundness status were not significantly associated with changes in psychosocial outcomes among individuals aged 65 years and over.

CONCLUSION

The onset of homeboundness in particular can contribute to unfavorable psychosocial outcomes, particularly in terms of increases in loneliness. Efforts to avoid homeboundness may assist in ageing successfully.

The Interplay Between Social Factors and Metabolic Bariatric Surgery Outcomes-A 5-Year Prospective Study

Introduction

Social relationships and support are vital for well-being and health. In the context of metabolic bariatric surgery (MBS), these relationships might influence emotion regulation and health behaviors that affect surgical outcomes. Conversely, the outcomes of MBS can impact an individual's social dynamics due to enhanced social engagement or potential shifts in social structures resulting from changes in self-perception.

Objective

This study investigated the bidirectional relationship between social factors and metabolic bariatric surgery (MBS) outcomes, testing if social factors are associated with improved MBS outcomes, and if MBS outcomes are associated with changes in social relationships.

Methods

Patients reported about structural and functional aspects of their social relations before surgery and at 1-, 3- and 5-year post-surgery. Physiological and mental health parameters were also collected. The relationship between pre-surgery social factors and MBS outcomes 5 years post-surgery was tested with a path model based on regression analysis. The relationship between MBS outcomes 1-year post-surgery and social relationships 3 years post-surgery was tested with multiple and logistic regressions.

Results

Non-family support predicted higher satisfaction with surgery. Increased family coherence in partnered patients was linked to a greater reduction in blood pressure 5 years post-surgery. However, relationship stability, social competence, relationship satisfaction, and weight-loss specific support were not related to biopsychosocial outcomes.On the other hand, changes in social relationships post-surgery were not related to weight loss or other outcomes. Depression and anxiety symptoms 1 year after surgery were associated with decreased relationship satisfaction 3 years post-surgery.

Conclusion

Overall, social factors had limited and selective predictive value to outcomes, potentially due to the dominant influence of physical changes or generally satisfactory relationships. These findings offer insights for patients and healthcare providers on the nuanced implications of MBS beyond physical health.

Aging Alone (While Black): Living Alone, Loneliness, and Health Among Older Black Women

BACKGROUND AND OBJECTIVES

Increasingly, Black women are aging alone. Yet information about health correlates and the residential context where older Black women are aging-in-place is lacking. The current study examines one aspect of Aging While Black that affects Black women-living alone without close family or kin in the household - among a sample of older Black women (N = 890).

RESEARCH DESIGN AND METHODS

Using hierarchical linear models and data from the 2014/2015 and 2019 waves of the Southeastern Pennsylvania Household Health Survey, living alone status (e.g., Level 1) and area-level indicators of residential segregation and social capital (e.g., Level 2) are examined as correlates of self-rated health and loneliness.

RESULTS

Our findings indicate that while Black women live in primarily segregated areas, living alone is associated with lower odds of loneliness and has no relation to self-rated health. Additionally, area-level social capital is correlated with a lower likelihood of reported loneliness.

DISCUSSION AND IMPLICATIONS

These results are somewhat contrary to the current aging-in-place literature that claims that living alone always contributes to social isolation, loneliness, and poorer health. For older Black women in urban settings, living alone may reflect independence rather than loneliness. Efforts to increase community supports and opportunities for maintaining social connectedness should be considered for future research and age-friendly policies.

Virtual avatar communication task eliciting pseudo-social isolation and detecting social isolation using non-verbal signal monitoring in older adults

Social isolation and loneliness are two of the main causes of mental health problems or suicide, not only in younger adults but also in older adults. Thus, identifying an effective method to detect social isolation is important in the field of human-machine interaction. However, to the best of our knowledge, no effective method has been developed to elicit pseudosocial isolation tasks to evaluate social isolation detection systems for older adults. This study has two research aims: 1. To develop a virtual avatar conversation cyberball task to evoke pseudosocial isolation in older adults and, 2. to identify non-verbal indicators that replace social isolation in older adults. To achieve these objectives, 22 older men were recruited as participants. They were asked to communicate with two virtual avatars on a monitor and then to rate the follow-up questions provided to evaluate the level of social isolation and emotions; meanwhile, facial expressions and gaze patterns were recorded by a camera and an eye tracker. In the results, the developed virtual avatar conversation cyberball task successfully induced pseudosocial isolation in older adults, and this social isolation was detected by the intensity of inner/outer eyebrow and eyelid movements and the blink frequency.

Social networks and loneliness differ between LGBTIA and cis-heterosexual persons: results from a two-wave survey in Germany

Current research suggests LGBTIA persons to be lonelier than cis-heterosexual persons. While they rely more on friends than on family as support network, their social network and weekly contact to family and friends, as well as the association between the social network and loneliness have not been fully explored yet. The aim of this analysis was to examine differences in the social network between LGBTIA and cis-heterosexual persons in Germany, and how these differences affect loneliness. Data was collected through an online survey conducted in two independent waves in March/April 2020 and in January/February 2021. Linear regression analyses were performed to examine the influence of the social network on loneliness. Of 6784 participants, 5442 identified as LGBTIA. Weekly contact to family was lower in the LGBTIA group than in cis-heterosexuals. LGBTIA were less likely to be in a relationship. Identifying as LGBTIA increased social and emotional loneliness. Differences in social network partly explained the risk for social loneliness of LGBTIA persons and, to a lower degree, the risk for emotional loneliness. We encourage health care professionals to inquire about sexual orientation, gender identity, and relationship status to raise awareness for feelings of loneliness and related health problems.

The Loneliness of the Odd One Out: How Deviations From Social Norms Can Help Explain Loneliness Across Cultures

Loneliness is an important health risk, which is why it is important to understand what can cause persistent or severe loneliness. Previous research has identified numerous personal or relational risk factors for loneliness. Cultural predictors, however, have been considered less. The new framework of norm deviations and loneliness (NoDeL) proposes that social norms, which are defining features of culture, can help explain loneliness within and across cultural contexts. Specifically, people who deviate from social norms are suggested to be at an increased risk for feeling lonely because they are more likely to experience alienation, inauthenticity, lower self-worth, social rejection, relationship dissatisfaction, and/or unfulfilled relational needs. Given that social norms vary by social, geographical, and temporal context, they can furthermore be considered cultural moderators between individual-level risk factors and loneliness: Personal or relational characteristics, such as shyness or being single, may increase the risk for loneliness particularly if they do not fit social norms in a specific environment. Integrating previous quantitative and qualitative findings, I hence offer a framework (NoDeL) to predict loneliness and cultural differences in risk factors for it. Thus, the NoDeL framework may help prepare culture-sensitive interventions against loneliness.

