Severe Loneliness Research Articles

Relationship of Loneliness and Social Isolation With Self-Care Ability Among Older Adults.

The current study aimed to assess the relationship of loneliness and social isolation with self-care ability (SCA) among older adults. Participants were 170 older adults randomly recruited from seven urban health care centers in Gonbad Kavus, Iran. Data were collected using a personal characteristics questionnaire, the UCLA Loneliness Scale, Lubben Social Network Scale, and Self-Care Ability Questionnaire for the Elderly. Findings showed that 72.9% of participants reported mild loneliness and 2.4% reported severe loneliness. Mean scores of participants' loneliness, social isolation, and SCA were 29.91 (SD = 11.22), 18.57 (SD = 4.97), and 146.39 (SD = 7.62), respectively. Mean SCA score had a significant inverse relationship with mean loneliness score (β = -0.368; p < 0.0001) and a significant direct relationship with mean social isolation score (β = 0.726; p < 0.0001). Current findings can be used to develop interventions for reducing loneliness and social isolation and improving SCA among older adults. [Journal of Psychosocial Nursing and Mental Health Services, 59(1), 15-20.].

Factors Associated With Loneliness During the COVID-19 Pandemic Among Older Adults With Chronic Conditions

Social distancing related to the COVID-19 pandemic may heighten loneliness among older adults, especially those with chronic conditions that increase risk for severe illness from the coronavirus. Little is known, however, about potential risk and protective factors linked to loneliness during the pandemic. In the present study, we examined factors associated with loneliness in a U.S. sample of adults aged 50 and older with at least one chronic condition. Participants included 701 adults aged 50 to 94 (M = 64.57 years, SD = 8.84) who were recruited over 8 consecutive weeks between May 14 and July 9, 2020 to complete an anonymous online survey. We estimated a series of multiple linear regressions to determine how sociodemographic characteristics, health characteristics, stress related to COVID-19, and social resources were independently associated with loneliness during the pandemic. Two-thirds of participants reported moderate to severe loneliness. The fully adjusted regression model showed that being a person of color, having a spouse or cohabiting partner, and reporting more emotional support were linked to lower levels of loneliness. Higher anxiety symptoms, more worry about being infected with COVID-19, and greater perceived financial strain because of COVID-19 were associated with higher levels of loneliness. These findings pinpoint potential targets for interventions to improve and maintain the well-being of a particularly vulnerable subgroup of older adults during the COVID-19 pandemic and in future public health crises.

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.

Cross-cultural comparisons of psychosocial distress in the USA, South Korea, France, and Hong Kong during the initial phase of COVID-19

The COVID-19 crisis has resulted in disruption of everyday life worldwide but the impact and response to the pandemic have not been uniform. Many countries rapidly deployed physical-distancing mandates to curb the spread of the virus; others did not. Social distancing strategies are necessary to reduce the transmission of the virus but there may be unintended consequences. We examined psychological distress in four societies with distinct public health strategies (South Korea, Hong Kong, France and the United States) to identify common and region-specific factors that may contribute to mental health outcome during the pandemic. From March to July of 2020, a survey of demographics, general health, mental health, loneliness and social networks was conducted. Overall, younger age, greater concern for COVID, and more severe loneliness predicted worse psychological outcome but the magnitudes of these effects varied across the four regions. Objective measures of social isolation did not affect mental health. There were also notable differences in psychological outcome; Hong Kong, with very strict social distancing protocols plus ongoing political unrest, suffered the most drastic deterioration of mental health. To prepare for an impending mental health crisis, concerted efforts to reduce loneliness should be integrated into a comprehensive public health strategy.

Prevalence of Loneliness and Depression among Elderly in South India

Introduction: ‘Old age’ considered as the least desirable phase of the life cycle and is characterized byfinancial, health, social and other problems. About 10% of the people over 65 years in community have signsof depression. The most common emotional disorder in the elderly population is depression, mostly causeddue to loneliness, which is often overlooked by health care professional and family members.Objectives: The objectives of the study were to assess the prevalence of loneliness and depression amongelderly and to associate the selected background variables with loneliness and depression.Methods: The research design adopted for this study was descriptive study design. The study was conductedamong 300 subjects to assess the prevalence of loneliness and depression among elderly.Findings: The study results revealed that majority of elderly 43.3% had experienced moderate loneliness,41.3% of elderly severe loneliness and 15.3% of elderly had mild loneliness. With regard to level ofdepression among elderly 52.0% had mild depression, 40.0% had severe depression and 8.0% of elderly hadno depression. A statistically significant association was identified between the loneliness among elderlywith regard to age, marital status, education, living status, economic dependency and between the depressionamong elderly with regard to age, education, living status and economic dependency at p&lt;0.001 level.Conclusion: This study brought into light that majority of the rural elderly population experienced mildloneliness and depression. Thus, active measures have to be initiated among family members and health careprofessionals to combat this dual problem of loneliness and depression among elderly population and aidthem to live a life with happiness and satisfaction.

