Do Loneliness and Perceived Social Isolation Reduce Expected Longevity and Increase the Frequency of Dealing with Death and Dying? Longitudinal Findings based on a Nationally Representative Sample

Perception of one's social environment and loneliness: results of the nationally representative "Old age in Germany (D80+)" study

OBJECTIVES

To examine the association between perception of one's social environment (in terms of residential attachment and neighborhood trust) and loneliness among the oldest old and whether these associations differ by living arrangement.

METHODS

We used data from the nationally representative "Old Age in Germany (D80+)" study that included individuals residing in private households and institutionalized settings. The analytic sample was 9,621 individuals (average age: 85.5 years, SD: 4.1 years; 62% female). Data collection took place from November 2020 to April 2021. Multiple linear regressions were conducted with adjustment for relevant covariates.

RESULTS

Higher residential attachment (β=-0.02, p < .05) and higher neighborhood trust (β=-0.12, p < .001) were associated with less loneliness. The latter association was moderated by living arrangement (β=-0.09, p = .04) such that the association between neighborhood trust and loneliness was stronger among individuals living in institutionalized settings compared to individuals in private households.

CONCLUSION

Greater residential attachment and neighborhood trust, particularly among individuals living in institutionalized settings, are associated with less loneliness among the oldest old. Finding ways to improve perceived attachment and trust may assist in avoiding loneliness among older individuals.

Chronic loneliness and chronic social isolation among older adults. A systematic review, meta-analysis and meta-regression

OBJECTIVES

We performed a systematic review and meta-analysis to examine the prevalence and antecedents/consequences of chronic loneliness and social isolation (i.e. enduring or persistent experience that extends over a certain period of time) among older adults. Moreover, we conducted a meta-regression to explore sources of heterogeneity.

METHOD

A search was conducted in four electronic databases. We included observational studies that reported prevalence and, where available, antecedents/consequences of chronic loneliness or chronic social isolation amongst older adults. Key characteristics of the studies were extracted.

RESULTS

Across 17 studies included in the meta-analysis, the estimated prevalence of chronic loneliness was 20.8% (95% CI: 16.1-25.5%), including 21.7% among women (95% CI: 16.1-27.4%) and 16.3% among men (95% CI: 10.6-21.9%). One study reported chronic social isolation (13.4%) and found that chronic social isolation predicted higher depression scores. Meta-regressions indicated that loneliness was less prevalent when assessed with single-item measures. Regarding antecedents/consequences, spousal loss can contribute to chronic loneliness which in turn may contribute to adverse health-related outcomes.

CONCLUSION

About one in five older adults experiences chronic loneliness reflecting the need to address chronic loneliness. More longitudinal research is needed on chronic loneliness and social isolation, particularly from low and middle-income countries.

Using Ecological Momentary Assessments to Study How Daily Fluctuations in Psychological States Impact Stress, Well-Being, and Health

Despite great interest in how dynamic fluctuations in psychological states such as mood, social safety, energy, present-focused attention, and burnout impact stress, well-being, and health, most studies examining these constructs use retrospective assessments with relatively long time-lags. Here, we discuss how ecological momentary assessments (EMAs) address methodological issues associated with retrospective reports to help reveal dynamic associations between psychological states at small timescales that are often missed in stress and health research. In addition to helping researchers characterize daily and within-day fluctuations and temporal dynamics between different health-relevant processes, EMAs can elucidate mechanisms through which interventions reduce stress and enhance well-being. EMAs can also be used to identify changes that precede critical health events, which can in turn be used to deliver ecological momentary interventions, or just-in-time interventions, to help prevent such events from occurring. To enable this work, we provide examples of scales and single-item questions used in EMA studies, recommend study designs and statistical approaches that capitalize on EMA data, and discuss limitations of EMA methods. In doing so, we aim to demonstrate how, when used carefully, EMA methods are well poised to greatly advance our understanding of how intrapersonal dynamics affect stress levels, well-being, and human health.

The relationship of social isolation and sleep in older adults: evidence from cross-sectional and longitudinal studies

OBJECTIVES

This study aimed to explore the relationship between social isolation and sleep in later life and the role of loneliness in this relationship.

METHODS

In Study 1, we conducted a cross-sectional analysis of the correlation between social isolation and sleep in community-dwelling older adults (N = 108). This relationship was assessed using subjective and objective measures. Moreover, we examined the mediating role of loneliness cross-sectionally (Study 1) and longitudinally (Study 2). Longitudinal study was based on three waves of data from the National Scale Life, Health, and Aging Project (N = 1, 554).

