Prevalence of Loneliness and Related Factors Among Older Adults in Taiwan: Evidence From a Nationally Representative Survey

Loneliness prevalence of community-dwelling older adults and the impact of the mode of measurement, data collection, and country: A systematic review and meta-analysis

OBJECTIVES

The aim of this systematic review and meta-analysis is to assess the prevalence of loneliness in many countries worldwide which have different ways of assessing it.

DESIGN

Systematic review and meta-analysis.

SETTING

We searched seven electronic databases for English peer-reviewed studies published between 1992 and 2021.

PARTICIPANTS

We selected English-language peer-reviewed articles, with data from non-clinical populations of community-dwelling older adults (>60 years), and with "loneliness" or "lonely" in the title.

MEASUREMENTS

A multilevel random-effects meta-analysis was used to estimate the prevalence of loneliness across studies and to pool prevalence rates for different measurement instruments, data collection methods, and countries.

RESULTS

Our initial search identified 2,021 studies of which 45 (k = 101 prevalence rates) were included in the final meta-analysis. The estimated pooled prevalence rate was 31.6% (n = 168,473). Measurement instrument was a statistically significant moderator of the overall prevalence of loneliness. Loneliness prevalence was lowest for single-item questions and highest for the 20-item University of California-Los Angeles Loneliness Scale. Also, differences between modes of data collection were significant: the loneliness prevalence was significantly the highest for face-to-face data collection and the lowest for telephone and CATI data collection. Our moderator analysis to look at the country effect indicated that four of the six dimensions of Hofstede also caused a significant increase (Power Distance Index, Uncertainty Avoidance Index, Indulgence) or decrease (Individualism) in loneliness prevalence.

CONCLUSIONS

This study suggests that there is high variability in loneliness prevalence rates among community-dwelling older adults, influenced by measurement instrument used, mode of data collection, and country.

A systematic review evaluating loneliness assessment instruments in older adults

Introduction and objectives

The experiences and changes that come along with old age may lead to a feeling of loneliness, usually followed by negative physical and mental manifestations. In this systematic review, we evaluated the existing tools to assess loneliness in older adults.

Methods

We performed a literature search in the Web of Science, Medline, and PsycINFO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After, we examined the psychometric properties of the instruments with a focus on reliability, validity, and main conclusions.

Results

We included 27 articles published between 1996 and 2021.

Conclusion

To date, there are few instruments to assess loneliness in older adults. In general, they present adequate psychometric properties, although it is true that some scales show somewhat low levels of reliability and validity.

Loneliness Status and Related Factors among the Hakka Elderly in Fujian, China: Based on the Health Ecological Model

There are few studies estimating the loneliness of the Hakka elderly in China. This study aims to examine the loneliness status and related factors among the Hakka elderly in Fujian, China. The short-form UCLA Loneliness Scale (ULS-8) was used to assess the loneliness of the Hakka elderly. Factors associated with loneliness were classified as individual indicators, behavioral indicators, interpersonal indicators, and social indicators according to the health ecological model (HEM). Hierarchical linear regression models were established to identify the main factors that were most predictive of loneliness. A sample of 1,262 Hakka elderly people was included in this study. Females (β = 0.631, P=0.012), those with ≥2 chronic diseases (β = 1.340, P < 0.001), those who were currently living in rural areas (β = 4.863, P < 0.001) or suburban areas (β = 2.027, P < 0.001), those with parents both died (β = 0.886, P=0.001), and those with the Urban Employees Basic Medical Insurance (UEBMI; β = 0.852, P=0.030) obtained a higher score of ULS-8. Those exercised regularly (β = −2.494, P < 0.001), those had leisure activities (β = −1.937, P < 0.001), those ate healthy (β = −1.270, P < 0.001), and those with better self-rated financial status and higher education level received a lower score of ULS-8. There are differences in loneliness among different Hakka elderly population subgroups, and healthy behaviors and lifestyles may reduce the loneliness of the Hakka elderly. Relevant interventions should be implemented in a targeted manner, focusing on susceptible populations. This is most evident among those who were female, living in rural areas, with parents both died, with lower education, and with multiple chronic diseases.