The experience of social and emotional loneliness among older people in Ireland

"You're Not Understood, and You're Isolated": A Narrative Account of Loneliness by Black Older Adults in Ontario, Canada

Loneliness among older adults is a leading health and social concern globally and in Canada, including racialized and minoritized groups. Although previous studies have explored loneliness among ethnic minoritized groups in Canada, little is known about the constellating factors contributing to loneliness among native-born and immigrant Black older adults (BOAs) in Canada and their unique ways of dealing with the experience. Our study explores the constellating factors shaping loneliness experiences among BOAs living in Ontario. Using a narrative approach, we purposively selected and interviewed 13 BOAs. Time as a driver of change, a sense of belonging reinforced through place identity, and challenges of making a new home were dominant themes. Our finding highlights the need for increased cultural sensitivity at the micro and macro levels, which will improve a sense of belonging and reduce loneliness among racialized immigrant older adults.

Rural-urban differences in older adults' life satisfaction and its determining factors

Although determinants of life satisfaction in older adults have been well documented, research has to date failed to fully address the experience of older adults living in places with different levels of urbanization. Furthermore, there are conflictive findings regarding the type of residence environment that offers the greatest benefits for the wellbeing of older adults. Our study proposes an integrative research model to determine the nature of the relationships between loneliness, self-esteem and life satisfaction, with a particular focus on the living environment (rural-urban) of the older adults. Using a cross-sectional survey design volunteers (aged 60+) from rural (n = 198) and urban (n = 198) in Galicia (Spain) completed a questionnaire. Structural Equation Modelling (SEM) was used to test the relationships between loneliness, self-esteem and life satisfaction and multigroup analysis was performed to analyse the existence of differences in the relationships based on the area of residence of older adults. We found that higher levels of loneliness were a significant predictor of reduced life satisfaction and reduced self-esteem. Self-esteem not only increases life satisfaction, but also reduces the negative impact loneliness may have on it. Where the older adults lived had a significant effect on the relationships between loneliness, self-esteem and life satisfaction. The relationships were stronger for older adults living in urban areas. Differentiated policy initiatives should be considered, depending on the area of residence in order to increase the life satisfaction of older adults.

Social frailty among older adults in India: Findings from the Longitudinal Ageing Study in India (LASI) - Wave 1

BACKGROUND

From an individual's perspective, social frailty may act as a key determinant of social capital, which is essential for meeting social needs and improvement of overall wellbeing. The present study aimed to understand the social frailty and its determining factors among Indian older adults.

METHODS

Data from the Longitudinal Ageing Study in India (LASI)-wave 1 was used. For the assessment of social frailty the study proposed a multidimensional Social Frailty Index (SFI) score ranging between 0 and 100 using 17 indicators. Bivariate analysis and quantile regression models were applied.

RESULTS

The study results indicated that on average female older adults (mean SFI = 63.7) are relatively more socially frail than male older adults (mean SFI = 59.0). Further, the quantile regression analysis revealed that at the 10th, 25th, 50th, and 75th percentiles, female older adults were significantly more likely to be socially frail than male older adults (β = 3.80, p < .01; β = 2.82, p < .01; β = 1.72, p < .01; and β = 2.62, p < .01, respectively). Educational attainment and better economic condition showed a protective effect against social frailty.

CONCLUSIONS

Investment to improve geriatric health status and socioeconomic conditions shall be a key focus to reduce social frailty prevalence among the older adults. A specific consideration is needed for addressing social frailty among female older adults.

The robust reciprocal relationship between loneliness and depressive symptoms among the general population: Evidence from a quantitative analysis of 37 studies

BACKGROUND

Loneliness has long been associated with depressive symptoms, but there is no evidence on the question of "which comes first". To help us to answer this question, this study conducted a meta-analysis using a cross-lagged formula to examine the reciprocal relations between loneliness and depressive symptoms, as well as potential moderators.

METHODS

The meta-analytic dataset consisted of 37 studies with sample sizes ranging from 52 to 5991. Effect sizes (including autoregressive effects and lagged coefficients) were included. We computed weighted mean effect sizes for the correlation effect and cross-lagged effect between loneliness and depressive symptoms. We also performed a meta-regression to investigate potential moderators.

RESULTS

The results showed that loneliness and depressive symptoms reciprocally predicted each other over time with similar effect sizes. There was no moderation of our overall effect size in either direction by time interval between measurements, the proportion of female participants, mean age of the sample, or type of measurement.

LIMITATIONS

Caution should be taken in drawing final conclusions about the relative strength of reciprocal effects between loneliness and depressive symptoms due to the potential influence of varied research focus in the included studies, which could affect the effect size.

CONCLUSIONS

These findings advance the study of the relationship between loneliness and depressive symptoms by providing evidence that the link between them is symmetrically reciprocal and robust, which may help clinicians to develop effective intervention methods.

Sex-related differences in the associations between diurnal cortisol pattern and social and emotional loneliness in older adults

Introduction

Loneliness is a distressful feeling that can affect mental and physical health, particularly among older adults. Cortisol, the primary hormone of the Hypothalamic-Pituitary-Adrenal axis (HPA-axis), may act as a biological transducer through which loneliness affects health. While most previous studies have evaluated the association between loneliness, as a unidimensional construct, and diurnal cortisol pattern, no research has examined this relationship discriminating between social and emotional loneliness in older adults. As sex differences in the negative mental health outcomes of loneliness have been reported, we also investigated whether diurnal cortisol indices and loneliness associations occur in a sex-specific manner.

Methods

We analyzed the diurnal cortisol- pattern in 142 community-dwelling, non-depressed, Caucasian older adults (55,6% female) aged 60-90. Social and emotional (family and romantic) loneliness scores were assessed using the Spanish version of the Social and Emotional Loneliness Scale for Adults (SELSA). Five salivary cortisol samples were used to capture key features of the diurnal cortisol pattern, including: awakening and bedtime cortisol levels, awakening response (CAR), post-awakening cortisol output (post-awakening cortisol [i.e., the area under the curve with reference to the ground: AUCG]), total diurnal cortisol release (AUCG), and diurnal cortisol slope (DCS).

Results

After controlling for sociodemographic variables, the hierarchical linear multiple regression analyses revealed that in male older adults, higher scores on social and family loneliness were associated with elevated awakening cortisol levels, total diurnal cortisol output, and a steeper diurnal cortisol slope (DCS). However, these associations were not observed in female older adults. In addition, feelings of romantic loneliness were positively associated with bedtime cortisol levels and AUCG in older males. Multilevel growth curve modeling showed that experiencing more social and emotional loneliness predicted higher diurnal cortisol output throughout the day in older male adults.

Discussion

The presence of sex differences in the relationship between cortisol indices and loneliness among older adults holds particular significance for diagnostic and screening procedures. Combining loneliness scales as screening tools with diurnal cortisol measures has the potential to be an effective and cost-efficient approach in identifying higher-risk individuals at early stages.

Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources

BACKGROUND

Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community.

OBJECTIVE

This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults.

METHODS

A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources.

RESULTS

The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services.

CONCLUSIONS

A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.

The Long Shadow: Early-Life Adversity and Later-Life Loneliness in the United States

OBJECTIVES

This study assesses how early-life adversity (ELA) is associated with later-life loneliness among those aged 55 and older in the United States. We consider multiple domains of ELA to understand domain-specific associations between ELA and later-life loneliness.

METHODS

Using data from the 2008 to 2016 rounds of Health and Retirement Study (n = 29,661 person-waves [weighted]), we evaluate whether and how different domains of ELA are associated with loneliness, and how their relationships are explained through adulthood conditions and are dependent on educational attainment.

RESULTS

Our analyses demonstrate significant and distinctive relationships between various domains of ELA and later-life loneliness. Whereas adulthood conditions largely explain positive associations between loneliness with some domains of ELA (socioeconomic disadvantages and chronic diseases), disruptive home environment, risky adolescent behaviors, and impairment during childhood are still related to a higher level of loneliness after controlling for adulthood conditions. We also find empirical evidence supporting educational differences in relationships between some ELA domains and later-life loneliness. Our results also show that the associations between ELA and later-life loneliness differ between subdimensions of loneliness (emotional vs. social loneliness).

DISCUSSION

This study underscores ELA as an important early-life risk factor contributing to later-life loneliness. Our findings suggest that policy interventions to reduce adverse childhood experiences may alleviate individuals' exposure to loneliness in later life.

Caregiving, volunteering, and loneliness in middle-aged and older adults: a systematic review

OBJECTIVES

Older adults contribute vast amounts of care to society, yet it remains unclear how unpaid productive activities relate to loneliness. The objective of this systematic review is to synthesise the evidence for associations between midlife and older people's unpaid productive activities (i.e., spousal and grandparental caregiving, volunteering) and loneliness.

METHODS

Peer-reviewed observational articles that investigated the association between loneliness and caregiving or volunteering in later life (>50 years) were searched on electronic databases (Ovid MEDLINE, Embase, PsychInfo and Global Health) from inception until July 2021. Studies were analysed using narrative synthesis and assessed for methodological quality applying the Newcastle Ottawa Scale.

RESULTS

A total of 28 articles from 21 countries with 191,652 participants were included (52.5% women). Results were separately discussed for the type of unpaid productive activity, namely, general caregiving (N = 10), spousal caregiving (N = 7), grandparental caregiving (N = 7), and volunteering (N = 6). Risk of bias assessments revealed a moderate to high quality of included studies. Loneliness was positively associated with spousal caregiving but negatively associated with caregiving to grandchildren and volunteering.

CONCLUSIONS

Grandparental caregiving and volunteering may be promising avenues for reducing loneliness in older age. Future studies will need to distinguish between different types of caregiving and volunteering and explore more complex longitudinal designs with diverse samples to investigate causal relationships with loneliness.

Why Not Lonely? A Longitudinal Study of Factors Related to Loneliness and Non-Loneliness in Different Age Groups Among People in the Second Part of Life

Age-related changes and losses may lead to loneliness. However, some people do not become lonelier, even after negative life events. This study examines the development of loneliness based on Norwegian panel data (N = 2,315), age 40-80 years at baseline, and the impacts of partnership and health measured in 2002, 2007, and 2017. We ask: How does loneliness develop over time, and who resists becoming lonely? In the total group, loneliness decreased from 2002 to 2007 and then leveled off. In the eldest age group, 70-80 years at baseline, loneliness increased but only in the last period, from 2007 to 2017. In all age groups and at all three times, those who were not lonely more often had a partner and were more often in good health compared to those who were lonely. Period effects, cohort, and age-related changes influencing the development in loneliness over time are discussed.

Implementation of a pan-European ecosystem and an interoperable platform for Smart and Healthy Ageing in Europe: An Innovation Action research protocol

As life expectancy continues to increase in most EU Member States, smart technologies can help enable older people to continue living at home, despite the challenges accompanying the ageing process. The Innovation Action (IA) SHAPES 'Smart and Healthy Ageing through People Engaging in Supportive Systems' funded by the EU under the Horizon 2020 Research and Innovation Programme (grant agreement number 857159) attends to these topics to support active and healthy ageing and the wellbeing of older adults. This protocol article outlines the SHAPES project's objectives and aims, methods, structure, and expected outcomes. SHAPES seeks to build, pilot, and deploy a large-scale, EU-standardised interoperable, and scalable open platform. The platform will facilitate the integration of a broad range of technological, organisational, clinical, educational, and social solutions. SHAPES emphasises that the home is much more than a house-space; it entails a sense of belonging, a place and a purpose in the community. SHAPES creates an ecosystem - a network of relevant users and stakeholders - who will work together to scale-up smart solutions. Furthermore, SHAPES will create a marketplace seeking to connect demand and supply across the home, health and care services. Finally, SHAPES will produce a set of recommendations to support key stakeholders seeking to integrate smart technologies in their care systems to mediate care delivery. Throughout, SHAPES adopts a multidisciplinary research approach to establish an empirical basis to guide the development of the platform. This includes long-term ethnographic research and a large-scale pan-European campaign to pilot the platform and its digital solutions within the context of seven distinct pilot themes. The project will thereby address the challenges of ageing societies in Europe and facilitate the integration of community-based health and social care. SHAPES will thus be a key driver for the transformation of healthcare and social care services across Europe.

Addressing the Experiences of Family Caregivers of Older Adults During the COVID-19 Pandemic in Finland

This cross-sectional study assessed the experiences of family caregivers of older adults during the COVID-19 pandemic. Participants were recruited (n = 101) between April and December 2019. We applied a mixed-method approach. Quantitative data were analyzed using an independent samples t-test and logistic regression analysis, and qualitative experiences with modified thematic content analysis. The mean age of the family caregivers was 76 years (SD = 7), and 72% were females. Experiences of loneliness and worry during the pandemic were evaluated by self-assessment. Approximately one-third of the participants reported loneliness and worry. These experiences were further associated with female sex, increased psychological distress and depressive symptoms, and decreased physical condition and social relationships. Family caregivers were also worried about the pandemic's impact on health and well-being. Thus, the COVID-19 pandemic has added an extra psychosocial load to family caregivers. The post-pandemic era requires increased attention to re-evaluating policies and services.

Posttraumatic stress disorder, complex PTSD and subtypes of loneliness among older adults

OBJECTIVES

Research examining the relationship between loneliness and Complex Posttraumatic Stress Disorder (CPTSD) is scarce, particularly among older adults. CPTSD includes the core symptoms of PTSD along with additional symptoms reflecting "disturbances in self-organisation" (DSO). This study examined the cross-sectional relationships between loneliness (emotional and social loneliness) and CPTSD symptoms (i.e., PTSD and DSO symptoms) in older adults.

