Drew M. Altschul Ph.D.

Reverse Causation


What Puts People at Higher Risk for Loneliness

Which factors are related to loneliness in middle-age and older people?

Posted Apr 22, 2020

Despite many of the great benefits of our modern information-age society, you may have heard that we are experiencing an epidemic of loneliness. As quarantine and social distancing radically change our lives, the COVID-19 pandemic only threatens to make this loneliness epidemic worse. Loneliness is considered to be a particular issue for older people. Yet these same people are at the highest risk from COVID-19 and are currently advised to self-isolate. Thus, we are faced with a compound challenge: how to look after the people who are the most at risk of both loneliness and COVID-19.

Although it’s possible to feel isolated or disconnected even while surrounded by friendly faces, loneliness stems in large part from being alone. By isolating ourselves from others, we are put at greater risk of experiencing loneliness. Except it is not that simple. Isolation is the situation, but loneliness is a perception. How lonely we feel depends in part on our personality—how introverted or extroverted we are and how much social contact we need in order to feel emotionally balanced. That means that not everyone will perceive isolation as loneliness to the same degree. Some people won’t mind being cut off, whereas others will find it increases their loneliness. So how do we know who we should worry about?

To begin to answer this question, my colleagues and I within Mental Health Data Science Scotland investigated loneliness in four different groups of older people. Two of these groups consisted of individuals aged 45 to 69, and the other two groups were over 70.

Fortunately, our research demonstrated that most people do not feel lonely. Only 4 to 6% of people over 70 reported feeling lonely “often” or “most of the time” (51-54% reported that they never felt lonely), and a similar pattern was observed in those aged 45 to 69.  However, research shows that for the small percentage of people who do feel lonely, it is likely to result in poorer health, cognitive decline, and dementia. So, how can we identify those who are most at risk?

The main factor relating to loneliness (that was common across all age groups) was a personality factor called emotional stability, a trait that is also known as neuroticism. People who score low on emotional stability (high in neuroticism) are those who tend to have more pessimistic, “glass half empty” outlooks. People with high emotional stability tend to be less anxious, hostile, self-conscious, and impulsive, as well as less lonely.

However, there were some differences between the groups. Looking first at those aged 70+, individuals who lived alone were particularly at risk of becoming lonely. This risk was further amplified if they had low emotional stability or were male—men living alone were lonelier than women living alone.

Iona Beange/MHDSS
Our major findings on loneliness in middle and older aged people.
Source: Iona Beange/MHDSS

On the other hand, in the younger group (aged 45 to 69), living alone was not a defining factor. Their risk of experiencing loneliness appeared more dependent on their personality, with extroverts experiencing less loneliness, and people with low emotional stability experiencing more.

So with much of the population now forced into isolation due to the COVID-19 pandemic, what can we do to avoid a seemingly inevitable explosion in loneliness? Thankfully, effective interventions do exist. These include gardening (horticulture), laughter, and reminiscence therapy; all are associated with reductions in loneliness. Many of these activities do not require face-to-face contact, and could be adapted for a socially isolated world.

Moreover, it may be possible to target these interventions toward those most in need. Personality remains quite stable throughout a person’s life. This means that someone who has previously shown low emotional stability (high neuroticism) would be predicted to be at elevated risk of becoming lonely (compared to the general population) if they were to encounter a stressful life event, such as losing their significant other. By targeting interventions toward those most at risk, we may be able to start the fight against this epidemic of loneliness.

Nevertheless, we recognize the limitations in our research—not least that our results are only correlational and that no long-term study has been conducted. Nevertheless, we hope that our insights will prove useful for policymakers and community organizations who provide services to those most at risk, and will help inform the wider public during these difficult times.

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