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Loneliness is considered a major issue, often negatively influencing the quality of life of individuals of all ages, and of older adults, in particular. The aims of this study are: (1) to assess the association between close social relationships and loneliness; and (2) to examine the moderating role of subjective age in this association. Married or cohabiting community-dwelling Israelis in the second half of life (N = 360) were interviewed and reported on their close social relationships, their level of loneliness, and their subjective age. The number of close social relationships was found to have a negative relationship with loneliness. Moreover, subjective age was found to moderate the relationship between close social relationships and loneliness, such that the association was weaker for those with older subjective age. Those with older subjective age are often not able to benefit from close social relationships to alleviate loneliness as much as their younger-subjective-age counterparts. Efforts to address older adults’ loneliness should consider focusing on older adults’ perceptions of aging.
Both morbidity and mortality are elevated for individuals with subsyndromal depression (SSD) compared to non-depression (ND) in those of younger ages, but scientific studies are scarce for very old individuals. The aim of this study was therefore to compare the morbidity and mortality in very old individuals with SSD and ND.
Design and setting:
An 8-year prospective population-based study was undertaken on 85-year-old individuals in Sweden.
Data were collected from postal questionnaires and clinical assessments at baseline, after 1, 5, and 8 years. Depressive symptoms were measured with Geriatric Depression Scale and the results were classified into ND, SSD, and syndromal depression. Mortality was investigated using multivariable cox regressions, and variables of morbidity were investigated using linear mixed models.
Compared to ND, in people with SSD, mortality was elevated in the univariate regression, but this association vanished when controlling for relevant covariates. Morbidity was elevated with regard to basic activities of daily living (ADLs), instrumental ADLs, loneliness, self-perceived health, and depressive symptoms for individuals with SSD compared to ND, whereas cognitive speed, executive functions, and global cognitive function were not significantly impaired when adjusting for covariates.
SSD among very old individuals is longitudinally associated with elevated morbidity but not mortality, when controlling for relevant covariates. Considering the high prevalence of SSD and the demographic development of increasing numbers of very old people, the findings highlight the need to develop clinical and societal strategies to prevent SSD and associated negative outcomes.
The purpose of the study is to explore feelings of loneliness among residents in assisted living facilities in terms of how loneliness is experienced and articulated, and what specific factors are related to the experiences. The study used a mixed-method approach. We individually interviewed 13 residents twice over six months. We conducted two focus group interviews and noted our observations each time we met the respondents. Data analysis leaned on abductive reasoning. The respondents described loneliness in versatile, rich ways. It proved to be time and place dependent. It was dependent on the time of day, days of the week and seasons. Lonely time was meaningless and filled with a feeling of waiting. Loneliness was also intertwined with place. None of the respondents called their apartment home; instead they called it a hospital, even a prison. They had to spend long periods of time in their apartments against their will, and their desire to interact with other residents was not met. The respondents felt invisible. Residents’ experiences of loneliness in assisted living facilities are unique and distinctive. Time- and place-dependent experiences of loneliness act as important signals for reflection on how care practices in these facilities could be more satisfying. Loneliness should therefore be a key topic and the target of prevention and interventions.
Perceived loneliness, an increasingly prevalent social issue, is closely associated with major depressive disorder (MDD). However, the neural mechanisms previously implicated in key cognitive and affective processes in loneliness and MDD still remain unclear. Such understanding is critical for delineating the psychobiological basis of the relationship between loneliness and MDD.
We isolated the unique and interactive cognitive and neural substrates of loneliness and MDD among 27 MDD patients (mean age = 51.85 years, 20 females), and 25 matched healthy controls (HCs; mean age = 48.72 years, 19 females). We assessed participants' behavioral performance and neural regional and network functions on a Stroop color-word task, and their resting-state neural connectivity.
