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Background: Older adults face greater risk of social isolation, but the extent of social isolation among low-income older adults living in social housing is unknown. This study aims to explore the rate of, and risk factors contributing to, subjective social isolation or loneliness among older adults in social housing. Methods: We conducted a cross-sectional study of data collected from a community program held in the common rooms of 55 social housing buildings in 14 communities across Ontario, Canada, from May 2018 to April 2019. Participants were program attendees aged 55 years and older who resided in the buildings. Program implementers assessed social isolation using the 3-Item Loneliness Scale from the University of California, Los Angeles and risk factors using common primary care screening tools. We extracted data for this study from the program database. We compared the rate of social isolation to Canadian Community Health Survey data using a 1-sample χ2 test, and evaluated associations between risk factors and social isolation using univariate and multivariate logistic regressions. Results: We included 806 residents in 30 buildings for older adults and 25 mixed-tenant buildings. Based on the 3-Item UCLA Loneliness Scale, 161 (20.0%) of the 806 participants were socially isolated. For those aged 65 and older, the rate of social isolation was nearly twice that observed in the same age group of the general population (36.1% v. 19.6%; p < 0.001). Risk factors were age (65–84 yr v. 55–64 yr adjusted odds ratio [OR] 1.99, 95% confidence interval [CI] 1.01–3.93), alcohol consumption (adjusted OR 2.45, 95% CI 1.09–5.54), anxiety or depression (adjusted OR 6.05, 95% CI 3.65–10.03) and income insecurity (adjusted OR 2.10, 95% CI 1.24–3.53). Protective factors were having at least 1 chronic cardiometabolic disease (adjusted OR 0.44, 95% CI 0.24–0.80), being physically active (adjusted OR 0.47, 95% CI 0.30–0.73) and having good to excellent general health (adjusted OR 0.60, 95% CI 0.39–0.90). Interpretation: The high rate of social isolation in low-income older adults living in social housing compared with the general population is concerning. Structural barriers could prevent engagement in social activities or maintenance of social support, especially for older adults with income insecurity and anxiety or depression; interventions are needed to reduce subjective social isolation in this population.

Background The Emergency Medicine Palliative Care Access (EMPallA) trial is a large, multicenter, parallel, two-arm randomized controlled trial in emergency department (ED) patients comparing two models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. This report aims to: 1) report baseline demographic and quality of life (QOL) data for the EMPallA cohort, 2) identify the association between illness type and baseline QOL while controlling for other factors, and 3) explore baseline relationships between illness type, symptom burden, and loneliness. Methods Patients aged 50+ years with advanced cancer (metastatic solid tumor) or end-stage organ failure (New York Heart Association Class III or IV heart failure, end stage renal disease with glomerular filtration rate 2, or Global Initiative for Chronic Obstructive Lung Disease Stage III, IV, or oxygen-dependent chronic obstructive pulmonary disease defined as FEV1 Results Between April 2018 and April 3, 2020, 500 patients were enrolled. On average, end-stage organ failure patients had lower QOL as measured by the FACT-G scale than cancer patients with an estimated difference of 9.6 points (95% CI: 5.9, 13.3), and patients with multiple conditions had a further reduction of 7.4 points (95% CI: 2.4, 12.5), when adjusting for age, education level, race, sex, immigrant status, presence of a caregiver, and hospital setting. Symptom burden and loneliness were greater in end-stage organ failure than in cancer. Conclusions The EMPallA trial is enrolling a diverse sample of ED patients. Differences by illness type in QOL, symptom burden, and loneliness demonstrate how distinct disease trajectories manifest in the ED. Trial registration Clinicaltrials.gov identifier: NCT03325985. Registered October 30, 2017.

Cancer patients with minor children are increasing; however, they do not receive sufficient support.This study aimed to investigate the association between loneliness and the frequency of using online peer support groups among cancer patients with minor children.A cross-sectional web-based survey was conducted from April to May 2019. Cancer patients with minor children were recruited from an online peer support group called "Cancer Parents." Individuals diagnosed with cancer and whose youngest children were younger than 18 years were enrolled. Materials included: the UCLA Loneliness Scale version 3 (UCLA-LS), K6 scale, abbreviated Lubben Social Network Scale, and the sociodemographic/clinical characteristics questionnaire. Multivariate logistics regression analysis was performed to determine the factors associated with the high loneliness group (defined as those above the median score on the UCLA-LS).A total of 334 patients participated (79.9% female; mean age 43.1 years, standard deviation 5.8). The most common primary cancer type was breast (34.1%). The median score of the UCLA-LS was 45 (interquartile range 37-53). The multivariate logistics regression analysis revealed that the high loneliness group was significantly associated with the frequent use of online peer support group less than once a week (odds ratio [OR] = 0.47; 95% CI = 0.26-0.85; P = 0.012), with a smaller social network (OR = 0.78; 95% CI = 0.73-0.83; P 0.001), and higher psychological distress (OR = 1.16; 95% CI = 1.09-1.23; P 0.001).Frequent use of online peer support groups was associated with less loneliness among cancer patients with minor children.

Background Loneliness in mothers raising children under 3 years of age is a major challenge. The purpose of this study was to identify the individual, family, and community factors associated with loneliness among mothers raising children under 3 years of age with social isolation as a mediator. Methods A cross-sectional survey was conducted using anonymous self-administered questionnaires. The target population was all 649 mothers of children under 3 years of age visiting a public health center in Yokohama City and eligible for child health examinations between November 2019 and February 2020. The study measures included loneliness (10-item version of the UCLA Loneliness Scale), social isolation (Lubben Social Network Scale [LSNS-6]), demographic data, individual factors, family factors, and community factors from an ecological systems model. Social isolation was classified based on the LSNS-6 cutoff points. Multiple regression analysis was conducted to examine the association between loneliness and individual, family, and community factors with social isolation as a mediator. Results A total of 531 participants (81.8% response rate) responded, and 492 (75.8% valid response rate) were included in the analysis. Loneliness was significantly higher in the isolated group (n = 171, 34.8%) than in the non-isolated group (n = 321, 65.2%) (mean = 22.3, SD = 5.6 and mean = 17.6, SD = 4.6, respectively). Factors associated with high loneliness included individual and family factors (a high number of parenting and life concerns [β = 0.211, p p p p p Conclusion Referral to a counseling organization to alleviate worries about parenting and the creation of a child-rearing environment to enhance the recognition of the community may be considered. These findings could help develop intervention programs for the prevention or alleviation of loneliness experienced by mothers and prevent the associated health risks among mothers and child outcomes.

The UCLA Loneliness Scale, with different short versions, is widely used to assess levels of loneliness. However, whether the scale is valid in assessing loneliness among sexual-minority men is unknown. Additionally, it is unclear whether the 8-item and 3-item short versions are comparable to the full 20-item version. The present study compared the validity of the three versions of the UCLA Loneliness Scale (i.e., 20-item, 8-item, and 3-item versions) among gay and bisexual men in Taiwan. The participants comprised 400 gay and bisexual men in Taiwan who completed a cross-sectional online survey, which included the UCLA Loneliness Scale, Center for Epidemiological Studies Depression Scale (CES-D) and State–Trait Anxiety Inventory (STAI). Confirmatory factor analysis was used to evaluate factorial validity. Convergent validity was examined between the three versions of the UCLA Loneliness Scale and the CES-D and STAI. Known-group validity was investigated with participants’ sexual orientation and educational levels. The unidimensional construct was supported in all three versions of the UCLA Loneliness Scale tested in the present study. Convergent validity was supported as the level of loneliness was correlated with the level of depression and anxiety for all three versions. There were no significant differences between gay and bisexual men, although significant differences were found across different educational levels. The study confirmed that all three versions of the UCLA Loneliness Scale were comparable with satisfactory reliability and validity in Taiwanese sexual-minority men.

