Social distancing and "stay-at-home" orders are essential to contain the coronavirus outbreak (COVID-19), but there is concern that these measures will increase feelings of loneliness, particularly ...in vulnerable groups. The present study examined change in loneliness in response to the social restriction measures taken to control the coronavirus spread. A nationwide sample of American adults (N = 1,545; 45% women; ages 18 to 98, M = 53.68, SD = 15.63) was assessed on three occasions: in late January/early February 2020 (before the outbreak), in late March (during the President's initial "15 Days to Slow the Spread" campaign), and in late April (during the "stay-at-home" policies of most states). Contrary to expectations, there were no significant mean-level changes in loneliness across the three assessments (d = .04, p > .05). In fact, respondents perceived increased support from others over the follow-up period (d = .19, p < .01). Older adults reported less loneliness overall compared to younger age groups but had an increase in loneliness during the acute phase of the outbreak (d = .14, p < .05). Their loneliness, however, leveled off after the issuance of stay-at-home orders. Individuals living alone and those with at least one chronic condition reported feeling lonelier at baseline but did not increase in loneliness during the implementation of social distancing measures. Despite some detrimental impact on vulnerable individuals, in the present sample, there was no large increase in loneliness but remarkable resilience in response to COVID-19.
Public Significance Statement
This study tests for change in loneliness prior and during the outbreak of the coronavirus in the United States. While continued attention should be directed to vulnerable groups, the study did not find a large increase in loneliness despite the social distancing measures undertaken to contain the outbreak. Even when physically isolated, the feeling of increased social support and of being in this together may help limit increases in loneliness.
Full text
Available for:
CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
•Social isolation is strongly associated with suicidal outcomes.•The subjective feeling of loneliness has a major impact, even transculturally.•Objective and subjective social isolation should be ...added in suicide risk assessment.
Social isolation is one of the main risk factors associated with suicidal outcomes. The aim of this narrative review was to provide an overview on the link between social isolation and suicidal thoughts and behaviors.
We used the PubMed database to identify relevant articles published until April 13, 2018. We focused on: (a) systematic reviews, meta-analyses, and narrative reviews; (b) original observational studies with large samples (N ≥ 500); and (c) qualitative studies. We included all relevant suicidal outcomes: suicidal ideation (SI), suicidal planning, non-suicidal self-injury, deliberate self-harm, suicide attempt (SA), and suicide.
The main social constructs associated with suicidal outcomes were marital status (being single, separated, divorced, or widowed) and living alone, social isolation, loneliness, alienation, and belongingness. We included 40 original observational studies, the majority of them performed on adolescents and/or young adults (k = 23, 57.5%). Both the objective condition (e.g., living alone) and the subjective feeling of being alone (i.e., loneliness) were strongly associated with suicidal outcomes, in particular with SA and SI. However, loneliness, which was investigated in most studies (k = 24, 60%), had a major impact on both SI and SA. These associations were transculturally consistent.
Confounding factors can limit the weight of the results obtained in observational studies.
Data from the observational studies suggest that both objective social isolation and the subjective feeling of loneliness should be incorporated in the risk assessment of suicide. Interventional studies targeting social isolation for suicide prevention are needed.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Little is known about the collective patterns of health-related behaviors of older adults living alone. We aimed to identify subgroups of older adults living alone based on their health lifestyle and ...examine the relationship between these subgroups and sociodemographic characteristics, life satisfaction, and depressive symptoms.
A total of 3137 older adults living alone were sampled from the 2020 National Survey of Older Koreans. Latent class analysis was performed using 11 health-related behaviors: smoking; alcohol consumption; fruit, vegetable, and dairy product consumption; exercise; cultural leisure; social groups; educational activities; health check-ups; and dementia screening. Multinomial logistic and multiple linear regression analyses were performed.
Three classes were identified: Consistently Healthy (CH), Moderately Healthy but Inactive (MHI), and Unhealthy but Active (UA). Compared to the CH, members of the MHI tend to have no formal education and rarely meet relatives. Members of the UA were more likely to be male and employed. The MHI and UA were more likely to have lower incomes, meet with children less frequently or have no children, and rarely meet friends, neighbors, and acquaintances when compared to the CH. Members of the UA group had the highest risk of reduced life satisfaction and increased depressive symptoms.