Behaviorally, we found greater incongruence-related accuracy cost in MDD patients, but reduced incongruence effect on reaction time in lonelier individuals. When performing the Stroop task, loneliness positively predicted prefrontal-anterior cingulate-parietal connectivity across all participants, whereas MDD patients showed a decrease in connectivity compared to controls. Furthermore, loneliness negatively predicted parietal and cerebellar activities in MDD patients, but positively predicted the same activities in HCs. During resting state, MDD patients showed reduced parietal-anterior cingulate connectivity, which again positively correlated with loneliness in this group.
We speculate the distinct neurocognitive profile of loneliness might indicate increase in both bottom-up attention and top-down executive control functions. However, the upregulated cognitive control processes in lonely individuals may eventually become exhausted, which may in turn predispose to MDD onset.
Loneliness has become an issue of significant academic, public and policy focus. There has been much research on experiences of loneliness in later life and many accompanying interventions targeting lonely older people. However, there has been a dearth of research on the impact that loneliness can have on older men and the resulting implications for policy and practice. This paper aims to redress this by developing a theoretical framework to improve understanding of older men's constructions and experiences of loneliness. It draws on two qualitative empirical studies: the first explores older men's perceptions of masculinity and loneliness; and the second looks at the effectiveness of a service for older men which was designed to alleviate loneliness among older people more generally. The paper outlines the way in which older men often construct masculinity as an oppressive (hegemonic) requirement, but which can be reformed into ‘positive’ traits of ‘strength of mind’, ‘responsibility’, ‘caring’, ‘helping out’, ‘doing a favour’ and ‘giving something back’, with a consistent yet implicit assumption that enactment of these denotes a ‘proud’ masculine identity. Loneliness, on the other hand, is represented as a subordinate social role, both non-masculine and related to marginalising stereotypes of age. This results in the identification of two important implications for the way in which services can assist in the alleviation of loneliness in older men: that men are more likely to engage with a service that can facilitate the construction of a ‘proud’ masculine identity; and that services which deconstruct hegemonic masculinities, particularly by providing a space where men feel comfortable being emotionally tactile, are likely to be most effective at both alleviating loneliness and promoting overall wellbeing.
Providing care to a loved one with cancer places demands on caregivers that result in changes to their daily routines and disruptions to their social relationships that then contribute to loneliness. Though caregivers’ psychosocial challenges have been well studied, loneliness — a determinant of health — has not been well studied in this population. This narrative review sought to describe the current evidence on loneliness among caregivers of cancer patients. We aimed to (1) define loneliness, (2) describe its prevalence, (3) describe the association between loneliness and health outcomes, (4) describe risks and consequences of loneliness among cancer caregivers, (5) identify ways to assess loneliness, and (6) recommend strategies to mitigate loneliness in this unique population.
We used evidence from articles listed in PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, book chapters, and reports. Articles were reviewed for the following inclusion criteria: (1) published in English, (2) caregivers of cancer patients, (3) loneliness as a study variable, and (4) peer-reviewed with no restriction on the timeframe of publication. Caregivers were defined as relatives, friends, or partners who provide most of the care and support for someone with cancer.
Eighteen studies met inclusion criteria and were included in the analysis. Caregivers’ experiences of loneliness can contribute to negative effects on one's social, emotional, and physical well-being. Social support interventions may not be sufficient to address this problem. Existing recommendations to mitigate loneliness include cognitive and psychological reframing, one-on-one and group therapy, befriending, resilience training, and technology-based interventions.
Significance of results
Limited attention to loneliness in cancer caregivers poses a twofold problem that impacts patient and caregiver outcomes. Interventions are critically needed to address loneliness as a determinant of health in caregivers, given their pivotal role in providing care and impacting health outcomes for people with cancer.
The USA and UK governmental and academic agencies suggest that up to 35% of dementia cases are preventable. We canvassed dementia risk and protective factor awareness among New Zealand older adults to inform the design of a larger survey.
The modified Lifestyle for Brain Health scale quantifying dementia risk was introduced to a sample of 304 eligible self-selected participants.