Multimorbidity clusters and their contribution to well-being among the oldest old: Results based on a nationally representative sample in Germany

AIM

Our aim was to identify multimorbidity clusters and, in particular, to examine their contribution to well-being outcomes among the oldest old in Germany.

METHODS

Data were taken from the large nationally representative D80+ study including community-dwelling and institutionalized individuals aged 80 years and over residing in Germany (n = 8,773). The mean age was 85.6 years (SD: 4.1). Based on 21 chronic conditions, latent class analysis was carried out to explore multimorbidity (≥2 chronic conditions) clusters. Widely used tools were applied to quantify well-being outcomes.

RESULTS

Approximately nine out of ten people aged 80 and over living in Germany were multimorbid. Four multimorbidity clusters were identified: relatively healthy class (30.2 %), musculoskeletal class (44.8 %), mental illness class (8.6 %), and high morbidity class (16.4 %). Being part of the mental disorders cluster was consistently linked to reduced well-being (in terms of low life satisfaction, high loneliness and lower odds of meaning in life), followed by membership in the high morbidity cluster.

CONCLUSIONS

Four multimorbidity clusters were detected among the oldest old in Germany. Particularly belonging to the mental disorders cluster is consistently associated with low well-being, followed by belonging to the high morbidity cluster. This stresses the need for efforts to target such vulnerable groups, pending future longitudinal research.

Where Are They Now: The Narratives of Children Who Lost a Parent on 9/11

There is a paucity of literature examining the experiences of children who lost a parent on 9/11. The primarily quantitative research has not allowed for a deeper understanding of how children who lost a parent on 9/11 make meaning of their experiences, especially in the context of a national tragedy. This study investigates how eight children who were between the ages of 5 and 12 when they lost a parent on 9/11 developed a personal narrative about this loss in the context of the collective narrative about 9/11. Using narrative inquiry, cases demonstrated patterns of narrative development about grief, tragedy, and collective themes of American exceptionalism, patriotism, triumph, and resiliency. These cases highlight de-personalized narratives of grief, tension between the grand narrative provided to them and their personal story of loss, and distance between the reality of their loss and the collective meaning-making of the tragedy. This study extends Bronfenbrenner's (1977) ecological systems theory by highlighting how a lack of bidirectionality between larger social and cultural systems and the individual negatively impacts personal experiences of grief and loss.

Institutional, neighborhood, and life stressors on loneliness among older adults

BACKGROUND

Loneliness is a public health epidemic in the United States (US), with older adults being vulnerable to experiencing loneliness. Predictors of loneliness are less understood among racial/ethnic groups of US older adults, and few studies have included perceived institutional discrimination (PID), stressful life events (SLE), and perceived neighborhood characteristics (PNC) as antecedent stressors of loneliness in diverse older adult samples. Our study assessed the relationship between these stressors and loneliness among specific racial/ethnic groups of older adults.

METHODS

We used the Health and Retirement Study data (n = 9,904) to examine whether PID, SLE, and PNC were associated with loneliness. Loneliness was measured using the 11-item UCLA Loneliness Scale. PID included unfairly not hired for a job, unfairly prevented from moving into a neighborhood, and unfairly treated by the police. SLE included moving to a worse neighborhood/residence, being robbed or burglarized, and unemployed/looking for a job. PNC were measured as discohesion and disorder. Lagged multivariate linear regression models regressed loneliness (2014/2016 HRS waves) on PID, SLE and PNC (2010/2012 HRS waves) measured as cumulative totals and individual items. Models were stratified by Black (BOAs), Hispanic/Latinx (HOAs), and White (WOAs) older adults.

RESULTS

Cumulative totals of PID, SLE, and neighborhood discohesion were associated with loneliness among BOAs while only discohesion was associated with loneliness among HOAs. Cumulative totals for PID, SLE, and PNC were associated with loneliness among WOAs. Individual stressors predicting loneliness for BOAs were moving to a worse residence and being robbed/burglarized. For HOAs, being prevented from moving to a neighborhood was associated with greater loneliness while being robbed/burglarized was associated with less loneliness. Individual stressors predicting greater loneliness for WOAs were being unfairly not hired for a job, receiving unfair treatment during police encounters, and moving to a worse residence.

CONCLUSIONS

Our study finds racial/ethnic variation in psychosocial stressors predicting loneliness four years later. Nevertheless, neighborhood discohesion was the most salient stressor and was associated with greater loneliness across all racial/ethnic groups. Future research and interventions should consider the differing stress appraisal processes across groups and to support the development of resources and policies to ameliorate loneliness among diverse older adults.

"Telephone Angels" Against Loneliness: Experimental Evaluation of the Effectiveness of Telephone Partnerships with Older Adults

Loneliness affects many older adults. As part of the "Telephone Angel" project, telephone partnerships between volunteers and older adults affected by loneliness were designed to counteract experiencing loneliness. Volunteers (100 ≤ N ≤ 114) and older adults who are (22 ≤ N ≤ 45) and who are not (25 ≤ N ≤ 71) part of the project were surveyed twice. Concerning loneliness, telephone partnerships increased the sense of community (d = .38). Older adults' life satisfaction increased (d = .46) as well. Stigmatization increased between the survey periods for those inside and outside the project (.21 ≤ d ≤ .35).

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

OBJECTIVES

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

METHODS

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

RESULTS

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

DISCUSSION

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

Momentary loneliness and intrusive thoughts among older adults: the interactive roles of mild cognitive impairment and marital status

OBJECTIVES

Loneliness is associated with maladaptive cognitions, yet little is known about the association between loneliness and intrusive thinking during older adulthood. Links between loneliness and intrusive thoughts may be particularly strong among individuals with mild cognitive impairment (MCI), who may have greater difficulty regulating emotion and intrusive thoughts. In contrast, having close relationships (e.g. being married) may serve as a protective factor as marital status is associated with better overall well-being.

METHOD

Participants were 316 older adults (recruited from the Bronx, NY, as part of a larger study) without dementia at study intake (40% Black; 13% Hispanic, Mage = 77.45 years, 67% women) who completed ecological momentary assessments five times daily for 14 consecutive days (13,957 EMAs total). Multilevel modeling was used to examine the association between momentary loneliness and intrusive thoughts and whether MCI and marital status interacted to moderate this association.