METHODS

Structural equation modelling was used to examine these relationships in a nationally representative sample of US adults aged 60-70 years (n = 456).

RESULTS

Controlling for covariates, emotional loneliness was associated with PTSD (β = 0.31) and DSO (β = 0.57) symptoms whereas social loneliness was only associated with DSO symptoms (β = 0.25). The model explained 35.0% of the variance in PTSD symptoms and 71.3% in DSO symptoms.

CONCLUSION

These findings have important implications for treating and understanding PTSD/CPTSD and their correlates among older adults.

Correlates of emotional and social loneliness among community dwelling older adults in Rotterdam, the Netherlands

OBJECTIVES

Loneliness is seen as an important problem, contributing to serious health problems. As a baseline measurement for the evaluation of a community project aimed at reducing loneliness in Rotterdam, loneliness was measured, as well as potential correlates. This article describes models of social and emotional loneliness among older adults.

METHODS

This study was conducted among 3,821 randomly selected community dwelling citizens of 65 years and older. Loneliness was measured by using the Jong-Gierveld loneliness questionnaire/scale. As potential correlates demographic, health and psychological and social variables were included. Data were subjected to multiple hierarchically regression analysis.

RESULTS

Emotional loneliness was reported by 60% and social loneliness by 47% of the sample. Women were more emotionally lonely than men , while men reported more social loneliness than women. Emotional social support and quality of life were strongest in predicting emotional loneliness and social capital in the neighbourhood, companionship and instrumental support were strongest predictors for social loneliness. Demographic variables predicted variability in emotional loneliness.

CONCLUSIONS

The strength of the correlates differed between the two dimensions of loneliness. In the design of interventions to prevent and reduce loneliness among older adults, strategies should be developed aimed at the specific dimensions of loneliness.

A realist evaluation of loneliness interventions for older people

INTRODUCTION

the aim of this study was to develop a programme theory to inform the design of loneliness interventions and guide any future evaluations.

METHODS

we undertook a mixed-method evaluation, informed by the realist approach, of different approaches to loneliness in one health and social care system in the East Midlands, UK. We used a combination of documentary analysis, interviews/focus groups with service providers and users and quantitative analysis to develop an initial programme theory.

RESULTS

common aims of local interventions included enhancing social connectivity, providing emotional support and advice/information; recurring interventions included social activities, emotional support, advice and information, lunch clubs, learning new skills and practical support. None were robustly evaluated.Fifty-six service user or providers were involved in interviews or focus groups, which highlighted the causes of loneliness, preferred services, access to services, thoughts about intervention configuration and desired outcomes from services.The themes emerging from the interviews/focus groups from both service provider and service user perspectives were combined with all of the previous emerging data to create an overarching programme theory. Statements were constructed to allow service providers to think about which interventions might be useful to achieve specific outcomes in different contexts.

CONCLUSION

the causes and consequences of loneliness vary widely between individuals, so a personalised approach is required to identify the causes and potential solutions. This study provides some high-level principles that can help commissioners and providers to tailor interventions to the individual needs of service users.

Loneliness and mental health among the elderly in Poland during the COVID-19 pandemic

Background

The unexpected changes caused by the COVID-19 pandemic related to the fear of developing the disease, and the need for social distancing and isolation have had an effect on people’s mental health. These drastic changes can result in the development of anxiety, depressive symptoms and sense of loneliness. Elderly and chronically ill individuals are at a particularly high risk of developing COVID-19, suffering severe illness and dying as a result of it.

Aim of the study

The aim of the study was to assess the prevalence of anxiety, depressive symptoms, irritability and loneliness in the elderly aged 60 years and older as a group exposed to the negative impact of the COVID-19 pandemic, and to analyze the relationships between loneliness and mental health of the respondents and sociodemographic variables and chronic diseases.

Materials and methods

The study was conducted in Poland among 221 individuals aged 60+. The study material was collected using a sociodemographic questionnaire, Hospital Anxiety and Depression Scale (HADS-M) and a revised University of California Los Angeles loneliness scale (R-UCLA). Women accounted for 47.51% and men for 52.49% of study participants; the mean age was 65.18 (SD = 4.06).

Results

In total, according to HADS-M, depressive symptoms were present in 19.15% of the participants and borderline states in 14.18% of them. Based on R-UCLA, moderate and moderately high sense of loneliness was present in 58.83% of the participants. Sense of loneliness was significantly correlated with the prevalence of depressive symptoms (p < 0.001).

Conclusions

In this study, one in five participants experienced anxiety and depressive symptoms. Two out of three participants experienced a moderate sense of loneliness. Individuals who displayed a higher level of loneliness also had a higher severity of anxiety level depressive symptoms and irritability. Elderly individuals should be under special care due to their high risk of experiencing physical and mental effects of the COVID-19 pandemic.

Experiences of social frailty among rural community-dwelling and assisted-living older adults: a qualitative study

Although social frailty has been described from a theoretical perspective, the lived experiences of older adults regarding social frailty are yet unknown. In this paper, we aim to (a) gain more in-depth insights into community-dwelling and assisted-living older adults’ experiences of social frailty and (b) explore the differences in these experiences between these two groups. We conduct a thematic analysis of 38 interviews with community-dwelling and assisted-living older adults in rural villages the Netherlands. We structure our findings along three overarching themes which highlight different aspects of the social frailty experiences of our participants: (a) present resources and activities to fulfil social needs, (b) resources and activities that have been lost, and (c) how they manage and adapt to changes in resources and activities over time. Loneliness is only reported among the community-dwelling participants, while the loss of mobility and participation in (social) activities is experienced most strongly by the assisted-living participants. These findings challenge the widespread policies and practices of ageing in place. We conclude that for some older adults, living in assisted arrangements is preferred over ageing in place, as doing so can prevent social frailty. The key reason for this is that life in assisted living is likely to bring about new social resources and activities, which may serve to fulfil the social needs of older adults.

Posttraumatic stress disorder and loneliness are associated over time: A longitudinal study on PTSD symptoms and loneliness, among older adults

Loneliness has a pernicious effect on mental health in later life and is likely to have a bidirectional relationship with psychopathology. However, longitudinal research examining loneliness and posttraumatic stress symptoms among older adults is scarce. This study aimed to examine the longitudinal relationship between different types of loneliness (social and emotional) and posttraumatic stress symptoms. Using two waves of an older adult sample (n = 1,276) from the Longitudinal Aging Study Amsterdam (LASA), this longitudinal relationship was examined using a multivariate two wave-latent change score (2W-LCS) model. There were significant, however, very small increases in both posttraumatic stress symptoms and emotional loneliness over time, whereas, average social loneliness scores did not significantly increase/decrease over time. Changes in both social (β = .16) and emotional loneliness (β = .15) were associated with small changes in posttraumatic stress symptoms, consistent with the existence of a longitudinal association between the constructs, net of covariate effects. Results provide evidence of the existence of a longitudinal association between subtypes of loneliness and posttraumatic stress symptoms, among older adults. Results have implications for clinicians who should identify individuals at risk of developing posttraumatic stress symptoms, and for the theory of both posttraumatic stress disorder and loneliness.