Background/Objectives Differences in older adults' worry, attitudes, and mental health between high‐income countries with diverging pandemic responses are largely unknown. We compared COVID‐19 worry, attitudes towards governmental responses, and self‐reported mental health symptoms among adults aged ≥55 in the United States and Canada early in the COVID‐19 pandemic. Design Online cross‐sectional survey administered between April 2nd and May 31st in the United States and between May 1st and June 30th, 2020 in Canada. Setting Nationally in the United States and Canada. Participants Convenience sample of older adults aged ≥55. Measurements Likert‐type scales measured COVID‐19 worry and attitudes towards government support. Three standardized scales assessed mental health symptoms: the eight‐item Center for Epidemiological Studies Depression Scale, the five‐item Beck Anxiety Inventory, and the three‐item UCLA loneliness scale. Results There were 4453 U.S. respondents (71.7% women; mean age 67.5) and 1549 Canadian (67.6% women; mean age 69.3). More U.S. respondents (71%) were moderately or extremely worried about the pandemic, compared to 52% in Canada. Just 20% of U.S. respondents agreed or strongly agreed that the federal government cared about older adults in their COVID‐19 pandemic response, compared to nearly two‐thirds of Canadians (63%). U.S. respondents were more likely to report elevated depressive and anxiety symptoms compared to Canadians; 34.2% (32.8–35.6) versus 25.6% (23.3–27.8) for depressive and 30.8% (29.5–32.2) versus 23.7% (21.6–25.9) for anxiety symptoms. The proportion of United States and Canadian respondents who reported loneliness was similar. A greater proportion of women compared to men reported symptoms of depression and anxiety across all age groups in both countries. Conclusion U.S. older adults felt less supported by their federal government and had elevated depressive and anxiety symptoms compared to older adults in Canada during early months of the COVID‐19 pandemic. Public health messaging from governments should be clear, consistent, and incorporate support for mental health.

This study sought to examine whether and how social connectedness impacts the association between physical activity and loneliness among older people in Ghana. Data for the analysis were obtained from the 2016-2017 Aging, Health, Psychological Wellbeing and Health-seeking Behavior Study (AgeHeaPsyWel-HeaSeeB) (N = 1200; mean age 66±12 years; women = 63%). Loneliness was assessed with the Short Form Revised UCLA Loneliness Scale. Multivariate linear regressions showed that increases in physical activity were associated with decreases in loneliness in the overall sample (β= -0.338, p0.005) and for men (β= -0.712, p0.005) but not in women (β = -0.039, p = 0.840). The negative association between physical activity and loneliness was moderated by social connectedness such that persons highly connected were much less likely to experience loneliness following physical activity engagement (β= -0.709, p = 0.023). Age-based analysis showed differential effects of physical activity on loneliness among the 65+ group (β = -0.437, p = 0.002) compared to the 50-64 group (β= -0.502, p = 0.031). Later life social connectedness tempers with the beneficial impact of physical activity on loneliness. Interventions to heal loneliness and for active aging should target physical activity and interpersonal engagements among older adults.

Background/aim Previous reviews of Social determinants of health in lung cancer patients have not examined essential factors such as social isolation and loneliness. This study aimed to explore the factors affecting social isolation and loneliness among lung cancer patients. Patients and methods A cross-sectional study was conducted. Social isolation, loneliness, and the presence of dementia were measured using Japanese adaptations of the Lubben Social Network Scale, UCLA Loneliness Scale, and Life Function Evaluation for Care Provision, respectively. Results From March 2019 to March 2020, 264 patients were included. Social isolation was significantly higher for patients receiving welfare (adjusted OR=5.28, 95% CI=2.24-12.4). Loneliness was significantly higher for patients receiving welfare (beta coefficient=0.52, 95% Cl=0.13-0.90) with symptoms of dementia (beta coefficient=0.28, 95% Cl=0.03-0.54). Conclusion Results showed that receiving welfare was associated with experiencing social isolation. Receiving welfare and symptoms of dementia were associated with experiencing loneliness.

Issues: Despite the serious implications of loneliness on health and wellbeing, little is understood about this experience across people with substance use problems. This systematic review aimed to examine: (i) correlates and predictors of loneliness; (ii) theories underpinning loneliness; (iii) methods employed to measure loneliness; and (iv) loneliness interventions for people with substance use problems. Approach: Empirical sources were identified from key databases for all publications preceding February 2019. Overall, 41 studies met the eligibility criteria and were included in the review. Key Findings: Findings from this review suggest that loneliness is related to poor physical and mental health, substance use, the quality of relationships, stigma and perception of ill treatment by others. Although cognitive theories have proposed cognitive patterns underlying the onset and maintenance of loneliness, they had not been investigated in relation to measurement or intervention efforts. Just one loneliness measure (UCLA Loneliness Scale) is valid for use with this population. Finally, only a single loneliness intervention had been trialled and was not found to be efficacious in reducing loneliness for people with substance use problems. Implications: Understanding possible links between loneliness and substance use and how to alleviate loneliness is important for this population in terms of their wellbeing and recovery. Conclusion: Loneliness is prevalent and experienced as problematic among people with substance use problems. Future research should focus on employing longitudinal designs, using validated, multidimensional measures of loneliness and on developing and trialling loneliness interventions that meet the specific needs of people with substance use problems.

OBJECTIVES: To establish whether positive affect (PA) is uniquely associated with loneliness and other social functioning variables beyond negative affect (NA) among older adults. METHODS: Four hundred and twenty-eight participants (aged 60+ years old, 82% White, and 48% female) were recruited using random digit-dialing and completed scales for loneliness (UCLA Loneliness Scale), companionship (PROMIS scale), satisfaction with discretionary social activities (PROMIS scale), PA (Center for Epidemiologic Studies [CES] Happiness Scale), and NA (CES-Depression scale and Brief Symptom Inventory-Anxiety Subscale). RESULTS: Multiple linear regression models found PA to be a significant predictor of lower loneliness where the effect of PA on loneliness is dependent on the level of NA; a large effect size at the mean level of NA, which becomes attenuated when NA increases. Although the direction of effect of PA on loneliness will change for NA > 5.10, which is 5 standard deviations away from 0, based on the model estimates, the percent of subjects with this large NA levels is practically 0. Thus, higher PA is associated with lower loneliness, however this effect is attenuated for larger NA. Similarly, multiple linear regression models found that companionship was associated with PA and NA where the effect of PA is dependent on the level of NA; a medium effect size at the mean level of NA, which becomes attenuated when NA increases. As in the case of loneliness, the direction of effect of PA on companionship will change for NA > 3.52, which is 3.5 standard deviation away from 0, based on the model estimates, but the percent of subjects with this large NA levels is practically 0. Thus, higher PA is associated with increased companionship, and this effect is attenuated with greater NA. Satisfaction with social activities was associated with PA only (medium effect size). CONCLUSIONS: Results suggest PA appears to be uniquely associated with social functioning among older adults. These findings support the potential for treatments that target PA to decrease loneliness among older adults, or vice versa.

The aim was to (i) compare the rates of perceived stress, post‐traumatic stress symptoms (PTSS) and other potential correlates (i.e., resilience, social support, coping strategies, and loneliness) in the general population between the two COVID‐19 lockdowns in Greece and (ii) explore risk and protective factors of PTSS. Online data were collected amid the first (timepoint 1‐T1) and second lockdown (timepoint 2‐T2) by 1009 and 352 participants, respectively. The PTSD Checklist for DSM‐5 and the Perceived Stress Scale measured levels of PTSS and perceived stress. The Brief Resilience Scale, the COPE, the revised UCLA Loneliness Scale, and the ENRICHD Social Support Instrument measured resilience, coping strategies, loneliness, and social support, respectively. Higher levels of PTSS and perceived stress were reported during T2, compared to T1. Clinically significant levels of PTSS were presented by 26.1% and 35.5% of the participants during T1 and T2, respectively. Higher levels of loneliness and use of maladaptive coping strategies and lower levels of social support, resilience and use of adaptive coping strategies were also found. During both lockdowns, PTSS were predicted by perceived stress, loneliness, reduced resilience and the coping strategies of denial and self‐blame. PTSS were associated with younger age, female gender, being single, not having children, and the evaluation of the pandemic as a crisis. The findings highlight the significant public mental health concerns during the COVID‐19 lockdowns. Understanding the risk and protective factors against PTSS and focusing on vulnerable populations should be prioritized by the governments worldwide in the development of evidence‐based interventions.

