Factors Contributing to Older Adults Living Alone and Thereby at Risk of Poor Health and Adverse Health Outcomes

Abstract

Introduction: Extensive research demonstrates that older adults living alone tend to be less healthy, have poorer health outcomes and are at greater risk of dying. While many investigators have explored various aspects of aging, there has been limited work assessing factors that increase the chances of an older adult to live alone. This study examines the association between demographic characteristics; current health status; and social, cultural, and environmental factors among older adults (65 years of age and older) and the likelihood they will live alone Methods: Secondary analyses is conducted of survey data from the Americans' Changing Lives (ACL) cohort study initiated in 1986 (Wave 1) and continued through 2012, with four follow-up surveys conducted in 1989 (Wave II), 1994 (Wave III), 2001/02 (Wave IV), and 2011/12 (Wave V). All ACL participants 65 years and older at time of survey (Wave I – V) are included for this study (N=7,020). An analysis of variance (ANOVA) that included demographics, health status, and social support factors is employed to determine the relationship of these variables to an older adult reporting living alone. Additionally, the Cox proportional hazards model is used for survival analysis to predict the expected age at onset of living alone. Results: Four critical factors reduce the probability of an older adult living alone: 1) marital status (married), 2) gender (male), 3) presence of at least one living child, and 4) willingness to spend time in the garden (physical activity). An older female adult who is currently single and without a living child is most likely to report living alone (p<.001). Conclusions: Older adults living alone are at higher risk of poor health and health outcomes. The influx of baby boomers whose life expectancy is longer than the past, will cause a dramatic increase in senior adults living alone. This research suggests a guideline to public health professionals for identifying those at risk of being negatively impacted by living alone so that they can intervene and provide alternative living arrangements and support services, as necessary. Keywords: living alone, older adults, health outcomes