Persistent Loneliness Research Articles

Loneliness in the elderly and disease development in European welfare regions: a longitudinal study

Abstract Healthy ageing research has brought a recent focus on the association between loneliness and disease. Regional differences on loneliness prevalence in the elderly across welfare systems, and its association with varying mortality rates, have recently been demonstrated. We hypothesise loneliness affects disease development in the elderly, impacted by socio-economic policies that characterise welfare systems in the EU. We use logistic regression models to assess the association between loneliness (R-UCLA scale) and onset of new chronic disease and disease events, in a European sample of people aged >50 (n = 40840), using the SHARE database, during 2013 - 22 (waves 5 to 9). Preliminary results from two subsequent waves (2015-17, n = 11870) show a statistically significant effect of persistent loneliness on disease onset (increase in new disease events), when adjusting for sex, age, previous illness, and other socio-economic covariates (AOR 1.22, 95%CI 1.08-1.39, p < 0.01). Notably, comparing to the Scandinavian welfare group, only Eastern European countries show higher odds of disease development (AOR 1.52, 95%CI 1.32-1.77, p < 0.001), while also having the highest incidence of new disease in our sample. Age and welfare group show the strongest association with the outcome of interest, followed by change in occupation (no longer employed). Our current analyses span a larger period (2013-22), and we are exploring additional mediators of this effect, such as behavioural and social activity-related variables. Additional analyses to control for unrelated disease (low biological plausibility) and a social isolation index, described in the literature, are added. Furthermore, we analyse the longitudinal association between loneliness and healthcare use, such as polypharmacy and consults. With this study, we aim to contribute decision-making in health in all policies, by increasing integration between health and social sectors, while considering different regional and welfare policies. Key messages • Understanding socio-economic and welfare mechanisms which impact health in the elderly allows for better cross-sector policy design, promoting healthier ageing. • Persistent feelings of loneliness affect disease development in the elderly, which appear to be worsened in some EU welfare groups, independently of socio-economic status.

Loneliness and Social Isolation Factors Under the Prolonged COVID-19 Pandemic in Japan: 2-Year Longitudinal Study.

Worsening loneliness and social isolation during the COVID-19 pandemic have become serious public health concerns worldwide. Despite previous research reporting persistent loneliness and social isolation under repeated emergency declarations and prolonged pandemics, long-term studies are needed to identify the actual conditions of loneliness and social isolation, and the factors that explain them. In this study, 3 web-based surveys were conducted at 1-year intervals during the 2 years after the first state of emergency to examine changes in loneliness and social isolation and the psychosocial factors associated with them in the Japanese population. The first survey (phase 1, May 11-12, 2020) was conducted at the end of the first emergency declaration period, the second survey (phase 2, June 14-20, 2021) was conducted at the end of the third emergency declaration period, and the third survey (phase 3, May 13-30, 2022) was conducted when the state of emergency had not been declared but many COVID-19-positive cases occurred during this period. We collected data on 3892 inhabitants (n=1813, 46.58% women; age: mean 50.3, SD 13.4 y) living in the 4 prefectures where emergency declaration measures were applied in phases 1 and 2. A linear mixed model analysis was performed to examine the association between psychosocial variables as explanatory variables and loneliness scores as the dependent variable in each phase. While many psychosocial and physical variables showed improvement for the 2 years, loneliness, social isolation, and the relationship with familiar people deteriorated, and the opportunities for exercise, favorite activities, and web-based interaction with familiar people decreased. Approximately half of those experiencing social isolation in phase 1 remained isolated throughout the 2-year period, and a greater number of people developed social isolation than those who were able to resolve it. The results of the linear mixed model analysis showed that most psychosocial and physical variables were related to loneliness regardless of the phase. Regarding the variables that showed a significant interaction with the phase, increased altruistic preventive behavior and a negative outlook for the future were more strongly associated with severe loneliness in phase 3 (P=.01 to <.001), while the association between fewer social networks and stronger loneliness tended to be more pronounced in phase 2. Although the interaction was not significant, the association between reduced face-to-face interaction, poorer relationships with familiar people, and increased loneliness tended to be stronger in phase 3. This study found that loneliness and social isolation remained unresolved throughout the long-term COVID-19 pandemic. Additionally, in the final survey phase, these issues were influenced by a broader and more complex set of factors compared to earlier phases.

