Trajectories of loneliness among middle-aged and older adults during and after the Covid-19 pandemic
DOI:
https://doi.org/10.12957/reuerj.2024.85645Keywords:
COVID-19, Middle Aged, Aged, Aging, LonelinessAbstract
Objective: to assess the factors associated with changes in loneliness among middle-aged and older adults during and after the Covid-19 pandemic. Method: a prospective, longitudinal, and analytical study with a convenience sample made up of 215 individuals aged 45 years and older. The first data collection was conducted between February and December 2021, while the second took place between March and July 2023. A questionnaire that included sociodemographic variables, dependency factors, cognitive performance and social support was used, as well as the Brazilian Loneliness Scale. Results: most participants were female, with an average age of 63 years. There was a decrease in the prevalence of loneliness in the second assessment (9.3%) compared to the first (17.7%). Loneliness was associated with older age, higher income, dependence in instrumental activities of daily living, and weak social support (p<0.05). Conclusion: the prevalence of loneliness decreased after the emergency phase of the Covid-19 pandemic.
References
Sharma A, Ahmad Farouk I, Lal SK. Covid‐19: a review on the novel coronavirus disease evolution, transmission, detection, control and prevention. Viruses. 2021 [cited 2024 Jun 15]; 13(2):202. DOI: https://doi.org/10.3390/v13020202.
Lima-Martínez MM, Carrera Boada C, Madera-Silva MD, Marín W, Contreras M. Covid-19 e diabetes: uma relação bidirecional. Clin Investig Arterioscler. 2021 [cited 2024 Jun 20]; 33(3):151-7. DOI: https://doi.org/10.1016/j.arteri.2020.10.001.
Wolf JM, Wolf LM, Bello GL, Maccari JG, Nasi LA. Molecular evolution of SARS-CoV-2 from December 2019 to August 2022. J Med Virol. 2023 [cited 2024 May 01]; 95(1):e28366. DOI: https://doi.org/10.1002/jmv.28366.
World Health Organization (WHO). Social isolation and loneliness among older people: advocacy brief 2021. Geneva: WHO; 2021 [cited 2024 Jun 30]. Available from: https://www.who.int/publications/i/item/9789240030749.
Aquino E, Silveira IH, Pescarini J, Aquino R, Souza-Filho JA. Medidas de distanciamento social no controle da pandemia de Covid-19: potenciais impactos e desafios no Brasil. Ciênc Saúde Colet. 2020 [cited 2024 May 16]; 25(Suppl 1):2423-46. DOI: https://doi.org/10.1590/1413-81232020256.1.10502020.
Armitage R, Nellums LB. Covid-19 and the consequences of isolating the elderly. Lancet Public Health. 2020 [cited 2024 Jul 01]; 5(5):e256. DOI: https://doi.org/10.1016/S2468-2667(20)30061-X.
Killgore WDS, Cloonan SA, Taylor EC, Dailey NS. Loneliness: A signature mental health concern in the era of Covid-19. Psychiatry Res. 2020 [cited 2024 Abr 18]; 290:113117. DOI: https://doi.org/10.1016/j.psychres.2020.113117.
Trad NK, Wharam JF, Druss B. Addressing loneliness in the era of Covid-19. JAMA Health Forum. 2020 [cited 2024 Mar 23]; 1(6):e200631. DOI: https://doi.org/10.1001/jamahealthforum.2020.0631.
Barroso SM, Baptista MN, Zanon C. Solidão como variável preditora na depressão em adultos. Est. Inter. Psicol. 2018 [cited 2024 Apr 24] ;9(3, supl.1):26-37. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S2236-64072018000400003&lng=pt&nrm=iso.
Carmona CF, Couto VV, Scorsolini-Comin F. A experiência de solidão e a rede de apoio social de idosas. Psicol Estudo (Maringá). 2014 [cited 2024 Jun 15]; 19(4):681-91. DOI: https://doi.org/10.1590/1413-73722395510.
