Loneliness In Adults Research Articles

Social isolation and loneliness in older adults in the context of COVID-19

The COVID-19 pandemic, accompanied by stringent social restrictions, wrought profound changes across various facets of human existence. Unprecedented measures, such as compulsory quarantines, curfews, and restrictions on mobility and social interactions, were implemented to mitigate infection rates. This paper delves into the repercussions of isolation, with a specific focus on its impact on the elderly population—an exceptionally vulnerable demographic. The primary objective of this study is to discern the ramifications of pandemic-induced isolation on the mental and physical well-being of senior citizens. This contribution underscores the comparative analysis of three prior studies that have illuminated the nexus between pandemic-induced isolation and heightened levels of anxiety, depression, and loneliness. A notable strength of this research lies in its comprehensive dataset, derived from comparisons with extant scientific literature and the utilization of diverse scientific methodologies. The preceding investigations centered on the Austrian populace, juxtaposing the effects of loneliness among senior citizens before and during the pandemic. However, these studies were constrained by their inability to explore the enduring consequences of isolation and loneliness post-repeal of anti-pandemic measures, and their incapacity to ascertain its correlation with senior citizens' mortality, particularly those residing in solitary circumstances. This article represents a partial outcome of the VEGA 1/0595/21 project, which investigates public administration interventions during the COVID-19 era and their influence on the quality of life of selected community residents.

Wearables, sensors and the future of technology to detect and infer loneliness in older adults

Wearables, sensors and the future of technology to detect and infer loneliness in older adults

Developmental Study on "Smart Silver Care": A Mobile Application to Alleviate Loneliness in Older Adults within the Community.

Loneliness poses a significant threat to the quality of life of older adults. Therefore, it is essential to implement non-face-to-face services to solve the loneliness of older adults in the community. This study used the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model to develop mobile applications as a loneliness intervention for older adults living in the community. A mobile application was developed using the ADDIE model to alleviate loneliness in older adults living in the community. The development process included a systematic review, a face-to-face preference survey, and an experts' evaluation. From 11 to 15 June 2021, the following six databases were used to search for related articles: Ovid-Medline, Ovid-EMBASE, Cochrane Library, KISS, Korea Med, RISS. A preference analysis was conducted on 100 adults aged 65 or older living in the community from 15 July to 31 August 2021. A mobile application for community-dwelling older adults was developed. Its contents included emotional support, cognition, physical activity, health data, nutrition, and motivation. They were organized through a systematic review and preference survey in the analysis stage. They were also designed as main menus and sub-content at the design stage. They also designed the structure, functionality, and interface layout. The application was developed by integrating the designed content and determining the operating system, language, access method, privacy, and server history. Then, experts evaluated the validity of the application. The prototype mobile application incorporates emotional support, cognition, physical activity, health data, nutrition, and motivation. It is expected to help older adults achieve their goals by promoting participation. By incorporating expert validity into the content development process of early prototypes, we have improved the usability and acceptability of our products. Future pilot trials are needed to evaluate the effectiveness of this mobile application among older adults.

Beyond Anxiety and Depression: Loneliness and Psychiatric Disorders in Adults with Atopic Dermatitis.

There is a lack of knowledge concerning loneliness and psychiatric disorders other than anxiety and depression in patients with atopic dermatitis. This cross-sectional study was conducted within the Lifelines Cohort Study, in the Netherlands, by sending an atopic dermatitis questionnaire to adult participants (n = 135,950) in 2020. Psychiatric disorders were measured with a self-reported question and validated instrument (Mini International Neuropsychiatric Interview; M.I.N.I.), and loneliness was assessed with the validated 6-item De Jong Gierveld Loneliness Scale. In total, 56,896 subjects (mean age 55.8 years, 39.7% males) were included. Atopic dermatitis showed positive associations with self-reported chronic fatigue syndrome, burnout, depression, social phobia, panic disorder, attention deficit hyperactivity disorder, and eating disorder in the participants' lifetimes. Based on the M.I.N.I., atopic dermatitis was positively associated with panic disorder and at least 1 anxiety disorder. In addition, subjects with atopic dermatitis were more likely to experience loneliness compared with those without atopic dermatitis. These associations were observed only in the moderate-to-severe, but not mild, atopic dermatitis group. This study raises awareness that a significant proportion of adults with atopic dermatitis feel lonely and are affected by several psychiatric disorders, especially those severely affected by atopic dermatitis. Further studies are required to evaluate if interdisciplinary care, such as the collaboration between dermatologists and psychiatrists, could optimize medical care for this vulnerable patient group.