The cross-sectional design precluded causal inferences.
Our study sheds light on the heterogeneity of health lifestyles among older adults living alone and highlights the need for tailored interventions to promote healthy aging in this population.
•There was heterogeneity in health lifestyles among older adults living alone.•Three groups were identified by performing latent class analysis.•Life satisfaction and depressive symptoms differ greatly among the three groups.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Adults with cognitive impairment are prone to living alone in large numbers but receive relatively little attention. This study aimed to evaluate whether living alone with cognitive impairment was ...associated with a higher burden of functional disability but lack of informal care.
982 observations of adults living alone with cognitive impairment and 50,695 observations of adults living with others and with normal cognition were identified from 4 waves (2011/2012, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study (CHARLS). A matched comparator was selected using propensity score matching (1:2). Functional disability included disability in Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), and mobility. The time of receiving informal care was measured in monthly hours.
Adults living alone with cognitive impairment demonstrated significantly higher odds ratio of ADL disability (OR = 1.59, 95 % CI: 1.30, 1.95), IADL disability (OR = 1.19, 95 % CI: 1.00, 1.44), mobility disability (OR = 1.38, 95 % CI: 1.12, 1.70), but received fewer hours of informal care (β = −127.7 h per month, standard error = 25.83, P < 0.001), compared to the adults living with others and with normal cognition.
This study highlights the high burden of functional disability but low coverage of informal care among Chinese adults living alone with cognitive impairment and calls for more resources to be allocated to this vulnerable subpopulation to improve the functional health and to increase the provision of long-term care services.
•Unique social-demographic features of adults living alone with cognitive impairment.•This vulnerable group experiences severe burden of functional disability.•Informal care coverage for such group in the community is low.•Propensity score matching is used to address the confounders and data imbalance.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Purpose To identify factors that affect the return to solitary living of patients with stroke who had lived alone prior to stroke onset. Participants and Methods From January 2017 to March 2020, we ...enrolled a total of 103 patients with stroke who had lived alone prior to stroke onset and retrospectively analyzed their age, gender, length of hospital stay, outcome (return to living alone or not), functional independence measure at discharge, and social score at discharge. We also analyzed the relationship between the above factors and the outcome. Results Functional independence measure and social score at discharge were significantly associated with the outcome. The cutoff value of the functional independence measure at discharge was 91 (area under the curve: 0.91; sensitivity: 0.96; specificity: 0.72), while the rate of return to living alone was 23.5% when the social score was ≥3. The sensitivity and specificity for return to living alone were 0.91 and 0.88, respectively, when cutoff values of the functional independence measure and social score at discharge were 91 and 3, respectively. Conclusion Social factors and ability to perform activities of daily living are important for return to solitary living for patients with stroke who lived alone prior to stroke onset.
The aims of the study were to examine the predictive value of social and emotional loneliness for all-cause mortality in the oldest-old who do and do not live alone and to test whether these varied ...by functional status and personality.
Participants were 413 older adults from the Berlin Aging Study (M SD = 84.53 8.61 years of age) who either lived alone (n = 253) or did not live alone (n = 160). Significance values for hazard ratios are reported having adjusted for age, sex, education, income, marital status, depressive illness, and both social and emotional loneliness.
Although social loneliness was not associated with mortality in those living alone, emotional loneliness was; with each 1 SD increase in emotional loneliness, there was an 18.6% increased risk of all-cause mortality in the fully adjusted model (HR = 1.186, p = .029). No associations emerged for social or emotional loneliness among those not living alone. Examinations of potential moderators revealed that with each 1 SD increase in functional status, the risk associated with emotional loneliness for all-cause mortality increased by 17.9% (hazard ratiointeraction = 1.179, p = .005) in those living alone. No interaction between personality traits with loneliness emerged.
Emotional loneliness is associated with an increased risk of all-cause mortality in older adults who live alone. Functional status was identified as one potential pathway accounting for the adverse consequences of loneliness. Emotional loneliness that can arise out of the loss or absence of a close emotional attachment figure seems to be the toxic component of loneliness.
