Lonely in a crowd: Overcoming loneliness with acceptance and wisdom

Study looked at characteristics of loneliness in a senior housing community and the strategies residents used to overcome it

January 10, 2020

Science Daily/University of California - San Diego

Researchers found the main characteristics of loneliness in a senior housing community and the strategies residents use to overcome it.

By nature, human beings are social creatures. Yet, as we age, personal dynamics and lifestyles change, which can result in loneliness and isolation. With older adults increasingly moving into senior living or retirement communities, researchers at University of California San Diego School of Medicine sought to identify the common characteristics of residents who feel lonely in these environments.

"Loneliness rivals smoking and obesity in its impact on shortening longevity," said senior author Dilip V. Jeste, MD, senior associate dean for the Center of Healthy Aging and Distinguished Professor of Psychiatry and Neurosciences at UC San Diego School of Medicine. "It is a growing public health concern, and it's important that we identify the underlying causes of loneliness from the seniors' own perspectives so we can help resolve it and improve the overall health, well-being and longevity of our aging population."

Jeste noted that there are few published qualitative studies about loneliness among older adults in the independent living sector of senior housing communities, where shared common areas, planned social outings and communal activities are intended to promote socialization and reduce isolation. "So why are many older adults living in this type of housing still experiencing strong feelings of loneliness?" asked Jeste.

The new study, published online in the January 10, 2020 issue of Aging and Mental Health, found that people's experience of living with loneliness is shaped by a number of personal and environmental factors.

Researchers conducted one-and-a-half-hour individual interviews of 30 adults ages 67 to 92, part of an overall study evaluating the physical, mental and cognitive functions of 100 older adults living in the independent living sector of a senior housing community in San Diego.

In this communal setting, 85 percent of the residents reported moderate to severe levels of loneliness. "Loneliness is subjective," said Jeste. "Different people feel lonely for different reasons despite having opportunities and resources for socialization. This is not a one size fits all topic."

Three main themes emerged from the study:

• Age-associated losses and inadequate social skills were considered to be primary risk factors for loneliness. "Some residents talked about the loss of spouses, siblings and friends as the cause of their loneliness. Others mentioned how making new friends in a senior community cannot replace deceased friends they grew up with," said first author Alejandra Paredes, PhD, a research fellow in the Department of Psychiatry at UC San Diego School of Medicine.

• The feeling of loneliness was frequently associated with a lack of purpose in life. "We heard powerful comments like, 'It's kind of gray and incarcerating,'" said Jeste. "Others expressed a sense of 'not being attached, not having very much meaning and not feeling very hopeful' or 'being lost and not having control.'"

• The research team also found that wisdom, including compassion, seemed to be a factor that prevented loneliness. "One participant spoke of a technique she had used for years, saying 'if you're feeling lonely, then go out and do something for somebody else.' That's proactive," said Jeste. Other protective factors were acceptance of aging and comfort with being alone. "One resident told us, 'I've accepted the aging process. I'm not afraid of it. I used to climb mountains. I want to keep moving, even if I have to crawl. I have to be realistic about getting older, but I consider and accept life as a transition,'" Jeste noted. "Another resident responded, 'I may feel alone, but that doesn't mean I'm lonely. I'm proud I can live by myself.'"

According to the National Center for Health Statistics, by 2029, more than 20 percent of the United States population will be over the age of 65. "It is paramount that we address the well-being of our seniors -- they are friends, parents and grandparents of the younger generations," said Jeste. "Our study is relevant to better understand loneliness within senior housing and other settings to so we can develop effective interventions."

https://www.sciencedaily.com/releases/2020/01/200110101033.htm

'Loneliness epidemic' may be due to increasing aging population

December 10, 2019

Science Daily/American Psychological Association

Despite some claims that Americans are in the midst of a 'loneliness epidemic,' older people today may not be any lonelier than their counterparts from previous generations -- there just might be more of them, according to a pair of new studies.

Despite some claims that Americans are in the midst of a "loneliness epidemic," older people today may not be any lonelier than their counterparts from previous generations -- there just might be more of them, according to a pair of studies published by the American Psychological Association.

