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The USA and UK governmental and academic agencies suggest that up to 35% of dementia cases are preventable. We canvassed dementia risk and protective factor awareness among New Zealand older adults to inform the design of a larger survey.
The modified Lifestyle for Brain Health scale quantifying dementia risk was introduced to a sample of 304 eligible self-selected participants.
Two hundred and sixteen older adults (≥50 years), with mean ± standard deviation age 65.5 ± 11.4 years (50–93 years), completed the survey (71% response rate). Respondents were mostly women (n = 172, 80%), European (n = 207, 96%), and well educated (n = 100, 46%, with a tertiary qualification; including n = 17, 8%, with a postgraduate qualification). Around half of the participants felt that they were at a future risk of living with dementia (n = 101, 47%), and the majority felt that this would change their lives significantly (n = 205, 95%), that lifestyle changes would reduce their risk (n = 197, 91%), and that they could make the necessary changes (n = 189, 88%) and wished to start changes soon (n = 160, 74%). Only 4 of 14 modifiable risk or protective factors for dementia were adequately identified by the participants: physical exercise (81%), depression (76%), brain exercises (75%), and social isolation (83%). Social isolation was the commonly cited risk factor for dementia, while physical exercise was the commonly cited protective factor. Three clusters of brain health literacy were identified: psychosocial, medical, and modifiable.
The older adults in our study are not adequately knowledgeable about dementia risk and protective factors. However, they report optimism about modifying risks through lifestyle interventions.
Long-stay home care clients mostly reside in private homes or retirement homes, and the type of residence may influence risk factors for long-term care placement. This multi-state analytic study uses RAI-Home Care and administrative data from the Hamilton Niagara Haldimand Brant Local Health Integration Network to model conceptualized states of risk at baseline through a 13-month follow-up period. Modifiable risk factors in these states were client loneliness or depressive symptoms, and caregiver distress. A higher adjusted likelihood of being discharged deceased was found for the lowest-risk clients in retirement homes. Adjusting for client, service, and caregiver characteristics, retirement home residency was associated with higher likelihood of placement in a long-term care home; reduced caregiver distress; and increased client loneliness/depression. As an alternative to private home settings as the location for aging in place among these long-stay home care clients, retirement home residency represents some trade-offs between client and informal caregiver.
There are many definitions of social isolation which draw on structural indicators (e.g. living alone), functional indicators (e.g. social support) or both. This makes comparing prevalence rates across studies difficult and provides little guidance for practitioners and service providers to identify and target socially isolated clients. The purpose of the present study was to compare, within one large population-based data-set of Canadians aged 45–85, single-item and composite indicators of social isolation, by total sample and by socio-demographics (age, sex) and health. Data were from the Canadian Longitudinal Study on Aging (CLSA) which assessed features of social network, social support and social participation. Two composite scales were created to compare prevalence rates based on structural only or both structural and functional indicators. Results indicated overall low prevalence rates of social isolation, regardless of the measure used. A composite scale using only structural features identified 5.8 per cent socially isolated adults aged 45–85. This compared with a structural and functional scale that identified 9.8 per cent socially isolated adults. The composite measures showed less variation across socio-demographics than single-item measures. Results shed light on different ways in which social isolation can be defined and how single-item and composite definitions impact our understanding of identifying socially isolated adults in a given population. Results add to discussion of measures that can be used by researchers, services providers and practitioners.
This project was a secondary hermeneutic analysis of text expressing loneliness or social isolation, gathered in an original study exploring how Chinese, Indian and Korean late-life immigrants participated in New Zealand society. It utilised the 24 interview recordings, initially transcribed in participants’ first languages from nine focus group and 15 individual interviews, and translated into English for analysis. Hermeneutic methods were used to extract and analyse quotes indicative of loneliness or social isolation. The data cohered into three notions: being unsettled, feeling sidelined and being oriented towards social connectedness. Being unsettled names the experiences of disconcerting loneliness or social isolation when previously familiar things, people and places were not there in the host society context. Feeling sidelined names the feelings of being put aside by others or feeling opaque with local communities. Being oriented towards social connectedness expresses these late-life immigrants’ longing to communicate with and to join with others in the community through culturally familiar engagements. A mood of loneliness coloured these late-life immigrants’ resettlement experiences in New Zealand. Yet they turned away from loneliness and sought out encounters with other older immigrants within co-ethnic communities.