RESULTS

There was a significant three-way interaction (β = -0.17, p < 0.05), such that lagged momentary loneliness was positively associated with intrusive thoughts (3-4 h later) for those with MCI who were not married.

CONCLUSION

Findings suggest that among older adults with MCI, being married may be a protective factor and being unmarried may be a risk factor for experiencing loneliness and subsequent intrusive thoughts.

The life course effects of socioeconomic status on later life loneliness: The role of gender and ethnicity

Precursors of loneliness include individual risk factors and experiences of social exclusion. Using the New Zealand Health Work and Retirement Life Course History Study, we investigated the impact of unequal access to material resources across the life course (from age 10 to present) on late life emotional and social loneliness and the moderating effects of gender and Māori ethnicity (indigenous population of Aotearoa/New Zealand) in 613 adults aged 65 to 81 years. Childhood and adult life socioeconomic status (SES) negatively predicted late life emotional and social loneliness, but their effects disappeared after controlling for late life SES, suggesting a mediation effect. Education was also a significant predictor; however, it exerted different effects on social (positive) and emotional (negative) loneliness. Education's effect was moderated by gender, indicating a protective effect for emotional and an exacerbating effect for social loneliness in men. These findings suggest that lifelong exclusion from material resources is a risk factor for late life loneliness.

Not Like Everybody Else but We're the Same: Psychosocial Variables Compared Across Diverse Sexual and Gender Identities

OBJECTIVE

Sexual and gender minority (SGM) people are underrepresented in psychological research. Part of the underrepresentation of SGM people likely stems from potential participants' unwillingness to join a study, but more concerningly, researchers exclude data from SGM participants. Furthermore, much of SGM research focuses on existing health disparities and risk factors rather than wellness-framed and personality research. To fill in this gap, the current study aims to quantify effect sizes of similarities/differences across a broad range of psychosocial measures.

METHOD

Applying the framework of the Gender Similarities Hypothesis, we compare means, variances, and correlations across 34 psychosocial variables between categories of SGM, gender identity, sexual orientation, relationship status, and monogamy (N = 1743). Data was collected online mainly through paid ads on Instagram.

RESULTS

Consistently, we find largely similarities across gender identity, sexual orientation, and relationship structure categories. These results support a general expectation that similarities are more common than differences in normative psychological domains, although clear differences in means and variances exist for specific experiences and outcomes.

CONCLUSIONS

This work informs the inclusion of diverse identities in basic psychological research and further speaks to the generalizability of past findings to populations historically underrepresented in psychological science.

Daily Social Isolation Maps Onto Distinctive Features of Anhedonic Behavior: A Combined Ecological and Computational Investigation

Background

Loneliness and social isolation have detrimental consequences for mental health and act as vulnerability factors for the development of depressive symptoms, such as anhedonia. The mitigation strategies used to contain COVID-19, such as social distancing and lockdowns, allowed us to investigate putative associations between daily objective and perceived social isolation and anhedonic-like behavior.

Methods

Reward-related functioning was objectively assessed using the Probabilistic Reward Task. A total of 114 unselected healthy individuals (71% female) underwent both a laboratory and an ecological momentary assessment. Computational modeling was applied to performance on the Probabilistic Reward Task to disentangle reward sensitivity and learning rate.

Results

Findings revealed that objective, but not subjective, daily social interactions were associated with motivational behavior. Specifically, higher social isolation (less time spent with others) was associated with higher responsivity to rewarding stimuli and a reduced influence of a given reward on successive behavioral choices.

Conclusions

Overall, the current results broaden our knowledge of the potential pathways that link (COVID-19-related) social isolation to altered motivational functioning.

Association of Loneliness with Functional and Cognitive Status in Minor and Major Neurocognitive Disorders

BACKGROUND

Neurocognitive disorders (NCDs) have a variable decline in cognitive function, while loneliness was associated with cognitive impairment and increased dementia risk. In the present study, we examined the associations of loneliness with functional and cognitive status in patients with minor (mild cognitive impairment) and major NCDs (dementia).

METHODS

We diagnosed mild NCD (n = 42) and major NCD (n = 164) through DSM-5 criteria on 206 participants aged > 65 years using the UCLA 3-Item Loneliness Scale (UCLA-3) to evaluate loneliness, the activities of daily living (ADL) and the instrumental activities of daily living (IADL) scales to measure functional status, and Mini-Mental State Examination (MMSE) to assess cognitive functions.

RESULTS

In a multivariate regression model, the effect of loneliness on cognitive functions was negative in major (β = -1.05, p < 0.0001) and minor NCD (β = -0.06, p < 0.01). In the fully adjusted multivariate regression model (sex-age-education-multimorbidity-depressive symptoms-antidementia drug treatment), the effect of loneliness remained negative for major NCD and became positive for minor NCD (β = 0.09, p < 0.001). The effect of loneliness on IADL (β = -0.26, p < 0.0001) and ADL (β = -0.24, p < 0.001) showed a negative effect for major NCD across the different models, while for minor NCD, the effect was positive (IADL: β = 0.26, p < 0.0001; ADL: β = 0.05, p = 0.01). Minor NCD displayed different levels of MMSE (β = 6.68, p < 0.001) but not ADL or IADL, compared to major NCD for the same levels of loneliness. MANOVA pill test suggested a statistically significant and different interactive effect of loneliness on functional and cognitive variables between minor and major NCDs.

CONCLUSIONS

We confirmed the relationships between loneliness and cognitive and functional status in major NCD, observing a novel trend in minor NCD.

Let me in: The neural correlates of inclusion motivation in loneliness

BACKGROUND

While it is well-established that humans possess an innate need for social belonging, the neural mechanisms underlying motivation for connection are still largely unknown. We propose that inclusion motivation - measured through the effort that individuals are willing to invest to be included in social interactions - may serve as one of the basic building blocks of social behavior and may change in lonely individuals.

METHODS

Following the screening of 303 participants, we scanned 30 low- and 28 high-loneliness individuals with functional magnetic resonance imaging while they performed the Active Inclusion Task (AIT). The AIT assesses the participants' levels of effort invested in influencing their inclusion during classic Cyberball conditions of fair play and exclusion.

RESULTS

High- compared to low-loneliness individuals showed higher urgency for inclusion, specifically during fair play, which correlated with higher activity in the right thalamus. Furthermore, in high-loneliness individuals, we found increased functional connectivity between the thalamus and the temporoparietal junction, putamen, and insula.

