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Objectives Despite media and public dialog portraying loneliness as a worsening problem, little is known about how the prevalence of loneliness has changed over time. Our study aims to identify (a) temporal trends in episodic and sustained loneliness (lonely in 1 wave vs consistently lonely in 3 consecutive waves); (b) trends across sociodemographic subgroups by sex, race/ethnicity, birth cohort, education, employment status, marital status, and living alone; and (c) longitudinal predictors of loneliness in middle-aged and older Americans (≥50 years). Methods Based on Waves 3 (1996) to 14 (2018) of the Health and Retirement Study (n = 18,841–23,227), we conducted a series of lagged mixed-effects Poisson regression models to assess trends of episodic and sustained loneliness in the overall and sociodemographic subgroup samples (by sex, race/ethnicity, birth cohort, education, employment, relationship, and living alone status). To examine the predictors of episodic and sustained loneliness, we used a multivariate mixed-effects Poisson regression model with all sociodemographic variables entered into the same model. Results Episodic loneliness prevalence decreased from 20.1% to 15.5% and sustained loneliness from 4.6% to 3.6%. Trends were similar across most subgroups. Males, Caucasians, those born in 1928–1945, with university education, working, married/partnered, and those not living alone reported lower episodic and sustained loneliness, although associations with sustained loneliness were stronger. Discussion Contrary to common perceptions, loneliness has decreased over 20 years of follow-up in middle-aged and older Americans. Several sociodemographic subgroups have been identified as having a higher risk of loneliness, prompting targeted public health attention. [ABSTRACT FROM AUTHOR]

Despite the widely publicized health benefits of physical activity, a large proportion of the world's population is insufficiently active or completely inactive. The 2018 edition of the Physical Activity Guidelines for Americans (PAGA18) was a mammoth feat that took over 2 years to complete and resulted in a 779-page report in early 2018, followed by the publication of the summary guidelines in the Journal of the American Medical Association . In this Viewpoint, the authors (1) summarize the key components of the PAGA18 with respect to adults, and (2) discuss the implications for the general public and health care practitioners. J Orthop Sports Phys Ther 2019;49(7):487-490. doi:10.2519/jospt.2019.0609 .