Kotwal AA, Cenzer IS, Waite LJ, Covinsky KE, Perissinotto CM, Boscardin WJ, Hawkley LC, Dale W, Smith AK. The epidemiology of social isolation and loneliness among older adults during the last years of life. J Am Geriatr Soc. 2021 [cited 2024 May 11]; 69(11):3081-91. DOI: https://doi.org/10.1111/jgs.17366.
Yang K, Victor C. Age and loneliness in 25 European nations. Ageing Soc. 2011 [cited 2024 Mar 30]; 31(8):1368-88. DOI: https://doi.org/10.1017/S0144686X1000139X.
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 [cited 2024 Jun 01]; 66:604449. DOI: https://doi.org/10.3389/ijph.2021.604449.
Braga LDS, Moreira BDS, Torres JL, Andrade ACDS, Lima ACL, Vaz CT, et al. A decreased trajectory of loneliness among Brazilians aged 50 years and older during the Covid-19 pandemic: ELSI-Brazil. Cad Saúde Pública. 2022 [cited 2024 Apr 09]; 38(1):e00106622. DOI: https://doi.org/10.1590/0102-311XEN106622.
Emerson, KG. Coping with being cooped up: Social distancing during Covid-19 among 60+ in the United States. Rev Panam Salud Publica. 2020 [cited 2024 May 29]; 44:e81. DOI: https://doi.org/10.26633/RPSP.2020.81.
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 [cited 2024 Mar 02]; 69(1):20-9. DOI: https://doi.org/10.1111/jgs.16865.
Torres JL, Braga LDS, Moreira BDS, Castro CMS, Vaz CT, Andrade ACD, et al. Loneliness and social disconnectedness in the time of pandemic period among Brazilians: evidence from the ELSI Covid-19 initiative. Aging Ment Health. 2022 [cited 2024 May 04]; 26(5):898-904. DOI: https://doi.org/10.1080/13607863.2021.1913479.
Peng S, Roth AR. Social isolation and loneliness before and during the Covid-19 pandemic: A longitudinal study of US adults older than 50. J Gerontol B Psychol Sci Soc Sci. 2022 [cited 2024 Apr 15]; 77(7):e185-e190. DOI: https://doi.org/10.1093/geronb/gbab068.
Holt-Lunstad, J. The potential public health relevance of social isolation and loneliness: prevalence, epidemiology, and risk factors. Public Policy Aging Rep. 2017 [cited 2024 Mar 27]; 27(4):127-30. DOI: https://doi.org/10.1093/ppar/prx030.
Luchetti M, Lee JH, Aschwanden D, Sesker A, Strickhouser JE, Terracciano A, Sutin AR. The trajectory of loneliness in response to Covid-19. Am Psychol. 2020 [cited 2024 Jun 12]; 75(7):897-908. DOI: https://doi.org/10.1037/amp0000690.
Mills JP, Kaye KS, Mody L. Covid-19 in older adults: clinical, psychosocial, and public health considerations. JCI Insight. 2020 [cited 2024 Jun 18]; 5(10):e139292. DOI: https://doi.org/10.1172/jci.insight.139292.
Banerjee D, Rai M. Social isolation in Covid-19: The impact of loneliness. Int J Soc Psychiatry. 2020 [cited 2024 Apr 07]; 66(6):525-7. DOI: https://doi.org/10.1177/0020764020922269.
Berg-Weger M, Morley JE. Loneliness in old age: an unaddressed health problem. J Nutr Health Aging 2020 [cited 2024 Jun 27]; 24:243-5. DOI: https://doi.org/10.1007/s12603-020-1323-6.
Chaparro L, Sánchez B, Carrillo GM. Encuesta de caracterización del cuidado de la diada cuidador familiar - persona con enfermedad crónica. Rev. Cien. Cuidad. 2014 [cited 2024 Apr 10];11(2):31-45. DOI: https://doi.org/10.14198/cuid.2019.55.02.
