Factors associated with loneliness in community-dwelling middle-aged and older adults during the COVID-19 pandemic
Factores asociados a la soledad en adultos de mediana edad y personas mayores de la comunidad durante la pandemia de COVID-19
Fatores associados à solidão em adultos de meia-idade e pessoas idosas da comunidade durante a pandemia da COVID-19
Claudinéia Macedo; Ana Beatriz Gomes Grecco; Bianca Cristina Ciccone Giacon; Marcelo Kwiatkoski; Bruna Moretti Luchesi; Tatiana Carvalho Reis Martins
Abstract
Objective to identify the prevalence and factors associated with loneliness in community-dwelling middle-aged and older adults during the COVID-19 pandemic.
Method a cross-sectional study with convenience sampling, conducted in the state of Mato Grosso do Sul, Brazil. Individuals aged 45 or older and enrolled in Family Health Units were evaluated. A structured questionnaire containing sociodemographic, health and social support network questions was used for data collection. The “loneliness” dependent variable was assessed using the UCLA Brazilian Loneliness Scale. The data were analyzed using a multiple logistic regression model.
Results two hundred and fifteen people took part in the study and 48.8% presented loneliness scores above the median. In the final model, the factors associated with the outcome remained: being at least 60 years old and having depressive symptoms.
Conclusion and implications for the practice our findings suggest that older adults and people with depressive symptoms are more likely to lead lonely lives. It is necessary to monitor loneliness in Primary Health Care and to think of intervention strategies aimed at factors that may be associated with it.
Keywords
Resumen
Palabras clave
Resumo
Objetivo: identificar a prevalência e os fatores associados à solidão em adultos de meia-idade e pessoas idosas residentes na comunidade durante a pandemia de COVID-19.
Método: trata-se de um estudo transversal, com amostragem por conveniência, realizado no estado do Mato Grosso do Sul/Brasil. Foram avaliados indivíduos com 45 anos ou mais, cadastrados em Unidades de Saúde da Família. Para a coleta de dados, utilizou-se um questionário estruturado, contendo questões sociodemográficas, de saúde e de rede de apoio social. A variável dependente “solidão” foi avaliada por meio da Escala Brasileira de Solidão da UCLA. Os dados foram analisados por meio de um modelo de regressão logística múltipla.
Resultados: duzentos e quinze pessoas participaram do estudo e 48,8% apresentaram escores de solidão acima da mediana. No modelo final, permaneceram como fatores associados ao desfecho: ter 60 anos ou mais e apresentar sintomas depressivos.
Conclusão e implicações para a prática: nossos achados sugerem que pessoas idosas e indivíduos com sintomas depressivos apresentam maior probabilidade de serem solitários. É necessário monitorar a solidão na Atenção Primária à Saúde e pensar em estratégias de intervenção direcionadas aos fatores que podem estar associados a ela.
Palavras-chave
Referencias
1 World Health Organization. Mental Health and Psychosocial Considerations during the COVID-19 Outbreak [Internet]. Geneva: WHO; 2020 [cited 2024 Apr 13]. Available from:
2 Aquino EML, Silveira IH, Pescarini JM, Aquino R, Souza-Filho JA, Rocha AS et al. Social distancing measures to control the COVID-19 pandemic: potential impacts and challenges in Brazil. Cien Saude Colet. 2020;25(Suppl. 1):2423-46.
3 American Psychological Association. COVID-19 isn’t just a danger to older people’s physical health [Internet]. Washington: APA; 2020 [cited 2024 Apr 15]. Available from:
4 Fiorillo A, Gorwood P. The consequences of the COVID-19 pandemic on mental health and implications for clinical practice. Eur Psychiatry. 2020;63(1):e32.
5 Holt-Lunstad J. The potential public health relevance of social isolation and loneliness: prevalence, epidemiology, and risk factors. Public Policy Aging Rep. 2017;27(4):127-30.
6 Luchetti M, Lee JH, Aschwanden D, Sesker A, Strickhouser JE, Terracciano A et al. The trajectory of loneliness in response to COVID-19. Am Psychol. 2020;75(7):897-908.