Two hundred and sixteen older adults (≥50 years), with mean ± standard deviation age 65.5 ± 11.4 years (50–93 years), completed the survey (71% response rate). Respondents were mostly women (n = 172, 80%), European (n = 207, 96%), and well educated (n = 100, 46%, with a tertiary qualification; including n = 17, 8%, with a postgraduate qualification). Around half of the participants felt that they were at a future risk of living with dementia (n = 101, 47%), and the majority felt that this would change their lives significantly (n = 205, 95%), that lifestyle changes would reduce their risk (n = 197, 91%), and that they could make the necessary changes (n = 189, 88%) and wished to start changes soon (n = 160, 74%). Only 4 of 14 modifiable risk or protective factors for dementia were adequately identified by the participants: physical exercise (81%), depression (76%), brain exercises (75%), and social isolation (83%). Social isolation was the commonly cited risk factor for dementia, while physical exercise was the commonly cited protective factor. Three clusters of brain health literacy were identified: psychosocial, medical, and modifiable.
The older adults in our study are not adequately knowledgeable about dementia risk and protective factors. However, they report optimism about modifying risks through lifestyle interventions.
Long-stay home care clients mostly reside in private homes or retirement homes, and the type of residence may influence risk factors for long-term care placement. This multi-state analytic study uses RAI-Home Care and administrative data from the Hamilton Niagara Haldimand Brant Local Health Integration Network to model conceptualized states of risk at baseline through a 13-month follow-up period. Modifiable risk factors in these states were client loneliness or depressive symptoms, and caregiver distress. A higher adjusted likelihood of being discharged deceased was found for the lowest-risk clients in retirement homes. Adjusting for client, service, and caregiver characteristics, retirement home residency was associated with higher likelihood of placement in a long-term care home; reduced caregiver distress; and increased client loneliness/depression. As an alternative to private home settings as the location for aging in place among these long-stay home care clients, retirement home residency represents some trade-offs between client and informal caregiver.
There are many definitions of social isolation which draw on structural indicators (e.g. living alone), functional indicators (e.g. social support) or both. This makes comparing prevalence rates across studies difficult and provides little guidance for practitioners and service providers to identify and target socially isolated clients. The purpose of the present study was to compare, within one large population-based data-set of Canadians aged 45–85, single-item and composite indicators of social isolation, by total sample and by socio-demographics (age, sex) and health. Data were from the Canadian Longitudinal Study on Aging (CLSA) which assessed features of social network, social support and social participation. Two composite scales were created to compare prevalence rates based on structural only or both structural and functional indicators. Results indicated overall low prevalence rates of social isolation, regardless of the measure used. A composite scale using only structural features identified 5.8 per cent socially isolated adults aged 45–85. This compared with a structural and functional scale that identified 9.8 per cent socially isolated adults. The composite measures showed less variation across socio-demographics than single-item measures. Results shed light on different ways in which social isolation can be defined and how single-item and composite definitions impact our understanding of identifying socially isolated adults in a given population. Results add to discussion of measures that can be used by researchers, services providers and practitioners.
This project was a secondary hermeneutic analysis of text expressing loneliness or social isolation, gathered in an original study exploring how Chinese, Indian and Korean late-life immigrants participated in New Zealand society. It utilised the 24 interview recordings, initially transcribed in participants’ first languages from nine focus group and 15 individual interviews, and translated into English for analysis. Hermeneutic methods were used to extract and analyse quotes indicative of loneliness or social isolation. The data cohered into three notions: being unsettled, feeling sidelined and being oriented towards social connectedness. Being unsettled names the experiences of disconcerting loneliness or social isolation when previously familiar things, people and places were not there in the host society context. Feeling sidelined names the feelings of being put aside by others or feeling opaque with local communities. Being oriented towards social connectedness expresses these late-life immigrants’ longing to communicate with and to join with others in the community through culturally familiar engagements. A mood of loneliness coloured these late-life immigrants’ resettlement experiences in New Zealand. Yet they turned away from loneliness and sought out encounters with other older immigrants within co-ethnic communities.