Analysis of changes in social isolation, loneliness, or both, and subsequent cognitive function among older adults: Findings from a nationwide cohort study.

The study aimed to investigate the associations of changes in social isolation, loneliness, or both, with cognitive function. Data were from 7299 older adults in the Chinese Longitudinal Healthy Longevity Survey. We defined four change patterns (no, incident, transient, and persistent) for social isolation and loneliness, and created nine-category variable to represent the joint changes. Tobit regression models and Cox models were performed. Incident, transient, and persistent social isolation or loneliness may accelerate cognitive decline (p<0.05). Incident, transient, and persistent social isolation wereassociated with higher cognitive impairment risk, while only persistent loneliness was associated with higher cognitive impairment risk (p<0.001). Notably, short-term or persistent social isolation was associated with accelerated cognitive decline and incident cognitive impairment, regardless of different loneliness change status (p<0.05). Short-term or persistent social isolation and persistent loneliness may be a salient risk factor for cognitive decline and cognitive impairment. Incident, transient, and persistent social isolation were associated with accelerated cognitive decline and higher cognitive impairment risk. Persistent loneliness was associated with accelerated cognitive decline and higher cognitive impairment risk. Short-term or persistent social isolation with concurrent different loneliness change status accelerated cognitive decline and higher cognitive impairment risk.

The social stigma of loneliness: A sociological approach to understanding the experiences of older people

Loneliness, and its stigmatising nature, has long been of interest to sociology, with germinal contributions by writers such as Robert Weiss. Yet, the social stigma of loneliness remains under-theorised. Furthermore, recent scholarship on loneliness is dominated by psychological perspectives that often overlook the social role of stigma and its entanglement with factors like age-related norms and contexts. To address these gaps, we develop a conceptual understanding of the stigma of loneliness in later life. We focus on older people (65+) since loneliness is strongly linked with assumed age-related decline – illness, ‘uselessness’ and increasing isolation – which research suggests is more likely to be internalised in later life. In developing our conceptual lens, we creatively combine Erving Goffman and Imogen Tyler’s work on stigma. Such reconfiguration integrates relationality and power within micro and macro approaches, pushing forward sociological boundaries on stigma. It also foregrounds the connections between agentic and structural elements of stigma, which have been missing in loneliness studies. Through this lens, we derive key dimensions of the stigma of loneliness: enaction, reception and management. To apply our framework, we draw on interviews, diaries and ethnographic data capturing persistent loneliness among older people living alone and in care homes. Findings illuminate the complexity of loneliness stigma in later life contexts, offering new research and policy directions.

Evaluation of Changes in Social Isolation and Loneliness with Incident Cardiovascular Events and Mortality

BackgroundIt remains unknown how the patterns of change of social isolation and loneliness are associated with the onset of cardiovascular disease (CVD) and mortality. We aimed to investigate the longitudinal association of changes in social isolation and loneliness with incident CVD, all-cause mortality, CVD mortality and subsequent cardiac function.MethodsThis prospective cohort study included 18,258 participants aged 38–73 years who participated in visit 0 (2006–2010) and visit 1 (2012–2013) using UK Biobank (mean age 57.1, standard deviation [SD] 7.4; 48.7% males). Social isolation or loneliness was categorized into four patterns: never, transient, incident, and persistent. Incident CVD, all-cause and CVD mortality were ascertained through linkage data. Cardiac function was assessed by cardiovascular magnetic resonance imaging in a subsample (N = 5188; visit 2, since 2014).ResultsOver a median follow-up of 8.3 (interquartile range [IQR] 8.1–8.6) years, compared with never social isolation, persistent social isolation was associated with the higher risk of incident CVD (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.03–1.33), all-cause (1.42, 1.12–1.81) and CVD (1.53, 1.05–2.23) mortality. Likewise, persistent loneliness was strongly associated with the greater risk of incident CVD (1.13, 1.00–1.27), all-cause (1.28, 1.02–1.61) and CVD mortality (1.52, 1.06–2.18).ConclusionsPersistent social isolation and loneliness posed a substantially higher risk for incident CVD, all-cause and CVD mortality, and cardiac dysfunction than other patterns. Persistent social isolation and loneliness, along with an increasing cumulative score, are associated with lower cardiac function.Graphical

Trajectories of social isolation and loneliness and the risk of incident type 2 diabetes mellitus across genetic risk score

