Risk Factors For Loneliness Research Articles

An appropriate approach to loneliness: A translation of empirical data into practice

We describe three subgroups of older lonely people (Persona), and design different approaches to loneliness that directly address their specific needs and circumstances: the combination approach. The use of Persona is a middle ground between 'one approach appropriate for all' and 'each person's own approach'. A Persona is described using various risk factors for loneliness. These are advanced age, living alone, small network, low perceived control, and low income. Based on this, we explore the potential effect of improving some of these situations for reducing loneliness (Cohen's d ranges between -0.33 and -0.58). For two approaches we report what the realized effect was (d=-0.83 in both interventions). The three Persona and the approaches are examples that designers of a loneliness approach can use by analogy to elaborate and substantiate their approach.

Loneliness Among US Adults During the Early Phase of the COVID-19 Pandemic: Findings From the COVID-19 Coping Study

We aimed to estimate the prevalence of loneliness and identify the key sociodemographic, employment, living, and health-related risk factors for loneliness among middle-aged and older adults during the early COVID-19 pandemic in the US, when shelter-in-place and social distancing restrictions were in place for much of the country. Data were collected from online questionnaires in the COVID-19 Coping Study, a national study of 6,938 US adults aged 55-110 years, from April 2nd through May 31st, 2020. We estimated the population-weighted prevalence of loneliness (scores of ≥6/9 on the 3-item UCLA Loneliness Scale), overall and according to sociodemographic, employment, living, and health-related factors. We used population-weighted modified Poisson regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the associations between these factors and loneliness, adjusted for age, sex, race, ethnicity, and education. Overall, 29.5% (95% CI: 27.9%, 31.3%) of US adults aged 55-110 were considered high in loneliness in April and May, 2020. In population-weighted, adjusted models, loneliness was most frequent among those with depression, those who were divorced or separated, those who lived alone, those diagnosed with multiple comorbid conditions, and individuals who were unemployed prior to the pandemic. In conclusion, we identified subpopulations of middle-aged and older US adults that were highly affected by loneliness during a period when COVID-19 shelter-in-place orders were in place across most of the country. These insights may inform the allocation of recourses to mitigate loneliness during times of restricted activity.

Relationship between Social Determinants of Health and Loneliness during COVID-19 Pandemic

Background: Older adults are most vulnerable to social isolation and loneliness during the COVID-19 pandemic compared to other populations. Risk factors for loneliness include old age, rural living, number of medical comorbidities, and poor social networks. The objectives of this study were to examine the prevalence of loneliness in older adults during COVID-19 and determine the correlation between social determinants of health and loneliness. Methods: A cross-sectional study was conducted in community dwelling older Veterans (N=132). Demographic data were collected along with variables related to social determinants of health. Loneliness data were collected with the 3-item loneliness questionnaire, and social network was assessed using the 6-item Lubben social network scale. Results: Demographic data included: mean age 73.3 (±7.5) years, 93.2% male, 53.5% rural, 84.1% Caucasian, and 13.6% African American. The majority of the participants reported loneliness (65.6%). Mean Lubben social network score was 14.6 (±6.6). There was a strong negative correlation between loneliness and social network (p<0.0001, r=-0.57; 95% CI: -0.67, -0.44). The prevalence of loneliness was significantly greater in those living alone compared to those not living alone (p=0.017; 83.9% vs. 60.6%) and those lacking internet access compared to those with internet access (p=0.025; 86.4% vs. 61.5%). Conclusion: Loneliness was found to be highly prevalent in an older cohort during the COVID pandemic. Routine inquiry about loneliness is important. Social determinants of health are likely correlated with the presence of loneliness in older adults and could be greatly impacted by policy decisions made to control community disease transmission.