"We found no evidence that older adults have become any lonelier than those of a similar age were a decade before," said Louise C. Hawkley, PhD, of NORC at the University of Chicago, lead author of one of the studies. "However, average reported loneliness begins to increase beyond age 75, and therefore, the total number of older adults who are lonely may increase once the baby boomers reach their late 70s and 80s."

The studies were published in the journal Psychology and Aging.

Hawkley and her colleagues used data from the National Social Life, Health and Aging Project and the Health and Retirement Study, two national surveys of older adults that compared three groups of U.S. adults born in different periods throughout the 20th century. They first analyzed data in 2005 to 2006 from 3,005 adults born between 1920 and 1947 and a second time in 2010 to 2011 from 3,377 people, which included those from the previous survey who were still alive, and their spouses or partners. The third survey, in 2015 to 2016, comprised 4,777 adults, which included an additional sample of adults born between 1948 and 1965 to the surviving respondents from the previous two surveys.

The authors examined participants' level of loneliness, educational attainment, overall health on a scale from poor to excellent, marital status and number of family members, relatives and friends they felt close to. They found that loneliness decreased between the ages of 50 and 74, but increased after age 75, yet there was no difference in loneliness between baby boomers and similar-aged adults of earlier generations.

"Loneliness levels may have decreased for adults between 50 and 74 because they had better educational opportunities, health care and social relationships than previous generations," said Hawkley.

Adults over 75 were more susceptible to becoming lonely, possibly due to life factors such as declining health or the loss of a spouse or significant other, according to Hawkley.

"Our research suggests that older adults who remain in good health and maintain social relationships with a spouse, family or friends tend to be less lonely," said Hawkley.

In a similar study, researchers in the Netherlands found that older adults were less lonely than their counterparts from previous generations.

These researchers used data from the Longitudinal Aging Study Amsterdam, a long-term study of the social, physical, cognitive and emotional functioning of older adults. A total of 4,880 people, born between 1908 and 1957, participated.

The study measured peoples' loneliness, control over situations and life in general and goal achievement. For example, participants rated loneliness on a scale from 0 (no loneliness) to 11 (severe loneliness) based on feelings such as, "I miss having people around."

Older adults born in later generations were actually less lonely, because they felt more in control and thus most likely managed their lives better, according to Bianca Suanet, PhD, of Vrije Universiteit Amsterdam and lead author of the study.

"In contrast to assuming a loneliness epidemic exists, we found that older adults who felt more in control and therefore managed certain aspects of their lives well, such as maintaining a positive attitude, and set goals, such as going to the gym, were less lonely," said Suanet. "Additionally, as is well-known in loneliness research, participants who had a significant other and/or larger and more diverse networks were also less lonely."

Suanet recommended that older adults take personal initiative to better nurture their social ties, such as making friends to help them overcome increasing loneliness as they age. Also, interventions to reduce loneliness should focus more on bolstering older adults' feelings of control, instead of only offering social activities.

"People must manage their social lives better today than ever before because traditional communities, which provided social outlets, such as neighborhoods, churches and extended families, have lost strength in recent decades," said Suanet. "Therefore, older adults today need to develop problem-solving and goal-setting skills to sustain satisfying relationships and to reduce loneliness."

Seniors may also want to make use of modern technology to maintain meaningful social connections, according to Hawkley.

"Video chatting platforms and the Internet may help preserve their social relationships," said Hawkley. "These tools can help older adults stay mobile and engaged in their communities."

https://www.sciencedaily.com/releases/2019/12/191210111711.htm

Furry friends ease depression, loneliness after spousal loss

September 5, 2019

Science Daily/Florida State University

As Healthy Aging Month is underway this September, Florida State University researchers have found the companionship of a pet after the loss of a spouse can help reduce feelings of depression and loneliness in older adults.

The study, funded by The Gerontological Society of America and the WALTHAM Centre for Pet Nutrition and published in The Gerontologist, examined depressive symptoms and loneliness among people age 50 and older who experienced the loss of a spouse through death or divorce.

"Increasingly, there's evidence that our social support networks are really beneficial for maintaining our mental health following stressful events, despite the devastation we experience in later life when we experience major social losses," said Dawn Carr, lead author and FSU associate professor of sociology. "I was interested in understanding alternatives to human networks for buffering the psychological consequences of spousal loss."