Although community services support ageing-in-place, older adults often report feelings of loneliness and social isolation. Unmet emotional needs are associated with poorer health, reduced functional abilities and increased mortality in this population. Pet ownership is an avenue worth exploring to reduce these adverse outcomes. This scoping review maps main findings and identifies key gaps with respect to the pros and cons of pet ownership in community-dwelling older adults pertaining to psycho-social, physical and functional outcomes. Scientific and grey literature published from January 2000 to July 2018 was searched. Data selection and extraction were performed by the first author and a sub-sample was co-validated by two co-authors. A total of 62 sources were included for descriptive and thematic analysis. A variety of pros (increased physical activity, wellbeing) and cons (grief, risk of falls) pertaining to psycho-social and physical outcomes were identified. Not many functional outcomes (support for daily routines) were mentioned, and few studies explored the simultaneous balance between the pros and cons of pet care. Further research exploring both clinicians’ and older pet owners’ perspectives is needed to deepen our understanding of the importance of considering companion animals in older adults’ daily lives and to strike a balance between perceived risks and benefits.
Loneliness and social isolation have negative health consequences and are associated with depression. Personality characteristics are important when studying persons at risk for loneliness and social isolation. The objective of this study was to clarify the association between personality factors, loneliness and social network, taking into account diagnosis of depression, partner status and gender.
Cross-sectional data of an ongoing prospective cohort study, the Netherlands Study of Depression in Older Persons (NESDO), were used.
Setting and participants:
474 participants were recruited from mental health care institutions and general practitioners in five different regions in the Netherlands.
NEO-Five Factor Inventory (NEO-FFI) personality factors and loneliness and social network were measured as well as possible confounders. Multinominal logistic regression analyses were performed to analyse the associations between NEO-FFI factors and loneliness and social network. Interaction terms were investigated for depression, partner status and gender.
Higher neuroticism and lower extraversion in women and lower agreeableness in both men and women were associated with loneliness but not with social network size irrespective of the presence of depression. In the non-depressed group only, lower openness was associated with loneliness. Interaction terms with partner status were not significant.
Personality factors are associated with loneliness especially in women. In men lower agreeableness contributes to higher loneliness. In non-depressed men and women, lower openness is associated with loneliness. Personality factors are not associated with social network size.
In this study, we examined coping strategies as a mediator of the association between loneliness and depressive symptoms. A sample of 364 Spanish young adults (75.5% females) completed measures of loneliness, coping, and depressive symptoms. In general, results from computing correlations (controlling for gender) indicated that loneliness was negatively associated with the use of one engaged coping strategy (viz., problem solving) and positively associated with the use of disengaged coping strategies (e.g., problem avoidance). A multiple mediation analysis (controlling for gender) was conducted to test for mediation. Results of this analysis indicated that part of the association between loneliness and depressive symptoms can be explained by the use of one engaged coping strategy (viz., problem solving; indirect effect, p < .05) and a variety of disengaged coping strategies (viz., problem avoidance, wishful thinking, social withdrawal, & self criticism; indirect effects, p < .05). Overall, the prediction model including loneliness and coping strategies was found to account for a large (f2 = .68) 40.5% of the variance in depressive symptoms in Spanish young adults. The present findings are the first to clarify how the association between loneliness and depressive symptoms in Spanish young adults might be due in part to the use of different coping strategies. Some implications for theory and practice are discussed.
Loneliness and social networks have been extensively studied in relation to cognitive impairments, but how they interact with each other in relation to cognition is still unclear. This study aimed at exploring the interaction of loneliness and various types of social networks in relation to cognition in older adults.
a cross-sectional study.
497 older adults with normal global cognition were interviewed.
Loneliness was assessed with Chinese 6-item De Jong Gierverg’s Loneliness Scale. Confiding network was defined as people who could share inner feelings with, whereas non-confiding network was computed by subtracting the confiding network from the total network size. Cognitive performance was expressed as a global composite z-score of Cantonese version of mini mental state examination (CMMSE), Categorical verbal fluency test (CVFT) and delayed recall. Linear regression was used to test the main effects of loneliness and the size of various networks, and their interaction on cognitive performance with the adjustment of sociodemographic, physical and psychological confounders.
