Hostname: page-component-cd4964975-598jt Total loading time: 0 Render date: 2023-04-01T17:37:23.868Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

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

Published online by Cambridge University Press:  30 August 2016

Department for Health, Faculty of Humanities and Social Sciences, University of Bath, UK.
Department for Health, Faculty of Humanities and Social Sciences, University of Bath, UK.
Primary Care Research Group, Medical School, University of Exeter, UK.
Address for correspondence: Jolanthe Louise de Koning, 6.11 Wessex House, University of Bath, Claverton Down, Bath BA2 7AY, UK E-mail:


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.

Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Age UK 2013. Later Life in Rural England. Available online at [Accessed 20 July 2012].Google Scholar
Barron, J. S., Tan, E. J., Yu, Q., Song, M., McGill, S. and Fried, L. P. 2009. Potential for intensive volunteering to promote the health of older adults in fair health. Journal of Urban Health, 86, 4, 641–53. doi: 10.1007/s11524-009-9353-8.CrossRefGoogle ScholarPubMed
Boss, L., Kang, D. H. and Branson, S. 2015. Loneliness and cognitive function in the older adult: a systematic review. International Psychogeriatrics, 27, 4, 541–53. doi: ScholarPubMed
Brown, G. 2005. Mapping spatial attributes in survey research for natural resource management: methods and applications. Society and Natural Resources, 18, 1, 1739. doi: 10.1080/08941920590881853.CrossRefGoogle Scholar
Burholt, V. 2012. The dimensionality of ‘place attachment’ for older people in rural areas of South West England and Wales. Environment and Planning A, 44, 12, 2901–21. doi: 10.1068/a4543.CrossRefGoogle Scholar
Burholt, V. and Dobbs, C. 2012. Research on rural ageing: where have we got to and where are we going in Europe? Journal of Rural Studies, 28, 4, 432–46. doi: 10.1016/j.jrurstud.2012.01.009.CrossRefGoogle Scholar
Cacioppo, S., Grippo, A. J., London, S., Goossens, L. and Cacioppo, J. T. 2015. Loneliness, clinical import and interventions. Perspectives on Psychological Science, 10, 2, 238–49. doi: 10.1177/1745691615570616.CrossRefGoogle ScholarPubMed
Cacioppo, J. T. and Cacioppo, S. 2014. Social relationships and health: the toxic effects of perceived social isolation. Social and Personality Psychology Compass, 8, 2, 5872. doi: 10.1111/spc3.12087. CrossRefGoogle ScholarPubMed
Cacioppo, J. T., Hawkley, L. C. and Berntson, G. G. 2003. The anatomy of loneliness. Current Directions in Psychological Science, 12, 3, 71–4. doi: 10.1111/1467-8721.01232.CrossRefGoogle Scholar
Cacioppo, J. T., Hawkley, L. C. and Thisted, R. A. 2010. Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and Aging, 25, 2, 453. doi: 10.1037/a0017216.CrossRefGoogle ScholarPubMed
Caspi, A., Harrington, H., Moffitt, T. E., Milne, B. J. and Poulton, R. 2006. Socially isolated children 20 years later: risk of cardiovascular disease. Archives of Pediatrics & Adolescent Medicine, 160, 8, 805–11. doi:10.1001/archpedi.160.8.805.CrossRefGoogle ScholarPubMed
Cattan, M., Hogg, E. and Hardill, I. 2011. Improving quality of life in ageing populations: what can volunteering do? Maturitas, 70, 4, 328–32. doi: 10.1016/j.maturitas.2011.08.010.CrossRefGoogle Scholar
Cattan, M., White, M., Bond, J. and Learmouth, A. 2005. Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Ageing & Society, 25, 1, 4167. doi: Scholar
Colbert, L. H., Matthews, C. E., Havighurst, T. C., Kim, K. and Schoeller, D. A. 2011. Comparative validity of physical activity measures in older adults. Medicine and Science in Sports and Exercise, 43, 5, 867–76. doi:10.1249/MSS.0b013e3181fc7162.CrossRefGoogle ScholarPubMed
Communities and Local Government 2007. The English Indices of Deprivation. Available online at [Accessed 3 February 2016].Google Scholar