7 Lonergan-Cullum M, Hooker SA, Levy R, Ricco J. A new pandemic of loneliness. J Am Board Fam Med. 2022;35(3):593-6.
8 Puyané M, Chabrera C, Camón E, Cabrera E. Uncovering the impact of loneliness in ageing populations: a comprehensive scoping review. BMC Geriatr. 2025;25(1):244.
9 Dahlberg L, McKee KJ, Frank A, Naseer M. A systematic review of longitudinal risk factors for loneliness in older adults. Aging Ment Health. 2022;26(2):225-49.
10 Surkalim DL, Luo M, Eres R, Gebel K, van Buskirk J, Bauman A et al. The prevalence of loneliness across 113 countries: systematic review and meta-analysis. BMJ. 2022;376:e067068.
11 Pengpid S, Peltzer K. Prevalence and associated factors of incident and persistent loneliness among middle-aged and older adults in Thailand. BMC Psychol. 2023;11(1):70.
12 Pengpid S, Peltzer K. Loneliness and associated factors among middle-aged and older adults: cross-sectional and longitudinal survey results from the HAALSI cohort in South Africa. Aging Ment Health. 2024;28(8):1179-87.
13 Lee SL, Pearce E, Ajnakina O, Johnson S, Lewis G, Mann F et al. The association between loneliness and depressive symptoms among adults aged 50 years and older: a 12-year population-based cohort study. Lancet Psychiatry. 2021;8(1):48-57.
14 Van Tilburg TG, Steinmetz S, Stolte E, Van der Roest H, de Vries DH. Loneliness and mental health during the covid-19 pandemic: a study among dutch older adults. J Gerontol B Psychol Sci Soc Sci. 2021;76(7):e249-55.
15 Romero DE, Muzy J, Damacena GN, Souza NA, de Almeida WS, Szwarcwald CL et al. Older adults in the context of the COVID-19 pandemic in Brazil: effects on health, income and work. Cad Saude Publica. 2021;37(3):e00216620.
16 Czaja SJ, Moxley JH, Rogers WA. Social support, isolation, loneliness, and health among older adults in the PRISM randomized controlled trial. Front Psychol. 2021;12:728658.
17 Cohen-Mansfield J, Hazan H, Lerman Y, Shalom V. Correlates and predictors of loneliness in older-adults: a review of quantitative results informed by qualitative insights. Int Psychogeriatr. 2016;28(4):557-76.
18 Cuschieri S. The STROBE guidelines. Saudi J Anaesth. 2019;13(5, Suppl 1):S31-4.
19 Stratton SJ. Population research: convenience sampling strategies. Prehosp Disaster Med. 2021;36(4):373-4.
20 Barroso S, Andrade V, Oliveira N. Escala Brasileira de Solidão: Análises de Resposta ao Item e definição dos pontos de corte. J Bras Psiquiatr. 2016;65(1):76-81.
21 Silveira DX, Jorge MR. Propriedades psicométricas da escala de Rastreamento Populacional para Depressão CES-D em populações clínicas e não-clínicas de adolescentes e adultos jovens. Rev Psiquiatr Clin. 1998;25(5):251-61.
22 Batistoni SST, Néri AL, Cupertino AP. Validade e confiabilidade da versão Brasileira da Center for Epidemiological Scale - Depression (CES-D) em idosos Brasileiros. Psico-USF. 2010;15(1):13-22.
23 Lawton MP, Brody EM. Assessment of older people: self-maintaining na instrumental activities of daily living. Gerontologist. 1969;9(3):179-86.
24 Kotwal AA, Holt-Lunstad J, Newmark RL, Cenzer I, Smith AK, Covinsky KE et al. Social isolation and loneliness among San Francisco Bay area older adults during the covid-19 shelter-in-place orders. J Am Geriatr Soc. 2021;69(1):20-9.
25 Stolz E, Mayerl H, Freidl W. The impact of COVID-19 restriction measures on loneliness among older adults in Austria. Eur J Public Health. 2021;31(1):44-9.