BACKGROUND Evidence-based interventions addressing loneliness and social isolation are needed, including among low-income, community-dwelling older adults of diverse racial and ethnic backgrounds. Our objective was to assess the effect of a peer intervention in addressing loneliness, isolation, and behavioral health needs in this population. METHODS We conducted a mixed-method, two-year longitudinal study of a peer-outreach intervention in 74 low-income older adults recruited via an urban senior center in San Francisco. Structured participant surveys were conducted at baseline and every 6 months for up to 2 years. Outcomes included loneliness (3-item UCLA loneliness scale), social interaction (10-item Duke index), self-perceived socializing barriers (range: 0-10), and depression (PHQ-2 screen). Data were analyzed using mixed-effects linear and logistic regression adjusted for age and gender. Qualitative, semi-structured interviews with participants (N = 15) and peers (N = 6) were conducted in English and Spanish and analyzed thematically. RESULTS Participants were on average 71 years old (range: 59-96 years), with 58% male, 15% LGBT, 18% African American, 19% Latinx, 8% Asian, 86% living alone, and 36% with an ADL impairment. On average, 43 contact visits (IQR: 31-97 visits) between participants and peers occurred over the first year. Loneliness scores decreased by, on average, 0.8 points over 24 months (p = 0.015). Participants reported reduced depression (38%-16%, p

BACKGROUND: Social isolation and loneliness are critical to the health of older adults, but they have not been well-described at the end of life. OBJECTIVES: To determine the prevalence and correlates of social isolation and loneliness among older adults in the last years of life. DESIGN: Nationally-representative, cross-sectional survey. SETTING: Health and Retirement Study, 2006–2016 data. PARTICIPANTS: Adults age >50 interviewed once in the last four years of life (n=3,613). MEASUREMENTS: We defined social isolation using a 15-item scale measuring household contacts, social network interaction, and community engagement, and frequent loneliness using the 3-item UCLA Loneliness Scale. We used multivariable logistic regression to determine their adjusted prevalence by time prior-to-death and by subgroups of interest. RESULTS: Approximately 19% experienced social isolation, 18% loneliness, and 5% both in the last four years of life (correlation=0.11). The adjusted prevalence of social isolation was higher for individuals nearer to death (4 years: 18% vs 0–3 months: 27%, p=0.05) and there was no significant change in loneliness (4 years: 19% vs 0–3 months: 23%, p=0.13). Risk factors for both isolation and loneliness included (p

BACKGROUND Depression and mild cognitive impairment (MCI) are often comorbid mental health issues in older adults. The current study explored the prospective mediating role of loneliness in the relationship between depression and the quality of life in elderly with MCI. A second aim was to examine differences in depression, loneliness, and the quality of life in the elderly with MCI among gender groups, and type of residence groups. METHODS A cross-sectional survey with purposive sampling was used. Older adults with MCI (N = 170) from old age homes in Lahore and Rawalpindi (n = 82) and family residences in Sargodha (n = 88) in Pakistan completed UCLA Loneliness Scale, Depression Anxiety Stress Scale, and Mild Cognitive Impairment Scale. RESULTS Most of the participants had severe to extreme depression (98.2%), and moderate to moderately high levels of loneliness (85.3%). Depression was significantly associated with loneliness (b = 0.29, P

Introduction Persons diagnosed with schizophrenia spectrum disorders (SSDs) often experience pervasive feelings of loneliness, which are considered a significant barrier to treatment and recovery. Aim As impaired social cognition may contribute to increased loneliness and less skillful social interactions, this study examines the relationships between loneliness and measures of social cognition and functional outcome from the Social Cognition Psychometric Evaluation (SCOPE) study. Methods This study evaluated the relationship between loneliness, social cognitive ability, and social functioning in the context of a large-scale psychometric investigation. We also explored the associations of select demographic characteristics and clinical variables on the endorsement of loneliness in persons diagnosed with a psychotic disorder. Results Seventy-four stable outpatients with SSDs and 58 healthy controls completed the UCLA Loneliness Scale in addition to the standard SCOPE battery. Our findings support prior research indicating persons diagnosed with a psychotic disorder experience greater levels of loneliness than normative groups. However, the results also indicate that self-reported loneliness is not associated with social cognitive abilities or functional outcome in psychosis. Regression analyses indicate that roughly half the variance in loneliness endorsed by persons with SSDs is accounted for by clinical variables, with loneliness most strongly associated with guilt and self-esteem. Conclusion These findings suggest that treatments aiming to reduce perceived social isolation in psychosis should incorporate techniques to bolster selfesteem, reduce guilt, and improve depressive symptoms.

Loneliness has been associated with an increased risk of cognitive decline and dementia in older people, as well as a dysregulation of Hypothalamic–Pituitary–Adrenal (HPA) axis functioning. In addition, it has been suggested that women are more vulnerable to the negative effects of loneliness on health. Our aim was to analyze the effect of HPA-axis functioning as a mediator in the relationship between loneliness and cognitive function, and interactions depending on sex, in healthy older people. To do so, 86 healthy older people (52.3% female) from 60 to 80 years old (M = 67.44, SD = 4.37) completed the revised UCLA loneliness scale. A neuropsychological battery was administered to assess global cognition, processing speed, attention and executive function, working memory, and verbal memory immediate and delayed recall. Saliva samples were provided on two consecutive weekdays to obtain awakening and bedtime cortisol levels, the diurnal cortisol slope (DCS), and the area under the curve with respect to the ground (AUCg). Our results showed that loneliness was not directly associated with cognitive performance. Furthermore, loneliness was related to higher bedtime cortisol levels, but not to awakening cortisol, the DCS, or the AUCg. In addition, loneliness was associated with worse performance on attention and processing speed, executive function, and verbal memory immediate recall, via bedtime cortisol levels. Therefore, we suggest that HPA-axis functioning is one of the biological mechanisms that mediate the relationship between loneliness and poorer cognitive function. No sex differences were observed in these associations.

Background Mothers with infants and toddlers are a potential target population for the prevention or alleviation of feelings of loneliness. However, the theory and methods for measuring loneliness among mothers with infants and toddlers have yet to be standardized worldwide, including in Japan. Our goal was to evaluate the reliability and validity of the Japanese version of the UCLA Loneliness Scale Version 3 (UCLA-LS3-J), as well as two short-form versions—the 10-item UCLA-LS3 (SF-10) and the 3-item UCLA-LS3 (SF-3)—for the measurement of loneliness in mothers with infants and toddlers in Japan. Methods This cross-sectional study was conducted using a self-report questionnaire. The target population was 430 mothers with infants and toddlers who visited a community health center in Yokohama City in Japan. Questionnaire items encompassed the UCLA-LS3-J, as well as demographic data, the feeling for childrearing scale, and measures of social networks and subjective health status. The reliability and validity of the UCLA-LS3-J and its two short-form versions (SF-3 and SF-10) were determined via IBM SPSS Amos and SPSS Statistics 22. Results Questionnaires were returned by 248 mothers (valid response rate: 57.7%) aged 32.7 ± 4.6 (mean ± SD) years. The mean score on the UCLA-LS3-J was 38.4 ± 9.7 (range 20.0–73.0), with a normal distribution. When confirmatory factor analysis was carried out (for a single factor model), the goodness of fit of the model was almost identical to that of the original UCLA-LS3 version for the UCLA-LS3-J: (GFI = 0.882, AGFI = 0.840, CFI = 0.932, RMSEA = 0.066) and SF-10: (GFI = 0.942, AGFI = 0.900, CFI = 0.956, RMSEA = 0.081). The SF-3 model also showed an acceptable fit. The UCLA-LS3-J total score was significantly correlated with the total score on the SF-10 (r = 0.965) and SF-3 (r = 0.868). The Cronbach’s α coefficient of the UCLA-LS3-J was 0.926, while those of the SF-10 and SF-3 were 0.888 and 0.790, respectively. The score on the UCLA-LS3-J was positively correlated with childcare burden (r = .319, p

Purpose The study was conducted for the purpose of determining the relationship between internalized stigma and loneliness in patients with schizophrenia. Design and methods The population of this correlational-descriptive study consisted of a total of 200 in patients with schizophrenia. The data were collected using "Form of Descriptive Characteristics", "Internalized Stigma of Mental Illness Inventory (ISMI)", and "UCLA Loneliness Scale". Findings It was determined that the loneliness level of the patients who participated in the study was 57.20 ± 10.38 and level of of internalized stigma was 79.65 ± 13.48. There was a statistically positive and strong correlation between loneliness and internalized stigma total mean scores of the patients (P = 0.001, r = 0.854). Practise implications It was found that the schizophrenic patients had high levels of internalized stigma and loneliness.