Older Adults' Loneliness in Early COVID-19 Social Distancing: Implications of Rurality

Objectives

Older adults face greater health risks due to coronavirus disease 2019 (COVID-19), yet preventative social distancing measures may cause increased social isolation, potentially heightening risk of loneliness. In this mixed-methods study we examine changes in older adults’ loneliness due to social distancing, explore variability in perceptions, and identify whether such changes differ by rurality.

Methods

A Midwestern sample of 76 older adults aged 70–97 (mean age = 82; 74% female; 95% White; 39% rural) completed a phone interview about their experiences with social distancing due to COVID-19. Interviews were conducted during early weeks of regional social distancing. Participants completed retrospective and current assessments of loneliness, including providing explanations of their responses.

Results

On average, loneliness increased during early social distancing, yet variability was evident. Those experiencing increased loneliness described a feeling of loss or lack of control, whereas those experiencing stability in loneliness identified adaptability in social connection modes or feeling accustomed to social isolation. Rural older adults experienced a significantly smaller increase in loneliness than their nonrural counterparts.

Discussion

These findings suggest nuanced experiences among older adults, but generally negative implications for loneliness. Interventions to address older adults’ social isolation and loneliness during COVID-19 are warranted.

Worry about debt is related to social loneliness in older adults in the Netherlands

The amount of financial debt held by older adults has grown substantially over the past two decades in Europe. This study examines the association of objective and subjective debt burden with social and emotional loneliness among 1,606 older adults in the Netherlands. Objective debt burden is based on financial terms, such as debt-to-income ratio; whereas subjective debt burden measures the psychological distress caused by financial debt. Data are from the 2015/2016 wave of the Longitudinal Aging Study Amsterdam. First, we use means-comparison tests to examine whether older adults who experience social and emotional loneliness differ from older adults who do not experience loneliness regarding their subjective and objective debt burdens. Subsequently, using linear regression models we address two questions: whether social loneliness and emotional loneliness are associated with objective and subjective debt burden; and whether social participation, social network size, anxiety and depression mediate these relationships. We find that subjective debt burden (i.e. the worry related to debt) is a significant predictor of social loneliness, above and beyond the role of social and psychological measures. Objective debt burden, in contrast, is unrelated to social and emotional loneliness. Social participation, social network size, anxiety and depression do not mediate the debt-burden-to-loneliness relationships. The results point to the importance of subjective debt burden in understanding social loneliness and designing interventions.

Socio-demographic characteristics associated with emotional and social loneliness among older adults

Background

International studies provide an overview of socio-demographic characteristics associated with loneliness among older adults, but few studies distinguished between emotional and social loneliness. This study examined socio-demographic characteristics associated with emotional and social loneliness.

Methods

Data of 2251 community-dwelling older adults, included at the baseline measure of the Urban Health Centers Europe (UHCE) project, were analysed. Loneliness was measured with the 6-item De Jong-Gierveld Loneliness Scale. Multivariable logistic regression models were used to evaluate associations between age, sex, living situation, educational level, migration background, and loneliness.

Results

The mean age of participants was 79.7 years (SD = 5.6 years); 60.4% women. Emotional and social loneliness were reported by 29.2 and 26.7% of the participants; 13.6% experienced emotional and social loneliness simultaneously. Older age (OR: 1.16, 95% CI: 1.06–1.28), living without a partner (2.16, 95% CI: 1.73–2.70), and having a low educational level (OR: 1.82, 95% CI: 1.21–2.73), were associated with increased emotional loneliness. Women living with a partner were more prone to emotional loneliness than men living with a partner (OR: 1.78, 95% CI: 1.31–2.40). Older age (OR: 1.11, 95% CI: 1.00–1.22) and having a low educational level (OR: 1.77, 95% CI: 1.14–2.74) were associated with increased social loneliness. Men living without a partner were more prone to social loneliness than men living with a partner (OR: 1.94, 95% CI: 1.35–2.78).

Conclusions

Socio-demographic characteristics associated with emotional and social loneliness differed regarding sex and living situation. Researchers, policy makers, and healthcare professionals should be aware that emotional and social loneliness may affect older adults with different socio-demographic characteristics.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02058-4.

Loneliness, Social Isolation and Their Difference: A Cross-Diagnostic Study in Persistent Depressive Disorder and Borderline Personality Disorder

Background: Interpersonal difficulties are a key feature of persistent depressive disorder (PDD) and borderline personality disorder (BPD). Caught in a vicious circle of dysfunctional interpersonal transaction, PDD and BPD patients are at great risk of experiencing prolonged loneliness. Loneliness, in turn, has been associated with the development of mental disorders and chronic illness trajectories. Besides, several factors may contribute to the experience of loneliness across the lifespan, such as social network characteristics, a history of childhood maltreatment (CM), and cognitive-affective biases such as rejection sensitivity (RS). This cross-diagnostic study approached the topic of perceived loneliness by comparing PDD and BPD patients with healthy controls (HC) in its interplay with symptom burden, social network characteristics, RS as well as CM. Method: Thirty-four PDD patients (DSM-5; 15 female, Mage = 38.2, SD = 12.3), 36 BPD patients (DSM-5; 19 female, Mage = 28.8, SD = 9.2), and 70 age- and gender-matched HC were assessed cross-sectionally using the following self-report measures: UCLA Loneliness Scale, Social Network Index (SNI; size, diversity, and embeddedness), Beck Depression Inventory (BDI-II), Borderline Symptom List (BSL-23), Childhood Trauma Questionnaire (CTQ), and Rejection Sensitivity Questionnaire (RSQ). Results: Both patient groups reported significantly higher levels of perceived loneliness, symptom severity, and smaller social network characteristics compared to HC. Loneliness was significantly correlated with severity of self-reported clinical symptoms in PDD and at trend level in BPD. Besides, loneliness tended to be related to social network characteristics for all groups except PDD patients. Both PDD and BPD patients showed higher RS as well as CTQ scores than HC. A history of emotional abuse and emotional neglect was associated with loneliness, and this association was mediated by RS as demonstrated by an exploratory mediation analysis. Discussion: Loneliness is highly prevalent in PDD and BPD patients and contributes to the overall symptom burden. Interestingly, loneliness showed an association with prior experiences of CM as well as current RS. We therefore propose a comprehensive model on how intra- und interpersonal aspects may interplay in the dynamics of loneliness in light of CM. Finally, this model may have further implications for psychotherapeutic interventions.