LIMITATIONS

Participants interacted with computerized avatars, reducing ecological validity. Additionally, although increasing inclusion in the task required action, the physical demand was not high. Additional limitations are discussed.

CONCLUSIONS

Inclusion motivation in loneliness is heightened during fair but not exclusionary interactions, and is linked to activity in brain regions implicated in appetitive behavior and social cognition. The findings indicate that lonely individuals may view threat in inclusionary interactions, prompting them to take action to regain connection. This suggests that inclusion motivation may help explain social difficulties in loneliness.

Frailty and Loneliness in Older Adults: A Narrative Review

(1) Background: In a society with an advancing aging rate, medical systems are coming under pressure due to an increasing flow of older patients with multiple somatic diseases, exacerbated by their psychological and sociological backgrounds. We aimed to investigate the relationship between frailty and loneliness in older adults and to provide a holistic perspective on these concepts. Our research question was "Is there a link between the loneliness and frailty in older people?" (2) Methods: To assess the link between loneliness and frailty, we conducted a search accessing Index Medicus and PubMed; the timeframe of our research was from 2013 until 2023. Data regarding the study population, as well as loneliness and frailty assessments and approaches, were extracted. (3) Results: A positive relationship between loneliness and the appearance and progression of frailty in older adults is argued for. (4) Conclusions: Frailty and loneliness in older adults are often interconnected and can have a significant impact on their overall well-being. Early identification of frailty by assessing risk factors (including loneliness and/or social isolation) should become a standard of care for older patients. Appropriate combined interventions that effectively address both frailty and loneliness (physical exercises, psychological support, and social engagement) can promote healthier aging, prevent health deterioration, maintain independence, and reduce healthcare costs.

On social health: history, conceptualization, and population patterning

We propose a psychologically-informed concept of social health to join physical and mental components in a more comprehensive assessment of human health. Although there is an extensive literature on the importance of social relationships to health, a theoretical framework is needed to coalesce this work into a codified conceptualisation of social health, defined here as adequate quantity and quality of relationships in a particular context to meet an individual's need for meaningful human connection. Informing this novel conceptualisation, we outline eight key propositions to guide future research and theory on social health, including five propositions focused on the conceptualisation of social health and three focused on its population patterning. The former five propositions include that social health is an outcome in its own right, that health interventions can have divergent effects on social versus physical and mental aspects of health, that social health has independent effects on quality of life, that it is a dynamic and contextual construct, and that it is embedded and encoded in the human body (and mind). The utility of the social health concept is further revealed in its significance for understanding and addressing population health concerns, such as health inequalities experienced by marginalised groups.

Loneliness Among Medical Students, Physician Trainees and Faculty Physicians

OBJECTIVE

Aims of this study were to explore 1) how often medical students, residents, fellows, and faculty physicians who completed a suicide screening questionnaire at a large US academic medical center endorsed intense loneliness and 2) the relationships of loneliness with other negative mental health states.

METHODS

Between May 2009 and September 2001, all medical students, residents, fellows, and faculty physicians were invited to complete an anonymous online questionnaire as part of a screening program to identify and engage individuals in distress with mental health support. The questionnaire assessed intense loneliness, other affective states known to be associated with suicide risk, burnout, depressive symptoms, and suicidal thoughts and behaviors. Chi-square tests, independent sample t-tests, ANOVA, and correlation analysis were used to examine relationships between loneliness and these other signals of suicide risk.

RESULTS

The response rate was  ~ 20%. Overall, 364 of 2016 respondents (18.1%) endorsed intense. loneliness "a lot" or "most" of the time. This included 134/641 (20.9%) medical students, 170/703 (24.2%) residents and fellows and 60/664 (9.4%) faculty physicians. A greater odds of endorsing intense loneliness was seen in those under age 40 (OR = 0.35, p < 0.001), women (OR = 1.30, p = 0.030), and non-Whites (OR = 1.70, p < 0.001); and in those with burnout (OR = 3.14, p < 0.001), depression (OR = 12.34, p < 0.001), other intense affective states (OR = 4.34-8.34, p < 0.05), and suicidal ideation (OR = 3.47-13.00, p < 0.001).

CONCLUSION

Interventions to mitigate loneliness in healthcare trainees and professionals may help decrease burnout, depression, and other suicide risk factors. A limitation of the study was the use of a single item to assess loneliness.

A Coordinated Data Analysis of Four Studies Exploring Age Differences in Social Interactions and Loneliness During a Global Pandemic

OBJECTIVES

Examining loneliness and social isolation during population-wide historical events may shed light on important theoretical questions about age differences, including whether these differences hold across different regions and the time course of the unfolding event. We used a systematic, preregistered approach of coordinated data analysis (CDA) of 4 studies (total N = 1,307; total observations = 18,492) that varied in design (intensive repeated-measures and cross-sectional), region, timing, and timescale during the first year of the coronavirus disease 2019 pandemic.

METHODS

We harmonized our data sets to a common period within 2020-2021 and created a common set of variables. We used a combination of ordinary least squares regression and multilevel modeling to address the extent to which there was within- and between-person variation in the associations between social isolation and loneliness, and whether these associations varied as a function of age.

RESULTS

Within- and between-person effects of social interactions were negatively associated with loneliness in 1 study; in follow-up sensitivity analyses, these patterns held across early and later pandemic periods. Across all data sets, there was no evidence of age differences in the within-person or between-person associations of social interactions and loneliness.

DISCUSSION

Applying the CDA methodological framework allowed us to detect common and divergent patterns of social interactions and loneliness across samples, ages, regions, periods, and study designs.

Racial/Ethnic Differences in Loneliness Among Older Adults: The Role of Income and Education as Mediators

Background and Objectives

Loneliness is a major public health concern; however, limited research has examined the mechanisms contributing to racial/ethnic inequities in loneliness. Race/ethnicity has been hypothesized to be a distal factor influencing loneliness, and racial/ethnic inequities in loneliness may be attributable to socioeconomic factors (e.g., income and education). Our study seeks to confirm these hypotheses by examining mechanisms that contribute to racial/ethnic inequities in loneliness. In other words, if racial/ethnic differences in loneliness among older adults are mediated by income and education.