Cornwell, E. Y. and Waite, L. J. 2009. Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior, 50, 1, 3148. doi: 10.1177/002214650905000103.CrossRefGoogle ScholarPubMed
Curry, N. and Fisher, R. 2013. Being, belonging and bestowing: differing degrees of community involvement amongst rural elders in England and Wales. European Journal of Ageing, 10, 4, 32333. doi: 10.1007/s10433-013-0277-5.CrossRefGoogle ScholarPubMed
De Jong Gierveld, J., van Tilburg, T. and Dykstra, P. A. 2006. Loneliness and social isolation. In Vangelist, A. and Perlman, D. (eds), Cambridge Handbook of Personal Relationships. Cambridge University Press, Cambridge, 485500.CrossRefGoogle Scholar
De Jong Gierveld, J. and Kamphuis, F. 1985. The development of a Rasch-type loneliness scale. Applied Psychological Measurement, 9, 3, 289–99. doi: 10.1177/014662168500900307.CrossRefGoogle Scholar
de Koning, J., Stathi, A. and Fox, K. R. 2015. Similarities and differences in the determinants of trips outdoors performed by UK urban- and rural-living older adults. Journal of Aging and Physical Activity, 23, 4, 613–21. Scholar
Demakakos, P., Nunn, S. and Nazroo, J. 2006. Loneliness, relative deprivation and life satisfaction. In Banks, J., Breeze, E., Lessof, C. and Nazroo, J. (eds), Retirement, Health and Relationships of the Older Population in England: The 2004 English Longitudinal Study of Ageing (Wave 2). Institute for Fiscal Studies: London.Google Scholar
Department for Environment, Food and Rural Affairs (DEFRA) 2013. The Rural–Urban Classification for England. Available online at [Accessed 20 May 2015].Google Scholar
Department for Environment, Food and Rural Affairs (DEFRA) 2015. Statistical Digest of Rural England. Available online at [Accessed 20 May 2015].Google Scholar
Devon County Council 2013. Rural Health and Wellbeing Strategy for 2010–2013. Available online at [Accessed 6 April 2015].Google Scholar
Dickens, A. P., Richards, S. H., Greaves, C. J. and Campbell, J. L. 2011. Interventions targeting social isolation in older people: a systematic review. BMC Public Health, 11, 1, 647. ScholarPubMed
Drennan, J., Treacy, M., Butler, M., Byrne, A., Fealy, G., Frazer, K. and Irving, K. 2008. The experience of social and emotional loneliness among older people in Ireland. Ageing & Society, 28, 8, 1113–32. doi: 10.1017/S0144686X08007526.CrossRefGoogle Scholar
Dykstra, P. A., Van Tilburg, T. G. and De Jong Gierveld, J. 2005. Changes in older adult loneliness results from a seven-year longitudinal study. Research on Aging, 27, 6, 725–47. doi: 10.1177/0164027505279712.CrossRefGoogle Scholar
Economic Social Research Council 2015. Grey and Pleasant Land? An Interdisciplinary Exploration of the Connectivity of Older People in Rural Civic Society. Available online at [Accessed 28 September 2015].Google Scholar
Ellwardt, L., Aartsen, M., Deeg, D. and Steverink, N. 2013. Does loneliness mediate the relation between social support and cognitive functioning in later life? Social Science & Medicine, 98, 116–24. doi:10.1016/j.socscimed.2013.09.002.CrossRefGoogle ScholarPubMed
Emmerson, C. and Tetlow, G. 2006. Labour market transitions. In Banks, J., Breeze, E., Lessof, C. and Nazroo, J. (eds), Retirement, Health and Relationships of the Older Population in England: The 2004 English Longitudinal Study of Ageing (Wave 2). Institute for Fiscal Studies: London.Google Scholar
Fokkema, T., De Jong Gierveld, J. and Dykstra, P. A. 2012. Cross-national differences in older adult loneliness. Journal of Psychology, 146, 1/2, 201–28. doi: 10.1080/00223980.2011.631612.CrossRefGoogle ScholarPubMed
Golden, J., Conroy, R. M., Bruce, I., Denihan, A., Greene, E., Kirby, M. and Lawlor, B. A. 2009. Loneliness, social support networks, mood and wellbeing in community-dwelling elderly. International Journal of Geriatric Psychiatry, 24, 7, 694700. doi: 10.1002/gps.2181.CrossRefGoogle ScholarPubMed