Although community services support ageing-in-place, older adults often report feelings of loneliness and social isolation. Unmet emotional needs are associated with poorer health, reduced functional abilities and increased mortality in this population. Pet ownership is an avenue worth exploring to reduce these adverse outcomes. This scoping review maps main findings and identifies key gaps with respect to the pros and cons of pet ownership in community-dwelling older adults pertaining to psycho-social, physical and functional outcomes. Scientific and grey literature published from January 2000 to July 2018 was searched. Data selection and extraction were performed by the first author and a sub-sample was co-validated by two co-authors. A total of 62 sources were included for descriptive and thematic analysis. A variety of pros (increased physical activity, wellbeing) and cons (grief, risk of falls) pertaining to psycho-social and physical outcomes were identified. Not many functional outcomes (support for daily routines) were mentioned, and few studies explored the simultaneous balance between the pros and cons of pet care. Further research exploring both clinicians’ and older pet owners’ perspectives is needed to deepen our understanding of the importance of considering companion animals in older adults’ daily lives and to strike a balance between perceived risks and benefits.
Loneliness and social isolation have negative health consequences and are associated with depression. Personality characteristics are important when studying persons at risk for loneliness and social isolation. The objective of this study was to clarify the association between personality factors, loneliness and social network, taking into account diagnosis of depression, partner status and gender.
Cross-sectional data of an ongoing prospective cohort study, the Netherlands Study of Depression in Older Persons (NESDO), were used.
Setting and participants:
474 participants were recruited from mental health care institutions and general practitioners in five different regions in the Netherlands.
NEO-Five Factor Inventory (NEO-FFI) personality factors and loneliness and social network were measured as well as possible confounders. Multinominal logistic regression analyses were performed to analyse the associations between NEO-FFI factors and loneliness and social network. Interaction terms were investigated for depression, partner status and gender.
Higher neuroticism and lower extraversion in women and lower agreeableness in both men and women were associated with loneliness but not with social network size irrespective of the presence of depression. In the non-depressed group only, lower openness was associated with loneliness. Interaction terms with partner status were not significant.
Personality factors are associated with loneliness especially in women. In men lower agreeableness contributes to higher loneliness. In non-depressed men and women, lower openness is associated with loneliness. Personality factors are not associated with social network size.
In this study, we examined coping strategies as a mediator of the association between loneliness and depressive symptoms. A sample of 364 Spanish young adults (75.5% females) completed measures of loneliness, coping, and depressive symptoms. In general, results from computing correlations (controlling for gender) indicated that loneliness was negatively associated with the use of one engaged coping strategy (viz., problem solving) and positively associated with the use of disengaged coping strategies (e.g., problem avoidance). A multiple mediation analysis (controlling for gender) was conducted to test for mediation. Results of this analysis indicated that part of the association between loneliness and depressive symptoms can be explained by the use of one engaged coping strategy (viz., problem solving; indirect effect, p < .05) and a variety of disengaged coping strategies (viz., problem avoidance, wishful thinking, social withdrawal, & self criticism; indirect effects, p < .05). Overall, the prediction model including loneliness and coping strategies was found to account for a large (f2 = .68) 40.5% of the variance in depressive symptoms in Spanish young adults. The present findings are the first to clarify how the association between loneliness and depressive symptoms in Spanish young adults might be due in part to the use of different coping strategies. Some implications for theory and practice are discussed.
Loneliness and social networks have been extensively studied in relation to cognitive impairments, but how they interact with each other in relation to cognition is still unclear. This study aimed at exploring the interaction of loneliness and various types of social networks in relation to cognition in older adults.
a cross-sectional study.
497 older adults with normal global cognition were interviewed.