Gender-specific association of loneliness and health care use in community-dwelling older adults

BackgroundLoneliness in older adults is common, particularly in women. In this article, gender differences in the association of loneliness and health care use are investigated in a large sample of community-dwelling older adults.MethodsData of 2525 persons (ages 55–85 years)—participants of the fourth follow- up (2011–2014) of the ESTHER study- were analyzed. Loneliness and health care use were assessed by study doctors in the course of a home visit. Gender-specific regression models with Gamma-distribution were performed using loneliness as independent variable to predict outpatient health care use, adjusted for demographic variables.ResultsIn older women, lonely persons were shown to have significantly more visits to general practitioners and mental health care providers in a three-month period compared to less lonely persons (p = .005). The survey found that outpatient health care use was positively associated with loneliness, multimorbidity, and mental illness in older women but not in older men. Older men had significantly more contact with inpatient care in comparison to women (p = .02).ConclusionsIt is important to consider gender when analyzing inpatient and outpatient health care use in older persons. In older women loneliness is associated with increased use of outpatient services.

Association of Loneliness With Change in Physical and Emotional Health of Older Adults During the COVID-19 Shutdown

To examine factors influencing loneliness and the effect of loneliness on physical and emotional health, in the context of the COVID-19 pandemic. Prospective, observational cohort. Community-dwelling participants. Older adults (n=238) enrolled in a longitudinal study. Interviews were completed July-December 2020. Loneliness was measured with the UCLA 3-item loneliness scale. Data including age, marriage, education, cognitive functioning, functional impairment, vision or hearing impairment, depression, anxiety, medical comorbidity, social network size, technology use, and activity engagement were collected. Health outcomes included self-rated health, and physical and mental composites from the 12-item Short Form Survey. Physical function was measured by a PROMIS-scaled composite score. Thirty-nine (16.4%) participants reported loneliness. Vulnerability factors for loneliness included age (RR=1.08, 95% CI 1.02-1.14); impairment with instrumental activities of daily living (RR=2.08, 95% CI 1.14-3.80); vision impairment (RR=2.09, 95% CI 1.10-3.97); depression (RR=1.34, 95% CI 1.25-1.43); and anxiety (RR=1.92, 95% CI 1.55-2.39). Significant resilience factors included high cognitive functioning (RR=0.88, 95% CI 0.83-0.94); large social network size (RR=0.92, 95% CI 0.88-0.96); technology use (RR=0.81, 95% CI 0.73-0.90); and social and physical activity engagement (RR=0.91, 95% CI 0.85-0.98). Interaction analyses showed that larger social network size moderated the effect of loneliness on physical function (protective interaction effect, RR=0.64, 95% CI 0.15-1.13, p <.01), and activity engagement moderated the effect of loneliness on mental health (protective interaction effect, RR=0.65, 95% CI 0.25-1.05, p <.001). Resilience factors may mitigate the adverse health outcomes associated with loneliness. Interventions to enhance resilience may help to diminish the detrimental effects of loneliness and hold great importance for vulnerable older adults.

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

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. 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. 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). 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.

The development and preliminary evaluation of Cognitive Behavioural Therapy (CBT) for Chronic Loneliness in Young People.