Ferreira HG, Casemiro NV. Solidão em Idosos e fatores associados. REFACS. 2021 [cited 2024 Apr 24]; 9(1):90-8. DOI: https://doi.org/10.18554/refacs.v9i1.5199.
Wright-St Clair VA, Neville S, Forsyth V, White L, Napier S. Integrative review of older adult loneliness and social isolation in Aotearoa/New Zealand. Australas J Ageing. 2017 [cited 2024 May 03]; 36(2):114-23. DOI: https://doi.org/10.1111/ajag.12379.
Costa FB. Espiritualidade, religiosidade e qualidade de vida em idosos [Dissertação de Mestrado]. Porto Alegre: Pontifícia Universidade Católica do Rio Grande do Sul, 2012 [cited 2024 Apr 10]. Available from: https://tede2.pucrs.br/tede2/handle/tede/2694.
Pai N, Vella SL. Covid-19 and loneliness: A rapid systematic review. Aust N Z J Psychiatry.2021 [cited 2024 Jun 18]; 55(12):1144-56. DOI: https://doi.org/10.1177/00048674211031489.
Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015 [cited 2024 Apr 05]; 10(2):227-37. DOI: https://doi.org/10.1177/1745691614568352.
Romero DE, Muzzy J, Damacena GN, Souza NA, Almeida WS, Szwarcwald CL, et al. Idosos no contexto da pandemia da Covid-19 no Brasil: efeitos nas condições de saúde, renda e trabalho. Cad. Saúde Pública.2021 [cited 2024 Mar 24]; 37(3):e00216620. DOI: https://doi.org/10.1590/0102-311X00216620.
Czaja SJ, Moxley JH, Rogers WA. Social Support, Isolation, Loneliness, and Health Among Older Adults in the PRISM Randomized Controlled Trial. Front Psychol. 2021 [cited 2024 May 31]; 12:728658. DOI: https://doi.org/10.3389/fpsyg.2021.728658.
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 [cited 2024 Apr 29]; 8(1):48-57. DOI: https://doi.org/10.1016/S2215-0366(20)30383-7.
Pegorari MC, Silva CFS, Araújo FC, Silva JS, Ohara DG, Matos AP, et al. Factors associated with social isolation and loneliness in community-dwelling older adults during pandemic times: a cross-sectional study. Rev Soc Bras Med Trop. 2021 [cited 2024 Mar 01]; 54:e01952020. DOI: https://doi.org/10.1590/0037-8682-0195-2020.
Mata LRFD, Kuznier TP, Menezes AC, Azevedo C, Amaral FMA, Chianca TCM. Validade e confiabilidade da Escala de Solidão da UCLA versão 3 entre idosos brasileiros. Esc. Anna. Nery. 2022 [cited 2024 Feb 07]; 26:e20210087. DOI: https://doi.org/10.1590/2177-9465-EAN-2021-0087.
Almeida PKP, Sena RMC, Dantas JLL, Trigueiro JG, Pessoa Jr JM, Nascimento EGC. “I lived, studied, loved, and even believed”: systematic review about loneliness in Brazilian elderly. Rev Intellectus. 2020 [cited 2024 Mar 20]; 57(1):41-55. Available from: http://www.revistaintellectus.com.br/ArtigosUpload/63.748.pdf.
Barroso SM, Andrade VS, Oliveira NR. Escala Brasileira de Solidão: análises de resposta ao item e definição dos pontos de corte. J Bras Psiquiatr. 2016 [cited 2024 Feb 20]; 65(1):76-81. DOI: https://doi.org/10.1590/0047-2085000000106.
Lino VTS, Pereira SRM, Camacho LAB, Ribeiro Filho ST, Buksman S. Adaptação transcultural da Escala de Independência em Atividades da Vida Diária (Escala de Katz). Cad Saúde Pública. 2008 [cited 2024 Mar 22]; 24:103-12. Available from: https://www.scielosp.org/pdf/csp/2013.v29n8/1631-1643/pt.
Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. The index of ADL: a standardized measure of biological and psychossocial function. JAMA. 1963 [cited 2024 Apr 09]; 185:914-9. DOI: https://doi.org/10.1001/jama.1963.03060120024016.
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist. 1979 [cited 2024 Mar 12]; 9(3):179-86. DOI: https://doi.org/10.1093/geront/9.3_Part_1.179.
Bertolucci PHF, Brucki SMD, Campacci SR, Juliano Y. O mini-exame do estado mental em uma população geral: impacto da escolaridade. Arq. Neuro-Psiquiatr. 1994 [cited 2024 Jan 09]; 52(1):1-7, 1994. DOI: https://doi.org/10.1590/S0004-282X1994000100001.
Graham JW. Missing data analysis: making it work in the real world. Annu Rev Psychol. 2009 [cited 2024 Apr 30]; 60:549-76. DOI: https://doi.org/10.1146/annurev.psych.58.110405.085530.
Priya Giri S, Dubey A. Loneliness in the time of Covid-19: an alarming rise. Lancet. 2023 [cited 2024 Mar 02]; 401(10394):2107-8. DOI: https://doi.org/10.1016/S0140-6736(23)01125-X.
Ruan J, Xu YM, Zhong BL. Loneliness in older Chinese adults amid the Covid-19 pandemic: prevalence and associated factors. Asia Pac Psychiatry. 2023 [cited 2024 Jun 13]; 15(4):e12543. DOI: https://doi.org/10.1111/appy.12543.
O’Shea BQ, Finlay JM, Kler J, Joseph CA, Kobayashi LC. Loneliness among US adults aged ≥55 early in the Covid-19 pandemic: findings from the Covid-19 coping study. Public Health Reports. 2021 [cited 2024 Feb 14]; 136(6):754-64. DOI: https://doi.org/10.1177/00333549211029965.
Kadowaki L, Wister A. Older adults and social isolation and loneliness during the Covid-19 pandemic: an integrated review of patterns, effects, and interventions. Can J Aging. 2023 [cited 2024 Apr 29]; 42(2):199-216. DOI: https://doi.org/10.1017/S0714980822000459.
Guo J, Luo R, Guo YM, Xu YS, Zhu L. Analysis on influencing factors on loneliness in the elderly aged 60 and above in China. 2023 [cited 2024 May 13]; 44(7):1086-91. DOI: https://doi.org/10.3760/cma.j.cn112338-20230227-00110.
Kino S, Stickley A, Arakawa Y, Saito M, Saito T, Kondo N. Isolamento social, solidão e seus correlatos em adultos japoneses mais velhos. Psicogeriatria. 2023 [cited 2024 Apr 01]; 23(3):475-86. DOI: https://doi.org/10.1111/psyg.12957.
Ibáñez-Del Valle V, Corchón S, Zaharia G, Cauli O. Solidão social e emocional em idosos que habitam na comunidade: o papel da sociodemografia. Int J Environ Res Saúde Pública. 2022 [cited 2024 Jun 20]; 19(24):16622. DOI: https://doi.org/10.3390/ijerph192416622.
Oliveira LMD, Abrantes GGD, Ribeiro GDS, Cunha NM, Pontes MDLDF, Vasconcelos SC. Loneliness in senescence and its relationship with depressive symptoms: an integrative review. Rev Bras Geriatr Gerontol. 2019 [cited 2024 Mar 17]; 22(6):e190241. DOI: https://doi.org/10.1590/1981-22562019022.190241.
Khan MSR, Kadoya Y. Loneliness during the Covid-19 pandemic: a comparison between older and younger people. Int J Environ Res Public Health. 2021 [cited 2024 Jun 11]; 18(15):7871. DOI: https://doi.org/10.3390/ijerph18157871.
Mistry SK, Ali ARMM, Yadav UN, Khanam F, Huda MN. Changes in loneliness prevalence and its associated factors among Bangladeshi older adults during the Covid-19 pandemic. PLoS One. 2022 [cited 2024 May 24]; 17(11):e0277247. DOI: https://doi.org/10.1371/journal.pone.0277247.