Impact of the COVID-19 Pandemic on Patient-Reported Outcomes of Breast Cancer Patients and Survivors.

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic (officially declared on the March 11, 2020), and the resulting measures, are impacting daily life and medical management of breast cancer patients and survivors. We evaluated to what extent these changes have affected quality of life, physical, and psychosocial well-being of patients previously or currently being treated for breast cancer.MethodsThis study was conducted within a prospective, multicenter cohort of breast cancer patients and survivors (Utrecht cohort for Multiple BREast cancer intervention studies and Long-term evaLuAtion). Shortly after the implementation of COVID-19 measures, an extra survey was sent to 1595 participants, including the validated European Organization for Research and Treatment of Cancer (EORTC) core (C30) and breast cancer-specific (BR23) Quality of Life Questionnaire (EORTC QLQ-C30/BR23) and Hospital Anxiety and Depression Scale (HADS) questionnaire. Patient-reported outcomes (PROs) were compared with the most recent PROs collected within UMBRELLA pre–COVID-19. The impact of COVID-19 on PROs was assessed using mixed model analysis, adjusting for potential confounders.Results1051 patients and survivors (65.9%) completed the survey; 31.1% (n = 327) reported a higher threshold to contact their general practitioner amid the COVID-19 pandemic. A statistically significant deterioration in emotional functioning was observed (mean = 82.6 [SD = 18.7] to 77.9 [SD = 17.3]; P < .001), and 505 (48.0%, 95% confidence interval [CI] = 45.0% to 51.1%) patients and survivors reported moderate to severe loneliness. Small improvements were observed in quality of life and physical, social, and role functioning. In the subgroup of 51 patients under active treatment, social functioning strongly deteriorated (77.3 [95% CI = 69.4 to 85.2] to 61.3 [95% CI = 52.6 to 70.1]; P = .002).ConclusionDuring the COVID-19 pandemic, breast cancer patients and survivors were less likely to contact physicians and experienced a deterioration in their emotional functioning. Patients undergoing active treatment reported a substantial drop in social functioning. One in 2 reported loneliness that was moderate or severe. Online interventions supporting mental health and social interaction are needed during times of social distancing and lockdowns.

26 - The impact of the COVID-19 pandemic on quality of life, physical and psychosocial wellbeing in breast cancer patients – a prospective, multicenter cohort study

Background: The COVID-19 pandemic, and the resulting measures, are impacting daily life and medical management of patients with breast cancer. We evaluated to what extent these changes have affected quality of life, and physical and psychosocial wellbeing of patients (being) treated for breast cancer. Materials and methods: This study was conducted within the prospective Utrecht cohort for Multiple BREast cancer intervention studies and Long-term evaluation (UMBRELLA). Shortly after the implementation of COVID-19 measures, extra questionnaires were sent to 1595 cohort participants, including standard quality of life (EORTC) questionnaires. Patient-reported outcomes (PROs) were compared to the most recent PROs collected within UMBRELLA before COVID-19. The impact of COVID-19 on PROs was assessed using mixed model analysis, adjusting for confounders. Results: 1051 patients (66%) completed the questionnaires; 31% (n = 327) reported a higher threshold to contact their general practitioner amid the COVID-19 pandemic. A significant deterioration in emotional functioning was observed (82.6 to 77.9, p < 0.001), and 505 (48%, 95% CI 45–51) patients reported moderate to severe loneliness. Small improvements were observed in QoL, physical-, social- and role functioning scores. In the subgroup of 51 patients under active treatment, social functioning strongly deteriorated (69.8 to 5.0, p = 0.03). Conclusion: Due to COVID-19, patients (being) treated for breast cancer are less likely to contact physicians, and experience a deterioration in emotional functioning. Patients undergoing active treatment report a strong drop in social functioning. One in two patients reports (severe) loneliness. Online interventions supporting mental health and social interaction are needed during times of social distancing and lockdowns. No conflict of interest.