Carr and her team compared individuals who experienced the loss of a spouse to those who stayed continuously married. Then they explored whether the effects of spousal loss differed for those who had a pet at the time of the death or divorce.

They found all individuals who lost their spouse experienced higher levels of depression. However, people without a pet experienced more significant increases in depressive symptoms and higher loneliness than those who had pets. In fact, those who had a pet and experienced the death or divorce of their spouse were no lonelier than older adults who didn't experience one of those events.

"That's an important and impressive finding," Carr said. "Experiencing some depression after a loss is normal, but we usually are able to adjust over time to these losses. Persistent loneliness, on the other hand, is associated with greater incidents of mortality and faster onset of disability, which means it's especially bad for your health. Our findings suggest that pets could help individuals avoid the negative consequences of loneliness after a loss."

Carr's team used data from a sample of older adults who participated in an experimental survey about human animal interaction as part of the University of Michigan's Health and Retirement Study in 2012, and linked the data with additional data collected between 2008 and 2014. They identified pet owners as those participants who either had a cat or a dog.

"In everyday life, having a cat or dog may not make you healthier," Carr said. "But when facing a stressful event, we might lean on a pet for support. You can talk to your dog. They're not going to tell you you're a bad person, they're just going to love you. Or you can pet your cat, and it's calming."

The researchers noted that additional studies should be conducted to explain why having pets helps maintain mental health better. However, Carr suggested part of it may relate to whether you feel like you matter to someone.

"Oftentimes, the relationship we have with our spouse is our most intimate, where our sense of self is really embedded in that relationship," Carr said. "So, losing that sense of purpose and meaning in our lives that comes from that relationship can be really devastating. A pet might help offset some of those feelings. It makes sense to think, 'Well at least this pet still needs me. I can take care of it. I can love it and it appreciates me.' That ability to give back and give love is really pretty powerful."

The findings have potential consequences for social policies. For instance, it may be beneficial to include companion animals in the treatment of people residing in senior-living facilities, or reducing barriers to pet ownership in such settings.

https://www.sciencedaily.com/releases/2019/09/190905102549.htm

Close ties with fathers help daughters overcome loneliness

Study examined changes in child loneliness over time

August 28, 2018

Science Daily/Ohio State University

Fathers play a key role in helping their young daughters overcome loneliness, a new study has found.

Researchers found that girls tended to report less loneliness as they went from first grade to fifth grade. But loneliness declined more quickly among girls who had a closer relationship with their fathers.

"The bond between fathers and daughters is very important," said Xin Feng, co-author of the study and associate professor of human sciences at The Ohio State University.

"We found that closeness between fathers and daughters tends to protect daughters and help them transition out of loneliness faster."

The study appears online in the Journal of Family Psychology and will be published in a future print edition.

The researchers studied 695 families who participated in the Study of Early Child Care and Youth Development, initiated and funded by the National Institute on Child Health and Development.

Mothers and fathers rated their relationships (both closeness and conflict) with their child when the child was in grades 1, 3, 4 and 5. In grades 1, 3 and 5 the children rated their levels of loneliness.

Results showed that levels of closeness tended to decline over this time period, while conflict increased. That's not surprising, said Julia Yan, lead author of the study and a doctoral student in human sciences at Ohio State.

"This is a time when children are becoming more independent, developing relationships with friends and spending more time outside the home," Yan said.

"So they become less close with their parents and have more conflict as their need for autonomy increases."

Loneliness also tended to decrease as the kids developed relationships with their peers and felt more comfortable with their social skills.

But the study showed that kids didn't shed their loneliness at the same rate. Daughters did better when they had closer relationships with their fathers.

Relationship closeness did not have an effect on loneliness in boys. The study can't show why, but Yan said it may be because parents don't socialize boys to have particularly close relationships and put less emphasis on them maintaining close ties.

Mothers' relationships didn't have an effect in this study, but that doesn't mean they aren't important, Yan said. One reason for the lack of impact among mothers in this research was that mothers nearly always had close relationships with their kids, so there was less difference to measure.

In addition, Feng noted that fathers have relationships with their children, particularly their daughters, that are different from relationships mothers have.