Risk factors for loneliness among older people in a Nordic regional context – a longitudinal study

AbstractThe aim of this study was to examine the prevalence of loneliness among older people and to identify risk factors for loneliness in a Nordic regional context over a six-year period. Longitudinal data from the Gerontological Regional Database (GERDA) study of 4,269 older adults living in northern Sweden and western Finland, aged 65, 70, 75 and 80 at baseline in 2010, were analysed. Logistic regressions were used to analyse socio-demographic, social and health-related risk factors at baseline and changes in these for experiences of loneliness at follow-up. The results showed that most older adults (85%) did not experience loneliness at baseline or at follow-up in our study region. However, 3 per cent of the sample reported loneliness in both study years, indicating enduring and chronic loneliness. Analyses revealed that being widowed and becoming a widow/er as well as poor self-rated health at baseline and the onset of depression were risk factors for loneliness. Finally, the risk of loneliness was higher in older people living in Sweden. Further work is needed to explore changes and stability in loneliness as well as to increase our understanding of between-country differences in loneliness.

Older people’s dialogue about loneliness and social support: a cross-cultural qualitative study conducted in Spain and South Africa (Diálogo entre las personas mayores sobre la soledad y el apoyo social: un estudio cualitativo transcultural en España y Sudáfrica)

ABSTRACT This study aimed to explore and gain insight from the dialogue and subjective perception of older people about loneliness and social support using a cross-cultural approach. A total of six focus groups with 43 community-dwelling older adults were conducted in two different cultural contexts: the Spanish and the South African. Data were analysed around two key topics — loneliness and social support — using methods of thematic analysis. Findings around the topic of loneliness showed that participants from both countries agreed that loneliness was a subjective feeling and a negative experience. Besides, solitude emerged in the focus groups discussions as a pleasant and desired experience. As for social support, the lack of it was seen as the most frequent risk factor for loneliness. Differences among both countries were found on the key sources of social support. Spanish participants identified the family as the major source of social support, while among South African participants the community was presented as a main source of social support. We concluded that considering these cultural aspects and social support perceptions when developing programmes and strategies aimed at alleviating loneliness may lead to an increase in the effectiveness of these kinds of interventions, and thus to more positive outcomes.

Secularism, family ties and loneliness: A multilevel longitudinal study of ten European societies

ObjectivesMass media suggest rising political and religious concern about secularism-induced decline of the family. Implications for loneliness remain unexamined. The current study filled this gap. MethodsData were from 10 national probability samples in the Survey of Health, Ageing and Retirement in Europe. Multilevel longitudinal models tested linkages of societal secularism with loneliness, their mediation by specific family relationships, and the role of this cultural dimension in weakening associations of family ties with loneliness. Both weighted Maximum Likelihood and unweighted Bayesian analyses were conducted, separately for each gender. ResultsSocietal secularism was not positively linked to either gender's loneliness. Associations with family ties were inconsistent, with only men's average partnered status lower in more secular settings. Nor did any positive indirect effects emerge. Moderation results were also inconsistent, with secularism only weakening linkages of some family dimensions with loneliness. Bayesian estimates were generally nonsignificant. DiscussionSocietal secularism may not be a risk factor for loneliness or for weak family ties. Results stand at odds with religious and political rhetoric on secularism-induced decline of the family, and its individual and societal consequences.

Social Isolation of Older Adults in Long Term Care as a Result of COVID-19 Mitigation Measures During the COVID-19 Pandemic

Social Isolation of Older Adults in Long Term Care as a Result of COVID-19 Mitigation Measures During the COVID-19 Pandemic

Older working adults in the HEAF study are more likely to report loneliness after two years of follow-up if they have negative perceptions of their work quality

BackgroundLoneliness is an important public health issue associated with mortality and morbidity. Often researched amongst older people, less is known about risk factors for loneliness among adults aged 50–64 years who are in work. We investigated (a) if exit from the workforce increases the odds of loneliness; (b) whether adverse psychosocial work factors are associated with increased odds of loneliness over 2 years of follow-up; and (c) whether the association is stronger among subjects still working compared with those who have exited the workforce.MethodsData came from the Health and Employment After Fifty (HEAF) study, a large population cohort who provided questionnaire information about work and health at baseline and 2 annual follow-ups. Logistic regression was used to explore the association between psychosocial risk factors and loneliness at follow-up 2, with adjustment for loneliness at baseline, sex, age, self-rated health, living alone, and mental health diagnosis.ResultsOf the initial 8134 participants, 4521 were working at baseline and provided data for this analysis. Of those, 507 (11.2%) were defined as lonely at 2 years’ follow-up. Exiting the workforce was not significantly associated with loneliness (OR = 1.1, 95%CI: 0.7–1.7). However, negative psychosocial work factors predicted loneliness at follow-up. After mutual adjustment, lack of choice at work (OR: 1.5, 95%CI: 1.1–1.9), often lying awake worrying about work (OR: 1.4, 95%CI: 1.0–1.9) and perceived not coping with physical demands of the job (OR: 1.3, 95%CI: 1.0–1.7) were independent predictors, with associations robust to adjustment for demographic factors and health. Associations were only slightly altered when we restricted the sample to those who remained in work until the end of follow-up.ConclusionsLoneliness amongst middle-aged working adults is not predicted by permanent work exit but is predicted by individuals’ perceptions about their work. Provision of good-quality work, matched to the capacity of the older worker, could prevent loneliness.