Social Distancing and Lockdown – An Introvert’s Paradise? An Empirical Investigation on the Association Between Introversion and the Psychological Impact of COVID19-Related Circumstantial Changes

The coronavirus disease 2019 (COVID19) pandemic has effected the implementation of social distancing and lockdown measures across the globe, and the psychological impact of associated life changes is experienced more severely by some individuals than others. Anecdotal evidence points to a common belief among the general public that introverts are faring better than their extraverted counterparts to this end. However, the claim lacks empirical research, and seems counterintuitive when the broader literature on the association between introversion and mental health is considered. The current study investigated whether the psychological impact of COVID19-related circumstantial changes was moderated by introversion, based on outcome measures across psychosocial, cognitive, and affective domains. The role of several demographic factors in determining COVID19-related mental health symptoms was also examined. One hundred and fourteen individuals (64 USA residents) completed measures of introversion, and reported on the extent to which they experienced loneliness, anxiety, depression and cognitive impairments as a function of COVID19-related circumstantial changes. Results showed that introversion predicted more severe loneliness, anxiety, and depression experienced as a function of COVID19-related circumstantial changes, but not cognitive impairments. Among the range of demographic factors examined (age, gender, living condition, recent unemployment), living with others (vs. living alone) predicted more severe COVID19-related mental health symptoms. However, these effects were only observed on outcome measures pertaining to anxiety and cognitive impairments, but not loneliness and depression. Current findings have implications for both consumers and disseminators of information on popular internet hubs. Current findings also highlight the possibility that living with others (close human affiliation) may have protective and detrimental effects on different domains of mental health during the COVID19 pandemic.

Relationships Between Coping Behaviors and Social Loneliness in Adults With Self-reported Hearing Problems.

To determine the association between various coping behaviors and social loneliness (self-reported deficits in social integration and embeddedness) in adults with self-reported hearing problems. It is hypothesized that adults who frequently use adequate coping behaviors experience less feelings of social loneliness than persons who use these behaviors less often. Cross-sectional data of 686 participants with hearing-impairment (24-75 years of age) of the online Netherlands Longitudinal Study on Hearing were analyzed. Six coping behaviors were measured using six subscales of the Communication Profile for the Hearing Impaired (maladaptive behavior, verbal strategies, nonverbal strategies, self-acceptance, acceptance of loss, and stress and withdrawal). The De Jong-Gierveld loneliness scale was used to measure social loneliness. Multiple logistic multinomial regression analyses were applied to determine associations between each of the coping behaviors and (1) moderate social loneliness (reference category: no loneliness) and (2) severe social loneliness (reference category: no loneliness). Potential subgroup effects and confounders were examined. Almost two-thirds of the sample reported feeling moderately or severely socially lonely. Significantly less feelings of social loneliness were experienced by participants who reported relatively high levels of self-acceptance or acceptance of loss, relatively infrequent use of maladaptive behavior, or relatively low levels of stress and withdrawal. Particularly those participants whose hearing loss dated back to ≤5 years, better coping with verbal strategies was associated with a lower likelihood of either moderate or severe social loneliness. More frequent use of nonverbal strategies was only associated with a lower likelihood of severe social loneliness for participants with paid work. To the best of our knowledge, this study is the first in which the relationship between a wide range of hearing coping behaviors and social loneliness was studied. The results show that more frequent use of adequate coping behaviors is significantly associated with less feelings of social loneliness. The findings underline the importance of recognizing and tackling inadequate coping behaviors so that social loneliness can be prevented or combated.

What is the prevalence of loneliness amongst older people living in residential and nursing care homes? A systematic review and meta-analysis.