AimThis study aimed to investigate the association of social isolation, loneliness, and their trajectory with the risk of developing type 2 diabetes mellitus (T2DM) across genetic risk. MethodsWe included 439,337 participants (mean age 56.3 ± 8.1 years) enrolled in the UK Biobank study who were followed up until May 31, 2021. Social isolation and loneliness were self-reported and were further categorized into never, transient, incident, and persistent patterns. ResultsDuring a median follow-up of 12.7 years, 15,258 incident T2DM cases were documented. Social isolation (versus no social isolation: hazard ratio (HR) 95 % confidence interval (CI) 1.04 [1.00;1.09]) and loneliness (versus no loneliness: 1.26 [1.19;1.34]) were associated with an increased T2DM risk, independent of the genetic risk for T2DM. The interactions existed between social isolation and loneliness (Pinteraction < 0.05); the increased T2DM risk associated with social isolation was only significant among participants without loneliness. In the longitudinal analysis, only persistent social isolation (versus never social isolation: 1.22 [1.02;1.45]) was associated with an increased T2DM risk, whereas incident loneliness (versus never loneliness: 1.95 [1.40;2.71]) and persistent loneliness (2.00 [1.31;3.04]) were associated with higher T2DM risks. ConclusionSocial isolation and loneliness, especially their persistent pattern, were independently associated with an increased incident T2DM risk, irrespective of an individual's genetic risk. Loneliness modified the association between social isolation and incident T2DM.

Disability and loneliness in the United Kingdom: cross-sectional and longitudinal analyses of trends and transitions

BackgroundLoneliness can have a detrimental impact on health, yet little is known about the association between disability and loneliness.MethodsSecondary analysis of three waves of data collected between 2017 and 2020 by the UK’s annual household panel study, Understanding Society. Direct age-standardisation was used to compare the prevalence of loneliness at each wave and the persistence of loneliness across all three waves for participants with/without disabilities aged 16–65 years. Transitional probabilities for the stability of loneliness, the stability of non-loneliness, the onset of loneliness and the offset of loneliness between consecutive waves were also estimated.ResultsAt each wave, the prevalence of loneliness was significantly higher among respondents with disabilities than respondents without disabilities; these inequalities persisted with no evidence of change over time. The prevalence of persistent loneliness was 46% for respondents with disabilities compared with 22% for respondents without disabilities. Risk factors for the likelihood of persistent loneliness included disability, financial stress, not living as a couple, living in rented accommodation, being female and not being employed. The probability of the onset and stability of loneliness between successive waves were markedly higher for people with disabilities compared with people without disabilities.ConclusionAdults with disabilities were more likely to experience loneliness, become lonely and remain lonely over time than their peers. Policies and interventions aimed at reducing loneliness should ensure that they are accessible and effective for people with disabilities. Further research is needed to explore the health outcomes of persistent loneliness among people with/without disabilities.

Does the Easing of COVID-19 Restrictive Measures Improve Loneliness Conditions? Evidence from Japan

Given the substantial changes in health and safety protocols and economic activities over the past year, socioeconomic routines have returned to a state of normalcy. Therefore, it is important to conduct a longitudinal study to determine whether these recent changes have left a lasting imprint on loneliness, specifically among those who have experienced post-pandemic loneliness in previous years. We investigated the incidence of loneliness and the risk factors associated with it during the post-pandemic period using recent data. We utilized longitudinal data spanning from 2020 to 2023 and employed mean comparison tests and weighted probit regression models in this analysis. Our study reveals that loneliness continues to be a notable issue, with persistent, post-pandemic, and recent loneliness rates of 47.6%, 4.3%, and 2.2%, respectively. We also observed a slight reduction in both persistent and post-pandemic loneliness compared to the previous year. Younger people continued to experience higher persistent loneliness rates, with no significant age or sex differences in post-pandemic or recent loneliness. Various factors, such as demographics, socioeconomic status, and psychological factors, influence loneliness differently across sexes and age groups. The policy implications include ongoing monitoring, targeted interventions, and support for specific demographic and socioeconomic groups to address post-pandemic loneliness for the sustainable management of the loneliness issue in Japan.

