A global study of 64,324 older adults found that loneliness may not be consistently higher among older adults, but that it may vary by country and could be influenced by factors such as marital status, employment, and depression.
Investigators analyzed data from individuals aged 50 to 90 years across 29 countries using the 3-item UCLA Loneliness Scale. They applied the concentration index (COIN) to quantify how loneliness is distributed across age. Positive COIN values indicated loneliness was more concentrated among older adults, whereas negative values showed it was more prevalent among middle-aged adults.
“These differences across countries suggest that loneliness is not an inevitable consequence of aging and may instead be socially determined by contextual environments within countries,” said lead study author Robin A. Richardson, PhD, an epidemiologist at Emory University, and colleagues.
In the United States and the Netherlands, loneliness was more concentrated among adults in their 50s and early 60s, contrary to trends observed in most other countries.
The investigators found that the relationship between age and loneliness was shaped by demographic and health-related factors. Not working was the top contributor to age-related loneliness inequalities, accounting for 19.8% of the disparity across countries. Being unmarried contributed 16.1%, followed by probable depression (12.9%) and poor self-rated health (9.9%).
In most countries, being out of the workforce contributed to greater loneliness in older adults. However, in the United States, it was linked to greater loneliness among middle-aged adults. These contrasting patterns underscored the influence of social and cultural context on loneliness.
"While being unmarried contributed to loneliness in all countries, in some countries being unmarried contributed very little to age inequalities in loneliness, whereas in other countries it was the top contributor," said investigators. In Austria, for example, being single, divorced, or widowed accounted for 27% of the observed age-related inequality in loneliness.
Some factors didn't substantially contribute to loneliness inequalities in any country, including sex, obesity, and having no children. About 20% of the inequality remained unexplained, with much of this residual disparity concentrated among middle-aged adults.
The study was limited by its cross-sectional design, which didn't allow for conclusions about causality. Additionally, response rates varied across countries, especially in Europe, where the COVID-19 pandemic disrupted survey collection.
Despite these limitations, the investigators said their study offered one of the most comprehensive international assessments of how loneliness changes with age. They recommended tailoring policies and interventions based on national context and focusing on the age groups most affected—whether middle-aged or older adults.
The authors declared no competing interests.
Source: Aging and Mental Health