Loneliness was assessed with Chinese 6-item De Jong Gierverg’s Loneliness Scale. Confiding network was defined as people who could share inner feelings with, whereas non-confiding network was computed by subtracting the confiding network from the total network size. Cognitive performance was expressed as a global composite z-score of Cantonese version of mini mental state examination (CMMSE), Categorical verbal fluency test (CVFT) and delayed recall. Linear regression was used to test the main effects of loneliness and the size of various networks, and their interaction on cognitive performance with the adjustment of sociodemographic, physical and psychological confounders.
Significant interaction was found between loneliness and non-confiding network on cognitive performance (B = .002, β = .092, t = 2.099, p = .036). Further analysis showed a significant interaction between loneliness and the number of family members in non-confiding network on cognition (B = .021, β = .119, t = 2.775, p = .006).
Results suggested that a non-confiding relationship with family members might put lonely older adults at risk of cognitive impairment. Our study might have implications on designing psychosocial intervention for those who are vulnerable to loneliness as an early prevention of neurocognitive impairments.
In the Swedish news-press, loneliness among older people is presented as a severe problem that needs to be solved. The issue of who is responsible for reducing loneliness and how this responsibility is designated is, however, rarely discussed. In this study, we have analysed how responsibility is designated and constructed in articles from the Swedish news-press. Focus has been on identifying responsibility in discourses proceeding from the concept of subject positions. This concept has enabled analysis on how responsibility is negotiated and who is positioned as a responsible actor with the ability to perform actions that reduce loneliness. Three dominating discourses were found. In the discourse of responsibility within politics and the welfare state, the responsibility is both self-taken and designated to other institutions held responsible for not initiating sufficient measures to reduce loneliness. In the discourse of responsibility within societal and evolutionary perspectives on loneliness, developments beyond the individual's control are considered to contribute to loneliness. At the same time ‘we’ in ‘society’ are considered capable of reducing loneliness, thereby constructing individuals as responsible actors. Within the discourses of responsibility within senior organisations, both senior organisations and people who participate in activities are constructed as responsible actors. In conclusion, the responsibility for reducing loneliness is, apart from the discourse on senior organisations, designated to those working with older people.
Older adults represent the highest proportion of gamblers (Ontario Lottery and Gaming Corporation [OLG], 2012). Unpartnered older adults may be more socially isolated and lonely (Dykstra & de Jong Gierveld, 2004), thus more likely to be at risk for problem gambling (McQuade & Gill, 2012). We examined whether gambling to socialize or from loneliness and going to the casino with friends/family mediate the relation between marital status and problem gambling. Data from a random sample of older adults at gambling venues across Southwestern Ontario indicated that gambling with family/friends and gambling due to loneliness mediated the relationship between marital status and problem gambling. Relative to those married, unpartnered older adults were less likely to gamble with family/friends, more likely to gamble due to loneliness, and had higher problem gambling. Prevention and treatment initiatives should examine ways to decrease loneliness and social isolation among older adults and offer alternative social activities.
To (i) systematically identify and review strategies employed by community dwelling lonely older people to manage their loneliness and (ii) develop a model for managing loneliness.
A narrative synthesis review of English-language qualitative evidence, following Economic and Social Research Council guidance. Seven electronic databases were searched (1990–January 2017). The narrative synthesis included tabulation, thematic analysis, and conceptual model development. All co-authors assessed eligibility of final papers and reached a consensus on analytic themes.
From 3,043 records, 11 studies were eligible including a total of 502 older people. Strategies employed to manage loneliness can be described by a model with two overarching dimensions, one related to the context of coping (alone or with/in reference to others), the other related to strategy type (prevention/action or acceptance/endurance of loneliness). The dynamic and subjective nature of loneliness is reflected in the variety of coping mechanisms, drawing on individual coping styles and highlighting considerable efforts in managing time, contacting others, and keeping loneliness hidden. Cognitive strategies were used to re-frame negative feelings, to make them more manageable or to shift the focus from the present or themselves. Few unsuccessful strategies were described.