Research Design and Methods

Data came from the Health and Retirement Study Leave-Behind Questionnaire, 2014-2016. Loneliness was measured by the UCLA 3-item loneliness scale. Race/ethnicity categories were White, Black, and Hispanic/Latino. The mediator variables were household income and education. Multivariable linear regression models were used to determine differences in loneliness by race/ethnicity. The Karlson-Holm-Breen (KHB) mediation method was used to determine if income and education mediated racial/ethnic differences in loneliness.

Results

In models examining income and education together, a complete mediation was found between White and Black older adults, in that income and education completely mediated differences in loneliness between these groups. A partial mediation was found between White and Hispanic, and Black and Hispanic older adults. When examining income and education separately, we found that income solely accounted for racial/ethnic differences in loneliness compared to education.

Discussion and Implications

Our study is the first to explicitly determine if socioeconomic factors mediate race/ethnicity differences in loneliness among a national sample of older adults. These findings illustrate that income may have greater proximate effects for loneliness among older adults in comparison to education. Additionally, these findings can inform evidence-based interventions to reduce loneliness among older adults. Interventions that enhance quality of life and provide opportunities for socialization for racialized low-income older adults may help decrease racial/ethnic inequities in loneliness.

A Longitudinal Study on the Relationship Between Family Size and Instrumental Activities of Daily Living: The Masking Effect of Depressive Symptoms

PURPOSE

According to use and disuse theory, the decreasing size of families in China may have a considerable influence on older adults' health. However, research on the associations among family size, depression, and instrumental activities of daily living (IADL) in this population is limited. Thus, the current study examined the role of depression on the impact of family size on IADL and explored the differences between urban and rural areas.

METHOD

Mediation analyses were performed with data from 7,290 older adults aged ≥60 years from the Harmonized China Health and Retirement Longitudinal Study in 2011, 2013, 2015, and 2018, using stepwise regression and bootstrap methods.

RESULTS

Family size had a positive impact on IADL limitations of older adults (0.29, p < 0.01), and the masking effects of depressive symptoms had a partial effect of family size on older adults' IADL. However, these effects only exist in rural areas.

CONCLUSION

Providing emotional support through psychological counseling and guiding caregivers to provide moderate care support is crucial, particularly in rural areas, for alleviating depressive symptoms due to changes in family size and maintaining independent living skills among older adults. [Research in Gerontological Nursing, 17(4), 165-175.].

Young adults with vision impairment in India: Loneliness and social networks

PURPOSE

To examine the prevalence of loneliness and associated factors in young adults with vision impairment (VI), including quality of life (QoL) in India.

METHODS

Two hundred and three VI young adults (18-35 years) and 219 age-matched non-VI (controls) adults completed the loneliness scale, WHOQOL-BREF, Social Network Index (SNI) (network diversity, people in network size and number of embedded network subscales) and questions regarding sociodemographic characteristics and independent mobility. Rasch analysis was used to validate the questionnaires and interval-level scores were generated. Generalised linear models were used to estimate independent associations of sociodemographic factors, VI characteristics, social networks and QoL with loneliness.

RESULTS

The prevalence of moderate and severe loneliness in the VI group was 10% (95% CI: 6.5, 15.4) and 4.4% (95% CI: 2.0, 8.2), respectively, and higher than that of controls. The VI group had a worse loneliness score than controls (-1.66 ± 2.25 vs. -2.13 ± 1.85 logits; p = 0.03). Those with ≤12 years and >12 years of education had loneliness scores of -1.58 ± 2.45 and -1.82 ± 1.99 logits, respectively (p = 0.01). Compared with controls, the VI group reported fewer extended family members, neighbours and friends leading to significantly smaller networks and network diversity (all p < 0.001). Loneliness scores demonstrated a significant correlation with only two SNI subscales for both groups: people in network size (r = -0.28 for VI; r = -0.30 for non-VI; p < 0.001 for both) and number of embedded networks (r = -0.22 for VI; r = -0.21 for non-VI; p = 0.002 for both). Both education (β = 0.45; p = 0.04) and QoL (β = -0.27, p = 0.02) were predictors of loneliness.

CONCLUSIONS

Loneliness was commonly experienced by young VI adults and was higher among those with lower levels of education. Loneliness decreased with the presence of a larger number of people in network, suggesting that interventions to increase social activity and participation may be valuable in young VI adults.

Communication Matters: Loneliness in Senior Living Communities During the COVID-19 Pandemic

Background and Objectives

The purpose of this study was to investigate individuals residing in senior living communities (SLCs) amid the coronavirus disease 2019 (COVID-19) pandemic. One reason those living in SLCs often choose these communities is to have a readily available social network. Necessary social distancing disrupted this socialization, thus, possibly increasing perceptions of loneliness in residents of SLCs. This study examined relationships among loneliness, perceived provider communication about the pandemic and related restrictions, as well as individual characteristics.

Research Design and Methods

In December 2020, a survey was administered to older adults residing in a network of SLCs in Nebraska. Utilizing data from 657 residents aged 60 and older, ordinary least squares regression models were used to examine associations between 2 distinct measures of perceived provider communication and feelings of loneliness during the pandemic. The analysis also considered whether these associations varied as a function of education.

Results

The respondents were, on average, 84 years of age, primarily female (72%), and living independently (87%) in the SLC. The linear regression results revealed that 53% of respondents were very lonely during the pandemic. However, provider communication that was rated as helpful to residents' understanding of the COVID-19 pandemic was associated with lower perceived loneliness. There was not a similar association for provider communication regarding services and amenities, and the association was not present for those with the highest level of education.

Discussion and Implications

Provider communication in times of disruption from normal activities, such as with the COVID-19 pandemic, is important to perceptions of loneliness among those living in SLCs, particularly for those with lower educational attainment. SLCs are communities that individuals select to reside in, and through communication, providers may have the opportunity to positively affect resident experiences, especially in times of stress.

Impact of Loneliness on Training Gains with Heart Rate Variability Biofeedback in the Elderly: A Pilot Study

The negative impact of loneliness on the health of the elderly is particularly noticeable because of the effects of central control on the autonomic nervous system. Such an impact can be assessed through heart rate variability (HRV) analysis and can be modified using HRV biofeedback training. This study aimed to investigate the impact of different levels of social interaction reported by the elderly on HRV before and after training with HRV biofeedback and after a follow-up period. The participants of this pilot study comprised 16 elderly people of both sexes with a mean age of 71.20 ± 4.92 years. The participants were divided into two groups, the loneliness group (N = 8) and the no-loneliness group (N = 8), based on a combination of both criteria: the institutionalization condition (institutionalized or not) and the score on the loneliness scale (high or low). All participants had their HRV components recorded at baseline, after 14 training sessions with HRV biofeedback (three times a week, 15 min each for 4.5 weeks), and after 4.5 weeks of follow-up without training. After HRV biofeedback training, HRV components increased in both groups. However, the gains lasted at follow-up only in the no-loneliness group. In conclusion, loneliness can influence the maintenance of HRV after interruption of training with HRV biofeedback in the elderly. HRV biofeedback training can be an innovative and effective tool for complementary treatment of elderly individuals, but its effects on lonely elderly individuals need to be further investigated.

