Most studies of social relationships in later life focus on the amount of social contact, not on individuals' perceptions of social isolation. However, loneliness is likely to be an important aspect of aging. A major limiting factor in studying loneliness has been the lack of a measure suitable for large-scale social surveys. This article describes a short loneliness scale developed specifically for use on a telephone survey. The scale has three items and a simplified set of response categories but appears to measure overall loneliness quite well. The authors also document the relationship between loneliness and several commonly used measures of objective social isolation. As expected, they find that objective and subjective isolation are related. However, the relationship is relatively modest, indicating that the quantitative and qualitative aspects of social relationships are distinct. This result suggests the importance of studying both dimensions of social relationships in the aging process.

Many older adults are sexually active. Women are less likely than men to have a spousal or other intimate relationship and to be sexually active. Sexual problems are frequent among older adults, but these problems are infrequently discussed with physicians.

The extent to which loneliness is a unique risk factor for depressive symptoms was determined in 2 population-based studies of middle-aged to older adults, and the possible causal influences between loneliness and depressive symptoms were examined longitudinally in the 2nd study. In Study 1, a nationally representative sample of persons aged 54 and older completed a telephone interview as part of a study of health and aging. Higher levels of loneliness were associated with more depressive symptoms, net of the effects of age, gender, ethnicity, education, income, marital status, social support, and perceived stress. In Study 2, detailed measures of loneliness, social support, perceived stress, hostility, and demographic characteristics were collected over a 3-year period from a population-based sample of adults ages 50-67 years from Cook County, Illinois. Loneliness was again associated with more depressive symptoms, net of demographic covariates, marital status, social support, hostility, and perceived stress. Latent variable growth models revealed reciprocal influences over time between loneliness and depressive symptomatology. These data suggest that loneliness and depressive symptomatology can act in a synergistic effect to diminish well-being in middle-aged and older adults.

Previous research has identified a wide range of indicators of social isolation that pose health risks, including living alone, having a small social network, infrequent participation in social activities, and feelings of loneliness. However, multiple forms of isolation are rarely studied together, making it difficult to determine which aspects of isolation are most deleterious for health. Using populationbased data from the National Social Life, Health, and Aging Project, we combine multiple indicators of social isolation into scales assessing social disconnectedness (e.g., small social network, infrequent participation in social activities) and perceived isolation (e.g., loneliness, perceived lack of social support). We examine the extent to which social disconnectedness and perceived isolation have distinct associations with physical and mental health among older adults. Results indicate that social disconnectedness and perceived isolation are independently associated with lower levels of self-rated physical health. However, the association between disconnectedness and mental health may operate through the strong relationship between perceived isolation and mental health. We conclude that health researchers need to consider social disconnectedness and perceived isolation simultaneously.Health risks associated with social isolation have been compared in magnitude to the wellknown dangers of smoking cigarettes and obesity (House 2001). Individuals who lack social connections or report frequent feelings of loneliness tend to suffer higher rates of morbidity and mortality (Brummett et al. 2001;Seeman 2000;Uchino, Cacioppo, and Kiecolt-Glaser 1996), as well as infection (Cohen et al. 1997;Pressman et al. 2005), depression (Heikkinen and Kauppinen 2004), and cognitive decline (Barnes et al. 2004;Wilson et al. 2007). Yet, compared to health behaviors such as smoking and obesity, much less is known about how and why social isolation affects health House, Landis, and Umberson 1988).One problem is that most research on social connectedness and health focuses on only one or two measures of social isolation, often due to data limitations (House 2001). Across a range of studies, a number of indicators of isolation have been associated with worse health, such as living alone, having a small social network, low participation in social activities, a perceived lack of social support, and feelings of loneliness (Berkman and Syme 1979;Dean et al. 1992;Hawkley et al. 2006;Krause 1987;Thoits and Hewitt 2001). But when these aspects of * The National Health, Social Life, and Aging Project (NSHAP) is supported by the National Institutes of Health, including the National Institute on Aging, the Office of Women's Health Research, the Office of AIDS Research, and the Office of Behavioral and Social Sciences Research (grant 5R01AG021487). We are grateful for comments and suggestions from Benjamin Cornwell, Louise Hawkley, Edward Laumann, Martha McClintock, Phil Schumm, Peggy Thoits, and four anonymous reviewers.Address corresp...

This study examined the relationship between loneliness, health, and mortality using a U.S. nationally representative sample of 2,101 adults aged 50 years and over from the 2002 to 2008 waves of the Health and Retirement Study. We estimated the effect of loneliness at one point on mortality over the subsequent six years, and investigated social relationships, health behaviors, and health outcomes as potential mechanisms through which loneliness affects mortality risk among older Americans. We operationalized health outcomes as depressive symptoms, self-rated health, and functional limitations, and we conceptualized the relationships between loneliness and each health outcome as reciprocal and dynamic. We found that feelings of loneliness were associated with increased mortality risk over a 6-year period, and that this effect was not explained by social relationships or health behaviors but was modestly explained by health outcomes. In cross-lagged panel models that tested the reciprocal prospective effects of loneliness and health, loneliness both affected and was affected by depressive symptoms and functional limitations over time, and had marginal effects on later self-rated health. These population-based data contribute to a growing literature indicating that loneliness is a risk factor for morbidity and mortality and point to potential mechanisms through which this process works.

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Both childhood and adult SES are important for health. The negative impact of low childhood SES can be partially ameliorated if people from a low SES position during childhood mobilize to higher status in adulthood.

Objectives The objective of this study was to test a conceptual model of loneliness in which social structural factors are posited to operate through proximal factors to influence perceptions of relationship quality and loneliness. Methods We used a population-based sample of 225 White, Black, and Hispanic men and women aged 50 through 68 from the Chicago Health, Aging, and Social Relations Study to examine the extent to which associations between sociodemographic factors and loneliness were explained by socioeconomic status, physical health, social roles, stress exposure, and, ultimately, by network size and subjective relationship quality. Results Education and income were negatively associated with loneliness and explained racial/ethnic differences in loneliness. Being married largely explained the association between income and loneliness, with positive marital relationships offering the greatest degree of protection against loneliness. Independent risk factors for loneliness included male gender, physical health symptoms, chronic work and/or social stress, small social network, lack of a spousal confidant, and poor-quality social relationships. Discussion Longitudinal research is needed to evaluate the causal role of social structural and proximal factors in explaining changes in loneliness.