Unveiling loneliness: health determinants of feeling alone in the older urban residents

Abstract In older people health condition contributes to the feeling of being alone (loneliness). We aimed to assess which chronic health conditions are the strongest determinants of loneliness in older urban residents. Participants of the Polish part of the HAPIEE Study (Health Alcohol and Psychosocial Factors in Eastern Europe) examined in 2019-20 were included to the analysis. Trained nurses interviewed respondents in their homes. Loneliness was assessed using 3-item UCLA scale (range: 3-9, cuf-off≥ 6 points). Socioeconomic data, self-rated health (SRH) and the history of 18 diseases diagnosed by the doctor was assessed using standardized questionnaire. Multivariable logistic regression was used; odds ratios and 95% confidence intervals are presented (OR (95%CI)). There were 461 participants (48% males) of mean age 72 years (SD = 6.3). In 34 participants (7%) UCLA score was 6 or more. The majority (63%) of respondents were married or cohabiting. Nearly 90% declared having children. After adjustment for marital status and having children, poor distance vision 3.84 (1.31-6.12), hearing problems 2.20 (1.07-4.53), acute back pain syndrome 2.21 (1.06-4.59) and cancer 2.36 (1.03-5.41) were determinants of loneliness. Further adjustment for age weakened the association with distance vision 2.74 (1.26-5.94) and waved the relationship with hearing problems 2.06 (0.99-4.29). The estimates for remaining health conditions remained almost unchanged. The strongest predictor of loneliness was SRH. After adjustment for age, marital status, having children and objective burden of chronic diseases, compared to good SRH, participants with moderate and poor SRH were more likely to report loneliness by over 3 and 6 times: 3.41 (1.29-9.05) and 6.60 (2.16-20.18), respectively. The perception of poor health and diagnosis of cancer strongly determined loneliness in older people, but other important predictors of loneliness were conditions that objectively hinder maintaining social contacts. Key messages • In older people health condition is related to the feeling of being alone, and the strongest objective health determinant of loneliness was diagnosis of cancer. • Independently of objective burden of chronic diseases, self-rated health was a significant predictor of loneliness in older urban residents.