Covitality moderates the relationship between victimisation and loneliness

ABSTRACT Objective: Research suggests that low levels of school belonging and high levels of victimisation predict negative emotions, including loneliness. However, few studies have examined this relation among Chinese elementary school students. The protective role of covitality against victimisation and loneliness also remains unexplored. This study examines the relations between bullying victimisation, school belonging, covitality, and loneliness over 6 months, and whether covitality moderates the relations between victimisation and loneliness. Method: Eight hundred students from five elementary schools in China completed self‐report surveys at two time points (6 months apart). Results: Bullying victimisation, school belonging, and covitality predicted loneliness 6 months later. Students who experienced more bullying victimisation, lower levels of school belonging, and lower covitality reported more loneliness 6 months later. Covitality buffered the relation between verbal victimisation at Time 1 (T1) and loneliness at T1 but did not buffer the relation between victimisation T1 and loneliness at Time 2 (T2). Conclusions: Schools should prevent bullying, foster school belonging, and promote covitality (positive psychological traits) to reduce Chinese youths' feelings of loneliness. KEY POINTS What is already known about this topic: (1) Victimisation is a risk factor for loneliness for children in the United States. (2) School belonging is a protective factor for loneliness for children in United States. (3) Covitality is a protective factor for youth. What this topic adds: (1) Victimisation is a risk factor for loneliness for children in China. (2) School belonging and covitality are protective factors against loneliness for children in China. (3) Covitality moderates the relation between verbal victimisation and loneliness using cross‐sectional data only.

Adolescents’ and young adults’ experiences of loneliness and their thoughts about its alleviation

ABSTRACT Society has undergone rapid changes over the last decade affecting adolescents and their mental health as well as experiences of loneliness. The aim of this study is to examine loneliness from adolescents’ and young adults’ perspectives. Data was collected through semi-structured interviews with eleven (n = 11) Finnish adolescents and young adults aged 17–28 and analysed using qualitative content analysis. Two main themes and six subthemes were found. The main themes were: risk factors for loneliness and different ways of alleviating loneliness. Risk factors for involuntary loneliness were: social transitions, isolation, not having anyone to contact, group differences, social expectations, viewing other companionships, ill-being, negative emotions, former destructive experiences or a negative self-image. Preventive measures, effective coping strategies together with tertiary measures are depicted and discussed. Risk factors should be identified in order to be able to effectively and adequately address involuntary loneliness amongst adolescents and young adults.

The Effect of Cognitive Impairment on Loneliness in Older Adulthood: Evidence From HRS 2008-2018

Background: People experience loneliness when there is a mismatch between desired and actual social interaction. Demographic and health factors have been implicated in loneliness; less is known about the unique association of cognitive impairment on loneliness in older adulthood. Purpose: This study examined the link between cognitive impairment status and level and change in loneliness over a 9-year period and whether it is independent of physical health, depression, and social isolation. We examine the associations for overall and the emotional and social loneliness sub-domains of loneliness. Methods: Data were from the Health and Retirement Study 2008-2018 waves (N = 8,269, age 50+). Cognitive impairment status was categorized using mTICS. Loneliness was measured with 11-item UCLA Loneliness scale. Multilevel modeling was used to analyze the effects of cognitive status on loneliness, controlling for time-varying functional limitation, disease burden, social contact, and depression. Results: Cognitive impairment not dementia (CIND) was associated with higher loneliness (b = .04, p < .001). CIND (b = .03, p = .036) and dementia (b = .09, p = .017) were linked to higher emotional loneliness but were not independent of social isolation and depression. Those with CIND had higher social loneliness (b = .04, p = .016), even after adjusting for covariates. The trajectory of loneliness did not vary by cognitive status. Conclusions: Cognitive impairment is a risk factor for loneliness among older adults. Those with mild cognitive impairment experienced heightened loneliness, especially for social belongingness. Cognitive function should be considered in designing interventions for loneliness.