Approximately 10% of young people 'often' feel lonely, with loneliness being predictive of multiple physical and mental health problems. Research has found CBT to be effective for reducing loneliness in adults, but interventions for young people who report loneliness as their primary difficulty are lacking. CBT for Chronic Loneliness in Young People was developed as a modular intervention. This was evaluated in a single-case experimental design (SCED) with seven participants aged 11-18 years. The primary outcome was self-reported loneliness on the Three-Item Loneliness Scale. Secondary outcomes were self-reported loneliness on the UCLA-LS-3, and self- and parent-reported RCADS and SDQ impact scores. Feasibility and participant satisfaction were also assessed. At post-intervention, there was a 66.41% reduction in loneliness, with all seven participants reporting a significant reduction on the primary outcome measure (p < .001). There was also a reduction on the UCLA-LS-3 of a large effect (d = 1.53). Reductions of a large effect size were also found for parent-reported total RCADS (d = 2.19) and SDQ impact scores (d = 2.15) and self-reported total RCADS scores (d = 1.81), with a small reduction in self-reported SDQ impact scores (d = 0.41). Participants reported high levels of satisfaction, with the protocol being feasible and acceptable. We conclude that CBT for Chronic Loneliness in Young People may be an effective intervention for reducing loneliness and co-occurring mental health difficulties in young people. The intervention should now be evaluated further through a randomised controlled trial (RCT).

Development and evaluation of the information and communication technology-based Loneliness Alleviation Program for community-dwelling older adults: A pilot study and randomized controlled trial

This study aimed to develop an information and communication technology (ICT)-based Loneliness Alleviation Program (LAP) for community-dwelling older adults, which was developed according to the ADDIE model. The LAP is a complex non-face-to-face program for physical, psychological, and interpersonal loneliness alleviation. We conducted a randomized controlled trial to verify the effects of the program on loneliness, depression, and laughter index in older adults. Program sessions were conducted twice a week for 6 weeks (12 sessions). Data on 40 older adults aged 65 years and above were collected from January 2, 2023 to February 17, 2023 at a public health center in South Korea. The experimental group showed statistically significant effects of the program on loneliness, depression, and laughter index scores. The older adults were alleviated their loneliness by utilizing non-face-to-face programs, and the program is expected to increase continuity and inclusiveness of care.

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.

Exploring the impact of online social participation on loneliness in older adults: Evidence from The Canadian Longitudinal Study on Aging

As individuals age, mental and physical impairment can emerge and impact their well-being. Previous research on social participation in older adults has typically focused on specific activities or failed to distinguish between different forms of participation. In contrast, we propose that social participation is a resource optimization process for older adults, where various forms of participation must be optimized in order to improve well-being outcomes. Drawing on Selective Optimization with Compensation theory, we develop hypotheses on how older adults with cognitive decline select and optimize their social participation profile and how multiple modes of participation synergistically affect their perceived loneliness. Using data from the Canadian Longitudinal Study on Aging (CLSA), we test a polynomial model and find that online social participation has a U-shaped effect on loneliness, while personal-oriented offline social participation mitigates this effect. We also find that the impact of social participation modes varies considerably between younger and older groups. Our findings suggest implications for the design of integrative aging support programs and the use of ICT to promote mental well-being in different stages of advanced age.

Cross-Temporal Patterns of Care Provision by Older Adults during COVID-19 Pandemic: Lessons for Resilience

The current study aimed to examine the link between cross-temporal patterns of care provision and loneliness in older adults. Social capital and caregiver stress perspectives served as a theoretical framework for the study. The data were obtained from the two COVID-19 waves of the Survey of Health, Ageing, and Retirement in Europe (SHARE) conducted in 2020 and 2021. The data were analyzed using logistic regression models. The analytical sample consisted of 48,722 older adults residing in Europe and Israel. The analysis results show that both starting and continuing to provide instrumental care between the survey waves negatively related to loneliness. In contrast, all cross-temporal patterns of personal care (starting, ceasing, and resuming) were positively associated with loneliness. The results suggest that cross-temporal patterns of care provision correspond differently to loneliness while supporting both theoretical perspectives. The results also suggest that the studied link exhibits different directions depending on the type of care provided.

