Loneliness among Chinese adults: Validation of the ALONE scale and its association with age

Abstract

Background This study translated the 5-item ALONE scale into Chinese and psychometrically validated the translated scale among Chinese adults, and determined the association between age and loneliness. Methods An online cross-sectional survey was conducted using the Wenjuanxing platform in mainland China in 2022. A total of 2,019 Chinese adults (≥ 18 years) participated in this study. Results The translated ALONE scale demonstranted an acceptable internal consistency (Cronbach’s α = 0.600) and a moderate association with the ULS-8 (r=0.606). Scores of the translated scale showed a stronger association with self-rated health than with other related variables. Receiver Operating Characteristic (ROC) curve analysis identified scores of 10 or greater as optimal for loneliness screening (sensitivity=0.88, specificity=0.74, and Area Under the Curve=0.899). Results from a locally weighted scatterplot smoothing (LOESS) curve found a non-linear age distribution of loneliness, marked by two minor peaks after adjustment (at ages 25 and age 50 for the total sample). The loneliness levels were lowest among older adults (≥ 60 years). Females reached peak loneliness approximately 10 years later than males. Logistic regression identified an inverse association between age and loneliess levels. Conclusions This study confirms the reliability and validity of the Chinese ALONE Scale for loneliness screening. Additionally, our findings offer valuable insights into vulnerability to loneliness across the lifespan within the Chinese context, supporting the development of age-specific interventions to address loneliness effectively.