Loneliness and isolation among people with dementia and their carers: Prevalence, risk factors and a dyadic analysis

AbstractBackgroundPeople with dementia and their carers may be vulnerable to loneliness and isolation. We investigated: (a) prevalence of, and risk factors for, loneliness and isolation among people with dementia and their carers and (b) the interrelationship between loneliness and isolation for dyads (person with dementia and carer).MethodThe IDEAL cohort of people with dementia and their carers includes two loneliness measures: the 6 item de Jong Gierveld (DJG) scale (range 0‐6 and classified: not lonely (0‐2), moderately lonely (3‐4) and severely lonely (5+)) and a single‐item question, plus a measure of social isolation, the six‐item Lubben social network scale (range 0‐30: not isolated (13+) or isolated (12 or less). For dyads consisting of a carer and a person with dementia, 1089 had complete data on loneliness and 1204 on social isolation. We report prevalence and examine loneliness/isolation risk factors using regression analysis for people with dementia and carers separately. We use Actor‐Partner Interdependence Models (APIM) to examine the relationship between isolation and loneliness within dyads and vice‐versa.ResultPrevalence of severe loneliness for people with dementia was 10% (single item score) and 5% (DJG score 5+) (15% and 18% respectively for carers). One third of people with dementia, 35%, were at risk of isolation (18% of carers). Social isolation was the only risk factor for loneliness consistent for both carers and people with dementia. Risk factors for loneliness in carers were caregiving stress and relationship quality and in people with dementia living alone, depression and life satisfaction/quality of life. Loneliness ratings were congruent in 43.1% of dyads (67.8% for isolation). Dyadic analysis using APIM demonstrates that loneliness is affected by both individuals’ own isolation and that of their partners.There were also actor and partner effects for the association between loneliness and isolation.ConclusionMost people with dementia and their carers are neither lonely nor isolated. Risk factors for loneliness are different for carers and people with dementia. Isolation in the carers influences the loneliness of the person with dementia and vice versa.

Loneliness and its Associated Risk Factors Among in-School Adolescents in Tanzania: Cross-Sectional Analyses of the Global School-Based Health Survey Data

Though considered a normal part of adolescent development, loneliness is a mental state that can result in considerable psychological distress. We examined the prevalence and risk factors for loneliness among in-school adolescents in Tanzania. This was a descriptive cross-sectional study of 2,449 in-school adolescents from Tanzania using data from the 2017 Global School-Based Health Survey. Frequencies, percentages, Chi-square, and binary logistic regression were used in analysing the data. The prevalence of loneliness was 17.4%. Adolescents in forms 1 and 2 were more likely to be lonely than those in grade 6–7. Adolescents who experienced hunger and anxiety, used tobacco, were truant, and engaged in a physical fight had higher risks of being lonely. The prevalence of loneliness among in-school adolescents in Tanzania is quite high. As a mental state, the drastic long-term effects of loneliness on its victims make it imperative for stakeholders in Tanzania’s health industry to plan and implement pragmatic innovative social support programmes and counselling support units in schools. This can ensure the attainment of the Sustainable Development Goal 3.4 target of improving mental health by the year 2030.

Prevalence of and risk factors for loneliness in rural older adults.

The study investigated the prevalence of and risk factors (socio-economic, health and kinship ties) for loneliness in older adults in rural India. Data were collected from a random sample of 897 older adults in rural India. Loneliness was measured through a 3-item scale, and measures of kinship ties and health status were included. A hierarchical regression analysis was conducted. The prevalence rate of loneliness was 48%. The kinship factors contributed more to loneliness than the socio-demographic and health variables. The subjective aspects of kinship ties (relationship strain, support, family cohesion) explained more variance in loneliness than the structural aspects (living arrangements, family size). Within the functional component of kinship ties, relationship strain contributed more to loneliness. Strategies to combat loneliness should include multidynamic interventions on strengthening family ties and promoting optimal health during old age.