RESULTS

The results showed that social isolation was robustly associated with sleep in the general population of older adults. Specifically, subjective social isolation was associated with subjective sleep, and objective social isolation was associated with objective sleep. The results of the longitudinal study showed that loneliness mediated the reciprocal link between social isolation and sleep across time after controlling for autoregressive effects and basic demographics.

CONCLUSIONS

These findings address the gap in the literature on the link between social isolation and sleep in older adults, extending the understanding of improvement in older adults' social networks, sleep quality, and psychological well-being.

Social isolation and loneliness: Undervalued risk factors for disease states and mortality

Social isolation and loneliness are two common but undervalued conditions associated with a poor quality of life, decreased overall health and mortality. In this review, we aim to discuss the health consequences of social isolation and loneliness. We first provide the potential causes of these two conditions. Then, we explain the pathophysiological processes underlying the effects of social isolation and loneliness in disease states. Afterwards, we explain the important associations between these conditions and different non-communicable diseases, as well as the impact of social isolation and loneliness on health-related behaviours. Finally, we discuss the current and novel potential management strategies for these conditions. Healthcare professionals who attend to socially isolated and/or lonely patients should be fully competent in these conditions and assess their patients thoroughly to detect and properly understand the effects of isolation and loneliness. Patients should be offered education and treatment alternatives through shared decision-making. Future studies are needed to understand the underlying mechanisms better and to improve the treatment strategies for both social isolation and loneliness.

Loneliness and Social Isolation among Transgender and Gender Diverse People

Here, we report the prevalence of loneliness and social isolation and investigate the levels of loneliness and social isolation among transgender and gender diverse people using cross-sectional data from the HH-TPCHIGV study. Using the De Jong Gierveld tool, we assess loneliness, using the Bude and Lantermann tool, we assess perceived social isolation and using the Lubben Social Network Scale, we assess objective social isolation. The prevalence rate of loneliness was 83.3% (perceived social isolation: 77.7%; objective social isolation: 34.4%). Regressions revealed that favorable outcomes (i.e., lower loneliness levels, lower perceived social isolation, and lower objective social isolation) were consistently associated with higher school education. Beyond that, we identify an association between particularly poor health-related factors and higher loneliness and objective social isolation levels. We also report that unemployment was significantly associated with higher levels of perceived social isolation. In conclusion, we show high prevalence rates of loneliness and social isolation among transgender and gender diverse people. Additionally, important correlates (e.g., education, health-related factors, or unemployment) were identified. Such knowledge may provide help to address transgender and gender diverse people at risk for loneliness and social isolation.

Do Individuals with High Climate Anxiety Believe That They Will Die Earlier? First Evidence from Germany

OBJECTIVES

To examine the association between climate anxiety and perceived longevity in the general adult German population (also stratified by age group).

STUDY DESIGN

Nationally representative survey.

METHODS

Data were used of the general adult German population, with n = 3015 individuals (18 to 74 years; data collection: March 2022). Climate anxiety was assessed using the validated Climate Anxiety Scale. It was adjusted for a wide array of covariates in linear-log regression analysis.

RESULTS

Even after adjusting for various covariates, there was an association between higher (log) climate anxiety and a lower perceived longevity in the total sample (β = -1.41, p < 0.01). Stratified by age group, a significant association was only present among individuals aged 18 to 29 years (β = -3.58, p = 0.01), whereas it was not present in the other age groups (i.e., individuals aged 30 to 49 years, individuals aged 50 to 64 years, and individuals aged 65 years and over).

CONCLUSIONS

This study showed an association between higher climate anxiety and lower perceived longevity, particularly among younger individuals. More clearly, younger individuals with a higher climate anxiety think they will die earlier. This is the first study on this topic and could serve as a foundation for upcoming research. For example, longitudinal studies are needed to confirm our findings.

Evaluating the Risk of Social Isolation in Older People: AHP-Fuzzy Comprehensive Evaluation

Background

Social isolation is a serious and pervasive health issue among older people, and it is difficult to identify and assess effectively. Based on a thorough and scientific evaluation index system, AHP-Fuzzy comprehensive evaluation could be a valuable technique.

Objective

It is crucial to establish interventions that focus on risk factors for the prevention of social isolation in order to give a strong scientific foundation for enhancing older people's health habits. This can be achieved by using a fuzzy comprehensive evaluation method to assess the risk of social isolation in older people.

Methods

A hundred community members over 60 from Nanjing were selected as the evaluation subjects in China. After the element layer was split into three categories of "social risk, economic risk, and cultural risk" using the analytic hierarchy process approach, a total of 22 assessment indicators were picked to develop a risk evaluation index system.