Identifying characteristics of adolescents with persistent loneliness during COVID‐19: A multi‐country eight‐wave longitudinal study

AbstractBackgroundElevated loneliness experiences characterise young people. While loneliness at this developmental juncture may emerge from age‐typical upheaval in social relationships, there is little data on the extent to which young people experience high and persistent levels of loneliness, and importantly, who is most vulnerable to these experiences. Using the widespread social restrictions associated with the COVID‐19 pandemic, which precipitated loneliness in many, we aimed to examine adolescents' loneliness profiles across time and the demographic predictors (age, sex, and country) of more severe trajectories.MethodsParticipants aged 12–18 years, recruited into a multi‐wave study (N = 1039) across three sites (UK, Israel, and India) completed a 3‐item loneliness measure fortnightly across 8 timepoints during the pandemic.ResultsLatent class growth analysis suggested 5 distinct trajectories: (1) low stable (33%), (2) low increasing (19%), (3) moderate decreasing (17%), (4) moderate stable (23%), and (5) high increasing (8%). Females and older adolescents were more likely to experience persistently high loneliness.ConclusionsThese findings indicate a need for interventions to reduce loneliness in adolescents as we emerge from the pandemic, particularly for those groups identified as being at highest risk.

Being cut off from social identity resources has shaped loneliness during the coronavirus pandemic: A longitudinal interview study with medically vulnerable older adults from the United Kingdom

AbstractLoneliness is a pernicious problem in older adulthood, associated with physical decline and isolation from valued social groups. However, the long‐term evolving experiences of ageing, identity and loneliness have yet to be elucidated. We use a Qualitative Longitudinal Research interview approach with nine vulnerable older adults (Agemean = 79.4 years), in which five participants were interviewed twice between 2019 and 2020, and four participants were interviewed at three‐time points from 2019 to 2021. This study aims to understand the unfolding experiences of ageing, social identity and loneliness during a prolonged period of social isolation during the Coronavirus pandemic. A theoretically guided thematic analysis highlights that participants initially experience ‘Categorisation as Vulnerable and Loss of Agency’ and ‘Shrinking Social Worlds’, leading to ‘Undermining of Reciprocal Support’ and ‘Fears of Persistent Loneliness’. Findings suggest that interventions to ameliorate loneliness among older adults would benefit from addressing age‐based stereotypes and emphasising the value of reciprocal contributions that older adults can make to their networks, as well as scaffolding and enhancing social identification with new groups. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Predictors of loneliness onset and maintenance in European older adults during the COVID-19 pandemic.

Loneliness is a major public health concern. Duration of loneliness is associated with severity of health outcomes, and further research is needed to direct interventions and social policy. This study aimed to identify predictors of the onset vs. the maintenance of loneliness in older adults before and during the pandemic using longitudinal data from the Survey of Health, Age, and Retirement in Europe (SHARE). Groupings of persistent, situational, and no loneliness were based on self-reports from an ordinary pre-pandemic SHARE wave and a peri-pandemic telephone interview. Predictors were identified and compared in three hierarchical binary regression analyses, with independent variables added in blocks of geographic region, demographics, pre-pandemic social network, pre-pandemic health, pandemic-related individual, and country level variables. Self-reported loneliness levels for the persistent, situational, and no loneliness groups were stable and distinct through 7 years preceding the pre-pandemic baseline measure. Shared predictors were chronic diseases, female sex, depression, and no cohabitant partner. Persistent loneliness was uniquely predicted by low network satisfaction (OR: 2.04), functional limitations (OR: 1.40), and a longer country-level isolation period for older adults (OR: 1.24). Interventions may target persons with depression, functional limitations, chronic health issues, and no cohabitant partner. The added burden of the length of isolation on those who are already lonely should be taken into account when employing social policies that target older adults. Further research should distinguish between situational and persistent loneliness, and seek to identify predictors of chronic loneliness onset.

Prevalence and associated factors of incident and persistent loneliness among middle-aged and older adults in Thailand

