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Risk factors for loneliness among older people in a Nordic regional context – a longitudinal study

Published online by Cambridge University Press:  09 December 2021

Fredrica Nyqvist*
Social Policy Unit, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
Marina Näsman
Social Policy Unit, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
Jessica Hemberg
Department of Caring Sciences and Health Sciences, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
Mikael Nygård
Social Policy Unit, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
*Corresponding author. Email:


The aim of this study was to examine the prevalence of loneliness among older people and to identify risk factors for loneliness in a Nordic regional context over a six-year period. Longitudinal data from the Gerontological Regional Database (GERDA) study of 4,269 older adults living in northern Sweden and western Finland, aged 65, 70, 75 and 80 at baseline in 2010, were analysed. Logistic regressions were used to analyse socio-demographic, social and health-related risk factors at baseline and changes in these for experiences of loneliness at follow-up. The results showed that most older adults (85%) did not experience loneliness at baseline or at follow-up in our study region. However, 3 per cent of the sample reported loneliness in both study years, indicating enduring and chronic loneliness. Analyses revealed that being widowed and becoming a widow/er as well as poor self-rated health at baseline and the onset of depression were risk factors for loneliness. Finally, the risk of loneliness was higher in older people living in Sweden. Further work is needed to explore changes and stability in loneliness as well as to increase our understanding of between-country differences in loneliness.

Copyright © The Author(s), 2021. Published by Cambridge University Press

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Aartsen, M and Jylhä, M (2011) Onset of loneliness in older adults: results of a 28 year prospective study. European Journal of Ageing 8, 3138.CrossRefGoogle ScholarPubMed
Beasley, TM and Schumacker, RE (1995) Multiple regression approach to analyzing contingency tables: post hoc and planned comparison procedures. Journal of Experimental Education 64, 7993.CrossRefGoogle Scholar
Boss, L, Kang, D-H and Branson, S (2015) Loneliness and cognitive function in the older adult: a systematic review. International Psychogeriatrics 27, 113.CrossRefGoogle ScholarPubMed
Brittain, K, Kingston, A, Davies, K, Collerton, J, Robinson, LA, Kirkwood, TB and Jagger, C (2017) An investigation into the patterns of loneliness and loss in the oldest old – Newcastle 85+ Study. Ageing & Society 37, 3962.CrossRefGoogle Scholar
Cacioppo, JT, Hughes, ME, Waite, LJ, Hawkley, LC and Thisted, RA (2006) Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyses. Psychology and Aging 21, 140151.CrossRefGoogle ScholarPubMed
Chatfield, MD, Brayne, CE and Matthews, FE (2005) A systematic literature review of attrition between waves in longitudinal studies in the elderly shows a consistent pattern of dropout between differing studies. Journal of Clinical Epidemiology 58, 1319.CrossRefGoogle Scholar
Cohen-Mansfield, J and Perach, R (2015) Interventions for alleviating loneliness among older persons: a critical review. American Journal of Health Promotion 29, 109125.CrossRefGoogle ScholarPubMed
Coll-Planas, L, Nyqvist, F, Puig, T, Urrútia, G, Solà, I and Monteserín, R (2017) Social capital interventions targeting older people and their impact on health: a systematic review. Journal of Epidemiology and Community Health 71, 663672.CrossRefGoogle ScholarPubMed
Coyle, CE and Dugan, E (2012) Social isolation, loneliness and health among older adults. Journal of Aging and Health 24, 13461363.CrossRefGoogle ScholarPubMed