Abstract
Background
loneliness and social isolation have been associated with mortality and with functional decline in older people. We investigated whether loneliness or social isolation are ...associated with progression of frailty.
Methods
participants were 2,817 people aged ≥60 from the English Longitudinal Study of Ageing. Loneliness was assessed at Wave 2 using the Revised UCLA scale (short version). A social isolation score at Wave 2 was derived from data on living alone, frequency of contact with friends, family and children, and participation in social organisations. Frailty was assessed by the Fried phenotype of physical frailty at Waves 2 and 4, and by a frailty index at Waves 2–5.
Results
high levels of loneliness were associated with an increased risk of becoming physically frail or pre-frail around 4 years later: relative risk ratios (95% CI), adjusted for age, sex, level of frailty and other potential confounding factors at baseline were 1.74 (1.29, 2.34) for pre-frailty, and 1.85 (1.14, 2.99) for frailty. High levels of loneliness were not associated with change in the frailty index—a broadly based measure of general condition—over a mean period of 6 years. In the sample as a whole, there was no association between social isolation and risk of becoming physically frail or pre-frail, but high social isolation was associated with increased risk of becoming physically frail in men. Social isolation was not associated with change in the frailty index.
Conclusion
older people who experience high levels of loneliness are at increased risk of becoming physically frail.
There are concerns internationally that lockdown measures taken during the coronavirus disease 2019 (COVID-19) pandemic could lead to a rise in loneliness. As loneliness is recognised as a major ...public health concern, it is therefore vital that research considers the impact of the current COVID-19 pandemic on loneliness to provide necessary support. But it remains unclear, who is lonely in lockdown?
This study compared sociodemographic predictors of loneliness before and during the COVID-19 pandemic using cross-cohort analyses of data from UK adults captured before the pandemic (UK Household Longitudinal Study, n = 31,064) and during the pandemic (UCL (University College London) COVID-19 Social Study, n = 60,341).
Risk factors for loneliness were near identical before and during the pandemic. Young adults, women, people with lower education or income, the economically inactive, people living alone and urban residents had a higher risk of being lonely. Some people who were already at risk of being lonely (e.g. young adults aged 18–30 years, people with low household income and adults living alone) experienced a heightened risk during the COVID-19 pandemic compared with people living before COVID-19 emerged. Furthermore, being a student emerged as a higher risk factor during lockdown than usual.
Findings suggest that interventions to reduce or prevent loneliness during COVID-19 should be targeted at those sociodemographic groups already identified as high risk in previous research. These groups are likely not just to experience loneliness during the pandemic but potentially to have an even higher risk than normal of experiencing loneliness relative to low-risk groups.
•We compared data from 31,000 UK adults during 2017-2019 with 60,000 UK adults during the COVID-19 pandemic.•Some risk factors for loneliness were the same as in ordinary circumstances (e.g. women and people living alone).•Other groups experienced even greater risk of loneliness than usual (e.g. younger people and people of low income).•Some groups were at risk of loneliness who are not usually considered high risk (e.g. students).
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The relationship between living alone, loneliness and social isolation, and how they are associated with health remain contentious. We sought to explore typologies based on shared experiences of ...loneliness, social isolation and living alone using Latent Class Analysis and determine how these groups may differ in terms of their physical and mental health. We used Wave 7 of the English Longitudinal Study of Ageing (N = 7,032; mean age = 67.3) and responses to the University of California, Los Angeles (UCLA) loneliness scale, household composition, participation in social/societal activities plus frequency of contact with friends, family and relatives for the Latent Class Analysis. The optimal number of groups was identified using model-fit criteria. The socio-demographic characteristics of groups and health outcomes were explored using descriptive statistics and logistic regression. We identified a six-cluster typology: Group 1, no loneliness or isolation; Group 2, moderate loneliness; Group 3, living alone; Group 4, moderate isolation; Group 5, moderate loneliness, living alone; and Group 6, high loneliness, moderate isolation (with high likelihood of living alone). Groups experiencing loneliness and/or isolation were more likely to report poorer physical and mental health even after adjusting for socio-demographic confounders, this was particularly notable for Group 6. Our results indicate that different typologies of living alone, loneliness and isolation can be identified using data-driven techniques, and can be differentiated by the number and severity of issues they experience.
PDF