Does Loneliness Thrive in Relational Freedom or Restriction? The Culture-Loneliness Framework

Loneliness is a common experience with major negative consequences for well-being. Although much research has examined protective and risk factors for loneliness, we know little about its cultural underpinnings. The few studies that exist seem paradoxical, suggesting that loneliness is higher in cultures where tighter and more demanding (i.e., more restrictive) cultural norms about social relationships decrease the risk of social isolation. At the same time, loneliness is lower among individuals who hold more restrictive norms or perceive such norms among others around them. We move beyond previous research by generating the culture-loneliness framework, suggesting that loneliness occurs across all levels of restrictiveness, but through different predominant types of isolation. More restrictive (i.e., more, tighter, or more demanding) norms about social relationships may better protect from physical isolation (i.e., a lack of social interaction or relationships) but increase the likelihood of emotional and perceived isolation (i.e., a lack of individually satisfying relationships or relationships that do not fulfill cultural ideals). We evaluate this framework by reviewing research at both the individual and the cultural levels, and discuss its theoretical and practical implications.

Loneliness in the UK during the COVID-19 pandemic: Cross-sectional results from the COVID-19 Psychological Wellbeing Study.

ObjectivesLoneliness is a significant public health issue. The COVID-19 pandemic has resulted in lockdown measures limiting social contact. The UK public are worried about the impact of these measures on mental health outcomes. Understanding the prevalence and predictors of loneliness at this time is a priority issue for research.MethodThe study employed a cross-sectional online survey design. Baseline data collected between March 23rd and April 24th 2020 from UK adults in the COVID-19 Psychological Wellbeing Study were analysed (N = 1964, 18–87 years, M = 37.11, SD = 12.86, 70% female). Logistic regression analysis examined the influence of sociodemographic, social, health and COVID-19 specific factors on loneliness.ResultsThe prevalence of loneliness was 27% (530/1964). Risk factors for loneliness were younger age group (OR: 4.67–5.31), being separated or divorced (OR: 2.29), scores meeting clinical criteria for depression (OR: 1.74), greater emotion regulation difficulties (OR: 1.04), and poor quality sleep due to the COVID-19 crisis (OR: 1.30). Higher levels of social support (OR: 0.92), being married/co-habiting (OR: 0.35) and living with a greater number of adults (OR: 0.87) were protective factors.ConclusionsRates of loneliness during the initial phase of lockdown were high. Risk factors were not specific to the COVID-19 crisis. Findings suggest that supportive interventions to reduce loneliness should prioritise younger people and those with mental health symptoms. Improving emotion regulation and sleep quality, and increasing social support may be optimal initial targets to reduce the impact of COVID-19 regulations on mental health outcomes.

Factors Associated With Loneliness: An Umbrella Review Of Observational Studies

BackgroundEvidence provides inconsistent findings on risk factors and health outcomes associated with loneliness. The aim of this work was to grade the evidence on risk factors and health outcomes associated with loneliness, using an umbrella review approach. MethodsFor each meta-analytic association, random-effects summary effect size, 95% confidence intervals (CIs), heterogeneity, evidence for small-study effect, excess significance bias and 95% prediction intervals were calculated, and used to grade significant evidence (p<0.05) from convincing to weak. For narrative systematic reviews, findings were reported descriptively. ResultsFrom 210 studies initially evaluated, 14 publications were included, reporting on 18 outcomes, 795 studies, and 746,706 participants. Highly suggestive evidence (class II) supported the association between loneliness and incident dementia (relative risk, RR=1.26; 95%CI: 1.14-1.40, I2 23.6%), prevalent paranoia (odds ratio, OR=3.36; 95%CI: 2.51-4.49, I2 92.8%) and prevalent psychotic symptoms (OR=2.33; 95%CI: 1.68-3.22, I2 56.5%). Pooled data supported the longitudinal association between loneliness and suicide attempts and depressive symptoms. In narrative systematic reviews, factors cross-sectionally associated with loneliness were age (in a U-shape way), female sex, quality of social contacts, low competence, socio-economic status and medical chronic conditions. LimitationsLow quality of the studies included; mainly cross-sectional evidence. ConclusionsThis work is the first meta-evidence synthesis showing that highly suggestive and significant evidence supports the association between loneliness and adverse mental and physical health outcomes. More cohort studies are needed to disentangle the direction of the association between risk factors for loneliness and its related health outcomes.