Gender and Age Differences in Loneliness: Evidence for People without and with Disabilities

This study examines the relationships between loneliness, gender, and age for people without and with disabilities (moderate versus severe) in Germany. Using data taken from the German Socio-Economic Panel (SOEP) for the years 2013 and 2017 and using the UCLA (University of California, Los Angeles) Loneliness Scale, in general we found that males report lower loneliness scores as compared to those for females. Furthermore, we found a strong association between loneliness and the individual's age, but with differences according to gender and disability status. For example, for males with severe disabilities levels of loneliness decrease with age, whereas for females with severe disabilities the opposite result is found. In addition, we found that participation in leisure activities and having a higher frequency of contacts with family, friends, and social online networks (measured by the relational time index) contribute to reducing loneliness for all individuals. From a public policy perspective, it is necessary to undertake the design, promotion, and implementation of instrumental, emotional, and social support measures for people with disabilities (in particular for females that are severely limited in their daily activities), which can contribute to reducing their loneliness scores and increasing their levels of life satisfaction.

Addressing elderly loneliness with ICT Use: the role of ICT self-efficacy and health consciousness

With an increasing aging population worldwide, loneliness among elderly individuals has become a salient societal problem. Fortunately, the last decade has also witnessed an upsurge in information and communication technology (ICT), which is ubiquitously deployed and integrated into our daily lives, including the lives of elderly people. This research investigates the potential exploitation of well-developed ICT to mitigate loneliness among the elderly. Specifically, we examined the effects of two dimensions of ICT use: communication use and information use. Moreover, we examined the moderating effects of two relevant features in the elderly population, namely, ICT self-efficacy and health consciousness. We applied structural equation modeling (SEM) to evaluate survey data from mainland China comprising 436 effective responses from the elderly population. We find that ICT use has a positive effect on loneliness among the elderly, and our results support and deepen this understanding, indicating that ICT self-efficacy and health consciousness can moderate the relationship between ICT use and loneliness. Our findings suggest that ICT use plays a significant role in mitigating elderly loneliness. Moreover, it is also suggested that the characteristics of ICT self-efficacy and health consciousness for the elderly can influence the relationship between their ICT use and loneliness. This gives a more accurate description, as compared with the main findings in prior literature, that ICT can help mitigate loneliness in the elderly. Finally, by adopting social cognitive theory, our research explains the moderating effect of ICT self-efficacy and health consciousness between the use of ICT by the elderly and their loneliness.

What role can videogames play in the COVID-19 pandemic?

Video games are often thought of as trite activities for younger generations. However, research in game studies over the last few decades have revealed that games can be valuable tools for growth and connection, particularly among older generations. Exploring the ways digital games can be used as tools for connection has gained increased attention in recent months with global quarantines as a result of COVID-19. This article reviews the research that has examined the utility of digital games for older adults, focusing specifically on the ways in which games can be tools for social connectedness and psychological healing for older adults and intergenerationally. Special focus will be placed on the role games can play for post-traumatic stress among first responders.

What role can videogames play in the COVID-19 pandemic?

Video games are often thought of as trite activities for younger generations. However, research in game studies over the last few decades have revealed that games can be valuable tools for growth and connection, particularly among older generations. Exploring the ways digital games can be used as tools for connection has gained increased attention in recent months with global quarantines as a result of COVID-19. This article reviews the research that has examined the utility of digital games for older adults, focusing specifically on the ways in which games can be tools for social connectedness and psychological healing for older adults and intergenerationally. Special focus will be placed on the role games can play for post-traumatic stress among first responders.

The meanings of loneliness for older persons

Objectives: We identify and describe the meanings of loneliness among older persons, the kinds of relationships they are seeking in order to alleviate it, and the barriers they face in developing these connections.Method: Study participants were 35 older persons between the ages of 66 and 92 years from Tel Aviv, Israel, who participated in an intervention which involved group activities and individual meetings. The transcriptions of the individual meetings in which participants described their loneliness and explored potential solutions formed the data for thematic analysis.Results: Participants experienced loneliness in highly individualized ways. They were more likely to experience it when alone in the evening and on weekends, and when distracting activities were not available. While most sought companionship, many focused on a specific type of relationship, ranging from instrumental companionships to intimate and spousal relationships. Participants often had particular preferences about the demographic and socioeconomic characteristics they desired in a companion. Barriers to alleviating loneliness included cognitive sets, social skills deficits, rejection of others, technological illiteracy, and physical, sensory, and cognitive limitations. External factors included economic hardship and community programming which failed to promote socialization.Conclusion: New approaches are needed to counter and prevent loneliness among older persons by addressing the types of particular desires raised in our findings, as well as the psychological barriers to realizing them. Public policy and societal initiatives should tackle external barriers through programming which promotes social engagement and the development of other innovative strategies.

Depressive symptoms predict increased social and emotional loneliness in older adults

Objectives: Explorations of relationships between loneliness and depression have focused on loneliness as a uni-dimensional construct. We hypothesised that reciprocal relationships may exist between depressive symptomatology and social and emotional subtypes of loneliness.Methods: Using data from 373 adults aged over 50, who participated in an observational cohort study, we employed a cross-lagged approach within a Structural Equation Modelling framework, to investigate reciprocal links between depressive symptomatology, and social and emotional loneliness, across two waves of data collection, two years apart (controlling for age, sex, education, comorbidities, social network index, and perceived stress).Results: Both depressive symptomatology and loneliness decreased slightly between waves. Auto-regressive effects were strong for all three variables of interest. Cross-lagged pathways were evident, such that depressive symptomatology at baseline predicted both emotional (β = 0.26, p < 0.05) and social (β = 0.17, p < 0.05) loneliness at follow-up. Neither emotional (β = 0.07, p > 0.05) nor social (β = 0.05, p > 0.05) loneliness at baseline predicted depressive symptomatology at follow-up.Conclusions: Results challenge existing understanding of the associations between loneliness and depression. Further investigation of emotional and social loneliness in individuals with depressive disorders is warranted. Findings are discussed in relation to mechanisms that may explain the relationships observed, and possible implications.

Hearing Impairment, Loneliness, Social Isolation, and Cognitive Function: Longitudinal Analysis Using English Longitudinal Study on Ageing

OBJECTIVE

This study examines the relationships between hearing impairment and cognitive function among older adults, and whether that association is mediated by loneliness and social isolation.

METHODS

Data were drawn from English Longitudinal Study of Ageing (ELSA) wave two (2004/2005) until wave seven (2014/2015). The study sample consisted of 8,199 individuals aged 50 years or older. Cognitive function was measured using episodic memory. We performed analysis using a generalized structural equation modeling (GSEM) technique.

RESULTS

GSEM analysis shows that the direct effect of hearing impairment on episodic memory was negative and significant (β = -0.29, p <0.001). Loneliness and social isolation mediated that effect. Hearing impairment was positively associated with loneliness (β = 0.10, p <0.001) and social isolation (β = 0.04, p <0.001). Loneliness (β = -0.08, p <0.001) and social isolation (β = -0.09, p = 0.001) were significantly associated with lower memory scores.