Background As the population ages, cognitive decline and dementia have become major health concerns in the UK. Loneliness has been linked to cognitive decline, but the reverse causality of this association remains unclear. This study aims to examine whether there is a bidirectional relationship between loneliness and cognitive function in older English adults (age 50 years and over) over a 10-year follow-up. Methods Data came from a nationally representative sample of 5885 participants in the English Longitudinal Study of Ageing (ELSA), free of stroke or dementia and followed every 2 years up to wave 7 (2014–15). At each wave, cognitive function was measured with word recall and verbal fluency tests, and loneliness was measured with the abridged version of the revised UCLA Loneliness Scale. Bivariate dual change score models were used to assess the multivariate associations between loneliness and cognitive function, used interchangeably as exposures and outcomes. Results Greater loneliness at baseline was associated with poorer memory [β intercept = −0.03, standard error (SE) = 0.01, P = 0.016] and verbal fluency (β intercept = −0.01, SE = 001, P = 0.027) at baseline, and with a stronger linear rate of decline in both memory (β linear slope = −0.07, SE = 001, P ≤ 0.001) and verbal fluency (β linear slope = −0.09, SE = 0.03, P = 0.003) over a 10-year follow-up period, although the performance on verbal fluency did not change substantially on average over this period. We also found that higher baseline memory, but not verbal fluency, predicted a slower change in loneliness (β linear slope = −0.01, SE = 001, P = 0.004) and that a linear decline in memory was associated with an acceleration in loneliness (β quadratic slope = −0.02, SE = 001, P ≤ 0.001) during follow-up. Conclusions Higher loneliness is associated with poorer cognitive function at baseline and contributes to a worsening in memory and verbal fluency over a decade. These factors seem, however, to be partially intertwined, since baseline memory and its rate of decline also contribute to an increase in loneliness over time.

BACKGROUND: The relationship between loneliness and both cardiovascular disease (CVD) and diabetes mellitus (DM) has been understudied in U.S. Hispanics, a group at high risk for DM. We examined whether loneliness was associated with CVD and DM, and whether age, sex, marital status, and years in U.S moderated these associations. METHODS: Participants were 5,313 adults (M (SD) age = 42.39 (15.01)) enrolled in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Loneliness was assessed via the 3-item Revised UCLA Loneliness Scale. RESULTS: Level of reported loneliness was low. Loneliness was significantly associated with CVD: OR = 1.10 (Cl: 1.01–1.20) and DM: OR = 1.08 (Cl: 1.00 – 1.16) after adjusting for depression, demographics, body mass index, and smoking status. Age, sex, marital status, and years in U.S. did not moderate associations. DISCUSSION: Given that increased loneliness is associated with higher cardiometabolic disease prevalence beyond depressive symptoms, regardless of age, sex, marital status, or years in the U.S., Hispanic adults experiencing high levels of loneliness may be a subgroup at particularly elevated risk for CVD and DM.

Background Loneliness is a major risk factor for mental and physical health worldwide. The Three-Item Loneliness Scale (TIL Scale; Hughes et al., 2004) has been widely applied to measure loneliness in a simplified format, but no validated Japanese version has been developed. This study adapted the TIL Scale into Japanese and tested its reliability and validity. Methods The original English version of the TIL Scale was translated into Japanese, and the expressions of the Japanese version were confirmed by a back translation procedure. The translated scale was then administered to Japanese respondents recruited from an online research panel (N = 1020) and an online crowdsourcing service (N = 500). To analyze the data containing polytomous responses to the items in the scale, this study used categorical Confirmatory Factor Analysis and the Generalized Partial Credit Model based on the Item Response Theory. To evaluate the psychometric properties of the scale, this study examined factorial validity, reliability, information curves, and the associations of the scale score with demographic variables (age, gender, marital status, and living arrangements), the scores of the Revised UCLA Loneliness Scale (R-UCLA), the Big Five scale of personality traits, and the sizes of personal networks. Results The translated TIL Scale showed essential unidimensionality and characteristics to differentiate among respondents at different levels of loneliness. The scale score was related positively with the scores of R-UCLA and neuroticism and negatively with the scores of extraversion, conscientiousness, openness, agreeableness, and the sizes of overall and support networks. Those who were unmarried and alone recorded a higher score on the scale than those who were married and living with someone. Age showed a negative correlation with the scale score only in Sample 1, in which the equal allocation procedure was introduced for the age stratum. Conclusions The results indicate that the Japanese version of the TIL Scale demonstrates adequate reliability and validity for the assessment of loneliness. Electronic supplementary material The online version of this article (10.1186/s40359-019-0285-0) contains supplementary material, which is available to authorized users.

In the face of the global coronavirus disease 2019 (COVID-19) pandemic, billions of people were forced to stay at home due to the implementation of social distancing and lockdown policies. As a result, individuals lost their social relationships, leading to social isolation and loneliness. Both social isolation and loneliness are major risk factors for poor physical and mental health status through enhanced chronic inflammation; however, there might be an interplay between social isolation and loneliness on the association with chronic inflammation. We aimed to clarify the link between social relationships and inflammation in the context of the COVID-19 pandemic by distinguishing whether social isolation only, loneliness only, or both were associated with chronic inflammation markers among community-dwelling adults. The data of 624 people (aged 18-92 years, mean 51.4) from the Utsunomiya COVID-19 seROprevalence Neighborhood Association (U-CORONA) study, which targeted randomly sampled households in Utsunomiya city, Japan, were analyzed. Social isolation was assessed as a structural social network by asking the number of social roles they have on a daily basis. Loneliness was measured with the UCLA loneliness scale. As chronic inflammation biomarkers, neutrophil-to-lymphocyte ratio (NLR) and the concentration of high-sensitivity C-reactive protein (CRP) were measured. Generalized estimating equations method was employed to take into account the correlations within households. Isolated-Lonely condition (i.e., being both socially isolated and feeling lonely) was associated with higher NLR among men (B = 0.141, 95%CI = -0.01 to 0.29). Interestingly, Nonisolated-Lonely condition (i.e., not socially isolated but feeling lonely) was associated with lower CRP among women (B = -0.462, 95%CI = -0.82 to -0.10) and among the working-age population (B = -0.495, 95%CI = -0.76 to -0.23). In conclusion, being both socially isolated and feeling lonely was associated with chronic inflammation. Assessing both social isolation and loneliness is critical for proper interventions to mitigate the impact of poor social relationships on health, especially in the context of the COVID-19 pandemic.

AIMS About 3.5 million Syrian refugees are living within the borders of Turkey. This study examined depression, loneliness and factors influencing refugee children who live outside the camps and attend school in Turkey. METHODS This was a descriptive study in Sanliurfa, which has the second highest refugee population in Turkey. The sample consisted of 535 students attending 6-8 grades in five schools randomly selected of 18 schools located in the city centre where the Syrian children received their education. Data were collected using the Sociodemographic Characteristics Question Form, the Depression Scale for Children and the UCLA Loneliness Scale. Data were analysed by IBM spss v23. The percentage, average and standard deviation were determined. A linear regression analysis was used to examine the independent variables affecting loneliness and depression scores, and the Backward method was used to include independent variables in the model. Significance level was considered as P

Ineffective emotional regulation and loneliness both play a key role in the development of mental disorders. Divorced individuals are particularly predisposed to loneliness in cultures where post-divorce relationships are uncommon or stigmatized. The aim of the present study was to determine the effectiveness of Acceptance and Commitment Therapy (ACT) on the emotional regulation and loneliness of divorced women in Iran, a culture with strong honor values that condemn post-divorce relationships for women leading to increased levels of loneliness and social exclusion in divorced Iranian women. The present study was carried out using a pretest-posttest control group study design. The research sample consisted of 30 divorced women who were randomly assigned to experimental (vs. control) groups. In order to evaluate the variables of interest, the emotional regulation Questionnaire (ERQ) and UCLA Loneliness Scale were used. Divorced women in the experimental group were treated using ACT techniques in eight sessions, each lasting 90 minutes. Results of analysis of covariance showed a significant increase in the adaptive emotional regulation of divorced women in the experimental group after the intervention. In addition, there was a significant reduction in the loneliness of divorced women who received the ACT intervention. We find that the ACT intervention improves emotional regulation and reduces loneliness in divorced women in Iran.