Results

The risk level of social isolation belonging to the "low risk, relatively low risk, medium risk, relatively high risk, high risk" of membership degree are respectively "0.3392, 0.2632, 0.2257, 0.1069, 0.0650". Fuzzy comprehensive evaluation analysis showed that social relations (0.4934), monthly income (0.4654), health status (0.5960) were significant factors of social isolation risk in older people. The results showed that factors related to social risk had the most significant impact on social isolation.

Conclusion

It is scientific and feasible to construct the risk evaluation index model of social isolation risk for the elderly by using AHP-Fuzzy comprehensive evaluation method. In preventing social isolation of older people in the future, we should pay attention to the impact of social and cultural factors on them, and provide practical intervention programs and references from the government, community, family.

Loneliness, perceived isolation and sleep quality in later life. Longitudinal evidence from a population-based German study

OBJECTIVES

To date, there is restricted knowledge regarding the association between loneliness, perceived social isolation and sleep quality based on longitudinal studies. Our aim was therefore to clarify the association between loneliness, perceived social isolation and sleep quality stratified by sex using a longitudinal approach.

METHODS

Longitudinal data (wave 5 and wave 6) were used from a nationally representative sample of community-dwelling individuals ≥ 40 years in Germany. In our analytical sample, n equaled 8784 observations. The Bude and Lantermann tool was used to quantify perceived social isolation and the De Jong Gierveld tool was used to measure loneliness. Relying on key items of the Pittsburgh Sleep Quality Index, sleep quality was assessed.

RESULTS

Increases in loneliness were associated with worsening sleep quality (in men: in two outcomes; in women: in all three outcomes). Moreover, in men, increases in perceived social isolation was associated with decreases in overall sleep quality (β = 0.10, p < 0.01), but not with the other outcomes. In contrast, perceived social isolation was not associated with changes in any of the outcome measures in women.

CONCLUSIONS

Increases in loneliness were particularly associated with worsening sleep quality among women, whereas the overall sleep quality decreases when perceived social isolation increases in men. Efforts to reduce perceived social isolation (men) and loneliness (in men, but particularly in women) can contribute to sleep quality in individuals aged 40 years and over in Germany.

Hope, Purpose, and Religiosity: The Impact of Psychosocial Resources on Trajectories of Depressive Symptoms Among Middle-Aged and Older Blacks

Objective: We assessed the effects of hope, purpose in life, and religiosity on trajectories of depressive symptoms among middle-aged and older Blacks, with a focus on age differences in these associations. Methods: Data come from 1906 respondents from the 2006-2016 Health and Retirement Study. Linear mixed models were estimated and included interactions between age and time and between age and each psychosocial resource. Results: Depressive symptoms decreased for Blacks ages 51-64, did not change for those 65-74, and increased among Blacks age 75+. Hope and purpose in life were inversely associated with symptom levels but were not associated with change over time in symptomology. Associations were stronger among the youngest age group and weakest among the oldest. Religiosity was unrelated to depressive symptoms. Discussion: Psychosocial resources protect against depressive symptoms in age-dependent ways among middle-aged and older Blacks. Differences in these effects may be related to aging, cohort, and selection effects.

Prevalence and correlates of loneliness, perceived and objective social isolation during the COVID-19 pandemic. Evidence from a representative survey in Germany

PURPOSE

Our aim was to identify the prevalence and correlates of loneliness, perceived and objective social isolation in the German population during the COVID-19 pandemic.

METHODS

Data were taken from a representative survey with n = 3075 individuals (18-70 years; August/September 2021). Valid measures were used to quantify the outcomes (loneliness: De Jong Gierveld scale; perceived social isolation: Bude/Lantermann tool; objective social isolation: Lubben Social Network Scale). Multiple logistic regressions were used to identify the correlates of these three outcomes.

RESULTS

The prevalence of loneliness was 83.4%, the prevalence of perceived social isolation was 59.1% and the prevalence of objective social isolation was 28.9%. The prevalence rate significantly differed between the subgroups (e.g., the prevalence of perceived social isolation was 73.9% among individuals aged 18-29 years, whereas it was 48.8% among individuals aged 60-70 years). In regression analysis, several correlates of these outcomes were identified (e.g., marital status, age group (with changing signs), migration background, sports activities, or self-rated health).

CONCLUSION

Our study particularly identified very to extraordinarily high prevalence rates for social isolation and loneliness, respectively. Knowledge about the correlates (e.g., age group) may help to address these individuals during the ongoing pandemic.

Pet ownership, loneliness, and social isolation: a systematic review

PURPOSE

Several publications explored a relationship between pet ownership and lower levels of loneliness and social isolation. However, to the best of our knowledge, no systematic review has yet synthesized the evidence on these associations. Thus, this systematic review aims to evaluate the findings regarding the relations between pet ownership, loneliness, and social isolation.