The Influence of Efficacy Beliefs on Interpersonal Loneliness Among Front-Line Healthcare Workers During the 2019 Novel Coronavirus Outbreak in China: A Cross-Sectional Study

Objectives: The purpose of this study was to determine the relationship of health beliefs interpersonal loneliness among front-line healthcare workers working in 2019 novel coronavirus epidemic areas. Methods: We conducted a cross-sectional study of 205 clinical medical staff from epidemic areas to examine the associations of self-efficacy with interpersonal loneliness in Hubei. We use the Internet survey platform questionnaire Star to make an online system to collect the basic socio-demographic characteristics of the participants, loneliness score, self-efficacy score, and locus of control. The linear regression model was used to examine the relationship between self-efficacy score and loneliness score, adjusted for sex and education. Results: Self-efficacy score was a positive correlation with loneliness score in the in both the unadjusted (β=0.30, 95%CI=0.12 to 0.48, p<0.001)and adjusted(β=0.30, 95%CI=0.12 to 0.48, p<0.001) analyses. Because of reverse scoring for self-efficacy, lower self-efficacy was associated with high levels of loneliness. Stratified analyses stratified by social demography characteristics showed that the no associations between self-efficacy score and loneliness score remained significant in over 35 years old or doctors. Conclusions: Low level of self-efficacy is a risk factor for loneliness in medical staff. The group of medical staff with low self-efficacy should attract our attention, and some strategies should be formulated to alleviate loneliness through improving self-efficacy.

SUBJECTIVE HEARING IMPAIRMENT AND LONELINESS IN COMMUNITY-DWELLING OLDER ADULTS

Loneliness in older adults is most often attributed to marital and living status, social life factors, and physical health. Hearing impairment, however, is an understudied, potentially modifiable risk factor for loneliness. Older adults with hearing impairment experience difficulties with communication and social functioning, which also could contribute to loneliness. For this analysis, we used data from Wave 2 of the National Social Life, Health, and Aging Project. Participants (N=3,174) were a nationally representative sample of community dwelling older adults aged 62 - 91 years. Poisson regression models with robust variance were used to model the cross-sectional relationship between self-reported hearing impairment and loneliness. We found a dose-response relationship such that individuals reporting very good/good and fair/poor hearing had a 9% [95% CI: 0.93 - 1.28] and 26% [95% CI: 1.10-1.46], respectively, higher prevalence of loneliness compared to individuals reporting excellent hearing, adjusting for chronic conditions, functional and cognitive ability, and demographic factors. Results were robust to exclusion of participants who reported hearing aid use. These findings suggest that self-reported hearing impairment is a strong factor associated with loneliness in older adults. Given the negative implications of loneliness on multiple facets of mental and physical health, functional ability, and premature mortality, efforts to further explore hearing impairment as a causal and modifiable risk factor for loneliness should be undertaken.

Pain as a Risk Factor for Loneliness Among Older Adults.

The objective of this is to examine whether pain is associated with the onset of loneliness in a sample of community-dwelling older adults. We used data from the 2008 and 2012 Health and Retirement Study. We limited the sample to community-dwelling persons aged 60 years and over who were not lonely in 2008 in order to predict the risk of onset of loneliness (incidence) in 2012. Our analytic sample included 1,563 observations. Approximately 31.7% of participants reported loneliness at follow-up (2012). Logistic regression models showed that the odds of loneliness onset was 1.58 higher for those with pain at both time points, compared with those who had pain at neither time point, even after controlling for other covariates. The results indicate that pain may increase the risk of loneliness in older adults. This suggests that appropriate pain interventions could prevent future loneliness, which in turn could prevent functional decline, disability, and premature mortality.