CONCLUSION

The link between hearing impairment and episodic memory was partly mediated by loneliness and social isolation. Interventions to improve the social networks of older adults with hearing impairment are likely to be beneficial in preventing cognitive decline. Thus, the importance of maintaining social relationships among older adults, especially those with hearing impairment is highlighted.

Comparisons of the discrepancy between loneliness and social isolation across Ireland and Sweden: findings from TILDA and SNAC-K

PURPOSE

Loneliness may have different cultural meanings in different countries. This may manifest as differing levels of Social Asymmetry-the discrepancy between loneliness and social isolation. Since loneliness is thought to be low in Sweden relative to more southerly countries, we hypothesised that more number of individuals would also fall into the "discordant robust" category of Social Asymmetry, i.e. that more individuals in Sweden would have lower loneliness levels relative to social isolation than in Ireland. We also explored the clinical relevance of Social Asymmetry in both countries, by examining its association with cognitive functioning.

METHODS

We derived Social Asymmetry metrics in two representative cohort studies: the Irish Longitudinal Study on Ageing (TILDA) and the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Data pertaining to a dementia-free sample of 4565 Irish participants and 3042 Swedish participants, all aged over 60 years, were analysed using a multilevel modelling approach, with country as a higher-order variable.

RESULTS

Contrary to the expected, more individuals in Ireland were "discordant robust" than in Sweden. We also found evidence for superior performance in global cognitive functioning among those in the "discordant robust" category relative to those in the discordant susceptible (i.e. those with higher levels of loneliness than social isolation) category, β = 0.61, p < .001, across both countries.

CONCLUSIONS

Irish older adults may be more robust to the impact of social isolation on loneliness than those in the Swedish cohort. Social Asymmetry was related to cognitive functioning in both countries, suggesting that Social Asymmetry is a clinically relevant construct.

Loneliness in later life: a cross-sectional survey analysis of place-based factors in Ireland

Purpose

The purpose of this paper is to investigate the relationship between the age-friendliness of local environments and self-reported loneliness for a representative sample of community-dwelling adults aged 55+ in Ireland.

Design/methodology/approach

Data were from the Healthy and Positive Ageing Initiative Age friendly Cities and Counties Survey (n=10,540) (2016). Several age friendly indicators, as proposed by World Health Organisation, were included in this study: outdoor spaces and buildings; access to social services; social participation; respect and social inclusion; and transport. Loneliness was measured using five items from the UCLA Loneliness Scale. Informed by an ecological approach to ageing, multi-level negative binomial regression models were used to investigate the association between each age friendly indicator and social loneliness. Models were adjusted for known demographic, socio-economic and health correlates of loneliness.

Findings

Average loneliness scores were significantly higher for those in poorer health, who lived alone, were materially deprived and those never or formerly married. Lower ratings and poorer outcomes for several interrelated age friendly place-based factors were significantly associated with higher loneliness scores: difficulty with transport, difficulty accessing social services, barriers to community activities, lower social engagement, and experiences and perceptions of ageism in the community; however, the effect sizes were small.

Originality/value

This study identified several modifiable age friendly features of local environments that are associated with loneliness in this older population. The results of this study can inform coordinated local and national efforts to enhance the age-friendliness of local environments and reduce the risk and experience of loneliness among the ageing population in Ireland.

The antecedents of loneliness in older people with an intellectual disability

INTRODUCTION

The cognitive discrepancy approach to loneliness is often used to describe loneliness in ageing populations, but to date, it has never been used to explore loneliness in older people with an intellectual disability. An analysis is needed utilising a refined list of causes of loneliness in this population.

METHOD

Using data from a nationally representative dataset of people aged over 40 with an intellectual disability (N = 708), this analysis runs repeated regressions of variables grouped into conceptual blocks, organised from sociodemographic to network quality.

RESULTS

Variables selected predicted 23% of the loneliness variance. Functional limitations, education, working in the community, transport difficulties, pain, stress caused by service change, emotional health problems and confiding were all significant predictors of loneliness.

CONCLUSION

That for those with fewer functional limitations only transport difficulties precipitated loneliness, suggests living a more independent life protects from loneliness, in this group. Those with functional limitations and who lead a more service dependent life appear more exposed to loneliness precipitating variables.

Medication taking in people with hip and knee osteoarthritis: An analysis of the English Longitudinal Study of Ageing

OBJECTIVES

Osteoarthritis (OA) is a highly prevalent condition seen across primary care services. Although evidence-based guidelines have encouraged the prescription of medications, including analgesics, for this population, there remains uncertainty as to which types of individuals actually take prescribed or over-the-counter medications. The purpose of the present study was to determine whether there is a difference in characteristics between people who take medicines for OA compared with those who do not.

METHODS

A cross-sectional analysis of the English Longitudinal Study of Ageing (ELSA) cohort was undertaken. Individuals who reported hip and/or knee OA pain were included. Data on medication taking were self-reported and collected as part of the ELSA data collection programme. Logistic regression analyses were undertaken to determine the relationship between potential predictors (demographic, pathology-specific, psychological, social and functional) and whether individuals took medications for their OA symptoms.

RESULTS

A total of 654 participants reported OA: 543 medicine takers and 111 nontakers. Individuals who had access to a car (odds ratio [OR]: 56.2; 95% confidence interval [CI]: 3.35 to 941.36), those with a greater duration of hip pain (OR: 5.79; 95% CI: 1.40 to 24.0) and those who achieved 10 chair raises at greater speed (OR: 1.08; 95% CI: 1.03 to 1.14) were more likely to take OA medicines.

CONCLUSIONS

The study identified predictors for medication taking in individuals with hip and/or knee OA. Strategies are now warranted to provide better support to these individuals, to improve health and well-being for this long-term, disabling condition.

Older People, Loss, and Loneliness: The Troublesome Nature of Increased Contact With Adult Children

Older people may experience considerable loss when they endure emotional or social loneliness. Emotional loneliness is related to the loss or absence of a confidant while social loneliness describes the discrepancy between the nature of one’s desired and actual social network. In this article, both concepts are examined in relation to new attendees at time-limited day center reablement programs in Northern Ireland. Using group work activities, reablement programs aim to motivate participants to continue to live independently, often in the face of later life losses. Out of a total of 91 initial respondents (range, 61–94), 13 lived with adult children (10 of whom were lone parents). Those living with, or who had daily contact with, adult children had significantly higher levels of emotional loneliness at the start of their program, but not at the end. For this sample, reductions in emotional loneliness in certain cohorts of older adults who attend these programs have been identified. In conclusion, it is proposed that fourth age losses mediate older people’s living arrangement and may create greater vulnerability to emotional loneliness in those living with adult children. In addition, social groups may be effective in helping reduce emotional loneliness.

