Lonely in a Crowd: Social Isolation Profiles and Caregiver Burden Among Family Caregivers of Community-Dwelling Older Adults With Cognitive Impairment

Abstract

Objectives This study identified distinct social isolation profiles among caregivers, each formed by varied combinations of social disconnectedness and loneliness, and examined if and how the profiles were associated with caregiver burden. Methods Latent class analysis and multivariable regression were applied to data from 266 caregivers of community-dwelling older Singaporeans with cognitive impairment. Results Two caregiver social isolation profiles were identified: strongly connected, not lonely (86%), and moderately connected, lonely (14%). Moderately connected and lonely caregivers tended to perceive a higher level of burden than strongly connected and not lonely caregivers. Moderately connected and lonely caregivers were also more likely to be burdened by their care recipients’ poor health than their connected and not lonely counterparts. Discussion Caregivers who feel “lonely in a crowd” are vulnerable to caregiving stress and burden. Tailored interventions, such as cognitive behavioral therapy, are needed to reduce the loneliness of moderately connected caregivers.

Loneliness and social isolation among informal carers of individuals with dementia: A systematic review and meta‐analysis

“…These studies were conducted in 17 countries and published between 2000 and 2024. Among the included studies, 25 were cross‐sectional, 8,17–40 and two were longitudinal 41,42 . The majority of the studies focused on informal carers of people with dementia in community and care facilities ( K = 22), with three centered on informal carers in hospitals or outpatient clinics, 17,22,28 one spanning both community and hospital settings, 8 and another involving carers within long‐term care facilities 23 .…”

“…Eleven studies were assessed as moderate quality, 22,25,27,28,32,[34][35][36]38,39,41 while 16 studies were deemed high quality. In crosssectional studies, the most frequent sources of bias included adjusting potential confounders, handling missing data, and…”

“…The mean age of the care recipients ranged from 70.0 to 81.4 years. 29,35 Five studies reported on informal carers of individuals with mild, moderate, or severe dementia (see Table 1). 8,17,18,32,41…”

Feeling Alone Together: Loneliness in Older Adults with Cognitive Impairment and Their Family Caregivers with Low Mastery

“…We analyzed data on 135 PCI-caregiver dyads from the “Caring for persons with dementia and their caregivers in the community: Towards a sustainable community based dementia care system (COGNITION)” study [ 10 ]. The study received approval from the Institutional Review Board at the National University of Singapore.…”

“…Family caregivers may also suffer from a lack of social contact due to the demands and responsibilities of caregiving. Some caregivers are socially connected but experience loneliness because the quality of their social relationships does not meet their expectations [ 4 , 10 ]. However, we know little about whether and when loneliness among PCI and loneliness among their family caregivers are related.…”