"In our society, mothers tend to be responsible for everyday care and stability for their children," Feng said. "Fathers have more freedom to interact with their children in different ways, to challenge them and have a wider range of emotional contact. That may be one reason why fathers had more impact on their daughters."

While relationship closeness was tied to changes in loneliness, the study did not find that levels of conflict between fathers and daughters had an effect.

One reason may be that most families didn't have high levels of conflict.

"Normal levels of conflict may not affect loneliness," Yan said. "If there is still communication going on and a good relationship, it may not matter as much."

The results affirm that fathers should nurture their relationships with their children, particularly their daughters, the researchers said.

"Pay attention to their feelings, especially when they are sad or unhappy, and help them cope," Feng said. "Our results suggest it can really help daughters feel less lonely over time."

https://www.sciencedaily.com/releases/2018/08/180828121422.htm

Loneliness is bad for the heart

June 9, 2018

Science Daily/European Society of Cardiology

Loneliness is bad for the heart and a strong predictor of premature death, according to a new study. The study found that feeling lonely was a stronger predictor of poor outcomes than living alone, in both men and women.

"Loneliness is more common today than ever before, and more people live alone," said Anne Vinggaard Christensen, study author and PhD student, The Heart Centre, Copenhagen University Hospital, Denmark. "Previous research has shown that loneliness and social isolation are linked with coronary heart disease and stroke, but this has not been investigated in patients with different types of cardiovascular disease."

The study investigated whether poor social network was associated with worse outcomes in 13,463 patients with ischaemic heart disease, arrhythmia (abnormal heart rhythm), heart failure, or heart valve disease. Data from national registers was linked with the DenHeart survey, which asked all patients discharged from April 2013 to April 2014 from five heart centres in Denmark to answer a questionnaire about their physical and mental health, lifestyle factors such as smoking, and social support.

Social support was measured using registry data on living alone or not, and survey questions about feeling lonely -- Do you have someone to talk to when you need it? Do you feel alone sometimes even though you want to be with someone? "It was important to collect information on both, since people may live alone but not feel lonely while others cohabit but do feel lonely," explained Ms Vinggaard Christensen.

Feeling lonely was associated with poor outcomes in all patients regardless of their type of heart disease, and even after adjusting for age, level of education, other diseases, body mass index, smoking, and alcohol intake. Loneliness was associated with a doubled mortality risk in women and nearly doubled risk in men. Both men and women who felt lonely were three times more likely to report symptoms of anxiety and depression, and had a significantly lower quality of life than those who did not feel lonely.

"Loneliness is a strong predictor of premature death, worse mental health, and lower quality of life in patients with cardiovascular disease, and a much stronger predictor than living alone, in both men and women," said Ms Vinggaard Christensen.

Ms Vinggaard Christensen noted that people with poor social support may have worse health outcomes because they have unhealthier lifestyles, are less compliant with treatment, and are more affected by stressful events. But she said: "We adjusted for lifestyle behaviours and many other factors in our analysis, and still found that loneliness is bad for health."

She concluded: "We live in a time when loneliness is more present and health providers should take this into account when assessing risk. Our study shows that asking two questions about social support provides a lot of information about the likelihood of having poor health outcomes."

European guidelines on cardiovascular prevention state that people who are isolated or disconnected from others are at increased risk of developing and dying prematurely from coronary artery disease. The guidelines recommend assessment of psychosocial risk factors in patients with established cardiovascular disease and those at high risk of developing cardiovascular disease.

https://www.sciencedaily.com/releases/2018/06/180609124652.htm

Known risk factors largely explain links between loneliness and first time heart disease/stroke

But social isolation still associated with death among those with preexisting cardiovascular disease

March 26, 2018

Science Daily/BMJ

Conventional risk factors largely explain the links observed between loneliness/social isolation and first time heart disease/stroke, a new study finds. But having few social contacts still remains an independent risk factor for death among those with pre-existing cardiovascular disease.

Recent research has increasingly highlighted links between loneliness and social isolation and cardiovascular disease and death. But most of these studies have not considered a wide range of other potentially influential factors, say the authors.

In a bid to clarify what role these other factors might have, they drew on data from nearly 480,000 people aged between 40 and 69, who were all part of the UK Biobank study between 2007 and 2010.