Significant interaction was found between loneliness and non-confiding network on cognitive performance (B = .002, β = .092, t = 2.099, p = .036). Further analysis showed a significant interaction between loneliness and the number of family members in non-confiding network on cognition (B = .021, β = .119, t = 2.775, p = .006).
Results suggested that a non-confiding relationship with family members might put lonely older adults at risk of cognitive impairment. Our study might have implications on designing psychosocial intervention for those who are vulnerable to loneliness as an early prevention of neurocognitive impairments.
In the Swedish news-press, loneliness among older people is presented as a severe problem that needs to be solved. The issue of who is responsible for reducing loneliness and how this responsibility is designated is, however, rarely discussed. In this study, we have analysed how responsibility is designated and constructed in articles from the Swedish news-press. Focus has been on identifying responsibility in discourses proceeding from the concept of subject positions. This concept has enabled analysis on how responsibility is negotiated and who is positioned as a responsible actor with the ability to perform actions that reduce loneliness. Three dominating discourses were found. In the discourse of responsibility within politics and the welfare state, the responsibility is both self-taken and designated to other institutions held responsible for not initiating sufficient measures to reduce loneliness. In the discourse of responsibility within societal and evolutionary perspectives on loneliness, developments beyond the individual's control are considered to contribute to loneliness. At the same time ‘we’ in ‘society’ are considered capable of reducing loneliness, thereby constructing individuals as responsible actors. Within the discourses of responsibility within senior organisations, both senior organisations and people who participate in activities are constructed as responsible actors. In conclusion, the responsibility for reducing loneliness is, apart from the discourse on senior organisations, designated to those working with older people.
Older adults represent the highest proportion of gamblers (Ontario Lottery and Gaming Corporation [OLG], 2012). Unpartnered older adults may be more socially isolated and lonely (Dykstra & de Jong Gierveld, 2004), thus more likely to be at risk for problem gambling (McQuade & Gill, 2012). We examined whether gambling to socialize or from loneliness and going to the casino with friends/family mediate the relation between marital status and problem gambling. Data from a random sample of older adults at gambling venues across Southwestern Ontario indicated that gambling with family/friends and gambling due to loneliness mediated the relationship between marital status and problem gambling. Relative to those married, unpartnered older adults were less likely to gamble with family/friends, more likely to gamble due to loneliness, and had higher problem gambling. Prevention and treatment initiatives should examine ways to decrease loneliness and social isolation among older adults and offer alternative social activities.
To (i) systematically identify and review strategies employed by community dwelling lonely older people to manage their loneliness and (ii) develop a model for managing loneliness.
A narrative synthesis review of English-language qualitative evidence, following Economic and Social Research Council guidance. Seven electronic databases were searched (1990–January 2017). The narrative synthesis included tabulation, thematic analysis, and conceptual model development. All co-authors assessed eligibility of final papers and reached a consensus on analytic themes.
From 3,043 records, 11 studies were eligible including a total of 502 older people. Strategies employed to manage loneliness can be described by a model with two overarching dimensions, one related to the context of coping (alone or with/in reference to others), the other related to strategy type (prevention/action or acceptance/endurance of loneliness). The dynamic and subjective nature of loneliness is reflected in the variety of coping mechanisms, drawing on individual coping styles and highlighting considerable efforts in managing time, contacting others, and keeping loneliness hidden. Cognitive strategies were used to re-frame negative feelings, to make them more manageable or to shift the focus from the present or themselves. Few unsuccessful strategies were described.
Strategies to manage loneliness vary from prevention/action through to acceptance and endurance. There are distinct preferences to cope alone or involve others; only those in the latter category are likely to engage with services and social activities. Older people who deal with their loneliness privately may find it difficult to articulate an inability to cope.
The aim of this study was to build a detailed, integrative profile of the correlates of young adults’ feelings of loneliness, in terms of their current health and functioning and their childhood experiences and circumstances.
Data were drawn from the Environmental Risk Longitudinal Twin Study, a birth cohort of 2232 individuals born in England and Wales in 1994 and 1995. Loneliness was measured when participants were aged 18. Regression analyses were used to test concurrent associations between loneliness and health and functioning in young adulthood. Longitudinal analyses were conducted to examine childhood factors associated with young adult loneliness.