Silber SD. A fragilidade econômica e financeira na pandemia do Sars-Covid-19. Estud Av. 2020 [cited 2024 Mar 28]; 34(100):107–15. DOI: https://doi.org/10.1590/s0103-4014.2020.34100.008.
Ferreira RR, Rita LPS. Impactos da Covid-19 na economia: limites, desafios e políticas. CP. 2020 [cited 2024 Jul 02]; 13(2):459-76. DOI: http://dx.doi.org/10.9771/cp.v13i2.36183.
Jessen MAB, Pallesen AVJ, Kriegbaum M, Kristiansen M. The association between loneliness and health - a survey-based study among middle-aged and older adults in Denmark. Aging Ment Health. 2018 [cited 2024 Jul 01]; 22(10):1338-43. DOI: http://dx.doi.org/10.1080/13607863.2017.1348480.
Edemekong PF, Bomgaars DL, Sukumaran S, Levy SB. Activities of daily living. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Jun 26]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470404.
Ryu SI, Cho B, Chang SJ, Ko H, Yi YM, Noh E, et al. Factors related to self-confidence to live alone in community-dwelling older adults: a cross-sectional study. BMC Geriatr. 2021 [cited 2024 Jun 20]; 21:291. DOI: https://doi.org/10.1186/s12877-021-02214-w.
Xie X, Huang C, Sitar S, Qiao X. Community engagement and loneliness in older adults in China: mediation effects of social support in the wake of Covid-19. Front Public Health. 2023 [cited 2024 Jun 19]; 11:1199577. DOI: https://doi.org/10.3389/fpubh.2023.1199577.
Tomás JM, Pinazo-Hernandis S, Oliver A, Donio-Bellegarde M, Tomás-Aguirre F. Loneliness and social support: Differential predictive power on depression and satisfaction in senior citizens. J Community Psychol. 2019 [cited 2024 Jun 10];47(5):1225-1234. DOI: https://doi.org/10.1002/jcop.22184.
Polenick CA, Perbix EA, Salwi SM, Maust DT, Birditt KS, Brooks JM. Loneliness during the covid-19 pandemic among older adults with chronic conditions. J Appl Gerontol. 2021 [cited 2024 Jun 30];40(8):804-813. DOI: https://doi.org/10.1177/0733464821996527.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Larissa Kazitani Cunha, Felipe Gutierres Machado Kepe, Iraneide Nascimento dos Santos, Marcelo Kwiatkoski, Bruna Moretti Luchesi, Tatiana Carvalho Reis Martins

This work is licensed under a Creative Commons Attribution 4.0 International License.
When publishing in Revista Enfermagem UERJ, the authors declare that the work is their exclusive authorship and therefore assume full responsibility for its content.
Authors retain copyright to their article and agree to license their work using a Creative Commons Attribution International Public License (CC BY), thereby accepting the terms and conditions of this license (https://creativecommons.org/licenses/by/4.0/legalcode.en), which allows material created by the author to be distributed, copied and displayed by third parties. The original work must be cited and present a link to the article available on the website of the journal in which it was published.
The Copyright of the articles published in Revista Enfermagem UERJ belongs to their respective author(s), with the rights of first publication assigned to Revista Enfermagem UERJ, with the work simultaneously licensed under a Creative Commons License CC BY, which allows sharing of work with recognition of authorship and initial publication in this journal.
The authors grant Revista Enfermagem UERJ the right of first publication, to identify themselves as the original publisher of the work and grant the magazine a license of non-exclusive rights to use the work in the following ways:
- Sell and/or distribute the work in printed copies and/or electronic format;
- Distribute parts and/or the work as a whole with the aim of promoting the magazine through the internet and other digital and printed media;
- Record and playback work in any format, including digital media.
In line with the journal's policies, each published article will be assigned a Creative Commons Attribution (CC BY) license.