Loneliness, sadness, and feelings of social disconnection in older adults during the COVID‐19 pandemic

Abstract

Background Public health measures to control the COVID‐19 pandemic have led to feelings of loneliness among older adults, which, prior to COVID, has been associated with subsequent morbidity and mortality. We sought to identify differences in feelings of loneliness, sadness, and social disconnection early in the pandemic across racial groups, and possible mitigating factors. Methods We performed a cross‐sectional analysis using the weighted nationally‐representative Medicare Current Beneficiaries Survey COVID‐19 supplement, collected summer 2020. We included all Medicare beneficiaries aged 65 years and older who did not respond by proxy. We examined changes in loneliness, sadness, or feelings of social disconnection. Multivariable logistic regression models accounted for sociodemographic variables, access to primary care and the internet, and history of depression or dementia. Results Among 8125 beneficiaries, representative of 43.7 million Medicare beneficiaries, 22.6% reported loneliness or sadness, and 37.1% feeling socially disconnected. In fully‐adjusted models, Hispanic/Latinx beneficiaries were most likely to report loneliness or sadness (OR = 1.3, CI: 1.02–1.65; p = 0.02) and Black beneficiaries were least likely to report feeling socially disconnected (OR = 0.55; CI: 0.42–0.73; p < 0.001). Internet access was associated with increased odds of both (OR = 1.29, 95 CI: 1.07–1.56; p = 0.009; and OR = 1.42, 95 CI: 1.24–1.63; p < 0.001, respectively). Access to primary care was associated with lower odds of both (OR = 0.77, 95 CI: 0.61–0.96; p = 0.02; and OR = 0.72, 95 CI: 0.61–0.87; p < 0.001). Conclusions Loneliness, sadness, and feelings of social disconnection were common among older Medicare beneficiaries early in the COVID‐19 pandemic. Differences by race/ethnicity may be driven by different living structures and social networks, and warrant further study. Policy makers and clinicians should consider facilitating connection by phone or in person, as internet access did not diminish feelings of loneliness, particularly for those living alone. Access to primary care, and tools for clinicians to address loneliness should be prioritized.

Exploring the effect of loneliness on fear: Implications for the effect of COVID-19-induced social disconnection on anxiety

“…While there is mixed evidence for whether occurrence of loneliness changed during the COVID-19 pandemic, with some literature demonstrating an increase ( Ausín et al, 2021 ; Holaday et al, 2022 ; Elran-Barak & Mozeikov, 2020 ) and some demonstrating no change ( Luchetti et al, 2020 ; McGinty, Presskreischer, Han, & Barry, 2020 ; Latikka, Koivula, Oksa, Savela, & Oksanen, 2022 ), examinations have shown that certain groups, including women, those living alone, and those who are younger, were all at higher risk of increased loneliness during COVID-19 ( Bu, Steptoe, & Fancourt, 2020 ; Li & Wang, 2020 ) as well as increased risk of psychiatric disorder ( Li & Wang, 2020 ). Importantly, work has also revealed that loneliness was linked to greater increases in psychological distress and anxiety during the pandemic, especially in these groups ( Latikka et al, 2022 ; McDonald et al, 2022 ).…”

Remote Healthcare During the COVID-19 Pandemic: Findings for Older Adults in 27 European Countries and Israel

“…Additionally, delayed medical care utilization and discontinued care-more pronounced during the COVID-19-are expected to adversely affect older adults' health status in the future (60). Here, telemedicine is a promising tool with great potential in reducing unmet healthcare needs (61) and its uptake in some countries after the outbreak was exceptional (33).…”

A single question assessment of loneliness in older adults during the COVID‐19 pandemic: A nationally‐representative study

“…Loneliness is common, particularly during the COVID‐19 pandemic, prompting many clinicians and researchers to assess for loneliness. 1 , 2 , 3 However, the best approach for screening is unclear. One option is a single question directly asking about loneliness (“how often are you lonely?”).…”