Lonelier young adults were more likely to experience mental health problems, to engage in physical health risk behaviours, and to use more negative strategies to cope with stress. They were less confident in their employment prospects and were more likely to be out of work. Lonelier young adults were, as children, more likely to have had mental health difficulties and to have experienced bullying and social isolation. Loneliness was evenly distributed across genders and socioeconomic backgrounds.
Young adults’ experience of loneliness co-occurs with a diverse range of problems, with potential implications for health in later life. The findings underscore the importance of early intervention to prevent lonely young adults from being trapped in loneliness as they age.
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.
Existing evidence for gene × environment interaction (G × E) in neuroticism largely relies on candidate gene studies, although neuroticism is highly polygenic. This study aimed to investigate the long-term associations between polygenic risk scores for neuroticism (PRSN), objective childhood adversity and their interplay on emotional health aspects such as neuroticism itself, depressive symptoms, anxiety symptoms, loneliness and life satisfaction.
The sample consisted of reared-apart (TRA) and reared-together (TRT) middle- and old age twins (N = 699; median age at separation = 2). PRSN were created under nine p value cut-off thresholds (pT-s) and the pT with the highest degree of neuroticism variance explained was chosen for subsequent analyses. Linear regressions were used to assess the associations between PRSN, childhood adversity (being reared apart) and emotional health. G × E was further investigated using a discordant twin design.
PRSN explained up to 1.7% (pT < 0.01) of phenotypic neuroticism in the total sample. Analyses across two separation groups revealed substantial heterogeneity in the variance explained by PRSN; 4.3% was explained in TRT, but almost no effect was observed in TRA. Similarly, PRSN explained 4% and 1.7% of the variance in depressive symptoms and loneliness, respectively, only in TRT. A significant G × E interaction was identified for depressive symptoms.
By taking advantage of a unique sample of adopted twins, we demonstrated the presence of G × E in neuroticism and emotional health using PRSN and childhood adversity. Our results may indicate that genome-wide association studies are detecting genetic main effects associated with neuroticism, but not those susceptible to early environmental influences.
The drive to deliver services addressing loneliness in older people by telephone and online makes it increasingly relevant to consider how the mode of communication affects the way people interact with services and the capacity of services to meet their needs. This paper is based on the qualitative strand of a larger mixed-methods study of a national phoneline tackling loneliness in older people in the United Kingdom. The research comprised thematic analysis of four focus groups with staff and 42 semi-structured interviews with callers. It explored the associations between telephone-delivery, how individuals used the services and how the services were able to respond. To understand these associations, it was useful to identify some constituent characteristics of telephone communication in this context: namely its availability, reach and non-visual nature. This enabled various insights and comparison with other communication media. For example, the availability of the services attracted people seeking frequent emotional support but this presented challenges to staff. More positively, the ability of the services to connect disparate individuals enabled them to form different kinds of satisfying relationships. The evolution of mixed communication forms, such as internet-based voice communication and smartphone-based visual communication, makes analysis at the level of a technology's characteristics useful. Such a cross-cutting perspective can inform both the design of interventions and assessment of their suitability for different manifestations of loneliness.
This study involved the longitudinal trajectories of loneliness with aging and models the effects of relevant risk factors. Data came from the second to the sixth waves (2004/5 – 2012/13) of the English Longitudinal Studies of Ageing (ELSA). Respondents who participated in at least two waves and offered valid responses to the UCLA three-item loneliness scale were included (baseline n = 9,171). Although statistics describing the inter-wave changes confirmed the longitudinal stability of loneliness among older people, serious attention should be paid to the small percentage of older people who are “longitudinally lonely”. Self-reported health and relations with spouse and children were significant risk factors, and it was the change of closeness to spouse rather than the loss of spouse that most affected the change of loneliness scores. Future research should aim to identify personal and social events that make older people lonely over a long period of time.