Background: Binge-watching refers to the watching of several episodes of a TV series or program in rapid succession. This study aims to investigate the associations of binge-watching behavior with depression, social interaction anxiety, and loneliness risks among adults in Taiwan. Methods: A cross-sectional online survey was conducted in October 2018, in which data from 1488 participants were collected using a self-administered questionnaire comprising four valid and reliable scales: the Center for Epidemiologic Studied Depression Scale (CES-D), the Chinese version of the Social Interaction Anxiety Scale (SIAS-C), the UCLA Loneliness Scale (version 3), and the Problematic Series Watching Scale (PSWS). Results: Among the surveyed participants, the mean age was 28.3, and most participants were women who had completed undergraduate education. Multiple regression analysis demonstrated that, after adjustments for sociodemographic characteristics and self-reported health statuses, the score on the problematic binge-watching scale was positively associated with the scores on the depression, social interaction anxiety, and loneliness scales (p &lt, 0.001 for each model). Conclusions: Problematic binge-watching was associated with increased depression, social interaction anxiety, and loneliness risks among adults in Taiwan. Additional studies on the relationship between problematic binge-watching and mental health problems, as well as its potential mechanism, are warranted.

ObjectivesThis study aims to investigate the potential factors associated with mental health outcomes among Chinese adults during the Coronavirus disease 2019 (COVID-19) epidemic.MethodsThis is an online cross-sectional survey conducted among Chinese adults in February 2020. Outcome measurements included the three-item UCLA Loneliness Scale (UCLA-3), two-item Patient Health Questionnaire (PHQ-2), two-item Generalized Anxiety Disorder Questionnaire (GAD-2), and two items from the Clinician-Administered Post-traumatic Stress Disorder (PTSD) Scale. COVID-19 related factors, physical health, lifestyle, and self-efficacy were also measured. Univariable and multivariable logistic regressions were performed.ResultsThis study included 1456 participants (age: 33.8±10.5 years; female: 59.1%). The prevalence of depressive symptoms, anxiety symptoms, loneliness, and PTSD symptoms were 11.3%, 7.6%, 38.7%, and 33.9%, respectively. In multivariable analysis, loneliness was associated with being single, separated/divorced/widowed, low level of education, current location, medication, more somatic symptoms, lower self-efficacy, and going out frequently. Depression was associated with fear of infection, binge drinking, more somatic symptoms, lower self-efficacy, and longer screen time. Anxiety was associated with more somatic symptoms and lower self-efficacy. PTSD symptoms were associated with more somatic symptoms, lower self-efficacy, higher perceived risk of infection, fear of infection, and self-rated more negative influence due to the epidemic (pConclusionsMental health problems during the COVID-19 epidemic were associated with various biopsychosocial and COVID-19 related factors. Psychological interventions should be aware of these influencing factors and prioritize support for those people at higher risk.

As is already well known, demographic changes will presumably lead to a rising number of old aged individuals and loneliness is a tremendous concern in aging populations. Poor health can be a potential consequence of loneliness, as well as a determining factor. Thus, the objective of the current study was to determine whether postponed dental appointments due to costs affect loneliness longitudinally. Focusing on Germany, data from two waves (waves 5 and 6) of the &ldquo, Survey of Health Ageing, and Retirement in Europe&rdquo, (SHARE) were analyzed (n = 7703). The three-item loneliness scale (modified version of the revised UCLA Loneliness scale) was used to quantify loneliness. The presence of postponed dental appointments due to costs in the past 12 months (no, yes) served as a key independent variable. Socioeconomic factors as well as health-related factors were adjusted in the longitudinal regression analysis. After adjusting for confounding variables, regression analyses revealed that loneliness increased with decreases in self-rated health among men. Among women, loneliness increased when self-rated health decreased, when fewer chronic diseases and postponed dental appointments due to costs were reported. Among older women, postponed dental appointments due to costs are associated with feelings of loneliness. The study results add evidence that proper dental care (i.e., regular and appropriate visits to the dentist) is vital not only to one&rsquo, s oral health, but also plays a role in one&rsquo, s physical and emotional health.

ObjectivesTo investigate the gender disparities in the prevalence and severity of depressive and anxiety symptoms and associated factors among internal migrant workers in Shenzhen.DesignCross-sectional study.SettingLabour intensive factories in Shenzhen, Guangdong, China.ParticipantsWe recruited 3200 internal migrant workers who aged over 18 years old and above and did not register in Shenzhen’s household registration system. There were 3095 participants eligible for this study.MethodsParticipants completed sociodemographic questionnaire, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the UCLA Loneliness Scale, the Barratt Impulsiveness Scale, the Social Support Rating Scale, the Simplified Coping Style Questionnaire and Meaning in Life Questionnaire. We applied χ2test, analysis of variance, Wilcoxon rank test, Fisher’s exact test and univariate and multivariate multilevel linear regression analysis.ResultsThe overall prevalence of depressive and anxiety symptoms was 27.85% and 19.26% among internal migrant workers. We reported gender disparities of depressive and anxiety symptoms among participants that the prevalence of depressive and anxiety symptoms was higher in women (30.57% vs 26.43% and 22.67% vs 17.47%), and the symptoms were more severe among women. Female migrant workers were more likely to be singled, have lower prevalence of smoking and drinking, receive less education and monthly income, have higher level of impulsiveness and social support and lower level of meaning in life. We found age, marriage, income, adaption to living in Shenzhen, being discriminated, drinking, loneliness, impulsiveness, social support, coping strategies and meaning of life were associated with the severity of depressive and anxiety symptoms among internal migrant workers in Shenzhen.ConclusionGender inequality may be the institutional factor leading to disparities in depressive and anxiety symptoms among internal migrant workers. Interventions should be embedded with strategies improving gender equality.

BackgroundWhile it is well established that skin disease places significant psychosocial burden on a patient’s wellbeing, its effects have rarely been examined in Asian populations.ObjectiveEvaluate the psychosocial burden of skin disease among community-dwelling adults in Singapore.MethodsThis cross-sectional study included 1510 participants interviewed on their history of thirteen skin diseases. The Patient Health Questionnaire (PHQ-9), Lubben Social Network Scale-6 (LSNS-6), University of California Los Angeles (UCLA) Loneliness Scale, and European Quality of Life-5 Dimensions- 5 Level (EQ-5D-5L) were used as measures for depressive symptoms, social isolation, loneliness and quality of life respectively. Multiple linear regression analysis was used to examine the association of skin diseases with each of the four measured outcomes.ResultsParticipants with skin diseases reported significantly higher PHQ-9 and UCLA Loneliness scale scores, and lower LSNS-6 and EQ-5D-5L scores when compared to their healthy counterparts. The presence of skin disease was positively associated with depressive symptoms (B = 0.40, SE = 0.11), and negatively associated with quality of life (B = -0.03, SE = 0.01). As disease severity was not evaluated in this study, we were unable to ascertain the associations between disease severity and measured outcomes.ConclusionParticipants with skin diseases were more likely to have depressive symptoms, social isolation, loneliness and lower quality of life. Unemployed, single and elderly patients were at higher risk of developing depressive symptoms. More emphasis should be placed on the psychosocial aspect of care to reduce the burden of skin disease. Some considerations include monitoring patients for mood-related changes and implementing early psychosocial interventions.

Isolation and loneliness are related to various aspects of health. Physical performance is a central component of health. However, its relationship with isolation and loneliness is not well understood. We therefore assessed the relationship between loneliness, different aspects of social isolation, and physical performance over time. 8,780 participants from the English Longitudinal Study of Ageing, assessed three times over 8 years of follow-up, were included. Measures included physical performance (Short Physical Performance Battery), loneliness (modified UCLA Loneliness Scale), and isolation considered in three ways (domestic isolation, social disengagement, low social contact). Fixed effects regression models were used to estimate the relationship between changes in these parameters. Missing data were imputed to account for variable response and ensure a representative sample. Loneliness, domestic isolation and social disengagement were longitudinally associated with poorer physical performance when accounting for both time-invariant and time-variant confounders (loneliness: coef = − 0.06, 95% CI − 0.09 to − 0.02; domestic isolation: coef = − 0.32, 95% CI − 0.46 to − 0.19; social disengagement: coef = − 0.10, 95% CI − 0.12 to − 0.07). Low social contact was not associated with physical performance. These findings suggest social participation and subjectively meaningful interpersonal interactions are related to physical performance, and highlight additional considerations regarding social distancing related to COVID-19 control measures.