Is it love or loneliness? Exploring the impact of everyday digital technology use on the wellbeing of older adults

Loneliness is a prevalent phenomenon within the older adult population. Previous literature suggests that technology use, specifically internet use, can alleviate loneliness and improve wellbeing. This research study follows 32 people over the age of 65 using a digital technology for six months. A mixed-method approach was used to collect quantitative and qualitative data throughout the time period. The repeated questionnaire measured changes in frequency of use, emotional attachment towards a device, a sense of belonging and perceptions of self-worth, whilst an event-based diary was used to note usages and influences of technology on lifestyle. Results revealed positive relationships between frequency of use and emotional attachment and frequency of use and perceptions of self-worth. There was no significant relationship between frequency of use and a sense of belonging for the aggregate data. There was, however, a negative relationship between emotional attachment towards a device and a sense of belonging, suggesting a fine balance between technology use to improve self-esteem through connections with social networks and an over-dependence on technology that can actually reduce feelings of belonging.

Predictors of loneliness and different types of social isolation of rural-living older adults in the United Kingdom

Loneliness and social isolation are recognised, conceptually distinct threats to health and wellbeing in older age but limited evidence is available on their predictors in rural populations. This study performed logistical regression modelling to explore the predictors of loneliness, isolation from one's family and isolation from one's community in 884 British rural-living older adults (57.9% female; mean age = 71.5, standard deviation = 8.1 years) within the Grey and Pleasant Land data-set. While 13 per cent of participants reported feeling lonely, 49 per cent reported isolation from their family and 9 per cent reported isolation from their community. Minimal cross-over between groups was observed. Widowhood, financial difficulties, area deprivation, and self-reported impairments in physical and mental health predicted loneliness. Greater financial difficulty gave lower odds of isolation from one's family, and higher levels of community engagement gave lower odds of isolation from the community. Ageing in place (longer residency) was the only common predictor for all three dependent variables. Initiatives aimed at tackling loneliness and social isolation in rural-living older people must recognise that the two concepts are distinct, affecting different population sub-groups with mostly different risk factor profiles. Future interventions and policies should clearly identify whether their target is loneliness or social isolation and tailor their interventions appropriately.

Correlates and predictors of loneliness in older-adults: a review of quantitative results informed by qualitative insights

BACKGROUND

Older persons are particularly vulnerable to loneliness because of common age-related changes and losses. This paper reviews predictors of loneliness in the older population as described in the current literature and a small qualitative study.

METHODS

Peer-reviewed journal articles were identified from psycINFO, MEDLINE, and Google Scholar from 2000-2012. Overall, 38 articles were reviewed. Two focus groups were conducted asking older participants about the causes of loneliness.

RESULTS

Variables significantly associated with loneliness in older adults were: female gender, non-married status, older age, poor income, lower educational level, living alone, low quality of social relationships, poor self-reported health, and poor functional status. Psychological attributes associated with loneliness included poor mental health, low self-efficacy beliefs, negative life events, and cognitive deficits. These associations were mainly studied in cross-sectional studies. In the focus groups, participants mentioned environmental barriers, unsafe neighborhoods, migration patterns, inaccessible housing, and inadequate resources for socializing. Other issues raised in the focus groups were the relationship between loneliness and boredom and inactivity, the role of recent losses of family and friends, as well as mental health issues, such as shame and fear.

CONCLUSIONS

Future quantitative studies are needed to examine the impact of physical and social environments on loneliness in this population. It is important to better map the multiple factors and ways by which they impact loneliness to develop better solutions for public policy, city, and environmental planning, and individually based interventions. This effort should be viewed as a public health priority.

Lost and unfulfilled relationships behind emotional loneliness in old age

Using a qualitative approach, this article examines how the experiences of emotional loneliness are embedded in the everyday lives and relationships of older adults. Ten in-depth interviews were conducted in 2010 with older people who reported feeling lonely, often or all the time, during a cohort study in southern Finland. The research reveals the multifaceted nature of loneliness and its causes. Behind emotional loneliness, we identified lost and unfulfilled relationships, involving the loss or lack of a partner, the absence of a meaningful friendship, complex parenthood and troubling childhood experiences. Most of the interviewees have faced loneliness that only began in old age, but for some, loneliness has been present for nearly a lifetime.

Widowhood, Socio-Economic Status, Health and Wellbeing in Low and Middle-Income Countries

Using data on women aged 50 and over from the WHO's Survey of Ageing and Adult Health for China, Ghana, India, the Russian Federation and South Africa (N=17,009), we assess associations between widowhood and socio-economic, health and quality of life deprivations. We find variations in the prevalence and timing of widowhood across the study countries, and associations between widowhood and being in the poorest wealth quintile for all five countries. For other deprivations, national experiences varied, with stronger and more consistent effects for India and China. These findings challenge generalised claims about widowhood and call for more contextualised analysis.

The Relationship Between Gratitude and Loneliness: The Potential Benefits of Gratitude for Promoting Social Bonds

This paper explores the potential role of gratitude on the reduction of loneliness feelings, even controlling for several variables related to social desirability, well-being (subjective happiness and life satisfaction) and socio-demographic characteristics. Through a web-based survey a convenience sample of 197 participants completed an online questionnaire including these measures. Correlation analyses and four-step hierarchical multiple regression analyses were conducted. The results show a negative correlation between gratitude and loneliness; specifically, gratitude succeeds in accounting for up to almost one-fifth of the total variability of loneliness even controlling for further variables. Being female, not having a stable and consolidated relationship and not participating in the labor force represent some risk factors affecting loneliness which should be taken into account in further research.

Loneliness among older persons in Uganda: examining social, economic and demographic risk factors

Later-life loneliness is becoming an area of great concern in Uganda in light of gradual weakening of extended family as a source of old-age human support. Although information about the effects of feeling lonely exists, little is known about the associated risk factors within the country's social and cultural setting. This paper discusses prevalence and correlates of feeling lonely among older persons. An interviewer-administered questionnaire was used to collect data on 605 older persons in a 2012 cross-sectional study. Respondents were asked to evaluate how they felt in terms of loneliness during the administration of the questionnaire. A total of ten focus group discussions and 12 key informant interviews were also conducted to collect qualitative data. Binary logistic regression was used to predict factors affecting loneliness. Findings indicate that approximately seven in ten older persons felt lonely. Elderly people residing in the urban area were more likely to be lonely than their counterparts staying in the rural environment. In comparison with married older persons, elderly people who were widowed were more likely to be lonely. Absence of a television and pension benefits and prevalence of limb joint ill-health predicted loneliness. The findings have several implications, including developing age-friendly urban centres, encouraging old-age social organisations, decentralising the elderly health-care system and establishing a special old-age fund.

Correlates of social and emotional loneliness in older people: evidence from an English community study

OBJECTIVES

Loneliness is an important influence on quality of life in old age and has been conceptualised as consisting of two dimensions, social and emotional. This article describes analyses that sought to produce models of social and emotional loneliness in older people, using demographic, psychological and health, and social variables.