BackgroundThe aim of the study was to assess the prevalence and associated factors of incident and persistent loneliness in a prospective cohort study among middle-aged and older adults (≥ 45 years) in Thailand.MethodsLongitudinal data from the Health, Aging, and Retirement in Thailand (HART) study in 2015 and 2017 were analysed. Loneliness was assessed with one item from the Center for Epidemiological Studies Depression scale. Logistic regression was used to calculate predictors of incident and persistent loneliness.ResultsIn total, at baseline 21.7% had loneliness, 633 of 3696 participants without loneliness in 2015 had incident loneliness in 2017 (22.2%), and 239 of 790 adults had persistent loneliness (in both 2015 and 2017) (30.3%). In adjusted logistic regression analysis, low income (aOR: 1.27, 95% CI: 1.03 to 1.57), poor self-rated physical health status (aOR: 1.64, 95% CI: 1.27 to 2.12), hypertension (aOR: 1.34, 95% CI: 1.09 to 1.65), depressive symptoms (aOR: 1.97, 95% CI: 1.11 to 3.49), and having three or chronic conditions (aOR: 1.76, 95% CI: 1.19 to 2.60) were positively associated and a higher education (aOR: 0.74, 95% CI: 0.55 to 0.98) and living in the southern region of Thailand (aOR: 0.43, 95% CI: 0.30 to 0.61) were inversely associated with incident loneliness. Poor self-rated physical health status (aOR: 1.91, 95% CI: 1.26 to 2.88), and having three or more chronic diseases (aOR: 1.78, 95% CI: 1.07 to 2.98), were positively associated, and living in the southern region (aOR: 0.40, 95% CI: 0.25 to 0.65) was inversely associated with persistent loneliness.ConclusionMore than one in five ageing adults had incident loneliness in 2 years of follow-up. The prevalence of incident and/or persistent loneliness was higher in people with a lower socioeconomic status, residing in the central region, poor self-rated physical health status, depressive symptoms, hypertension, and a higher number of chronic diseases.

Loneliness, social isolation, depression and anxiety among the elderly in Shanghai: Findings from a longitudinal study

ObjectivesTo investigate the longitudinal associations between loneliness, social isolation, depression and anxiety in the elderly. MethodsA longitudinal cohort study was conducted among 634 older adults from three districts of Shanghai. Data were collected at baseline and 6-month follow-up. Loneliness and social isolation were measured using the De Jong Gierveld Loneliness Scale and the Lubben Social Network Scale respectively. Depressive and anxiety symptoms were assessed using the subscales of Depression Anxiety Stress Scales. Logistic regression and negative binomial regression models were used to examine the associations. ResultsWe found that moderate to severe loneliness at baseline predicted higher depression scores 6 months later (incidence rate ratio (IRR)=1.99, 95% confidence interval (CI) [1.12, 3.53], p=0.019), while higher depression scores at baseline predicted social isolation at follow-up (odds ratio (OR)=1.14, 95% CI [1.03, 1.27], p=0.012). We also observed that higher anxiety scores predicted lower risk of social isolation (OR=0.87, 95% CI [0.77, 0.98], p=0.021). Additionally, persistent loneliness at both timepoints was significantly associated with higher depression scores at follow-up, and persistent social isolation was associated with a greater likelihood of having moderate to severe loneliness and higher depression scores at follow-up. ConclusionsLoneliness was found to be a robust predictor of changes in depressive symptoms. Both persistent loneliness and social isolation were closely associated with depression. We should develop effective and feasible interventions for older adults who have depressive symptoms or who are at risk of long-term social relationship problems to avoid the vicious circle among depression, social isolation and loneliness.

Exploring blog narratives of parental loneliness: A thematic network analysis

UK-based national surveys and international longitudinal studies have shown that around a third of parents experience chronic or persistent loneliness. There is limited research about the experience of loneliness in parenthood, however blogs authored by parents, sharing their personal experiences about loneliness offer a potential rich data source. The purpose of this study was to identify and analyse blog narratives written by parents who had experienced loneliness to increase understanding of their experiences. One hundred and ninety-six relevant blog posts were identified, of which 157 had contact details to request permission to use the blog post in the study. Twenty-two parent bloggers gave their permission. Thematic network analysis was used to open code the blogs and 4 organising themes and subthemes emerged, which centred on a global theme of disconnection. Disconnection underpinned themes relating to a sense that being a parent was overwhelming, changes in identity linked to becoming a parent, difficulties in sharing feelings of loneliness with others, and a need for social connection. Findings point to parents being unprepared for the transition to parenthood, with implications for perinatal education and support, including further opportunities for parents to connect to reduce social isolation.