To explore the association between the personal social capital and loneliness among the widowed older adults in China. Data from 1497 widowed older adults were extracted from China&rsquo, s Health-Related Quality of Life Survey for Older Adults 2018. The Chinese version of the Personal Social Capital Scale (PSCS-16) was used to evaluate the participants&rsquo, status of bonding and bridging social capital (BOC and BRC). Loneliness was assessed by the short-form UCLA Loneliness Scale (ULS-8). Multiple linear regression models were established to examine the relationship between social capital and loneliness. The BOC and BRC of rural widowed older people were significantly lower than those of widowed older people in urban areas, while loneliness of rural widowed older people was higher than that of widowed older people in urban areas. The result of the final model showed that loneliness of rural participants was significantly associated with both BOC (B = 0.141, p = 0.001) and BRC (B = &minus, 0.116, p = 0.003). The loneliness of the urban widowed sample had no association with both BOC and BRC (p &gt, 0.05). These findings suggested that more social support and compassionate care should be provided to enrich the personal social capital and thus to reduce loneliness of widowed older adults, especially those in rural areas.

Background The burden of psychological distress is increasing with the spread of the pandemic and also with the enforcement of its containment measures. The aim of this research was to determine the proportion of self-reported psychological distress, loneliness and degrees of resilient coping, and to also investigate the relationship of loneliness, coping and other variables with psychological distress among apparently healthy Indians during nation-wide lockdown period. Methods A cross-sectional, region-stratified survey using pre-designed pre-tested Google form disseminated via different social media platforms was conducted. A total of 1249 responses were analysed all over India. The form enquired about Socio-demographic profile, awareness on COVID pandemic and cases in the surroundings. UCLA Loneliness scale, Brief resilience and coping scale (BRCS) and Psychological distress scale (K6) assessed self-reported loneliness, coping and psychological distress, respectively. Special regressor technique adjusting for endogeneity and heteroskedasticity was used to extract the average marginal effects. Results Majority of the respondents were 18–35 years old, male, single and urban residents. News media, social media mostly acted as sources of information regarding COVID related news. Overall, 54.47% (95% CI: 51.39–57.53%) and 38.39% (95% CI: 35.57–41.29%) were reported to be lonely and had low resilient coping ability respectively. Around 44.68% had high risk of developing psychological distress. Being a student (average marginal effect coefficient (AMECoef).: -0.07, 95% CI: [-0.12, -0.01]) and perceiving lockdown as an effective measure (AMECoef: -0.11, 95% CI: [-0.19, -0.03]) were protective against psychological distress. Psychological distress was associated with male respondents (AMECoef 0.07, 95% CI: [0.02, 0.11]), low or medium resilient copers (AMECoef 0.89, 95% CI: [0.17, 1.61]), and perceiving a serious impact of social distancing measures (AMECoef 0.17, 95% CI: [0.09, 0.26]). Conclusions Psychological distress among Indian population during lockdown was prevalent. Poor coping ability and perceiving social distancing to have a serious impact was found to be significantly contributing to psychological distress. Appropriate measures to address these issues would be beneficial for the community mental health.

Highlights • Social support is inversely related to depression, anxiety, irritability, sleep quality and loneliness during quarantine. • Higher levels of social support reduces the risk of depression during quarantine. • Higher levels of social support increases sleep quality during quarantine., The aim of the present study was to examine the role of perceived social support pertaining to a range of psychological health outcomes amongst individuals undergoing social isolation and social distancing during COVID-19. A total of 2,020 participants provided responses to an online cross-sectional survey comprised of validated instruments including the Multidimensional Scale of Perceived Social Support (MSPSS), the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-9), the Brief Irritability Test (BITe) and the UCLA Loneliness Scale (UCLA-LS). Individuals experiencing self-isolation had significantly higher rates of depression, irritability and loneliness compared to those who were not. The risk for elevated levels of depression symptoms was 63% lower in individuals who reported higher levels of social support compared to those with low perceived social support. Similarly, those with high social support had a 52% lower risk of poor sleep quality compared to those with low social support. Social support was found to be significantly associated with elevated risk for depression and poorer sleep quality. The results contribute to our understanding of differential psychological outcomes for individuals experiencing anti-pandemic measures.

Background: Research on the relationship between resilience and loneliness is sparse. The construct of resilience has been conceptualized in multiple ways, including the measurement of resilience. The Resilience Scale for Adults (RSA) is a measure of protective factors. The present study examined whether resiliency moderates any negative relationship between loneliness and mental health and additionally examined the psychometric properties of the Danish translation of the RSA. Methods: A Danish sample (N = 422) completed the UCLA Loneliness Scale, Hopkins Symptom Check List-25 (HSCL- 25), the Sense of Coherence (SOC-13), and the RSA, Resilience Scale for Adults. Results: The measure of loneliness correlated significantly and negatively with most facets of the RSA, except the subscales of family cohesion and structured style. The strongest correlation was the negative one between loneliness and SOC. The results indicated that people feeling lonely also experience their life as less meaningful. Conclusion: The study supports the existing six-factor structure of the Resilience Scale for Adults (RSA) in a Danish sample. The results indicate that all facets of resiliency were negatively related to loneliness. Also, the facets of perception of self and family coherence could explain a substantial amount of the variance associated with symptoms of depression in relation to loneliness. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Highlights • What is the primary question addressed by this study? This paper explores the use of natural language processing techniques and machine learning models to predict loneliness in older community-dwelling adults. • What is the main finding of this study? There are structural differences in how older men and women talk about loneliness that can be detected using natural language processing techniques. Text features can be used to predict loneliness with reasonable validity. • What is the meaning of the finding? NLP and machine learning approaches provide a novel way to analyze text data to identify loneliness, while accounting for key sociodemographic factors like sex and age., Objective The growing pandemic of loneliness has great relevance to aging populations, though assessments are limited by self-report approaches. This paper explores the use of artificial intelligence (AI) technology to evaluate interviews on loneliness, notably, employing natural language processing (NLP) to quantify sentiment and features that indicate loneliness in transcribed speech text of older adults. Design Participants completed semi-structured qualitative interviews regarding the experience of loneliness and a quantitative self-report scale (UCLA loneliness scale) to assess loneliness. Lonely and non-lonely participants (based on qualitative and quantitative assessments) were compared. Setting Independent living sector of a senior housing community in San Diego County. Participants 80 English-speaking older adults of ages 66-94 (mean 83 years). Measurements Interviews were audiotaped and manually transcribed. Transcripts were examined using NLP approaches to quantify sentiment and expressed emotions. Results Lonely individuals (by qualitative assessments) had longer responses with greater expression of sadness to direct questions about loneliness. Women were more likely to endorse feeling lonely during the qualitative interview. Men used more fearful and joyful words in their responses. Using linguistic features, machine learning models could predict qualitative loneliness with 94% precision (sensitivity=0.90, specificity=1.00) and quantitative loneliness with 76% precision (sensitivity=0.57, specificity=0.89). Conclusions Artificial intelligence (e.g., NLP and machine learning approaches) can provide unique insights into how linguistic features of transcribed speech data may reflect loneliness. Eventually linguistic features could be used to assess loneliness of individuals, despite limitations of commercially developed NLU programs.

OBJECTIVE Loneliness is a prevalent and serious public health problem due to its effects on health, well-being, and longevity. Understanding correlates of loneliness is critical for guiding efforts toward the development of evidence-based strategies for prevention and intervention. Considering that patterns of association between age and loneliness vary, the present study sought to examine age-related differences in risk and protective factors for loneliness. METHODS Correlates of loneliness were examined through a large web-based survey of 2,843 participants (aged 20-69 years) from across the United States from April 10, 2019, through May 10, 2019. Participants completed the 4-item UCLA Loneliness Scale, San Diego Wisdom Scale (with the following subscales measuring components of wisdom: Prosocial Behaviors, Emotional Regulation, Self-Reflection, Acceptance of Divergent Values, Decisiveness, and Social Advising), and other scales measuring psychosocial variables. Multivariate regression analyses were conducted to identify the best model of loneliness and examine potential age-related differences. RESULTS Age demonstrated a nonlinear quadratic relationship with loneliness (Wald statistic = 5.48, P = .019); levels were highest in the 20s and lowest in the 60s with another peak in the mid-40s. Across all decades, loneliness was associated with not having a spouse or partner (P < .001), sleep disturbance (P < .02), lower prosocial behaviors (P < .001), and smaller social network (P < .001). Lower social self-efficacy (P < .001) and higher anxiety (P < .005) were associated with worse loneliness in all age decades, except the 60s. Loneliness was uniquely associated with decisiveness in the 50s (P = .012) and with education (P = .046) and memory complaints (P = .013) in the 60s. CONCLUSIONS Our findings identify several potentially modifiable targets related to loneliness, including several aspects of wisdom and social self-efficacy. Differential predictors at different decades suggest a need for a personalized and nuanced prioritizing of prevention and intervention targets.