the number of older people living in residential and nursing care homes is rising. Loneliness is a major problem for older people, but little is known about the prevalence of loneliness amongst older people living in care homes. to undertake a systematic review of literature on the prevalence of moderate and severe loneliness amongst older people living in residential and nursing care homes. we systematically reviewed the databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Embase, Scopus, Cochrane and Allied and Complementary Medicine Database (AMED) from inception to January 2019. We included all studies reporting data on the prevalence of loneliness amongst older people living in care homes. A random-effects meta-analysis was conducted on all eligible data. a total of 13 articles were included, representing 5,115 participants (age range of 55-102years, mean age 83.5years, 68% female). There was a significant variation between studies in estimates of prevalence. The prevalence of moderate loneliness ranged from 31 to 100%, and the prevalence of severe loneliness ranged from 9 to 81%. The estimated mean prevalence of 'moderate loneliness' was 61% (95% confidence interval (CI): 0.41, 0.80). The estimated mean prevalence of 'severe loneliness' was 35% (95% CI: 0.14, 0.60). the prevalence of both moderate loneliness and severe loneliness amongst care home residents is high enough to warrant concern. However, the significant variation in prevalence estimates warrants further research. Future studies should identify which interventions can address loneliness and promote meaningful social engagement to enhance quality of life in care homes.

Prevalence and determinants of loneliness in people living with dementia: Findings from the IDEAL programme

To establish the prevalence and determinants of loneliness among people living with dementia. Using data from the baseline wave of the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study, we examined the prevalence and predictors of loneliness in 1547 people with mild-to-moderate dementia. Loneliness was assessed using the six-item De Jong Gierveld loneliness scale. About 30.1% of people with dementia reported feeling moderately lonely and 5.2% severely lonely. Depressive symptoms and increased risk of social isolation were associated with both moderate and severe loneliness. Those living alone were more likely to experience severe loneliness as were those reporting poorer quality of life. Marital status was not associated with loneliness nor were dementia diagnosis or cognitive function. This is one of the few large-scale studies to explore the prevalence of and determinants of loneliness among people living with dementia. Social isolation, depression and living alone were associated with experiencing loneliness. Longitudinal studies are needed to determine the directionality of these associations.

The prevalence and predictors of loneliness in caregivers of people with dementia: findings from the IDEAL programme

Objectives To establish the prevalence of loneliness among family caregivers of people with dementia and to identify potential risk factors for loneliness. Methods Using data from the baseline wave of the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study, we examined loneliness in 1283 family caregivers of people with mild-to-moderate dementia living in Great Britain. Multinomial regression was used to examine the relative influence of a series of risk factors for caregiver loneliness. Results Almost half, 43.7%, of caregivers reported moderate loneliness and 17.7% reported severe loneliness. Greater social isolation and increased caregiving stress were linked with both moderate and severe loneliness. Better quality of relationship with the person with dementia along with increased levels of well-being and life satisfaction were associated with a lower relative risk of reporting both moderate and severe loneliness. Discussion This study examines the prevalence and predictors of loneliness in a large sample of family caregivers of people with dementia. Notably over two-thirds of caregivers in our sample reported feeling lonely. Interventions aimed at reducing caregiving stress and supporting meaningful relationships may go some way towards helping to reduce loneliness.

Intervention to reduce perceived loneliness in community-dwelling older people.

We evaluated the reduction in perceived loneliness and depression and the increase in social support and quality of life in community-dwelling lonely people aged >65years included in a community intervention compared with nonlonely controls from the same urban area. Randomised clinical trial without blind evaluation. Urban area of Barcelona. Community dwellers aged >65years with loneliness identified by the primary care team. The primary care team together with community agents (municipal social services, community civil and religious associations) carried out 18 sessions developing activities including educational workshops, mindfulness, yoga, walking and visits to urban gardens. We included 55 patients (87% female, mean age 80.6±6.86years) of whom 82% had moderate and 18% severe loneliness. Six months postintervention, 48.3% of the intervention group did not feel lonely compared with 26.9% of controls (p=0.001). Social support (DUKE-UNC-11) increased from 33.5±9.3 to 41.4±6.6, and mental health (SF-12) from 36±610.4 to 48±11.1 and depressive symptoms (Yesavage test) decreased from 9.2±3.6 to 5.2±5.0 in the intervention but not the control group. The intervention mainly reached people with moderate loneliness and significantly improved the perception of loneliness, depressive symptoms, social support and the mental health component of the quality of life. The intervention may be more suitable for people with moderate loneliness, but these types of activities may be difficult to accept by people with severe loneliness not related to the barriers to socialisation generated by ageing.

Loneliness among veterans in the Netherlands.