Can Social Participation Mediate the Motoric Cognitive Risk Syndrome, Depression &amp; Loneliness in Older Adults?

Abstract Date Presented 04/22/2023 In this study, we found the mediating role of social participation in the association of motoric cognitive risk (MCR) with depression of older adults. A social participation program to intervene with depression is recommended for older adults with MCR. Primary Author and Speaker: Jihyeun Park Additional Authors and Speakers: Suyeong Bae, Ji-Hyuk Park Contributing Authors: Ickpyo Hong, Sangmi Park, Jaehyu Jung, Sohyeon Yun, Anastassiya Khan

Changes in loneliness prevalence in Denmark in the 21st century: Age-period-cohort analysis.

The aim of this study was to investigate changes in the prevalence of loneliness in Denmark from 2000 to 2021 by conducting age-period-cohort analysis. Our study was based on a sample (N=83,437; age: ⩾16 years) of the Danish Health and Morbidity Surveys conducted in Denmark in 2000, 2005, 2010, 2013, 2017 and 2021. We used logistic regression models by gender to estimate the age-period-cohort effects, with loneliness as the dependent variable and age, survey year and birth cohort as independent variables, mutually adjusted. The prevalence of adult loneliness increased by each survey year over the entire period (from 13.2% in 2000 to 27.4% in 2021 among men and from 18.8% to 33.7% among women). Overall, a U-shaped curve, for the prevalence of loneliness among different age groups, was observed, which was most pronounced among women. The greatest increase in the prevalence of loneliness from 2000 to 2021 was observed among the youngest age group (16-24 years), with 28.4 and 30.7 percentage points for men and women. No significant cohort effect was observed. The observed increase in loneliness prevalence from 2000 to 2021 was driven by period and age effects rather than cohort effects. It should be noted that data from 2021 were collected during a national lockdown due to an outbreak of COVID-19, which could explain part of the large increase in loneliness from 2017 to 2021.

Community Wise—effects and participant perceptions of a community- based -positive health intervention for older inhabitants of low SES neighbourhoods: a mixed-methods approach

BackgroundThe Community Wise (CW) intervention applies a community-based approach to improve the physical fitness, self-management ability, loneliness, social cohesion, and well-being of older adults living in neighbourhoods characterized by lower socioeconomic status (SES).MethodsParticipants (N = 108) were recruited using several strategies, including door-to-door visits and community key peers. The study was based on a pre-test/post-test design. Outcomes were assessed through mixed methods using questionnaires, performance tests, semi-structured interviews, and focus-group sessions.ResultsResults showed significant improvements on aerobic endurance and shoulder flexibility, but no significant improvements on self-management ability, social cohesion, loneliness, or well-being. Qualitative data analysis did indicate that participants experienced improvements on social connectedness with members of the group, as well as on self-management ability.ConclusionThe results of the intervention seem to depend on programme fidelity and method of assessment. Adapting the intervention and including more older adults with poor health status could lead to better outcomes in the future. This results of this study should be interpreted in light of the complexity and methodological challenges of conducting a community-based health-promotion intervention for this target group.Trail registrationRetrospective registration.

Impact of Social Isolation and Loneliness in Older Adults: Current Understanding and Future Directions

Impact of Social Isolation and Loneliness in Older Adults: Current Understanding and Future Directions

Addressing social isolation and loneliness in older adults at the health plan level: A quality improvement project

The aim of this quality improvement project was to develop and implement a strategy to address social isolation and loneliness in older adults at the health plan level. Validated tools were utilized to identify health plan members experiencing social isolation and/or loneliness. Identified members were offered a home-based intervention which consisted of a befriending model provided through in-home caregiver visits (n = 26) as well as a social prescribing (navigation) model (n = 23) to connect members to community resources. The quality improvement project demonstrated that validated assessment tools can successfully identify older health plan members experiencing social isolation and/or loneliness. In addition, the project results indicated that befriending through in-home caregiver visits and social navigation can improve social isolation and loneliness scores. Additional studies are needed to determine the significance of these improvements and if social navigation adds any additional benefit compared to in-home caregiver visits alone.