Background The data of the International Diabetes Federation show that about 463 million people have diabetes. Better understanding of psychosocial aspects of life with this disease has become one of healthcare priorities in this group of patients. The aim of this study was to assess the relationships between loneliness and blood glucose control in diabetic patients. Methods The study included 250 hospitalized patients with type 1 and 2 diabetes. The patients included in the study were those who had had diabetes for at least 1 year and received pharmacotherapy. Standardized Revised UCLA Loneliness Scale (R-UCLA) and an analysis of patient test results including 10 indicators of blood glucose control were used for data collection. Correlation analysis, i.e. Pearson’s linear correlation coefficient (r, parametric method), was used for hypothesis verification. Results Less than one-fifth (16%) of the patients included in the study had higher loneliness index (based on the R-UCLA scale), and this loneliness index (total result) was significantly correlated with higher blood pressure. No significant correlations were demonstrated between loneliness and the other 9 indicators of blood glucose control. Conclusions Systolic blood pressure was significantly correlated with loneliness in patients with diabetes. Further studies are needed to confirm these findings.

Student well-being is a growing issue in higher education, and assessment of the prevalence of conditions as loneliness is therefore important. In higher education and population surveys the Three-Item Loneliness Scale (T-ILS) is used increasingly. The T-ILS is attractive for large multi-subject surveys, as it consists of only three items (derived from the UCLA Loneliness Scale). Several ways of classifying persons as lonely based on T-ILS scores exist: dichotomous and trichotomous classification schemes and use of sum scores with rising levels indicating more loneliness. The question remains whether T-ILS scores are comparable across the different population groups where they are used or across groups of students in the higher education system. The aim was to investigate whether the T-ILS suffers from differential item functioning (DIF) that might change the loneliness classification among higher education students, using a large sample just admitted to 22 different academy profession degree programs in Denmark (N = 3,757). DIF was tested relative to degree program, age groups and gender. The framework of graphical loglinear Rasch models was applied, as this allows for adjustment of sum scores for uniform DIF, and thus for assessment of whether DIF might change the classification. Two items showed DIF relative to degree program and gender, and adjusting for this DIF changed the classification for some subgroups. The consequences were negligible when using a dichotomous classification and larger when using a trichotomous classification. Therefore, trichotomous classification should be used with caution unless suitable adjustments for DIF are done prior to classification.

Globally the number of older people living alone is increasing. Little is known about the life experience of older people living alone in Mainland China. This study aimed to explore older people's experience regarding different components of their lives. A cross-sectional survey of 387 older people aged 60 years and above and living alone in two communities in Shanghai was conducted from April to July 2015. A structured questionnaire including 15-item Geriatric Depression Scale, Activity of Daily Living Scale, UCLA Loneliness Scale version 3, Social Support Rate Scale and Older People's Quality of Life Questionnaire was used to assess the health status, loneliness, social support, quality of life and demographic information. A total of 15.7% of the participants rated their health as poor with 56.8% reporting chronic diseases and 26.9% reporting being depressed. A total of 71.1% of the participants reported a high level of functional ability. However, 54.3% and 21.7% of the participants reported a moderately and moderately high level of loneliness respectively. The median of SSRS was 30 and the mean of Older People's Quality of Life Questionnaire was 120.2, indicating a lower level of social support and quality of life. There were statistically significant differences in health, loneliness, social support and quality of life across the participants with different characteristics. Interventions to improve the health status, reduce loneliness, increase social support and maintain or improve quality of life of older people living alone in Shanghai could be developed and implemented. Potential interventions include providing frequent home care services, early detection of depression, encouraging more contacts from children and other family members, and providing support from other sources.

Background: Loneliness in mothers raising children can adversely impact the health of their children and lead to child abuse, depression, and deterioration of mothers’ health. Few studies to date have specifically assessed the association between loneliness and social factors, including the use of social network sites (SNSs), and personal factors. This study aimed to identify predictors of loneliness in mothers raising children, with special reference to SNS use. Methods: This cross-sectional study involved an anonymous self-reported questionnaire survey of mothers participating in the health check-ups for their children in Nagahama City, Japan, from July 28 to September 29, 2014. The following items were assessed: revised UCLA Loneliness Scale, “Secure” subscale of the Internal Working Model Scale (IWMS-S), psychological distress scale (K6), abbreviated Lubben Social Network Scale (LSNS-6), and types of communication devices and information sources. Multiple regression analysis was performed using the Loneliness Scale score as the dependent variable. Results: Among 763 mothers attending health check-ups for children in Nagahama City, 715 were available for the survey. Among a total of 638 respondents, data from 523 mothers were analyzed (valid response rate: 73.1%). The mean Loneliness Scale score ± standard deviation was 36.1 ± 9.7. The multiple regression analysis revealed that loneliness was significantly associated with being financially worse-off (β = − 3.35, p = 0.004) and struggling (β = − 2.47, p = 0.047); having a smaller family social network (β = − 0.32, p = 0.032), having fewer friends (β = − 0.49, p = 0.001), and having a smaller SNS network (β = − 0.21, p = 0.018); a lower secure subscale score on the IWMS-S (β = − 0.56, p, SNS使用と育児中のお母さんの孤独感との関連を見出しました. 京都大学プレスリリース. 2018-08-24.

This study was designed to investigate the situation of social anxiety among left-behind children in rural areas of Hunan Province, China, and to study the effect of social anxiety on loneliness. A total of 797 left-behind children were selected from rural areas in Hunan Province, China. The basic information questionnaire for left-behind children, Social Anxiety Scale for Children, Perceived Social Support Scale and UCLA Loneliness Scale were used for investigation. (1) The social anxiety score of left-behind children in China is 6.84 ± 4.28, higher than non-left-behind children, and the score of boys is lower than that of girls, with no significant difference. The score of left-behind children in grade 5 is significantly lower than that of left-behind children in other grades. (2) The overall loneliness score is 16.30 ± 5.10, higher than non-left-behind children, and the score of boys is significantly higher than that of girls. (3) Social anxiety has a significant positive predictive effect on loneliness (P

Background Dog ownership is suggested to improve mental well-being, although empirical evidence among community dog owners is limited. This study examined changes in human mental well-being following dog acquisition, including four measures: loneliness, positive and negative affect, and psychological distress. Methods We conducted an eight-month controlled study involving three groups (n = 71): 17 acquired a dog within 1 month of baseline (dog acquisition); 29 delayed dog acquisition until study completion (lagged control); and 25 had no intentions of acquiring a dog (community control). All participants completed the UCLA Loneliness Scale (possible scores 0–60), Positive and Negative Affect Schedule and Kessler10 at baseline, three-months and eight-months. We used repeated measures ANCOVAs to analyse data with owner age and sex included as covariates. Post-hoc tests were performed for significant effects (p Results There was a statistically significant group by time interaction for loneliness (p = 0.03), with an estimated reduction of 8.41 units (95% CI -16.57, − 0.26) from baseline to three-months and 7.12 (95% CI -12.55, − 1.69) from baseline to eight-months in the dog acquisition group. The group by time interaction for positive affect was also significant (p = 0.03), although there was no change in the dog acquisition group. Conclusions Companion dog acquisition may reduce loneliness among community dog owners. Our study provides useful direction for future larger trials on the effects of dog ownership on human mental well-being. Trial registration This trial was retrospectively registered on 5th July 2017 with the Australian New Zealand Clinical Trials Registry (ACTRN12617000967381).