Eight-Year Trajectories of Late-Life Loneliness and Incident Dementia: A Nationally Representative Cohort Study

Some older adults with loneliness might have transient loneliness, followed by full remission, while others might have persistent loneliness. Such different courses might differ in predicting the risk of dementia, but most previous studies assessed short-term loneliness at a single time point, ignoring the long-term changes of loneliness. This study aimed to explore the association between 8-year trajectories of late-life loneliness and incident dementia. Data were from the English Longitudinal Study of Ageing (waves 2-9). This study included 6,722 older adults measured for loneliness greater than or equal to three times from wave 2 (2004-2005) to wave 6 (2012-2013) and free from dementia in wave 6. Loneliness was assessed using the short 1980 version of the University of California, Los Angeles Loneliness Scale. Group-based trajectory modeling was used to explore loneliness trajectories during waves 2-6. Cox proportional hazard models were used to investigate the association of loneliness trajectories with incident dementia during waves 6-9. Five distinct loneliness trajectories were identified: long-term low, persistently decreasing, persistently increasing, long-term moderate, and long-term high. Compared with long-term low loneliness, the HRs (95% confidence intervals) for persistently decreasing, persistently increasing, long-term moderate, and long-term high loneliness were 1.29 (0.83-2.00), 1.55 (1.04-2.31), 1.56 (1.03-2.38), and 3.35 (1.89-5.91), respectively. The elderly show distinct patterns of loneliness over time, which cannot be captured by a single assessment of loneliness. The elderly with long-term loneliness and persistently increasing loneliness might be the high-risk group for dementia. Further studies are needed to determine whether reducing loneliness can prevent dementia.

Lonelygenic environments: a call for research on multilevel determinants of loneliness

Loneliness is a felt deprivation of connection, companionship, and camaraderie. At least a quarter of adults are reported to experience persistent loneliness and the consequences can be highly detrimental to mental and physical health.1 Amid increasing evidence of the harms that loneliness can cause or aggravate, the UK Government appointed a Minister for Loneliness in 2018. Japan followed in 2021.

Different loneliness types, cognitive function, and brain structure in midlife: Findings from the Framingham Heart Study.

SummaryBackgroundIt remains unclear whether persistent loneliness is related to brain structures that are associated with cognitive decline and development of Alzheimer's disease (AD). This study aimed to investigate the relationships between different loneliness types, cognitive functioning, and regional brain volumes.MethodsLoneliness was measured longitudinally, using the item from the Center for Epidemiologic Studies Depression Scale in the Framingham Heart Study, Generation 3, with participants’ average age of 46·3 ± 8·6 years. Robust regression models tested the association between different loneliness types with longitudinal neuropsychological performance (n = 2,609) and regional magnetic resonance imaging brain data (n = 1,829) (2002-2019). Results were stratified for sex, depression, and Apolipoprotein E4 (ApoE4).FindingsPersistent loneliness, but not transient loneliness, was strongly associated with cognitive decline, especially memory and executive function. Persistent loneliness was negatively associated with temporal lobe volume (β = −0.18, 95%CI [−0.32, −0.04], P = 0·01). Among women, persistent loneliness was associated with smaller frontal lobe (β = −0.19, 95%CI [−0.38, −0.01], P = 0·04), temporal lobe (β = −0.20, 95%CI [−0.37, −0.03], P = 0·02), and hippocampus volumes (β = −0.23, 95%CI [−0.40, −0.06], P = 0·007), and larger lateral ventricle volume (β = 0.15, 95%CI [0.02, 0.28], P = 0·03). The higher cumulative loneliness scores across three exams, the smaller parietal, temporal, and hippocampus volumes and larger lateral ventricle were evident, especially in the presence of ApoE4.InterpretationPersistent loneliness in midlife was associated with atrophy in brain regions responsible for memory and executive dysfunction. Interventions to reduce the chronicity of loneliness may mitigate the risk of age-related cognitive decline and AD.FundingUS National Institute on Aging.

Persistent loneliness due to COVID-19 over 18 months of the pandemic: A prospective cohort study.