Dahlberg, L and McKee, KJ (2014) Correlates of social and emotional loneliness in older people: evidence from an English community study. Aging & Mental Health 18, 504514.CrossRefGoogle ScholarPubMed
Dahlberg, L, Andersson, L, McKee, KJ and Lennartsson, C (2015) Predictors of loneliness among older women and men in Sweden: a national longitudinal study. Aging & Mental Health 19, 409417.CrossRefGoogle ScholarPubMed
Dahlberg, L, Frank, A, Lennartsson, C, McKee, K, Naseer, M and Rehnberg, J (2020) Ensamhet bland äldre personer i Norden. Copenhagen: Nordisk ministerråd. Available at Scholar
Dahlberg, L, McKee, KJ, Frank, A and Naseer, M (2021) A systematic review of longitudinal risk factors for loneliness in older adults. Aging & Mental Health. DOI:10.1080/13607863.2021.1876638.Google ScholarPubMed
D'Ath, P, Katona, P, Mullan, E, Evans, S and Katona, C (1994) Screening, detection and management of depression in elderly primary care attenders: the acceptability and performance of the 15 item Geriatric Depression Scale (GDS-15) and the development of shorter versions. Family Practice 11, 260266.CrossRefGoogle Scholar
de Jong-Gierveld, J (1987) Developing and testing a model of loneliness. Journal of Personality and Social Psychology 53, 119128.CrossRefGoogle Scholar
de Jong-Gierveld, J and Kamphuis, F (1985) The development of a Rasch-type loneliness scale. Applied Psychological Measurement 9, 289299.CrossRefGoogle Scholar
de Jong Gierveld, J (1998) A review of loneliness: concept and definitions, determinants and consequences. Reviews in Clinical Gerontology 8, 7380.CrossRefGoogle Scholar
de Jong Gierveld, J and Tesch-Römer, C (2012) Loneliness in old age in Eastern and Western European societies: theoretical perspectives. European Journal of Ageing 9, 285295.CrossRefGoogle ScholarPubMed
de Jong Gierveld, J, Dykstra, PA and Schenk, N (2012) Living arrangements, intergenerational support types and older adult loneliness in Eastern and Western Europe. Demographic Research 27, 167200.CrossRefGoogle Scholar
DiTommaso, E, Fizell, SR and Robinson, BA (2015) Chronic loneliness within an attachment framework: processes and interventions. In Sha'ked, A and Rokach, A (eds), Addressing Loneliness: Coping, Prevention and Clinical Interventions. New York, NY: Routledge, pp. 241253.Google Scholar
Donovan, NJ, Wu, Q, Rentz, DM, Sperling, RA, Marshall, GA and Glymour, MM (2017) Loneliness, depression and cognitive function in older US adults. International Journal of Geriatric Psychiatry 32, 564573.CrossRefGoogle Scholar
Dykstra, PA (2009) Older adult loneliness: myths and realities. European Journal of Ageing 6, 91100.CrossRefGoogle ScholarPubMed
Dykstra, PA, van Tilburg, TG and de Jong Gierveld, J (2005) Changes in older adult loneliness: results from a seven-year longitudinal study. Research on Aging 27, 725747.CrossRefGoogle Scholar
Eloranta, S, Arve, S, Isoaho, H, Lehtonen, A and Viitanen, M (2015) Loneliness of older people aged 70: a comparison of two Finnish cohorts born 20 years apart. Archives of Gerontology and Geriatrics 61, 254260.CrossRefGoogle ScholarPubMed
Garli, F and Pettersson, Ö (2011) Befolkningsutveckling och-prognoser: teori och tillämpning för Västerbottens län. CERUM, Umeå universitet. Available at Scholar
Hawkley, LC and Kocherginsky, M (2018) Transitions in loneliness among older adults: a 5-year follow-up in the National Social Life, Health, and Aging Project. Research on Aging 40, 365387.CrossRefGoogle ScholarPubMed
Holt-Lunstad, J, Smith, TB, 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, 227237.CrossRefGoogle ScholarPubMed
Holwerda, TJ, Beekman, AT, Deeg, DJ, Stek, ML, van Tilburg, TG, Visser, PJ, Schmand, BA, Jonker, C and Schoevers, R (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, 843853.CrossRefGoogle ScholarPubMed