Social isolation in the oldest-old: determinants and the differential role of family and friends

PURPOSE

To examine the association of sociodemographic and health-related determinants with social isolation in relation to family and friends in the oldest-old.

METHODS

Database was the multi-center prospective AgeCoDe/AgeQualiDe cohort study assessed at follow-up wave 5 (N = 1148; mean age 86.6 years (SD 3.0); 67% female). Social isolation was assessed using the short form of the Lubben Social Network Scale (LSNS-6). The LSNS-6 contains two sets of items establishing psychometrically separable subscales for isolation from family and friends (ranges 0-15 points), with lower scores indicating higher isolation. Cross-sectional linear (OLS) regression analyses were used to examine multivariate associations of sociodemographic and health-related determinants with social isolation from family and friends.

RESULTS

Overall, n = 395 participants (34.6%) were considered socially isolated. On average, isolation was higher from friends (mean 6.0, SD 3.8) than from family (mean 8.0, SD 3.5). Regression results revealed that in relation to family, males were more socially isolated than females (β = - 0.68, 95% CI - 1.08, - 0.28). Concerning friends, increased age led to more isolation (β = - 0.12, 95% CI - 0.19, - 0.05) and functional activities of daily living to less isolation (β = 0.36, 95% CI 0.09, 0.64). Independent of the social context, depression severity was associated with more social isolation, whereas cognitive functioning was associated with less social isolation.

CONCLUSIONS

Different determinants unequally affect social isolation in relation to family and friends. The context of the social network should be incorporated more strongly regarding the detection and prevention of social isolation to sustain mental and physical health.

Loneliness in OCD and its determinants

Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by intrusive thoughts and repetitive behaviors, affecting approximately 1.3 % of the population. Loneliness has serious consequences for future health outcomes. Although it has been extensively studied in depression, its prevalence in obsessive-compulsive disorder (OCD) has hardly been investigated. The current study sought to examine the association between loneliness and OCD, through an exploratory investigation of their demographic and clinical correlates. This cross-sectional study utilized data from the Netherlands Obsessive-Compulsive Disorder Association (NOCDA) study, designed to investigate determinants, course, and consequences of OCD in a large clinical sample. In this data base, a cohort of 363 OCD adult patients underwent assessment for loneliness severity, OCD symptomatology, comorbid conditions, and demographic variables. Findings reveal a high prevalence of loneliness among OCD patients, with nearly three-quarters (73.6 %) experiencing elevated levels. Loneliness was associated with greater depression severity and specific demographic factors such as gender, age, and education level. However, the relationship between OCD severity and loneliness was explained by depression severity. Clinical and theoretical implications are discussed as well as limitations and directions for future research.

An Iterative Participatory Design Approach to Develop Collaborative Augmented Reality Activities for Older Adults in Long-Term Care Facilities

Over four million older adults living in long-term care (LTC) communities experience loneliness, adversely impacting their health. Increased contact with friends and family is an evidence-based intervention to reduce loneliness, but in-person visits are not always possible. Augmented Reality (AR)-based telepresence activities can offer viable alternatives with increased immersion and presence compared to video calls. However, its feasibility as an interaction technology for older adults is not known. In this paper, we detail the design of two dyadic collaborative AR activities that accommodate diminished physical and cognitive abilities of older adults. The findings include a general design framework based on an iterative participatory design focusing on preferred activities, modes of interaction, and overall AR experience of eight older adults, two family members, and five LTC staff. Results demonstrate the potential of collaborative AR as an effective means of interaction for older adults with their family, if designed to cater to their needs.

Addressing loneliness and social isolation in 52 countries: a scoping review of National policies

BACKGROUND

Even prior to the advent of the COVID-19 pandemic, there was ample evidence that loneliness and social isolation negatively impacted physical and mental health, employability, and are a financial burden on the state. In response, there has been significant policy-level attention on tackling loneliness. The objective of this scoping review was to conduct a loneliness policy landscape analysis across 52 countries of the UN European country groups. Our policy analysis sought to highlight commonalities and differences between the different national approaches to manage loneliness, with the goal to provide actionable recommendations for the consideration of policymakers wishing to develop, expand or review existing loneliness policies.

METHODS

We searched governmental websites using the Google search engine for publicly available documents related to loneliness and social isolation. Seventy-eight documents were identified in total, from which 23 documents were retained. Exclusion of documents was based on predetermined criteria. A structured content analysis approach was used to capture key information from the policy documents. Contextual data were captured in a configuration matrix to highlight common and unique themes.

RESULTS

We could show that most policies describe loneliness as a phenomenon that was addressed to varying degrees in different domains such as social, health, geographical, economic and political. Limited evidence was found regarding funding for suggested interventions. We synthesised actionable recommendations for the consideration of policy makers focusing on the use of language, prioritisation of interventions, revisiting previous campaigns, sharing best practice across borders, setting out a vision, evaluating interventions, and the need for the rapid and sustainable scalability of interventions.

CONCLUSIONS

Our study provides the first overview of the national loneliness policy landscape, highlighting the increasing prioritisation of loneliness and social isolation as a major public health and societal issue. Our findings suggest that policymakers can sustain this momentum and strengthen their strategies by incorporating rigorous, evidence-based intervention evaluations and fostering international collaborations for knowledge sharing. We believe that policymakers can more effectively address loneliness by directing funds to develop and implement interventions that impact the individual, the community and society.

