Are we measuring loneliness in the same way in men and women in the general population and in the older population? Two studies of measurement equivalence

Effect of telehealth yoga on loneliness and social isolation among rural older adults: a randomized controlled trial

OBJECTIVES

Loneliness and social isolation are associated with a range of deleterious health outcomes. Yoga is a mind-body physical activity that is used in health care settings and increasingly in a telehealth group format. This trial aimed to determine the effect of a brief course of telehealth yoga on loneliness among rural older adults.

METHOD

In this pragmatic trial among rural-residing Veterans Affairs patients over age 60 (https://clinicaltrials.gov/study/NCT05431166), participants were randomized to eight, 60-minute telehealth yoga classes delivered to their homes or waitlist control. The primary outcome was loneliness at 10 wk. Additional outcomes included measures of social isolation, fidelity, and acceptability, as well as interview findings.

RESULTS

Of 70 participants, 52 completed follow-up (mean [SD] age 67.8 [5.9] years). Loneliness significantly decreased between baseline and follow-up in both groups, but there were no significant between-group differences in loneliness or social isolation. Ratings of fidelity and acceptability were high. Qualitative findings indicated benefits related to the telehealth format and aspects of social connection not captured in quantitative measures.

CONCLUSION

A brief course of weekly telehealth yoga was feasible and acceptable among older rural patients but not effective at reducing loneliness and social isolation.

Can the Short-Form UCLA Loneliness Scale Be Used to Measure Loneliness Among Chinese Older Adults? From Classical Test Theory to Rasch Analysis

BACKGROUND

Loneliness among older adults, is a subjective experience and a public health issue in aging societies. Psychometrically sound and culturally sensitive measures are needed for developing precisely targeted interventions in culturally distinct groups. This study tested the Short-Form UCLA Loneliness Scale (ULS-8) among Chinese older adults.

METHOD

Confirmatory factor analysis, internal consistency, and the correlation with the single question of loneliness were conducted with a sample of Chinese older adults. Rasch analyses assessed the unidimensionality, response category functioning, item difficulty, and targeting of the ULS-8 for older Chinese adults.

RESULTS

Data from 347 Chinese older adults (mean age 71.36 ± 9.51 years) were analyzed; 74.64% of the participants were female. The ULS-8 showed acceptable internal consistency and criterion validity in Classical Test Theory. Confirmatory factor analysis and Rasch analysis indicated that the ULS-8 did not demonstrate a unidimensional structure. Additionally, Rasch analysis revealed (1) a misfit in item 3, indicating a problem with construct validity; (2) the need to combine response categories; and (3) that Chinese older adults are less likely to endorse a high level of loneliness when using the ULS-8.

CONCLUSIONS

To ascertain the adequacy of the loneliness measure, it is crucial to customize a new short version of the loneliness scale for Chinese older adults through Rasch analysis.

Predictive factors and risk and protection groups for loneliness in older adults: a population-based study

BACKGROUND

Loneliness is considered a public health problem, particularly among older adults. Although risk factors for loneliness have been studied extensively, fewer studies have focused on the protected and risk groups that these factors configure. Our objective is to analyze the variables and latent factors that predict loneliness in older adults and that enable risk and protected groups to be configured.

METHODS

We employed an epidemiological, cross-sectional survey that was carried out on a random sample of 2060 people over 65 years extracted from the census. A structured telephone interview was used to assess mental and physical health, habits, quality of life, and loneliness, applying the COOP-Wonca, Goldberg General Health (GHQ-12), and Barber Questionnaires.

RESULTS

Predictors of loneliness were: mental health, living alone, quality of life, depressive symptoms, low educational level, and some deficiency situations such as having no one to turn to for help. The factors extracted (Factorial Analysis) were: a subjective experience of poor health, objective isolation, and psychological isolation. We established at risk and protected groups ("Decision Tree" procedure), and loneliness was referred to by 73.2% of the people living alone and with poor mental health and quality of life (risk group). By contrast, only 0.8% of people living with others, with good mental health and good quality of life felt loneliness (protected group).

CONCLUSION

In a well-developed city, subjective and objective factors are associated with loneliness. These factors, especially those associated with at risk or protected groups, must be considered to develop strategies that address loneliness.

Relationship of Living and Eating Arrangements to Mental Distress Among Older Korean Immigrants: Gender Difference in the Mediating Role of Loneliness

This study examined how different living/eating arrangements were associated with loneliness and depressive symptoms among older Korean immigrants. We examined gender differences considering: (1) patterns of living/eating arrangements and their relations with loneliness and mental distress and (2) indirect effect of living/eating arrangements on mental distress through feeling lonely. Data were drawn from the Study of Older Korean Americans that surveyed older; Korean immigrants during 2017-2018 (N = 2150). Living/eating arrangements were classified in the combination of four categores. Using the PROCESS macro, we tested gender differences in the mediation effect of loneliness on the relationship between living/eating arrangements and mental distress while controlling for background/health characteristics and social connectedness-related variables. The mediating role of loneliness was manifested differentially between men and women. By administering simple measures of living/eating arrangements, practitioners could potentially identify key targets to improve social and mental well-being, particularly among older immigrants with limited resources.