Hörnsten, C, Weidung, B, Littbrand, H, Carlberg, B, Nordström, P, Lövheim, H and Gustafson, Y (2016) High blood pressure as a risk factor for incident stroke among very old people: a population-based cohort study. Journal of Hypertension 34, 20592065.CrossRefGoogle ScholarPubMed
Houtjes, W, van Meijel, B, van de Ven, PM, Deeg, D, van Tilburg, T and Beekman, A (2014) The impact of an unfavorable depression course on network size and loneliness in older people: a longitudinal study in the community. International Journal of Geriatric Psychiatry 29, 10101017.CrossRefGoogle ScholarPubMed
Jylhä, M (2004) Old age and loneliness: cross-sectional and longitudinal analyses in the Tampere Longitudinal Study on Aging. Canadian Journal on Aging/La revue canadienne du vieillissement 23, 157168.CrossRefGoogle ScholarPubMed
Kangas, O and Kvist, J (2019) Nordic welfare states. In Greve, B (ed.), Routledge Handbook of the Welfare State. London: Routledge, pp. 124136.Google Scholar
Katz, S and Akpom, CA (1976) A measure of primary sociobiological functions. International Journal of Health Services 6, 493508.CrossRefGoogle ScholarPubMed
Lara, E, Caballero, FF, Rico-Ulribe, LA, Olaya, B, Haro, JM, Ayuso-Mateos, JL and Miret, M (2019) Are loneliness and social isolation associated with cognitive decline? International Journal of Geriatric Psychiatry 34, 16131622.CrossRefGoogle ScholarPubMed
Luanaigh, and Lawlor, BA (2008) Loneliness and the health of older people. International Journal of Geriatric Psychiatry 23, 12131221.CrossRefGoogle ScholarPubMed
Lundberg, O and Manderbacka, K (1996) Assessing reliability of a measure of self-rated health. Scandinavian Journal of Social Medicine 24, 218224.CrossRefGoogle ScholarPubMed
Luo, Y, Hawkley, LC, Waite, LJ and Cacioppo, JT (2012) Loneliness, health, and mortality in old age: a national longitudinal study. Social Science & Medicine 74, 907914.CrossRefGoogle ScholarPubMed
Lykes, VA and Kemmelmeier, M (2014) What predicts loneliness? Cultural difference between individualistic and collectivistic societies in Europe. Journal of Cross-cultural Psychology 45, 468490.CrossRefGoogle Scholar
Masi, CM, Chen, HY, Hawkley, LC and Cacioppo, JT (2011) A meta-analysis of interventions to reduce loneliness. Personality and Social Psychology Review 15, 219266.CrossRefGoogle ScholarPubMed
McRae, KD (1999) Conflict and Compromise in Multilingual Societies, Finland. Waterloo, Canada: Wilfred Laurier University Press.Google Scholar
Morgan, DJ and Burholt, V (2020) Loneliness as a biographical disruption – theoretical implications for understanding changes in loneliness. Journals of Gerontology: Psychological Sciences and Social Sciences 75B, 20292039.CrossRefGoogle Scholar
Mund, M, Freuding, MM, Möbius, K, Horn, N and Neyer, FJ (2020) The stability and change of loneliness across the life span: a meta-analysis of longitudinal studies. Personality and Social Psychology Review 24, 2452.CrossRefGoogle ScholarPubMed
Mushtaq, R, Shoib, S, Shah, T and Mushtaq, S (2014) Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. Journal of Clinical and Diagnostic Research 8, WE01WE04.Google Scholar
Newall, NE, Chipperfield, JG and Bailis, DS (2014) Predicting stability and change in loneliness in later life. Journal of Social and Personal Relationships 31, 335351.CrossRefGoogle ScholarPubMed
Nicolaisen, M and Thorsen, K (2014) Loneliness among men and women – a five-year follow-up study. Aging & Mental Health 18, 194206.CrossRefGoogle ScholarPubMed
Nyqvist, F, Nygård, M and Steenbeek, W (2014) Social capital and self-rated health amongst older people in Western Finland and Northern Sweden: a multi-level analysis. International Journal of Behavioral Medicine 21, 337347.CrossRefGoogle ScholarPubMed