Participants provided detailed information on their ethnic background, educational attainment, household income, lifestyle (smoking, drinking, exercise) and depressive symptoms.

They were also asked a series of questions to gauge their levels of social isolation and loneliness. Height, weight, and grip strength were measured, and blood samples taken.

Their health was then tracked for an average of 7 years.

Nearly one in 10 (9%) respondents were deemed to be socially isolated, 6 percent lonely, and 1 percent both.

Those who were socially isolated and/or lonely were more likely to have other underlying long term conditions and to be smokers, while those who were lonely reported more depressive symptoms.

During the 7 year monitoring period, 12,478 people died. And 5731 people had a first time heart attack while 3471 had a first time stroke.

Social isolation was associated with a 43 percent higher risk of first time heart attack, when age, sex, and ethnicity were factored in.

But when behavioural, psychological, health, and socioeconomic factors were added into the mix, these factors accounted for most (84%) of the increased risk, and the initial association was no longer significant.

Similarly, social isolation was initially associated with a 39 percent heightened risk of a first time stroke, but the other conventional risk factors accounted for 83 percent of this risk.

Similar results were observed for loneliness and risk of first time heart attack or stroke.

But this was not the case for those with pre-existing cardiovascular disease among whom social isolation was initially associated with a 50 percent heightened risk of death. Although this halved when all the other known factors were considered, it was still 25 percent higher.

Similarly, social isolation was associated with a 32 percent heightened risk of death even after all the other conventional factors had been accounted for.

This is an observational study so no firm conclusions can be drawn about cause and effect, but the findings echo those of other research in the field, say the study authors.

And the size and representative nature of the study prompt the authors to conclude that their findings "indicate that social isolation, similarly to other risk factors such as depression, can be regarded as a risk factor for poor prognosis of individuals with cardiovascular disease."

This is important, they emphasise, as around a quarter of all strokes are recurrent, and targeting treatment of conventional risk factors among the lonely and isolated might help stave off further heart attacks and strokes, they suggest.

https://www.sciencedaily.com/releases/2018/03/180326213304.htm

Older Adults Who Sleep Poorly React to Stress with Increased Inflammation

March 1, 2012

Science Daily/University of Rochester Medical Center

Older adults who sleep poorly have an altered immune system response to stress that may increase risk for mental and physical health problems, according to a study led by a University of Rochester Medical Center researcher.

In the study, stress led to significantly larger increases in a marker of inflammation in poor sleepers compared to good sleepers -- a marker associated with poor health outcomes and death.

"This study offers more evidence that better sleep not only can improve overall well-being but also may help prevent poor physiological and psychological outcomes associated with inflammation," said Kathi L. Heffner, Ph.D., assistant professor of Psychiatry at the Medical Center.

Poor sleepers reported more depressive symptoms, more loneliness and more global perceived stress relative to good sleepers. Poor sleepers did not differ from good sleepers when IL-6 was measured before the tests began. Across the group, the participants showed increases in IL-6. However, poor sleepers had a significantly larger increase in IL-6 in response to the stressful tests compared to good sleepers, as much as four times larger and at a level found to increase risk for illness and death in older adults.

A further analysis of the results for the impact of loneliness, depression or perceived stress on IL-6 levels found no association. Poor sleep stood as the predictor of elevated inflammation levels.

"We found no evidence that poor sleep made them deal poorly with a stressful situation. They did just as well on the tests as the good sleepers. We did not expect that," Heffner said. "We did find that they were in a worse mood after the stressor than a good sleeper, but that change in mood did not predict the heightened inflammatory response."

As people age, a gradual decline in the immune system occurs along with an increase in inflammation. Heightened inflammation increases the risk for cardiovascular disease, diabetes and other illnesses, as well as psychiatric problems.

While relatively little is known about the pathways through which poor sleep impacts circulating levels of inflammatory proteins, the study led by Heffner provides a clinical target for preventing poor outcomes for older adults.

"There are a lot of sleep problems among older adults," Heffner said. "Older adults do not have to sleep poorly. We can intervene on sleep problems in older adulthood. Helping an elderly person become a better sleeper may reduce the risk of poor outcomes associated with inflammation."

http://www.sciencedaily.com/releases/2012/03/120301103758.htm