Health Effects of Loneliness in Older Adults

Systematic Reviews, 2019

Background: The health impacts of loneliness and social isolation among older adults are widely acknowledged. Despite this, there is no consensus on the possible causal nature of this relationship, which could undermine effectiveness of interventions. One body of thought is that loneliness and social isolation affect health-related behaviours to indirectly damage health. However, there has not been any systematic assessment of the association between loneliness and social isolation and health-related behaviours which considers the possible impact from confounding factors and the causal direction of this association. Methods/design: The research will comprise a systematic review and meta-analysis to address the evidence gap. EMBASE, MEDLINE, PSYCINFO, CINAHL, SocIndex, Scopus and Web of Science will be systematically searched for quantitative observational studies considering an association between loneliness/social isolation and key healthrelated behaviours in older adults. Two reviewers will independently check the study titles and abstracts for eligibility. Included studies will be critically appraised using Newcastle-Ottawa Scale by the lead author and checked by the second reviewer. Discrepancies in eligibility or quality assessment will be resolved via discussion or referral to a third reviewer. Results will be synthesised and reported in accordance with the Centre for Reviews and Dissemination (CRD) guidelines. This will be in the form of a descriptive summary, risk of bias assessment together with a meta-analysis and subgroup analyses (for covariate adjusted results) where sufficient heterogeneity of results is established. Finally, any associations identified will be analysed using the Bradford-Hill criteria to explore causal relationships which, if they exist, will be reported by means of a computed causations score. Discussion: This review aims to assess the extent and causal nature of associations between loneliness/social isolation and health-related behaviours among older adults. This data will provide a comprehensive overview of the quality of the evidence base to inform stakeholders in tackling the growing public health challenges arising from loneliness/ social isolation in ageing populations. Systematic review registration: PROSPERO CRD42017020845

Health Psychology, 2017

Objective: The present analysis aimed to examine the associations of isolation and loneliness, individually as well as simultaneously, with two measures of functional status (gait speed and difficulties in activities of daily living) in older adults over a 6-year period using data from the English Longitudinal Study of Ageing, and to assess if these associations differ by SES. Methods: Loneliness was measured using the short form of the Revised UCLA scale and an index of social isolation was computed incorporating marital status; frequency of contact with friends, family, and children; and participation in social activities. Measures of functional status were assessed identically at baseline and 6 years later for 3070 participants (mean age 69 years). Wealth was used as an indicator of SES. Results: In fully and mutually adjusted models, social isolation and loneliness were found to be associated with a decrease in gait speed at follow-up, with stronger effects among more disadvantaged individuals. Loneliness was associated with an increase in difficulties with activities of daily living. Conclusions: Isolation and loneliness were adversely associated with different aspects of functional status. Interventions to reduce isolation and loneliness may be particularly beneficial for individuals in disadvantaged groups.

Background: This study examines predictors of loneliness among low-income older adults through a framework named MODEL (Model of Depression and Loneliness), which we developed to address the need for a comprehensive and intervention-oriented theory of loneliness in old age. The framework is rooted in a cognitive-behavioral theory that conceptualizes behaviors as resulting from an interaction of cognitive processes and environmental events.

Aging & Mental Health

Objectives: To effectively reduce loneliness in older adults, interventions should be based on firm evidence regarding risk factors for loneliness in that population. This systematic review aimed to identify, appraise and synthesise longitudinal studies of risk factors for loneliness in older adults. Methods: Searches were performed in June 2018 in PsycINFO, Scopus, Sociology Collection and Web of Science. Inclusion criteria were: population of older adults (M ¼ 60þ years at outcome); longitudinal design; study conducted in an OECD country; article published in English in a peer-review journal. Article relevance and quality assessments were made by at least two independent reviewers. Results: The search found 967 unique articles, of which 34 met relevance and quality criteria. The Netherlands and the United States together contributed 19 articles; 17 analysed national samples while 7 studies provided the data for 19 articles. One of two validated scales was used to measure loneliness in 24 articles, although 10 used a single item. A total of 120 unique risk factors for loneliness were examined. Risk factors with relatively consistent associations with loneliness were: not being married/partnered and partner loss; a limited social network; a low level of social activity; poor self-perceived health; and depression/depressed mood and an increase in depression. Conclusion: Despite the range of factors examined in the reviewed articles, strong evidence for a longitudinal association with loneliness was found for relatively few, while there were surprising omissions from the factors investigated. Future research should explore longitudinal risk factors for emotional and social loneliness.