METHODS

PubMed, CINAHL, and PsycInfo were searched in January 2022. Observational studies relying on appropriate instruments to assess the exposure and the outcome variables were included. Two reviewers independently executed study selection, data extraction, and quality assessment.

RESULTS

n = 24 studies were included. Among adult samples, the studies examining the relationship between pet ownership and social isolation found that owning a pet was associated with lower levels of social isolation. Concerning loneliness, studies that were conducted after the outbreak of COVID-19 mostly showed that pet ownership can contribute to lower levels of loneliness, but did not reveal an overall significant association until then. In turn, the studies that examined child and adolescent samples suggest that pet ownership was related to reduced loneliness before COVID-19. Furthermore, most of the studies did not reveal any differences between dogs, cats, and other kinds of pets regarding their relationship to loneliness and social isolation.

CONCLUSION

All in all, only a part of the studies detected a significant association between pet ownership, loneliness and social isolation. However, the COVID-19 pandemic seemed to strengthen this relationship, so that future research is required to assess the longevity of this potential effect.

The Association between Oral Health-Related Quality of Life, Loneliness, Perceived and Objective Social Isolation-Results of a Nationally Representative Survey

The aim was to examine the association between oral health-related quality of life and loneliness and perceived as well as objective social isolation. Data were used from a nationally representative survey with n = 3075 (late Summer 2021). The established Oral Health Impact Profile (OHIP-G5) was used to quantify oral health-related quality of life. Moreover, established tools were used to quantify the outcome measures (De Jong Gierveld loneliness scale, Bude/Lantermann scale and Lubben Social Network Scale). It was adjusted for several covariates in regression analysis. Linear regressions showed that low oral health-related quality of life is associated with higher loneliness (B = 0.03, p < 0.001), higher perceived social isolation (B = 0.06, p < 0.001) and higher objective social isolation (B = 0.07, p < 0.05). Further regressions were performed (e.g., stratified by denture usage). Our study stressed the importance of low oral health-related quality of life for loneliness and social isolation (both perceived and objective). This knowledge is important to address individuals at risk. Future studies should clarify the underlying mechanisms.

Informal Caregiving, Loneliness and Social Isolation: A Systematic Review

Background: Several empirical studies have shown an association between informal caregiving for adults and loneliness or social isolation. Nevertheless, a systematic review is lacking synthesizing studies which have investigated these aforementioned associations. Therefore, our purpose was to give an overview of the existing evidence from observational studies. Materials and Methods: Three electronic databases (Medline, PsycINFO, CINAHL) were searched in June 2021. Observational studies investigating the association between informal caregiving for adults and loneliness or social isolation were included. In contrast, studies examining grandchild care or private care for chronically ill children were excluded. Data extractions covered study design, assessment of informal caregiving, loneliness and social isolation, the characteristics of the sample, the analytical approach and key findings. Study quality was assessed based on the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Each step (study selection, data extraction and evaluation of study quality) was conducted by two reviewers. Results: In sum, twelve studies were included in our review (seven cross-sectional studies and five longitudinal studies)—all included studies were either from North America or Europe. The studies mainly showed an association between providing informal care and higher loneliness levels. The overall study quality was fair to good. Conclusion: Our systematic review mainly identified associations between providing informal care and higher loneliness levels. This is of great importance in assisting informal caregivers in avoiding loneliness, since it is associated with subsequent morbidity and mortality. Moreover, high loneliness levels of informal caregivers may have adverse consequences for informal care recipients.

Does obesity lead to loneliness and perceived social isolation in the second half of life? Findings from a nationally representative study in Germany

AIM

Little is known about the link between obesity and loneliness as well as perceived social isolation. Therefore, the objective of this longitudinal study is to clarify whether the onset and the end of obesity is associated with changes in perceived social isolation as well as loneliness (stratified by sex) in older age.

METHODS

Longitudinal data were used from wave 5 (year 2014) and 6 (year 2017) of the German Ageing Survey - a nationally representative sample of community-dwelling individuals aged ≥40 years in Germany. Established tools were used to quantify loneliness and perceived social isolation. A body mass index ≥30 kg/m² was used to classify individuals as being obese. Asymmetric fixed effects regressions were used.

RESULTS

Regressions showed that the end of obesity was associated with decreases in perceived social isolation among women (β = -0.24, P = 0.01), but not in men (with significant sex differences). The onset of obesity was not associated with changes in perceived social isolation. Neither the beginning of obesity nor the end of obesity was associated with changes in loneliness.

CONCLUSIONS

Our findings emphasize the importance of overcoming obesity for women in the second half of life. As most of the existing studies were conducted in Germany, studies from other countries are of importance to understand this association better. Geriatr Gerontol Int 2021; 21: 836-841.