Previous research suggests that women who experience pain during intercourse also experience higher rates of depressive symptoms. Loneliness might be one factor that contributes to this relationship. We hypothesized that women who experience more severe and interfering pain during intercourse would report higher rates of loneliness and higher rates of depressive symptoms. Further, we hypothesized that loneliness would mediate the relationship between pain during intercourse and depressive symptoms. A total of 104 female participants (85.6% white, 74.03% partnered, 20.9 [3.01] years old) completed an online survey including demographic information, PROMIS Vaginal Discomfort Measure, PROMIS Depression Measure, and Revised UCLA Loneliness Scale. Pearson correlations and bootstrapped mediation analysis examined the relationships among pain during intercourse, loneliness, and depressive symptoms. Pain during intercourse, loneliness, and depressive symptoms were all significantly correlated (p

Internet addiction is common among medical students, and the prevalence is higher than the general population. Identifying and creating solutions for this problem is important. The aim of this study was to examine the prevalence and associated factors, particularly loneliness and interpersonal problems among Chiang Mai medical students.Of 324 first to sixth year medical students, 56.8% comprised females with a mean age of 20.88 (SD 1.8). All completed questionnaires related to the objectives and activities of internet use, the Young Internet Addiction Test, the UCLA loneliness scale, and the Interpersonal Problems Inventory were employed to identify internet addiction.In all, 36.7% of the subjects exhibited internet addiction, mostly at mild level. Amount of time used daily, loneliness and interpersonal problems were strong predictors (beta = 0.441, p 0.05, beta = 0.219, p 0.001 and beta = 0.203 p 0.001, respectively), whereas age and sex were not. All objectives of using internet contributed to the variance of internet addiction score. For internet activities, only non-academic or studying contributed. The final model accounted for 42.8% of total variance of the internet addiction score.Even though most addiction was at a mild level, careful strategies should be applied to better understand the situation. Along with a screening for potential internet addiction among medical students, attention should be paid to identifying those who experience loneliness and interpersonal problems, because both are strong predictors that can be improved by a variety of appropriate intervention.

Το explore the relationship between mental health (depression, anxiety, and stress), loneliness, and illness perception with health-related quality of life (HRQoL) in young breast cancer patients, within a year after mastectomy, and to investigate the role of breast reconstruction. Eighty-one women with stage II breast cancer—35 with breast reconstruction and 46 without breast reconstruction—completed the Missoula-VITAS Quality of Life Index-15, the Depression Anxiety Stress Scale 21, the UCLA Loneliness Scale, the Brief Illness Perception Questionnaire, and a questionnaire with demographic and medical information. Statistical analysis was performed using IBM SPSS Statistics version 20. Breast reconstruction was a significant predictor of total HRQoL and its domains. Women with breast reconstruction had better HRQoL, significantly better mental health, less stress and anxiety levels but experienced more physical discomfort and perceived higher level of physical distress compared to the ones without breast reconstruction. On the contrary, patients without breast reconstruction had higher level of loneliness, which was found to be correlated with poor HRQoL and higher levels of anxiety. Negative illness perceptions were associated with poor HRQoL for both groups. Breast reconstruction is not a panacea for patients in improving HRQoL.

The purpose of this study was to investigate the mediating effects of self-acceptance on loneliness and subjective well-being (SWB) among elderly subjects living in Chinese nursing homes. This cross-sectional study was conducted between October 2019 and March 2020. A total of 415 elderly participants aged 60 to 97 years (mean 81.12 ± 8.90 years) from 3 medical and nursing homes in Fuyang city, Anhui province, were selected using a convenience sampling method. Data were collected using a general information questionnaire, the Memorial University of Newfoundland Scale of Happiness, the self-acceptance scale, and the UCLA Loneliness scale. Correlations, regressions, and structural equation models were used for the analyses. Multiple linear regression analysis was performed to confirm the factors influencing the SWB. Bootstrapping was performed to confirm the mediation effect. The loneliness of elderly subjects in nursing homes was significantly correlated with self-acceptance and SWB (r = −0.338, P

Background Individuals with internet gaming disorder (IGD) usually report a higher sense of loneliness. Although studies have suggested a key role of the prefrontal cortex-based resting-state functional connectivity (rsFC) in both IGD and loneliness, the potential mechanism between IGD and loneliness remains unclear. Methods Fifty-seven IGD and 81 matched recreational internet gamer users (RGU) underwent resting-state fMRI scans. The UCLA loneliness scale was used to measure loneliness. We first explored the brain areas that are both associated with loneliness and IGD severity. Then, the neuroimaging findings were extracted to test whether the rsFC of these brain regions moderates the relationship between IGD and loneliness. Results We observed reduced rsFC between the left dorsolateral prefrontal cortex (DLPFC) and the left precentral and the postcentral gyri and the supplementary motor area (SMA), which also correlated with increased IAT (Young’'s internet addiction test) scores. More importantly, the rsFC of the DLPFC-precentral gyrus and the DLPFC-postcentral gyrus moderated the relationship between IGD severity and loneliness scores. Additionally, we also found that the rsFC of the left DLPFC-precentral gyrus, the DLPFC-postcentral gyrus and the right DLPFC-SMA moderated the relationship between self-reported gaming craving and the UCLA scores. Conclusions The current study confirmed the role of the DLPFC in reward control (game craving) and emotion regulation (loneliness). Additionally, the rsFC of the prefrontal cortex-supplementary motor area moderates IGD and loneliness. These findings provide valuable understanding of the two-way relationship between IGD and loneliness.

Objectives: Stressful life events (SLEs) have been linked to depression, anxiety, and reduced life satisfaction. The inoculation hypothesis of aging suggests older adults may be less vulnerable to poor psychological outcomes following SLEs than working-age adults. The current study compared relationships between SLEs, mood and life satisfaction among older adults (65+), and adults aged 50–64, and investigated whether group identification and loneliness moderate these relationships.\ud \ud Method: A community-based sample of 121 Scottish participants responded to measures of SLEs (modified Social Readjustment Rating Scale), symptoms of depression and anxiety (Hospital Anxiety and Depression Scale), life satisfaction (Life Satisfaction Index A), group identification (Group Identification Scale), and loneliness (UCLA Loneliness Scale).\ud \ud Results: In the 50–64 age group, the number of SLEs was significantly associated with greater symptoms of depression and anxiety, and reduced life satisfaction. Group identification and loneliness did not moderate these relationships. There were no significant relationships in the older adult group.\ud \ud Conclusion: The finding of relationships in working-age, but not older adults, supports the inoculation hypothesis of aging. Further research to better understand changes across the lifespan, and inter-relationships with related variables, would be valuable from both theoretical and clinical perspectives.

Social relationships often decline after brain injury. Although much of this is due to psychosocial impairments caused by the injury, the reactions to the injury of others in the person's wider social network, along with the response of the person with the injury to those reactions, also need to be considered. Anxiety about stigmatising reactions from others may lead some to conceal information about their brain injury. This study investigated some of the social consequences of such concealment. Sixty-five participants with acquired brain injury completed the Anticipated Stigma and Concealment Questionnaire, the Social Avoidance and Distress Scale, the UCLA Loneliness Scale, the Rosenberg Self-Esteem Scale, the Social Integration subscale of the Community Integration Questionnaire, and the Enacted Social Support Questionnaire. As hypothesised, concealment was associated with social anxiety, social avoidance, loneliness and lower self-esteem; and anxiety mediated the impact that concealment had on avoidance, loneliness and reduced community activity. However, contrary to expectation, concealment was not associated with reduced use of social support. Concealment may have negative consequences, but inappropriate disclosure can also be harmful. Services should support individuals to make optimal decisions about disclosing information about the brain injury and also help them address psychological barriers to disclosure.

Background Chinese rural elderly are at higher risk of committing suicide. However, little is known about the suicidal ideation (SI) of institutional elderly residents in rural China. Methods 250 participants aged 60 or above living in Chinese rural nursing homes were recruited. Data were collected on subjects' SI, social-demographic characters, physical illness and psychological factors. Univariate comparisons and path analysis were conducted then. Results 19.5% (40/205) of the participants reported a current SI. Hopelessness and depression had significant direct impacts on SI, and self-esteem and loneliness can impact SI through the mediating of depression and hopelessness. Visiting frequency of children, number of physical illnesses and social activities can also affect SI through the mediating of loneliness or self-esteem. Conclusion As the first study on path analysis of SI of rural institutional elderly, the findings are significant. All these factors in our model should be considered when interventions are being conducted.