Havens, B., Hall, M., Sylvestre, G. and Jivan, T. 2004. Social isolation and loneliness: differences between older rural and urban Manitobans. Canadian Journal on Aging/La Revue canadienne du vieillissement, 23, 2, 129–40. doi: 10.1353/cja.2004.0022.CrossRefGoogle ScholarPubMed
Hawkley, L. C. and Cacioppo, J. T. 2010. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40, 2, 218–27. doi: 10.1007/s12160-010-9210-8.CrossRefGoogle ScholarPubMed
Hawkley, L. C., Thisted, R. A. and Cacioppo, J. T. 2009. Loneliness predicts reduced physical activity: cross-sectional & longitudinal analyses. Health Psychology, 28, 3, 354. doi: 10.1037/a0014400.CrossRefGoogle ScholarPubMed
Hennessy, C., Means, R. and Burholt, V. (eds) 2014. Countryside Connections: Older People, Community and Place in Rural Britain. University of Bristol Policy Press, Bristol, UK.CrossRefGoogle Scholar
Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T. and Stephenson, D. 2015. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on Psychological Science, 10, 2, 227–37. doi: 10.1177/1745691614568352.CrossRefGoogle ScholarPubMed
Holt-Lunstad, J., Smith, T. B. and Layton, J. B. 2010. Social relationships and mortality risk: a meta-analytic review. PLoS Medicine, 7, 7, e1000316. doi: 10.1371/ journal.pmed.1000316.CrossRefGoogle ScholarPubMed
Holwerda, T. J., Beekman, A. T. F., Deeg, D. J. H., Stek, M. L., Van Tilburg, T. G., Visser, P. J. and Schoevers, R. A. 2012. Increased risk of mortality associated with social isolation in older men: only when feeling lonely? Results from the Amsterdam Study of the Elderly (AMSTEL). Psychological Medicine, 42, 4, 843–53. doi: 10.1017/S0033291711001772.CrossRefGoogle Scholar
House of Lords 2013. Report of Session 2012–13: Ready for Ageing? Select Committee on Public Service and Demographic Change. The Stationery Office, London. Available online at [Accessed 3 February 2016].Google Scholar
Jivraj, S., Nazroo, J. and Barnes, M. 2012. Change in social detachment in older age in England. In Banks, J., Nazroo, J. and Steptoe, A. (eds), The Dynamics of Ageing. Evidence from the English Longitudinal Study of Ageing 2002–2010 (Wave 5). Available online at [Accessed 20 March 2013].Google Scholar
Jopling, K. 2015. Promising Approaches to Reducing Loneliness and Isolation in Later Life. Age UK, London. Available online at [Accessed 3 February 2016].Google Scholar
Kerwin, K. C. 2004. Is retirement depressing? Labor force inactivity and psychological well-being in later life. Accounting for Worker Well-being Research in Labor Economics, 23, 269–99. National Bureau of Economic Research, Inc.: Cambridge, US doi: 10.3386/w9033.Google Scholar
Le Mesurier, N. 2003. The Hidden Store – Older People's Contributions to Rural Communities. Age Concern report. Available online at [Accessed 3 February 2016].Google Scholar
Lee, S. J., Steinman, M. A. and Tan, E. J. 2011. Volunteering, driving status, and mortality in US retirees. Journal of the American Geriatrics Society, 59, 2, 274–80. doi: 10.1111/j.1532-5415.2010.03265.x.CrossRefGoogle Scholar
Litwin, H. and Shiovitz-Ezra, S. 2011. Social network type and subjective well-being in a national sample of older Americans. The Gerontologist, 51, 3, 379–88. doi:10.1093/geront/gnq094.CrossRefGoogle Scholar
Losada, A., Márquez-González, M., García-Ortiz, L., Gómez-Marcos, M. A., Fernández-Fernández, V. and Rodríguez-Sánchez, E. 2012. Loneliness and mental health in a representative sample of community-dwelling Spanish older adults. The Journal of Psychology, 146, 3, 277292. doi: 10.1080/00223980.2011.582523.CrossRefGoogle Scholar
Luo, Y., Hawkley, L. C., Waite, L. J. and Cacioppo, J. T. 2012. Loneliness, health, and mortality in old age: a national longitudinal study. Social Science & Medicine, 74, 6, 907–14. doi:10.1016/j.socscimed.2011.11.028.CrossRefGoogle Scholar
Masi, C. M., Chen, H. Y., Hawkley, L. C. and Cacioppo, J. T. 2010. A meta-analysis of interventions to reduce loneliness. Personality and Social Psychology Review, 15, 3, 219–66. doi: 10.1177/1088868310377394.CrossRefGoogle ScholarPubMed