Strategies to manage loneliness vary from prevention/action through to acceptance and endurance. There are distinct preferences to cope alone or involve others; only those in the latter category are likely to engage with services and social activities. Older people who deal with their loneliness privately may find it difficult to articulate an inability to cope.
The aim of this study was to build a detailed, integrative profile of the correlates of young adults’ feelings of loneliness, in terms of their current health and functioning and their childhood experiences and circumstances.
Data were drawn from the Environmental Risk Longitudinal Twin Study, a birth cohort of 2232 individuals born in England and Wales in 1994 and 1995. Loneliness was measured when participants were aged 18. Regression analyses were used to test concurrent associations between loneliness and health and functioning in young adulthood. Longitudinal analyses were conducted to examine childhood factors associated with young adult loneliness.
Lonelier young adults were more likely to experience mental health problems, to engage in physical health risk behaviours, and to use more negative strategies to cope with stress. They were less confident in their employment prospects and were more likely to be out of work. Lonelier young adults were, as children, more likely to have had mental health difficulties and to have experienced bullying and social isolation. Loneliness was evenly distributed across genders and socioeconomic backgrounds.
Young adults’ experience of loneliness co-occurs with a diverse range of problems, with potential implications for health in later life. The findings underscore the importance of early intervention to prevent lonely young adults from being trapped in loneliness as they age.
The relationship between living alone, loneliness and social isolation, and how they are associated with health remain contentious. We sought to explore typologies based on shared experiences of loneliness, social isolation and living alone using Latent Class Analysis and determine how these groups may differ in terms of their physical and mental health. We used Wave 7 of the English Longitudinal Study of Ageing (N = 7,032; mean age = 67.3) and responses to the University of California, Los Angeles (UCLA) loneliness scale, household composition, participation in social/societal activities plus frequency of contact with friends, family and relatives for the Latent Class Analysis. The optimal number of groups was identified using model-fit criteria. The socio-demographic characteristics of groups and health outcomes were explored using descriptive statistics and logistic regression. We identified a six-cluster typology: Group 1, no loneliness or isolation; Group 2, moderate loneliness; Group 3, living alone; Group 4, moderate isolation; Group 5, moderate loneliness, living alone; and Group 6, high loneliness, moderate isolation (with high likelihood of living alone). Groups experiencing loneliness and/or isolation were more likely to report poorer physical and mental health even after adjusting for socio-demographic confounders, this was particularly notable for Group 6. Our results indicate that different typologies of living alone, loneliness and isolation can be identified using data-driven techniques, and can be differentiated by the number and severity of issues they experience.
Existing evidence for gene × environment interaction (G × E) in neuroticism largely relies on candidate gene studies, although neuroticism is highly polygenic. This study aimed to investigate the long-term associations between polygenic risk scores for neuroticism (PRSN), objective childhood adversity and their interplay on emotional health aspects such as neuroticism itself, depressive symptoms, anxiety symptoms, loneliness and life satisfaction.
The sample consisted of reared-apart (TRA) and reared-together (TRT) middle- and old age twins (N = 699; median age at separation = 2). PRSN were created under nine p value cut-off thresholds (pT-s) and the pT with the highest degree of neuroticism variance explained was chosen for subsequent analyses. Linear regressions were used to assess the associations between PRSN, childhood adversity (being reared apart) and emotional health. G × E was further investigated using a discordant twin design.
PRSN explained up to 1.7% (pT < 0.01) of phenotypic neuroticism in the total sample. Analyses across two separation groups revealed substantial heterogeneity in the variance explained by PRSN; 4.3% was explained in TRT, but almost no effect was observed in TRA. Similarly, PRSN explained 4% and 1.7% of the variance in depressive symptoms and loneliness, respectively, only in TRT. A significant G × E interaction was identified for depressive symptoms.
By taking advantage of a unique sample of adopted twins, we demonstrated the presence of G × E in neuroticism and emotional health using PRSN and childhood adversity. Our results may indicate that genome-wide association studies are detecting genetic main effects associated with neuroticism, but not those susceptible to early environmental influences.