The goal of this research is to test whether often observed correlates of loneliness in older age are related to onset of loneliness longitudinally. Despite the increasing number of longitudinal studies, the investigation of factors that are related to onset of loneliness is still limited. Analyses are based on data of the TamELSA study, which is a population-based prospective study in Tampere, Finland and started in 1979. For the present study 469 older adults aged between 60 and 86 years at baseline, who were not lonely at baseline, were selected and followed-up in 1989, 1999 and 2006. During the 28 years of follow-up approximately one third (N = 178) of the study population developed feelings of loneliness. Logistic regression analyses indicated that losing a partner, reduced social activities, increased physical disabilities, increased feelings of low mood, uselessness and nervousness, rather than baseline characteristics, are related to enhanced feelings of loneliness at follow-up. The higher incidence of loneliness among women can be fully explained by the unequal distribution of risk factors among men and women (e.g., women more often become widowed). Our results are in line with the cognitive approach that conceptualizes loneliness as an unpleasant feeling due to a perceived discrepancy between the desired and the achieved level of social and personal resources.

International Journal of Environmental Research and Public Health

Background: This study aimed to assess the association between loneliness and Health-Related Quality of Life (HR-QoL) among community-dwelling older citizens in five European countries. We characterize loneliness broadly from an emotional and social perspective. Methods: This cross-sectional study measured loneliness with the 6-item De Jong Gierveld Loneliness Scale and HR-QoL with the 12-Item Short-Form Health Survey. The association between loneliness and HR-QoL was examined using multivariable linear regression models. Results: Data of 2169 citizens of at least 70 years of age and living independently (mean age = 79.6 ± 5.6; 61% females) were analyzed. Among the participants, 1007 (46%) were lonely; 627 (29%) were emotionally and 575 (27%) socially lonely. Participants who were lonely experienced a lower HR-QoL than participants who were not lonely (p ≤ 0.001). Emotional loneliness [std-β: −1.39; 95%-CI: −1.88 to −0.91] and social loneliness [−0.95; −1.44 to −0.45] were both asso...

Archives of Gerontology and Geriatrics, 2012

Aging is the entirety of the irreversible structural and functional changes which occur with passing of time in an organism at the levels of molecules, cells, tissues, organs and systems (I ˙lic ¸in et al., 2005). Although the age of 65 is accepted as the inception of old age, the results of scientific research emphasize personal differences in the process of aging. Such personal differences include inheritance, lifestyle, occupation, eating habits, chronic diseases and personality traits . The rate of mortality has been reduced owing to the scientific and technological developments in healthcare, the prevention of diseases through effective diagnosis and treatment methods developed, and more possibilities of treatment at an early stage . The life expectancy at birth has increased as a result of the advancements in protective health services; an important demo-graphic change being observed in the world. Particularly in developed countries in the last 40-50 years is the growing population of elderly people. For example, the population of those 65 years of age and older went up to 6.8% in Turkey in 2008; it is estimated that the elderly population will reach to a level of 9-10% in 2025 as the life expectancy increases and the number of old people will exceed 800 million globally . Loneliness leads to fear, grief and anxiety which develop along with a sense of losing independence in elderly people. Lonely elderly people tend to think negatively and focus their thoughts on themselves rather than on positive expectations . Reduced confidence in other people, shyness, depressive symptoms, anger, tension and fear of being battered isolate them from the society and increase their senses of loneliness and alienation . The most frequently used measure of loneliness is the revised ULS, a 20-item questionnaire measuring general feelings of social isolation and dissatisfaction with one's social interactions . Of these, 10 items involve positive expressions showing satisfaction from social relationships and 10 items negative expressions showing dissatisfaction from social relationships. Individuals assess each item in the scale according to how often they believe the statement is true for them. The ULS is observed to have been used in many studies

Purpose of the research: (a) To identify the degree of much loneliness reported in the Portuguese population over 50 years of age and (b) test whether loneliness can be predicted by socio-demographic, health related or social characteristic of the sample other than age. Materials and methods: 1174 late middle age and older adults were interviewed face to face by different interviewers across the country; after the informed consent was signed, we asked the participants several socio-demographic and health-related questions; finally we asked ‘‘How often do you feel lonely?’’ and participants responded according to a five point Likert scale. Principal results: The results showed that 12% of participants reporting feeling lonely often or always, whereas 40% reporting never feeling lonely. The remaining 48% self-reported they felt lonely seldom or sometimes. Additionally, results show that, when taken together, variables such as marital status, type of housing, residence settings, health conditions, social satisfaction, social isolation, lack of interest, transportation, and age were predictors of loneliness. Major conclusions: (1) The association of loneliness with advanced age has been greatly exaggerated by mass media and common sense; (2) But although our findings did not confirm the most alarmist views, the 12% of older adults reporting that they are feeling lonely always or often should be cause for attention and concern. It is necessary to understand the meaning, reasons and level of suffering implied on those feelings of loneliness. (3) Our findings suggest that it makes no sense to construe age as a singular feature or cause for feelings of loneliness. Instead, age and also a number of other features combine to predict feelings of loneliness. But even with our predictor variables there was a substantial of variance left unexplained. Therefore it is necessary to continue exploring how feelings of loneliness arise from the experience of living and how they can be changed.