26 Werneck AO, Silva DR, Malta DC, Souza-Júnior PRB, Azevedo LO, Barros MBA et al. Physical inactivity and elevated TV-viewing reported changes during the COVID-19 pandemic are associated with mental health: a survey with 43,995 Brazilian adults. J Psychosom Res. 2021;140:110292.
27 Torres JL, Braga LS, Moreira BS, Sabino Castro CM, Vaz CT, Andrade ACS et al. Loneliness and social disconnectedness in the time of pandemic period among Brazilians: evidence from the ELSI COVID-19 initiative. Aging Ment Health. 2021;26(5):898-904.
28 Gao Q, Prina AM, Prince M, Acosta D, Luisa Sosa A, Guerra M et al. Loneliness among older adults in Latin America, China, and India: prevalence, correlates and association with mortality. Int J Public Health. 2021;66:604449.
29 Ahmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated psychological problems. Asian J Psychiatr. 2020;51:102092.
30 Losada-Baltar A, Jiménez-Gonzalo L, Gallego-Alberto L, Pedroso-Chaparro MDS, Fernandes-Pires J, Márquez-González M. “We are staying at home. ”Association of self-perceptions of aging, personal and family resources, and loneliness with psychological distress during the lock-down period of COVID-19. J Gerontol B Psychol Sci Soc Sci. 2021;76(2):e10-6.
31 Müller F, Röhr S, Reininghaus U, Riedel-Heller SG. Social isolation and loneliness during covid-19 lockdown: associations with depressive symptoms in the german old-age population. Int J Environ Res Public Health. 2021;18(7):3615.
32 Chen Z, Song X, Lee TMC, Zhang R. The robust reciprocal relationship between loneliness and depressive symptoms among the general population: Evidence from a quantitative analysis of 37 studies. J Affect Disord. 2023;343:119-28.
33 Puyané M, Chabrera C, Camón E, Cabrera E. Uncovering the impact of loneliness in ageing populations: a comprehensive scoping review. BMC Geriatr. 2025;25(1):244.
34 Macedo MJA, Costa BL, Fernandes MJB, Ceitlin LHF. Reflexos da (in)capacidade de estar só em tempos de isolamento social na pandemia COVID-19. Rev Bras Psicoter. 2021;23(1):247-56.
35 Son H, Cho HJ, Cho S, Ryu J, Kim S. The moderating effect of social support between loneliness and depression: differences between the young-old and the old-old. Int J Environ Res Public Health. 2022;19(4):2322.
36 Kissler SM, Tedijanto C, Goldstein E, Grad YH, Lipsitch M. Projecting the transmission dynamics of SARS-CoV-2 through the post pandemic period. Science. 2020;368(6493):860-8.
37 Previtali F, Allen LD, Varlamova M. Not only virus spread: the diffusion of ageism during the outbreak of COVID-19. J Aging Soc Policy. 2020;32(4-5):506-14.
38 Gorenko JA, Moran C, Flynn M, Dobson K, Konnert C. Social isolation and psychological distress among older adults related to covid-19: a narrative review of remotely-delivered interventions and recommendations. J Appl Gerontol. 2021;40(1):3-13.
39 Crowe CL, Liu L, Bagnarol N, Fried LP. Loneliness prevention and the role of the Public Health system. Perspect Public Health. 2024;144(1):31-8.
40 Sade RMS, Sashidharan SP, Silva MNRMO. Paths and detours in the trajectory of the Brazilian psychiatric reform. Salud Colect. 2021;17:e3563.
41 Sousa SB, Costa LSP, Jorge MSB. Cuidado em saúde mental no contexto da atenção primária: contribuições da enfermagem. Rev Baiana de Saúde Pública. 2019;43(1):151-64.
42 Jafelice GT, Ziliotto GC, Marcolan JF. Concepção dos profissionais de centro de atenção psicossocial sobre as políticas públicas de saúde mental. Res Soc Dev. 2020;9(5):e71953100.
43 Nóbrega MPSS, Venzel CMM, Sales ES, Próspero AC. Mental health nursing education in Brazil: perspectives for primary health care. Texto Contexto Enferm. 2020;29:e20180441.
Accepted date:
29/01/2026
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email