Naef, R., Ward, R., Mahrer-Imhof, R. and Grande, G. 2013. Characteristics of the bereavement experience of older persons after spousal loss: an integrative review. International Journal of Nursing Studies, 50, 8, 1108–121. ScholarPubMed
Newall, N. E., Chipperfield, J. G., Bailis, D. S. and Stewart, T. L. 2013. Consequences of loneliness on physical activity and mortality in older adults and the power of positive emotions. Health Psychology, 32, 8, 921–24. doi: 10.1037/a0029413.CrossRefGoogle ScholarPubMed
Newall, N. E., Chipperfield, J. G., Clifton, R. A., Perry, R. P., Swift, A. U. and Ruthig, J. C. 2009. Causal beliefs, social participation, and loneliness among older adults: a longitudinal study. Journal of Social and Personal Relationships, 26, 2/3, 273–90. doi: 10.1177/0265407509106718.CrossRefGoogle Scholar
Newall, N., McArthur, J. and Menec, V. H. 2015. A longitudinal examination of social participation, loneliness, and use of physician and hospital services. Journal of Aging and Health, 27, 3, 500–18. doi: 10.1177/0898264314552420.CrossRefGoogle ScholarPubMed
Norfolk County Council 2013. Mental Health Needs Assessment. Alabady, K., Hillman, L. and Rennie, C. (eds). Available online at [Accessed 6 April 2015].Google Scholar
Office for National Statistics (ONS) 2012. Mid-2011 Population Estimated for Local Authority Areas. Available online at [Accessed 26 June 2012].Google Scholar
Office for National Statistics (ONS) 2016. Rural/Urban Local Authority (LA) Classification (England). Available online at [Accessed 3 February 2016].Google Scholar
Peplau, L. A. and Perlman, D. 1982. Perspectives on loneliness. In Peplau, L. A. and Perlman, D. (eds), Loneliness: A Sourcebook of Current Theory, Research and Therapy. Wiley, New York, 118.Google Scholar
Perlman, D. 2004. European and Canadian studies of loneliness among seniors. Canadian Journal on Aging/La Revue canadienne du vieillissement, 23, 2, 181–8. doi: ScholarPubMed
Patterson, A. C. and Veenstra, G. 2010. Loneliness and risk of mortality: A longitudinal investigation in Alameda County, California. Social Science & Medicine, 71, 181186. doi: 10.1016/j.socscimed.2010.03.024.CrossRefGoogle ScholarPubMed
Philip, L. J. and Gilbert, A. 2007. Low income amongst the older population in Great Britain: a rural/non-rural perspective on income levels and dynamics. Regional Studies, 41, 6, 735–46. doi: 10.1080/00343400701281717.CrossRefGoogle Scholar
Rabe-Hesketh, S. and Skondral, A. 2012. Multilevel and Longitudinal Modelling Using Stata. Volume II: Categorical Responses, Counts and Survival. Third edition, Stata Press, College Station, Texas.Google Scholar
Scharf, T. and De Jong Gierveld, J. 2008. Loneliness in urban neighbourhoods: an Anglo-Dutch comparison. European Journal of Ageing, 5, 2, 103–15. doi: 10.1007/s10433-008-0080-x.CrossRefGoogle ScholarPubMed
Shankar, A., Hamer, M., McMunn, A. and Steptoe, A. 2013. Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English Longitudinal Study of Ageing. Psychosomatic Medicine, 75, 2, 161–70. doi: 0033-3174/13/7502Y0161.CrossRefGoogle ScholarPubMed
Shergold, I. and Parkhurst, G. 2012. Transport-related social exclusion amongst older people in rural Southwest England and Wales. Journal of Rural Studies, 28, 4, 412–21. doi:10.1016/j.jrurstud.2012.01.010.CrossRefGoogle Scholar
Shor, E. and Roelfs, D. J. 2015. Social contact frequency and all-cause mortality: a meta-analysis and meta-regression. Social Science & Medicine, 128, 7686. doi:10.1016/j.socscimed.2015.01.010 CrossRefGoogle Scholar
Sinclair, D. and Watson, J. 2013. Making Our Communities Ready for Ageing: A Call to Action. Community Matters ILC-UK and Age UK Seminar Series. Available online at [Accessed 3 February 2016].Google Scholar