Clinical Social Work and Health Intervention, 2016

The aim of the study was to determine the impact of loneliness on the emergence of depression in the elderly. The sample consisted of 168 elderly living in their natural social environment. The depressive symptomatology was examined by the Geriatric Depression Scale (GDS). The impact of loneliness on depression development has been assessed by the non-parametric Kruskal Wallis and Chi-square Tests. The study found that up to 60.7% of seniors suffer from some degree of depression: 32.1% reporting mild; 28.6% manifesting full depression. We also have found a relationship between loneliness and depression development of the elderly.

Social Work in Public Health

Loneliness has a significant impact on the health and well-being of older people, including an increased risk of mortality. This cross-sectional study explored possible risk and protective factors that can help explain loneliness and emotional and social loneliness in a sample of community-dwelling older adults (N = 477). The survey incorporated a standardized scale of loneliness and items to assess type and quality of contact with others, community support, social isolation, physical health, cognitive health, and functional ability. Bivariate and multivariate analyses explored the factors that contributed to loneliness, emotional loneliness, and social loneliness. Results indicated overall quality of contact with others, use of phone contact, and social isolation was significant in all three regressions; other significant variables were different for each analysis. The findings support social work and public health recommendations for addressing loneliness, particularly within the current climate of "social distancing" under the COVID-19 pandemic.

BMJ Open

ObjectiveThe purpose of this consensus statement is to determine the state of the field of loneliness among older people, highlighting key issues for researchers, policymakers and those designing services and interventions.MethodsIn December 2018, an international meeting on loneliness was held in Belfast with leaders from across the USA and Europe. A summary of the conclusions reached at this event is presented following a consensus-building exercise conducted both during this event after each presentation as well as after the event through the drafting, reviewing and agreement of this statement by all authors for over 6 months.ResultsThis meeting resulted in an agreement to produce a consensus statement on key issues including definitions of loneliness, measurement, antecedents, consequences and interventions.DiscussionThere has been an exponential growth in research on loneliness among older adults. However, differing measurements and definitions of loneliness mean the incidence ...

Journal of the American Geriatrics Society, 2010

To live with feelings of loneliness has negative implications for quality of life, health and survival. This study aimed to examine changes in loneliness among older people, both with regard to prevalence rates, and socio-demographic, social and health-related correlates of loneliness. This study had a repeated cross-sectional design and was based on the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD). Analyses of trends in loneliness covered the years 1992, 2002, 2004, 2011 and 2014, and included people aged 77 years or older (n = 2 572). Analyses of correlates of loneliness covered 2004 and 2014, and included people aged 70 years or older (n = 1 962). Logistic regression analyses were conducted with findings presented as average marginal effects. Contrary to what is often assumed, there has been no increase in loneliness among older people over time (1992–2014). Regression analyses for 2004 and 2014 showed that social and health-related correlates were more strongly associated with loneliness than socio-demographic correlates. Psychological distress was most strongly associated with loneliness, followed by widowhood. Most associations between the correlates and loneliness were stable over time.

Research on Aging, 2005

This study examines loneliness and its correlates-health, residential care, partner status, and network size-over a seven-year period among adults born between 1908 and 1937. The four waves of data are from the Dutch "Living Arrangements and Social Networks of Older Adults" and the "Longitudinal Aging Study of Amsterdam" programs. Data from at least two waves are available for 2,925 respondents. Results show that older adults generally become lonelier as time passes. The increase is greater for the oldest, the partnered, and those with a better functional capacity at baseline. Older adults who lose their partner by death show the greatest increase in loneliness. Not all older adults become more lonely: Improvement in functional capacity and network expansion lead to less loneliness. Entry into residential care does not affect loneliness. The longitudinal design provides new insights into factors that protect against loneliness compared to cross-sectional studies.

Archives of Gerontology and Geriatrics, 2020

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