Men's Social Connectedness in Later Life: A Qualitative Study with Older Men

This qualitative study aimed to understand men's social connectedness in later life in Portugal focusing on their perceptions, obstacles, strategies, and impact on well-being. The sample included 104 older Portuguese men over 65 years of age (Mage = 70.76 years). The qualitative data were the direct transcriptions of the answers given by participants to the electronic interview using thematic analysis. Findings revealed six overarching themes encompassing 18 subcategories: definitions of social connectedness (social support, community identity, mental health promotion, use of community structures), difficulties/obstacles in maintaining social connectedness (ageism, lack of initiative, physical limitations, psychological traits, resources), strategies/actions or resources to establish social connections (use of technology, use of community groups, leisure and sport activities, church/religion), negative impact of difficulties in establishing relevant social connections (mental health, physical health, relationships), positive actions from being socially connected (positive prescriptions to promote social connectedness), and concerns from being socially disconnected (health risks). These findings indicate that the lack of social connectedness creates social vulnerability in later life, and social support is needed to ensure safer aging among older men.

The relationship between loneliness and the experiences of everyday stress and stressor-related emotion

Loneliness influences how people experience and respond to stressors, which may account for its role as a risk factor for morbidity and mortality. The present study was motivated by emerging evidence that affective responses to minor daily events have long-term implications for health and well-being. Specifically, we evaluated how individual differences in loneliness relate to the frequency of everyday stressors and stressor-related negative emotions. A diverse community sample of 255 adults (age 25-65 years) completed ecological momentary assessments (EMA), during which they reported recent stressors and current negative affect (NA) five times a day for 14 days. Multilevel logistic analyses indicated that there was a quadratic association between loneliness and likelihood of reporting stressors, controlling for demographics, social isolation, depressive symptoms, and context (current activities, current location). Multilevel regression indicated that loneliness was unrelated to the concurrent effect of stressors on NA but significantly larger lagged stressor effects were observed among individuals in the low and high ranges of loneliness. These findings suggest that individuals with high levels of loneliness are more likely to experience everyday stressors and have prolonged emotional responses following stressors.

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.

Reciprocal association between social support and psychological distress in chronic physical health conditions: A random intercept cross-lagged panel model

The onset of a chronic physical health condition (CHC) can highly impact individuals' well-being and mental health. Social support has been shown to help people rebound after the onset of a CHC. Nonetheless, little is known about the longitudinal pattern of social support and its reciprocal association with mental health in CHC. This study aimed to illustrate the longitudinal pattern of perceived social support and to examine the reciprocal association between perceived social support and psychological distress across 6 years. Two random intercept cross-lagged panel models were conducted, one for emotional and one for practical support, using yearly assessments of 582 Swiss Household Panel's participants reporting a CHC. A reciprocal association was found, with psychological distress 1 year after the onset being linked to less emotional support in the following year and vice versa, more emotional support being linked to less psychological distress the following year. A unidirectional association was found for practical support, with more psychological distress 1 year before the CHC onset being linked to more practical support at the onset year. This study underlines the importance of involving the social environment of individuals living with a CHC, especially around the first year after the onset.

The association between social isolation, loneliness and psychological problems in young adults: A study during the acute phase of COVID-19 in Italy

During the COVID-19 pandemic, governments had to impose social isolation measures to safeguard the citizens' health. However, this could have affected psychological problems. The aim of the present study was to investigate the psychological effects associated with social and emotional isolation during the acute phase of the COVID-19 in Italy. To this purpose, the degree of social isolation and loneliness and the presence of psychological problems (externalising and internalising) were investigated online in a sample of 395 young adults (18-30 years; 57% women). Results confirmed the relevant association between social isolation, loneliness and psychological problems, in both internalising and externalising dimensions. Particularly, loneliness showed the strongest association. Moreover, consistently with surveys conducted during the COVID-19-era, data highlighted that men were more vulnerable to social isolation and loneliness than women. These results underline the need for adequate interpersonal support during moments of isolation to prevent negative effects on psychological problems.

Loneliness among older Chinese individuals: the status quo and relationships with activity-related factors

BACKGROUND

With the rapid population aging, healthy aging has become a concern for society as a whole. In this study, loneliness and its relationships with activity-related individual factors were examined among older Chinese individuals from the perspective of mental health and daily leisure activities.

METHODS

The data were from the fourth investigation of the Sample Survey of the Aged Population in Urban and Rural China, which had a total of 220,506 participants. Activity ability was assessed by the Barthel Activity of Daily Living Index, a self-designed activity type questionnaire was used to evaluate activity participation, and loneliness was measured with a single-item question.

RESULTS

The prevalence of varying degrees of loneliness among Chinese older individuals was 36.6%. The prevalence of loneliness among the older individuals differed significantly by age gender, age, physical health status, annual household income, education level, marital status, living status, ethnic minority status, religious faith and territory of residence. There were differences in activity participation among older Chinese adults in terms of all the demographic factors mentioned above, while there were no significant differences in living status or religious faith, and significant differences in several other demographic factors in terms of activity ability. Self-care ability, as a form of activity ability, and activity participation significantly predicted loneliness among the older participants.

CONCLUSION

The topic of loneliness among Chinese older individuals is complex and requires greater attention. The buffering effect of activity-related factors on loneliness suggests that old people should improve their activity ability and participate more in daily activities.

Subjective well-being patterns in older men and women without someone to confide in: a latent class analysis approach

Objective

This study aimed to identify the latent subtypes of subjective well-being (SWB) and associated factors in older adults without a confidant in China.

Methods

The data came from the most recent (seventh) wave (2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). This cross-sectional study included 350 older adults who lacked a close confidant. We utilized latent class analysis and multiple logistic regression models to examine the latent SWB subtypes and associated factors.

Results

Three distinct patterns of SWB were identified: the very low SWB class (32%), the medium-low SWB class (46%), and the low evaluative and high affective SWB class (22%). The results indicated that compared to the low evaluative and high affective SWB class, respondents who self-rated their health as not good, currently drank alcohol and rated their financial status as poor/very poor were more likely to be in the very low SWB class, while those who participated in social activities were less likely to be in the very low SWB class. Respondents who had limitations in instrumental activity of daily living (IADL) and rated their financial status as poor/very poor were more likely to be in the medium-low SWB class. However, gender did not affect SWB patterns.

Conclusion

Our findings highlight awareness of the heterogeneity of SWB in older adults without close confidants and provide valuable information for the development of tailored intervention programs to improve their well-being.

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

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

Effectiveness of social support programmes on loneliness in community-dwelling older adults: study protocol for a meta-analysis of randomised controlled trials

BACKGROUND

The prevalence of loneliness among older adults is of great importance in the field of public health. Numerous studies have provided evidence supporting the effectiveness of social support as a powerful intervention for reducing loneliness in older individuals. However, the specific types of social support that yield positive results are yet to be determined. Therefore, this study aims to conduct a comprehensive review to compare and analyse the effectiveness of different support mechanisms in alleviating loneliness among community-dwelling older adults.