Nyqvist, F, Nygård, M and Scharf, T (2019) Loneliness amongst older people in Europe: a comparative study of welfare regimes. European Journal of Ageing 16, 133143.CrossRefGoogle ScholarPubMed
Nyqvist, F, Nygård, M and Snellman, F (2021) Changes in active ageing in a Nordic regional context: results based on the GERDA study in 2005 and 2016. International Journal of Social Welfare 00, 114. Scholar
Perlman, D and Peplau, LA (1981) Toward a social psychology of loneliness. Personal Relationships 3, 3156.Google Scholar
Pinquart, M and Sörensen, S (2003) Risk factors for loneliness in adulthood and old age: a meta-analysis. In Shohov, SP (ed.), Advances in Psychology Research. Hauppauge, NY: Nova Science Publishers, pp. 111143.Google Scholar
Prohaska, T, Burholt, V, Burns, A, Golden, J, Hawkley, L, Lawlor, B, Leavey, G, Lubben, J, O'Sullivan, R, Perissinotto, C, van Tilburg, T, Tully, M, Victor, C and Fried, L (2020) Consensus statement: loneliness in older adults, the 21st century social determinant of health? BMJ Open 10, e034967.CrossRefGoogle ScholarPubMed
Russell, DW (1996) UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure. Journal of Personality Assessment 66, 2040.CrossRefGoogle ScholarPubMed
Russell, D, Peplau, LA and Cutrona, CE (1980) The revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. Journal of Personality and Social Psychology 39, 472480.CrossRefGoogle ScholarPubMed
Schwarzbach, M, Luppa, M, Forstmeier, S, König, HH and Riedel-Heller, SG (2014) Social relations and depression in late life: a systematic review. International Journal of Geriatric Psychiatry 29, 121.CrossRefGoogle ScholarPubMed
Stroebe, W, Zech, E, Stroebe, MS and Abakoumkin, G (2005) Does social support help in bereavement? Journal of Social and Clinical Psychology 27, 10301050.CrossRefGoogle Scholar
Sullivan, C and Infurna, FJ (2020) The multidimensional nature of social support and engagement in contributing to adjustment following spousal loss. Aging & Mental Health 24, 857869.CrossRefGoogle ScholarPubMed
Sundström, G, Fransson, E, Malmberg, B and Davey, A (2009) Loneliness among older Europeans. European Journal of Ageing 6, 267275.CrossRefGoogle ScholarPubMed
Tijhuis, MA, de Jong-Gierveld, J, Feskens, EJ and Kromhout, D (1999) Changes in and factors related to loneliness in older men: the Zutphen Elderly Study. Age and Ageing 28, 491495.CrossRefGoogle ScholarPubMed
Tilvis, RS, Routsalo, P, Karppinen, H, Strandberg, TE, Kautiainen, H and Pitkälä, KH (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, 1822.CrossRefGoogle Scholar
Valtorta, NK, Kanaan, M, Gilbody, S, Ronzi, S and Hanratty, B (2016) Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart 102, 10091016.CrossRefGoogle ScholarPubMed
Victor, CR and Bowling, A (2012) A longitudinal analysis of loneliness among older people in Great Britain. Journal of Psychology 146, 313331.CrossRefGoogle ScholarPubMed
Vozikaki, M, Papadaki, A, Linardakis, M and Philalithis, A (2018) Loneliness among older European adults: results from the Survey of Health, Aging and Retirement in Europe. Journal of Public Health 26, 613624.CrossRefGoogle Scholar
Ware, JE Jr and Sherbourne, CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care 30, 473483.Google ScholarPubMed
Warner, DF and Adams, SA (2016) Physical disability and increased loneliness among married older adults: The role of changing social relations. Society and Mental Health 6, 106128.CrossRefGoogle ScholarPubMed
Weiss, RS (1973) Loneliness: The Experience of Emotional and Social Isolation. Cambridge, MA: MIT Press.Google Scholar
Yang, K (2018) Longitudinal loneliness and its risk factors among older people in England. Canadian Journal on Aging/La Revue canadienne du vieillissement 37, 1221.CrossRefGoogle ScholarPubMed
Yang, K and Victor, C (2011) Age and loneliness in 25 European nations. Ageing & Society 31, 13681388.CrossRefGoogle Scholar