It is well known that negative ageing perceptions have various detrimental effects on indicators of successful ageing, but less is known about the role of social support networks and loneliness in ageing perceptions. The objective of this study was therefore to assess the association of social networks, relationship quality and loneliness with negative ageing perceptions in late life. Cross-sectional data on 6,912 adults aged ⩾50 years from the first wave of the Irish Longitudinal Study on Ageing (TILDA) were analysed. Ageing perceptions were assessed with the Brief Ageing Perceptions Questionnaire. Information on social support networks, loneliness and socio-demographics were obtained using standard questions. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression scale. Multivariable linear regression was conducted to assess the associations. Social isolation, poor relationship quality (with spouse, children, other family members or friends) and loneliness were all significantly associated with negative ageing perceptions even after adjustment for all potential confounders including depressive symptoms. Our study indicates that targeting integration into social support networks and improving relationship quality may potentially reduce the extent to which older individuals adopt negative ageing perceptions. Future studies with prospective design are warranted to understand the temporal direction and causal association of social support networks and loneliness with negative ageing perceptions.
The aim of the study was to predict loneliness with regard to parental acceptance-rejection and sibling relationship quality after controlling for gender, age, grade, school type, field of study, birth order, and number of siblings. The UCLA Loneliness Scale, Maternal and Paternal Acceptance-Rejection Questionnaire, and Sibling Relationship Questionnaire were administered to 1,451 high school students, and multiple hierarchical regression analysis was conducted. Results showed that 1.7% of variance was explained by model 1, including demographic variables, but model 1 was not significant. After adding mother and father acceptance to model 2, the explained variance increased to 18.1%. In model 3, sibling variables were added and the explained variance was 19.6%, which were both significant results. Mother acceptance was the best predictor of loneliness, followed by father acceptance. Parental variables explained loneliness better than sibling and demographic variables. Understanding the family predictors of loneliness may be seen as the first step for a subsequent intervention.
Loneliness is a risk factor for morbidity as well as mortality. Older people are more vulnerable to feeling alone due to age-associated changes and losses they might experience. This study aimed to analyze sociodemographic, psychosocial, and mental health variables related to loneliness in the elderly. A random sample of 419 people over 65 years old from the Community of Madrid was used. The UCLA Loneliness Scale, the CIDI65+ Diagnostic Interview, and the WHOQOL-BREF Quality of Life Measure were administered. A regression p model was estimated to identify the variables that best predict loneliness associated with old age. Loneliness-associated variables included living alone t(161.41) = 2.07; p < .040, marital status F(5, 404) = 4.52; p < .001, frequency of economic problems F(1, 408 ) = 4.86; p < .028, quality of life F(4, 405) = 7.36; p < .001, satisfaction with life F(4, 405) = 3.80; p < .005, satisfaction with social relationships F(4, 405) = 19.50; p < .001, presence of a mental disorder (t(98.70) = 2.92; p < .004), and having an anxiety disorder (t(51.11) = 2.19; p < .033). The results presented in this paper highlight some predictors of loneliness in older people that could be useful in intervention, to minimize harmful conditions that can lead to loneliness in people over 65.
Hopelessness and loneliness are potent risk factors for poor mental and physical health in later life, although the nature of their relationships with each other over time is not clear. The aim of the current study was to examine relationships between hopelessness and loneliness over an eight-year study period.
Three waves of data from the US Health and Retirement Study (2006, 2010, 2014) were used to test a cross-lagged model of hopelessness and loneliness (N = 7,831), which allows for the simultaneous evaluation of the reciprocal associations of loneliness and hopelessness. Age in 2006, gender, years of education, number of medical conditions, and depressive symptoms were included as covariates.
The autoregressive effects of loneliness (B (SE) = 0.63 (0.02), p < 0.001) and hopelessness (B (SE) = 0.63 (0.02), p < 0.001) were substantive and significant across the three waves, pointing to the stability of both constructs over the eight-year study period. The lagged effect of loneliness on hopelessness was non-significant (B (SE) = 0.05 (0.03), p = 0.16), whereas the lagged effect of hopelessness on loneliness was significant (B (SE) = 0.01 (0.01), p = 0.03). These lagged effects were not significantly different from each other, however, χ2 (1) = 2.016, p = 0.156.
Participants who were more hopeless tended to become lonelier four years later, but lonelier participants did not become more hopeless four years later. Findings are tentative given the small magnitude and lack of difference between the cross-lagged effects. Future directions include replicating these findings in different samples and time frames, examining potential mechanisms of relationships between hopelessness and loneliness, and potential intervention strategies that might improve both conditions.