Loneliness among military veterans may have unique features because of deployment-related experiences. Consequently, loneliness is increasingly recognized as an issue that may affect the health of veterans, even years after military deployment. To examine the prevalence of loneliness in Dutch veterans and to assess the extent to which their loneliness is associated with deployment-related factors. We invited 6000 veterans who have left the Armed Forces to fill out a questionnaire. Hierarchical regression analysis was used to assess the association between loneliness and deployment-related factors in addition to demographic information, social support and needs of care. We received the responses of 2643 veterans (44%). Of them, 27% experienced at least some loneliness and 13% experienced severe loneliness. Social support, perceived comradeship during deployment and a perceived positive effect of one's deployment on life at present are negatively related to loneliness. Younger age, living alone (with or without children), unemployment or work disability, needs of care in general or deployment-related, perceived frustration related to the deployment and longing back to the time of the deployment were positively associated with loneliness. Feelings of loneliness are prevalent among Dutch veterans who have left the Armed Forces. Veterans' loneliness is associated with several deployment-related factors. To reduce veterans' loneliness, attention for deployment-related experiences and its consequences is recommended.

LONELINESS AND ASSOCIATED OUTCOMES IN A LARGE SURVEY OF OLDER ADULTS

Loneliness and social isolation are major risk factors for poor physical and mental health among older adults. Studies demonstrate that loneliness is associated with depression, impaired cognitive performance, increased chronic disease, and mortality. However, the impact on other psychosocial constructs and healthcare outcomes remain understudied. The purpose of this study was to estimate the prevalence of loneliness and examine associations with socio-demographic, medical, and psychosocial characteristics in a large national survey of older adults (N=4,525). Overall, 43% of participants reported either moderate or severe loneliness. Older age, female gender, income, depression, hearing difficulty, and poorer health were all associated with loneliness. Purpose of life, resilience, optimism, and a diverse social network were associated with low loneliness. On average, lonely participants had a higher rate of emergency department visits, inpatient admissions, and medical costs. Based on findings, interventions should aim to alleviate loneliness among older adults.

PREVALENCE OF LONELINESS AND ISOLATION AMONG PEOPLE WITH DEMENTIA AND THEIR CARERS

People with dementia and carers may be vulnerable to loneliness and isolation. The IDEAL study includes two loneliness measures: 6 item de Jong Gierveld (DJG) scale (range 0-6) and a single-item self-report measure and the six-item Lubben social network scale (range 0-30). Full data are available for 1533 people with dementia for self-rated loneliness and for 1455 for the DJG scale and 1232 and 1195 carers respectively. For isolation complete data are available for 1489 people with dementia and 1252 carers. The prevalence of severe loneliness for people with dementia were 10% (self-rated) and 5% (DJG score 5+), approximately the population norm, and 15% and 18% respectively for carers. Most people with dementia or carers did not rate themselves as lonely ((79% and 71%) compared with 65% and 39% using the DJG scale. One third, 35%, of people with dementia were at risk of isolation compared with 18% of carers.

Experiences of suffering among elderly hip-fracture patients during the preoperative period: patients' and nurse's perspective.

In Norway, 6000 patients were operated on due to hip fracture in 2016. Hip fracture results in increased suffering and often in a dramatic change in an older person's life. The experience of suffering in patients with hip fracture, or nursing staff's perception of it in the preoperative period, is sparsely studied. The perspective of the study was based on caring sciences. The aim of this study was to gain a deeper understanding of subjective experiences of suffering among elderly hip-fracture patients during the preoperative period, seen from the patients' and nurses' perspective. A Q-methodological approach was used. Forty statements (Q-sample), based on interviews and theory, were ranked in a forced-choice distribution curve from 'mostly agree' to 'mostly disagree', followed by postinterviews. Nine patients and five nurses participated. A by-person factor analysis in the form of principal component analysis with varimax and hand rotation was conducted. Three factors, also called viewpoints, emerged as follows: (i) 'Feeling safe through presence, trust and hope'; (ii) 'Feeling safe occurs when the patient is seen, met and informed'; and (iii) 'Feeling alone and angry at oneself'. A polarisation between participants occurred, since the youngest patients (median age 73), the oldest patients (median age 90) and the nurses were represented in each specific factor. There exist differences between how the nursing staff, the youngest and the oldest elderly patients experienced the preoperative period and what can enhance or alleviate their suffering. Where the youngest elderly communicated safety through trust and relatives' presence, the oldest elderly communicated insecurity in relation to staff and experienced severe pain and loneliness. Nursing staff and one patient emphasised the importance of seeing the patient in the first meeting to establish a feeling of security.