Statistics for Wales 2008. Welsh Index of Multiple Deprivation. Available online at [Accessed 3 February 2016].Google Scholar
Steptoe, A., Owen, N., Kunz-Ebrecht, S. R. and Brydon, L. 2004. Loneliness and neuroendocrine, cardiovascular, and inflammatory stress responses in middle-aged men and women. Psychoneuroendocrinology, 29, 5, 593611. doi: 10.1016/S0306-4530(03)00086-6.CrossRefGoogle ScholarPubMed
Steptoe, A., Shankar, A., Demakakos, P. and Wardle, J. 2013. Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences, 110, 15, 57975801. doi: 10.1073/pnas.1219686110.CrossRefGoogle ScholarPubMed
Stockdale, A. 2011. A review of demographic ageing in the UK: opportunities for rural research. Population, Space and Place, 17, 3, 204–21. doi: 10.1002/psp.591.CrossRefGoogle Scholar
Sundström, G., Fransson, E., Malmberg, B. and Davey, A. 2009. Loneliness among older Europeans. European Journal of Ageing, 6, 4, 267–75. doi: 10.1007/s10433-009-0134-8.CrossRefGoogle ScholarPubMed
Thomas, J. 2015. Insights into Loneliness, Older People and Well-being. Office for National Statistics. Available online at [Accessed 3 February 2016].Google Scholar
Tilvis, R. S., Routasalo, P., Karppinen, H., Strandberg, T. E., Kautiainen, H. and Pitkala, K. H. 2012. Social isolation, social activity and loneliness as survival indicators in old age; a nationwide survey with a 7-year follow-up. European Geriatric Medicine, 3, 1, 1822. doi:10.1016/j.eurger.2011.08.004.CrossRefGoogle Scholar
Victor, C. R., Bond, J. and Bowling, A. 2003. Loneliness, Social Isolation and Living Alone in Later Life. Economic and Social Research Council. Available online at [Accessed 27 March 2012].Google Scholar
Victor, C. R. and Bowling, A. 2012. A longitudinal analysis of loneliness among older people in Great Britain. Journal of Psychology, 146, 3, 313–31. ScholarPubMed
Victor, C. R., Scambler, S. J., Bowling, A. N. N. and Bond, J. 2005. The prevalence of, and risk factors for, loneliness in later life: a survey of older people in Great Britain. Ageing & Society, 25, 6, 357–75. doi: 10.1017/S0144686X04003332.CrossRefGoogle Scholar
Victor, C. R., Scambler, S. J., Marston, L., Bond, J. and Bowling, A. 2006. Older people's experiences of loneliness in the UK: does gender matter? Social Policy and Society, 5, 1, 2738. doi: 10.1017/S1474746405002733.CrossRefGoogle Scholar
Victor, C. R. and Yang, K. 2012. The prevalence of loneliness among adults: a case study of the United Kingdom. Journal of Psychology, 146, 1/2, 85104. ScholarPubMed
Wenger, G. C. 1995. A comparison of urban with rural support networks: Liverpool and North Wales. Ageing & Society, 15, 1, 5981. doi: Scholar
Wenger, G. C. 1997. Review of findings on support networks of older Europeans. Journal of Cross-cultural Gerontology, 12, 1, 121. doi: 10.1023/A:1006597110040.CrossRefGoogle ScholarPubMed
Wenger, G. C. 2001. Myths and realities of ageing in rural Britain. Ageing & Society, 21, 1, 117130. doi: Scholar
Wenger, G. C. and Burholt, V. 2004. Changes in levels of social isolation and loneliness among older people in a rural area: a twenty-year longitudinal study. Canadian Journal on Aging/La revue canadienne du vieillissement, 23, 2, 115–27. doi:10.1353/cja.2004.0028.CrossRefGoogle Scholar
Wenger, G. C., Davies, R., Shahtahmasebi, S. and Scott, A. 1996. Social isolation and loneliness in old age: review and model refinement. Ageing & Society, 16, 3, 333–58. doi: Scholar
Wiltshire Council 2013. Joint Strategic Assessment Wiltshire 2012/13. Available online at [Accessed 6 April 2015].Google Scholar
Wu, Y. T., Prina, A. M., Barnes, L. E., Matthews, F. E. and Brayne, C. 2015. Relocation at older age: results from the Cognitive Function and Ageing Study. Journal of Public Health, 37, 3, 480487. doi:10.1093/pubmed/fdv050.CrossRefGoogle Scholar
Yang, K. and Victor, C. R. 2011. Age and loneliness in 25 European nations. Ageing & Society, 31, 8, 1368–88. doi: 10.1017/S0144686X1000139X.CrossRefGoogle Scholar