Typologies of Loneliness, Isolation and Living Alone Are Associated with Psychological Well-Being among Older Adults in Taipei: A Cross-Sectional Study

Abstract

Background: Loneliness, isolation, and living alone are emerging as critical issues in older people’s health and well-being, but the effects are not consistent. The purpose of this study was to examine the clustering of loneliness, isolation, and living alone, the risk factors and the associations with psychological well-being. Methods: The data were collected from the 2019 Taipei City Senior Citizen Condition Survey by face-to-face interviews and included a community-based sample (n = 3553). Loneliness, isolation, and living arrangement were analyzed by cluster analysis to define Loneliness-Isolation-Living-Alone clusters. Multinomial logistic regression was used to examine the factors related to Loneliness-Isolation-Living-Alone clusters, and linear regression was used to examine association of clusters with psychological well-being. Results: Five clusters of older adults were identified and named as follows: Not Lonely-Connected-Others (53.4%), Not Lonely-Isolated-Others (26.6%), Not Lonely-Alone (5.0%), Lonely-Connected (8.1%), and Lonely-Isolated-Others (6.9%). Demographics, financial satisfaction, physical function, family relationship, and social participation were related to the Loneliness-Isolation-Living-Alone clusters. Compared with the Not Lonely-Connected-Others cluster, the Lonely-Connected cluster and Lonely-Isolated-Others cluster had higher depressive symptoms and lower life satisfaction, and the Not Lonely-Isolated-Others cluster reported lower life satisfaction; the Not Lonely-Alone cluster was not different. Discussion: Loneliness and isolation are negatively associated with psychological well-being, and living arrangement is not the determinant to loneliness or isolation. Older adults are suggested to strengthen their informal social support, and the government may encourage social care and create an age friendly environment to reduce loneliness and isolation.

The Association between Social Participation and Loneliness of the Chinese Older Adults over Time—The Mediating Effect of Social Support

“…However, given differences in the cultural and social environment in China, it may be difficult for Chinese older adults to understand the concept and connotation of loneliness used in Western culture and the single item may be adequate in this case [ 26 ]. Third, in addition to social support, there may be other related factors (i.e., subjective well-being [ 11 , 44 ], depression [ 1 , 37 ], personality traits [ 27 ]) moderating or mediating the relationship between social participation and loneliness, leading to the results of this paper possibly only reflecting part of the overall impact of social participation. Therefore, a database with more comprehensive indicators and finer dimensions is needed in the future to supplement the specific approaches for studying the relationship between social participation and loneliness, so as to provide a rigorous and rich theoretical framework and model overview.…”

“…We chose this single-item measure of loneliness for two reasons: first, there is no longitudinal and nationwide survey of older Chinese which uses a standardized scale (i.e., ULCA). Second, different from specific research studies on the structure and differential experience of loneliness in the field of psychology, this study focused on the global perception of loneliness, and this single-item measure has been demonstrated to correlate highly with multi-item loneliness scales and has been widely used in previous studies [ 36 , 42 , 43 , 44 ].…”

“…The control variables were included in the analysis because of their well-documented associations with older adults’ loneliness or social participation [ 44 , 46 , 47 ]. These covariates included age; gender (female = 1); marital status (married = 1); education level (illiterate = 1; below primary school = 2; primary school graduate = 3; middle school and higher = 4); working status (working = 1); annual family income, which was log-transformed; self-rated health (poor = 1; fair = 2; good = 3); and living arrangement (alone = 0) (see Table 1 ).…”

Loneliness in Old Age, the Related Factors, and Its Association with Demographics and Districts of Residence

“…On the other hand, the living arrangement is not a key determinant of loneliness, as older adults who live alone are not necessarily lonely. Some older people who live with their family still feel lonely because of the inappropriate quality of the support that they receive [47]. For older people who have experienced a loss of relationships and a disruption of interpersonal or social relationships, informal social support, such as group integrated intervention programs could not only improve their social interactions but strengthen their cognitive and physical capabilities [48].…”

Social Isolation and Loneliness among Near-Centenarians and Centenarians: Results from the Fordham Centenarian Study

“…Recently, some scholars have started to examine social isolation and loneliness in combination in an effort to understand their association with physical and mental health. More specifically, Hsu and colleagues used a survey on older adults in Taipei, Smith and Victor analyzed data from the English Longitudinal Study of Aging, and the study by Menec and colleagues was based on the Canadian Longitudinal Study on Aging [46][47][48]. However, in all these studies, researchers focused on a wide category of older individuals (i.e., 65 years of age or older) without specific attention to the oldestold or centenarians.…”