METHODS AND ANALYSIS

A thorough search will be conducted on various electronic databases, including EMBASE, PubMed, the Cochrane Library, Web of Science, PsycINFO, Scopus, Google Scholar, China National Knowledge Infrastructure Library, China Science and Technology Journal Database (Weipu), WanFang Database, and China Biology Medicine Disc. The search will include randomised controlled trials published in English or Chinese that focus on interventions for loneliness in older individuals, with loneliness as the primary measure of interest. The selection and choice of articles will be the responsibility of both reviewers. The JBI Critical Appraisal Checklist for Randomised Controlled Trials will be used to assess the methodological quality of the included trials. When sufficient data are obtained and the study is relatively homogeneous, a random-effects or fixed-effects model will be employed to conduct a meta-analysis, yielding a descriptive synthesis of the findings.

ETHICS AND DISSEMINATION

Ethics approval will not be sought for this systematic review as it will exclusively focus on published papers. The review findings will be showcased at a conference dedicated to this specific field and published in an appropriate journal that undergoes peer evaluation.

PROSPERO REGISTRATION NUMBER

CRD42020226523.

Balance between solitude and socializing: everyday solitude time both benefits and harms well-being

Two literatures argue that time alone is harmful (i.e., isolation) and valuable (i.e., positive solitude). We explored whether people benefit from a balance between their daily solitude and social time, such that having 'right' quantities of both maximizes well-being. Participants (n = 178) completed a 21-day diary study, which quantified solitude time in hours through reconstructing daily events. This procedure minimized retrospective bias and tested natural variations across time. There was no evidence for a one-size-fits-all 'optimal balance' between solitude and social time. Linear effects suggested that people were lonelier and less satisfied on days in which they spent more hours in solitude. These detrimental relations were nullified or reduced when daily solitude was autonomous (choiceful) and did not accumulate across days; those who were generally alone more were not, on the whole, lonelier. On days in which people spent more time alone they felt less stress and greater autonomy satisfaction (volitional, authentic, and free from pressure). These benefits were cumulative; those who spent more time alone across the span of the study were less stressed and more autonomy satisfied overall. Solitude time risks lowering well-being on some metrics but may hold key advantages to other aspects of well-being. PROTOCOL REGISTRATION: The stage 1 protocol for this Registered Report was accepted in principle on June 1, 2022. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/5KXQ3 .

Loneliness in older Chinese adults amid the COVID-19 pandemic: Prevalence and associated factors

INTRODUCTION

Data on loneliness among older adults in China during the COVID-19 pandemic are still scarce. This study aimed to examine the prevalence of loneliness and identify its associated factors among older Chinese adults during the COVID-19 pandemic.

METHODS

During the COVID-19 pandemic, 1268 older Chinese adults (aged 50+ years) were recruited through snowball sampling. The Chinese version of the validated six-item De Jong Gierveld Loneliness Scale was used to assess participants' recent feelings of loneliness, and a cut-off score of two or more was used to indicate the presence of loneliness.

RESULTS

Loneliness was experienced by 37.9% of the participants in recent days. Factors significantly associated with loneliness included male sex (vs. female, OR: 1.62, p < .001), an education level of middle school and below (vs. college and above, OR: 1.50, p = .007), residing in the COVID-19 epicenter (vs. other provinces, OR: 1.48, p = .004), concern about contracting COVID-19 (OR: 1.68, p = .001), poor knowledge of COVID-19 (OR: 2.39, p = .012), and physical health problems (OR: 1.65, p < .001).

DISCUSSION

Loneliness is common among older Chinese adults amid the COVID-19 pandemic. Targeted intervention programs may be more effective in reducing loneliness among older adults who are worried about contracting COVID-19, have poor COVID-19 knowledge, and experience physical health problems.

National Prevalence of Social Isolation and Loneliness in Adults with Chronic Obstructive Pulmonary Disease

Rationale: Social isolation and loneliness are gaining recognition for their role in health outcomes, yet they have not been defined in people with chronic obstructive pulmonary disease (COPD). Objective: To determine the national prevalence of and characteristics associated with social isolation and loneliness in people with COPD. Methods: This is a cross-sectional study of community-dwelling adults aged ⩾50 years in the nationally representative HRS (Health and Retirement Study) (2016-2018). Participants self-reported COPD and supplemental oxygen use and were categorized into three groups: 1) no COPD; 2) COPD; and 3) COPD on oxygen. Social isolation was defined using a nine-item scale indicating minimal household contacts, social network interaction, and community engagement. Loneliness was measured using the 3-Item UCLA Loneliness Scale. Multivariable logistic regression defined prevalence and associated characteristics for both. Results: Participants (n = 10,384) were on average 68 years old (standard deviation, ±10.5), 54% female, 10% Black, 11% self-reported COPD, and 2% self-reported supplemental oxygen. Overall, 12% were socially isolated, 12% lonely, and 3% both socially isolated and lonely. People with COPD had a higher adjusted prevalence of social isolation (no COPD: 11%; COPD: 16%; COPD on oxygen: 20%; P < 0.05) and loneliness (no COPD: 11%; COPD: 18%; COPD on oxygen: 22%; P < 0.001). In those with COPD, characteristics associated with social isolation (P < 0.05) included sex (men: 22%; women: 13%), non-Hispanic White ethnicity (White: 19%; Black: 7%), low net worth (<$6,000: 32%; $81,001-$239,000: 10%), depression (depression: 24%; no depression: 14%), having difficulty with one or more activities of daily living (one or more difficulty: 22%; no difficulty: 14%), and current cigarette use (current: 24%; never: 13%). Characteristics associated with loneliness (P < 0.05) included younger age (50-64 yr: 22%; 75-84 yr: 12%), being single (single: 32%; married: 12%), depression (depression: 36%; no depression: 13%), having difficulty with one or more activities of daily living (one or more difficulty: 29%; no difficulty: 15%), diabetes (diabetes: 26%; no diabetes: 17%), and heart disease (heart disease 23%; no heart disease: 17%). Conclusions: Nearly one in six adults with COPD experience social isolation, and one in five experience loneliness, with almost twice the prevalence among those on supplemental oxygen compared with the general population. Demographic and clinical characteristics identify those at highest risk to guide clinical and policy interventions.