The Mediating Role of Social Participation in Motoric Cognitive Risk and its Relation to Depression and Loneliness in Older Adults.

Motoric cognitive risk syndrome (MCR) reduces the quality of life, independence, and social interaction in older adults. Social participation is a potentially modifiable factor that benefits cognitive and mental health. This study explored the mediating roles of social participation between MCR and depression and between MCR and loneliness. We performed a secondary analysis of data from the 2015-2016 National Social Life, Health, and Aging Project. Slow gait speed and cognitive decline were used to assess MCR. Mediation analysis was applied to two models, both of which used MCR as an exposure and social participation as a mediator. The outcomes were depression and loneliness for each model, respectively. Among 1,697 older adults, 196 (11.6%) had MCR. The mediating role of social participation was statistically significant in both models. The indirect effect (β=0.267, p=0.001) of MCR on depression through social participation comprised 11.97% of the total effect (β=2.231, p&lt;0.001). The indirect effect (β=0.098, p=0.001) of MCR on loneliness through social participation was 19.48% of the total effect (β=0.503, p&lt;0.001). Interventions to increase social participation may reduce depression and loneliness of older adults with MCR.

Measurement Properties and Cross-Cultural Adaptation of the De Jong Gierveld Loneliness Scale in Adults

Abstract: This systematic review evaluated the measurement properties of the De Jong Gierveld Loneliness Scale (DJGLS) in adults. A systematic search of four electronic databases (PubMed, EMBASE, Scopus, and PsycINFO) was conducted from inception until December 2022. The COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) guidelines were used to assess the methodological quality and evidence synthesis of the included studies. Forty-six studies assessed the validity and reliability of the DJGLS-11 and its short version, the DJGLS-6. Very-low-quality evidence supported the content validity, moderate to high-quality evidence confirmed the structural validity and internal consistency, and low-quality evidence supported the construct validity of the two versions. Test-retest reliability was examined for the DJGLS-6 with low-quality evidence supporting excellent interclass coefficient values of 0.73–1.00. Both scales were cross-culturally adapted and translated into 18 languages across 12 countries. Although the structural validity and internal consistency of the DJGLS were supported by high-quality evidence, very-low to low-quality evidence was available for its other measurement properties. Future studies are needed to perform a more comprehensive assessment of the measurement properties of the DJGLS before fully recommending the scale to assess loneliness in adults.

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

BackgroundWhile loneliness is common in older adults, some immigrant groups are at higher risk. To inform tailored interventions, we identified factors associated with loneliness among immigrant and Canadian-born older adults living in Ontario, Canada.MethodsWe conducted a cross-sectional analysis of 2008/09 data from the Canadian Community Health Survey (Healthy Aging Cycle) and linked health administrative data for respondents 65 years and older residing in Ontario, Canada. Loneliness was measured using the Three-Item Loneliness Scale, with individuals categorized as ‘lonely’ if they had an overall score of 4 or greater. For immigrant and Canadian-born older adults, we developed separate multivariable logistic regression models to assess individual, relationship and community-level factors associated with loneliness.ResultsIn a sample of 968 immigrant and 1703 Canadian-born older adults, we found a high prevalence of loneliness (30.8% and 34.0%, respectively). Shared correlates of loneliness included low positive social interaction and wanting to participate more in social, recreational or group activities. In older immigrants, unique correlates included: widowhood, poor health (i.e., physical, mental and social well-being), less time in Canada, and lower neighborhood-level ethnic diversity and income. Among Canadian-born older adults, unique correlates were: female sex, poor mental health, weak sense of community belonging and living alone. Older immigrant females, compared to older immigrant males, had greater prevalence (39.1% vs. 21.9%) of loneliness.ConclusionsAlthough both groups had shared correlates of loneliness, community-level factors were more strongly associated with loneliness in immigrants. These findings enhance our understanding of loneliness and can inform policy and practice tailored to immigrants.