BackgroundLoneliness was common early in the COVID‐19 pandemic due to physical distancing measures, but little is known about how loneliness persisted into later stages of the pandemic. We therefore examined longitudinal trajectories of loneliness over 18 months of the pandemic and subgroups at risk for persistent loneliness.MethodsWe used data from the COVID‐19 & Chronic Conditions study collected between March 27, 2020 to December 10, 2021, including 641 predominantly older adults with ≥1 chronic condition who completed six interviews at approximately 3 month intervals. Participants reported loneliness (defined as some, most, or all of the time) during the past week due to COVID‐19. We used trajectory mixture models to identify clusters of individuals following similar trajectories of loneliness, then determined subgroups likely to be classified in different loneliness trajectories using multivariable regression models adjusted for sociodemographic and clinical covariates.ResultsParticipants were on average 63 years old, 61% female, 30% Black, 20% Latinx, and 29% were living below the poverty level. There was an overall reduction in loneliness over time (March to April/2020: 51% to September to December/2021: 31%, p = 0.01). Four distinct trajectory groups emerged: (1) “Persistent Loneliness” (n = 101, 16%); (2) “Adapted” (n = 141, 22%), individuals who were initially lonely, with feelings of loneliness decreasing over time; (3) “Occasional loneliness” (n = 189, 29%); and (4) “Never lonely” (n = 211, 33%). Subgroups at highest risk of the “Persistently Lonely” trajectory included those identifying as Latinx (aOR 2.5, 95% CI: 1.2, 5.2), or living in poverty (aOR 2.5; 95% CI: 1.4, 4.6).ConclusionsAlthough loneliness declined for a majority of older adults during the pandemic in our sample, persistent loneliness attributed to the COVID‐19 pandemic was common (1 in 6 adults), particularly among individuals identifying as Hispanic/Latinx or living in poverty. Interventions addressing loneliness can ease pandemic‐related suffering, and may mitigate long‐term mental and physical health consequences.

Loneliness, subjective health complaints, and medicine use among Finnish adolescents 2006–2018

Loneliness is an important public health challenge for all ages. This study reports time trends of loneliness among adolescents over a 12-year period and analyses the strength of the associations between loneliness, health complaints, and medicine use. Data were derived from the cross-sectional Finnish Health Behaviour in School-aged Children study conducted in 2006, 2010, 2014, and 2018. The study population is based on a random sample of schools with 20,444 participants aged 11-15 years. The trends were analysed with a Mantel-Haenszel test, and the strength of the associations was evaluated by mixed-effects logistic and linear regressions. An increasing prevalence in frequent loneliness (2006: 11%; 2018: 15%) was evident over the 12-year study period, especially in girls and 15-year-olds. Among all adolescents, loneliness was associated with a higher risk of recurrent health complaints and medicine use to treat the corresponding health issues, especially nervousness (odds ratio 5.8) and sleeping difficulties (odds ratio 7.6). Adolescence is a period of higher risk of frequent loneliness and associated health complaints. In this study, loneliness was common among adolescence and an increasing trend of loneliness was observed between 2006 and 2018. Also, psychosomatic health complaints and medicine use were strongly associated with loneliness. Persistent loneliness is a significant health risk and failure to resolve loneliness before entering adulthood may imply significant concerns for future well-being.

Impact of transient and chronic loneliness on progression and reversion of frailty in community-dwelling older adults: four-year follow-up

BackgroundFrailty is a common condition in older adults that is characterized by transitions between frailty states in both directions (progression and reversion) over time. Loneliness has been reported to be associated with the incidence of frailty, but few studies have explored the impact of persistent loneliness over time on frailty. In this study, we aimed to whether and how two different types of loneliness, transient and chronic, were associated with changes in frailty status in older adults.MethodsThe analytic sample contained 2961 adults aged ≥ 60 years who completed interviews for both the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. The logistic regression model was used to examine the relationship between transient and chronic loneliness and progression and reversion of frailty. Demographics (age, sex, education level, marital status, urban–rural residence), living alone, chronic conditions, physical function, and depressive symptoms from the 2011 wave were adjusted.ResultsAfter four years, 21% of the studied sample reported progression, 20% reported reversion in frailty, 31% reported transient loneliness, and 14% reported chronic loneliness. There was no significant difference in participants who reported transient loneliness (OR = 1.10, 95% CI [0.89,1.37]), or chronic loneliness (OR = 1.14, 95% CI [0.84,1.57]) on the progression of frailty, compared with no report of loneliness. Participants reporting chronic loneliness (OR = 0.68, 95% CI [0.50,0.93]) were less likely to report reversion in their level of frailty compared to participants who did not report loneliness but not transient loneliness (OR = 0.87, 95% CI [0.70,1.08]).ConclusionsRoughly the same percentage, a fifth, of older Chinese adults progressed or reversed in frailty status without active intervention. Chronic loneliness was related to a lower probability of reversion in the frail group than in the no loneliness group, but not in the transient loneliness group. More attention should be given to older adults with chronic loneliness.