METHOD

Older people (aged 65+, n=1255) from the Barnsley metropolitan area of the United Kingdom were recruited randomly from within a stratified sampling frame and received a questionnaire-based interview (response rate: 68.1%). The questionnaire contained items and scales on demographic, psychological and health, and social characteristics, and a validated measure of loneliness that assesses both social and emotional loneliness.

RESULTS

Of the respondents, 7.7% were found to be severely or very severely lonely, while another 38.3% were moderately lonely. Social and emotional loneliness shared 19.36% variance. Being male, being widowed, low well-being, low self-esteem, low-income comfort, low contact with family, low contact with friends, low activity, low perceived community integration, and receipt of community care were significant predictors of social loneliness (R=0.50, R2=0.25, F(18, 979)=18.17, p<0.001). Being widowed, low well-being, low self-esteem, high activity restriction, low-income comfort, and non-receipt of informal care were significant predictors of emotional loneliness (R=0.55, R2=0.30, F (18, 973)=23.00, p<0.001).

CONCLUSION

This study provides further empirical support for the conceptual separation of emotional and social loneliness. Consequently, policy on loneliness in older people should be directed to developing a range of divergent intervention strategies if both emotional and social loneliness are to be reduced.

The intertwining of second couplehood and old age

Second couplehood in old age is a growing phenomenon alongside increases in life expectancy. Lately, a shift has occurred in that individual diversity of ageing is perceived to depend on the physical and social contexts in which older persons experience change. Thus, the purpose of the study on which this paper reports was to examine second couplehood in the context of old age and old age in the context of second couplehood using an existential-phenomenological theoretical orientation. Twenty couples were recruited using criterion-sampling: men aged 65+ and women aged 60+, with children and grandchildren from a lifelong marriage that had ended in widowhood or divorce, living in second couplehood – married or not – in separate houses or co-habitating. Forty individual semi-structured interviews were tape-recorded, transcribed verbatim and analysed according to phenomenological tradition. Five sub-themes emerged, demonstrating couplehood and old age intertwining: (a) enjoying life while still possible; (b) living with health-related issues; (c) relationships with adult children: autonomy versus dependency; (d) loneliness: living as a couple is better than living alone; (e) self-image: feeling young–feeling old. Findings support the existence of positive and negative aspects of old age. Our discussion suggests the need to replace perceptions of old age as either a negative burden or a positive asset towards a period of balancing between gains and losses. Furthermore, we acknowledge the role of second couplehood in older peoples’ wellbeing on the personal–micro level through love, the familial–mezzo level through care-giving and the social–macro level by reducing prejudice.

Poor health and loneliness in later life: the role of depressive symptoms, social resources, and rural environments

OBJECTIVES

We draw on cognitive discrepancy theory to hypothesize and test a pathway from poor health to loneliness in later life. We hypothesize that poor health will have a negative influence on social participation and social resources, and these factors will mediate between health and loneliness. We hypothesize that rural environments will amplify any difficulties associated with social participation or accessing social resources and that depression will moderate how intensely people react to levels of social contact and support.

METHODS

We conceptualize a mediation model and a moderated-mediation model. Nationally representative data on older people living in the Republic of Ireland are used to validate the hypothesized pathways.

RESULTS

In the mediation model, health has a significant indirect effect on loneliness through the mediating variables social resources and social participation. In the moderated-mediation model, rurality moderates the pathway between health and social resources but not social participation. Depressive symptoms moderate the effect of social resources on loneliness but not social participation.

DISCUSSION

The results provide further credence to cognitive discrepancy theory, suggesting that depressive symptoms influence cognitive processes, interfering with judgments about the adequacy of social interaction. The theory is extended by demonstrating the impact of the environment on loneliness.

Impact of internet use on loneliness and contact with others among older adults: cross-sectional analysis

Background

Older adults are at increased risk of experiencing loneliness and depression, particularly as they move into different types of care communities. Information and communication technology (ICT) usage may help older adults to maintain contact with social ties. However, prior research is not consistent about whether ICT use increases or decreases isolation and loneliness among older adults.

Objective

The purpose of this study was to examine how Internet use affects perceived social isolation and loneliness of older adults in assisted and independent living communities. We also examined the perceptions of how Internet use affects communication and social interaction.

Methods

One wave of data from an ongoing study of ICT usage among older adults in assisted and independent living communities in Alabama was used. Regression analysis was used to determine the relationship between frequency of going online and isolation and loneliness (n=205) and perceptions of the effects of Internet use on communication and social interaction (n=60).

Results

After controlling for the number of friends and family, physical/emotional social limitations, age, and study arm, a 1-point increase in the frequency of going online was associated with a 0.147-point decrease in loneliness scores (P=.005). Going online was not associated with perceived social isolation (P=.14). Among the measures of perception of the social effects of the Internet, each 1-point increase in the frequency of going online was associated with an increase in agreement that using the Internet had: (1) made it easier to reach people (b=0.508, P<.001), (2) contributed to the ability to stay in touch (b=0.516, P<.001), (3) made it easier to meet new people (b=0.297, P=.01, (4) increased the quantity of communication with others (b=0.306, P=.01), (5) made the respondent feel less isolated (b=0.491, P<.001), (6) helped the respondent feel more connected to friends and family (b=0.392, P=.001), and (7) increased the quality of communication with others (b=0.289, P=.01).

Conclusions

Using the Internet may be beneficial for decreasing loneliness and increasing social contact among older adults in assisted and independent living communities.

Feelings of loneliness among adults with mental disorder

Loneliness can affect people at any time and for some it can be an overwhelming feeling leading to negative thoughts and feelings. The current study, based on the Adult Psychiatric Morbidity Survey in England, 2007, quantified the association of loneliness with a range of specific mental disorders and tested whether the relationship was influenced by formal and informal social participation and perceived social support.Methods Using a random probability sample design,7,461 adults were interviewed in a cross-sectional national survey in England in 2007. Common Mental Disorders were assessed using the revised Clinical Interview Schedule;the diagnosis of psychosis was based on the administration of the Schedules of the Clinical Assessment of Neuropsychiatry, while loneliness was derived from an item in the Social Functioning Questionnaire.Results Feelings of loneliness were more prevalent in women (OR = 1.34, 95 % CI 1.20–1.50, P\0.001) as well as in those who were single (OR = 2.24, 95 % C I1.96–2.55, P<0.001), widowed, divorced or separated(OR = 2.78, 95 % CI 2.38–3.23, P<0.001), economically inactive (OR = 1.24, 95 % CI 1.11–1.44,P = 0.007), living in rented accommodation (OR = 1.73,95 % CI 1.53–1.95, P<0.001) or in debt (OR = 2.47,95 % CI 2.07–1.50, P<0.001). Loneliness was associated with all mental disorders, especially depression [corrected].