Understanding the psychological drivers of loneliness: the first step towards developing more effective psychosocial interventions

Purpose The purpose of this paper is to outline the need to develop a more balanced approach to addressing the loneliness experience by older people by recognising the psychological and emotional dynamics which cause it. It proposes a more holistic psychosocial approach to loneliness. Design/methodology/approach This paper draws on and reviews the published literature on the psychological aspects of loneliness. Findings Although not extensive, there is sufficient evidence to begin to develop and test more psychosocial approaches to addressing loneliness. Research limitations/implications The evidence base is not extensive and a fair degree of it has not been fully trialled with older people. Practical implications There is an a priori case for using the evidence that exists to develop and test out new psychosocial interventions for addressing loneliness. Social implications It is possible that a more psychosocial approach to loneliness will enable more to be done to address the significant distress of older people experience severe and chronic loneliness. It may also be possible to develop more effective preventative strategies which build resilience in older people. Originality/value The field of loneliness practice and research is overwhelmingly based on sociological analysis and social interventions. This paper is one of the first to explicitly highlight the value in drawing from psychological data in order to develop psychosocial approaches.

Loneliness and Illicit Opioid Use Among Methadone Maintenance Treatment Patients

Background: Loneliness has been linked to greater substance use, especially among women. Yet little is known about how loneliness is associated with treatment outcomes for patients with opioid use disorder (OUD). Objectives: We evaluated how patient reports of using illicit opioids (i.e. heroin or non-prescription pain medications) are linked to perceptions of loneliness in a sample of adults receiving methadone maintenance treatment (MMT), and whether this link varies by gender. Methods: Participants for this cross-sectional observational study included 371 MMT patients aged 18 and older drawn from four opioid treatment programs in Southern New England and the Pacific Northwest. Patients completed a self-administered survey assessing sociodemographic and health information, loneliness, illicit opioid use, and MMT characteristics. Logistic regressions were estimated to examine the link between patient odds of illicit opioid use in the past month and perceived loneliness. Results: Patient gender moderated the association between illicit opioid use and loneliness such that severe loneliness was associated with higher odds of using illicit opioids among women (OR = 3.00, 95% CI [1.19, 7.57], p=.020) but lower odds of using illicit opioids among men (OR = 0.35, 95% CI [0.14, 0.87], p=.024), accounting for age, marital status, work status, depressive symptoms, and MMT characteristics (treatment episode, treatment duration, and methadone dose). Conclusions/importance: This study underscores the importance of considering loneliness in the management of OUD. Routine clinical care and treatment may benefit from strategies to build and sustain social connections that support long-term recovery among MMT patients.

Trends across 20 years in multiple indicators of functioning among older adults in the Netherlands.

BackgroundMonitoring of trends in functioning of older adults provides indispensable information for health care policy. This study examined trends in multiple indicators of functioning among Dutch older adults across a period of 20 years.MethodsData from the Longitudinal Aging Study Amsterdam were used. We included 10 870 observations of 3803 respondents aged 64–84 years across seven waves (1992–12) and 931 observations of 603 respondents aged 85–94 years across four waves (2001–12). At each wave, 8 indicators of functioning were measured: multimorbidity, severe functional limitations, depression, anxiety, cognitive impairment, physical inactivity, loneliness and social isolation. In addition, a sum score (range: 0–8) of these indicators was calculated, with a score of ≥5 indicating ‘multiple problems.’ Trends in functioning over time were assessed using Generalized Estimating Equation analyses.ResultsIn the 64-84-years-olds, the prevalence of multimorbidity increased over time [OR(year) = 1.06, 95% CI = 1.05–1.06], whereas the prevalence of the other indicators decreased [i.e. cognitive impairment, physical inactivity (in women) and loneliness (in women)] or remained stable [i.e. severe functional limitations, depression, anxiety, physical inactivity (in men), loneliness (in men) and social isolation]. In the 85-94-year-olds, the prevalence of severe functional limitations increased over time [OR(year) = 1.08, 95% CI = 1.02–1.13], whereas the prevalence of the other indicators remained stable. In both age groups, the prevalence of ‘multiple problems’ remained stable.ConclusionUnfavorable trends were observed in multimorbidity among 64-84-years-olds and in severe functional limitations among 85-94-year-olds. Favorable trends were found in cognitive impairment, physical inactivity (in women) and loneliness (in women) among 64–84-years-olds.