Psycho-social and health predictors of loneliness in older primary care patients and mediating mechanisms linking comorbidities and loneliness

Abstract

Abstract Population aging is the global demographic trend in EU countries in the last decades. Aging is associated with unfavorable sociodemographic factors such as widowhood, lower physical and mental functioning, and fewer possibilities for social participation. All these factors have been found to be associated with loneliness – a feeling of social isolation. Living with feeling of loneliness may, in turn, have negative implications on quality of life, physical and mental health, and mortality, of elderly individuals. The aim was to assess associations of feeling of loneliness with sociodemographic and psycho-social characteristics and comorbidities of older individuals from the general population. The sample consisted of 189 (58% F) older individuals (> 50 years) (mean ± SD, 78.47 ± 6.65), attenders in Primary Health Care. Apart from sociodemographic characteristics and comorbidities, participants were described by psychological characteristics, assessed by a set of standard questionnaires, including: UCLA loneliness scale, MSPSS (Multidimensional Scale of Perceived Social Support), GAS (Geriatric Anxiety Scale), GDS (Geriatric Depression Scale), ADL (Activities of Daily Living), IADL (Instrumental Activities of Daily Living), GSE (General Self-Efficacy) and ERQ (Emotional Regulation Questionnaire). The effect of particular blocks of factors on status loneliness was assessed by the hierarchical regression model. We also analyzed if any of psychological characteristics mediate associations between comorbidities and loneliness, when controlling for sociodemographic characteristics. The results indicated that older individuals who lived alone, had difficulties in relations with their family members, suffered from depression, and had lower level of education, felt much lonely. Individuals who were generally engaged in hobbies, were less lonely. The level of comorbidity was shown to be associated with loneliness, with some diagnoses contributing more than some others. Some psychological traits can lessen feeling of loneliness, while anxiety and depression make it worsen. Mediation analysis informed us on how to help patients with comorbidities to feel less lonely, including interventions such as those that can reduce anxiety and depression, improve cognitive abilities and emotional regulation, and enhance social support.