Loneliness and mental health in older people in Spain and Sweden

Abstract Objectives The mental health of older people is often related to situations of loneliness and social isolation, in addition to the socio-cultural context in which they live. The aim of this study is to analyze the relationship of social isolation and loneliness with symptoms of depression in older population from a cross-national perspective. Methods Cross-sectional, nationally representative study with data from W8 of SHARE survey in Spain (n = 1759) & Sweden (n = 2068). Sociodemographic data was collected together with assessments of loneliness (R-UCLA scale), social connectedness, depression (Euro-D scale), number of chronic diseases and daily living limitations. Linear regression models of the Euro-D scale as dependent variable were performed, controlling for age and sex, comparing results by country. Results The sample, composed of 54.5% women (56% in Spain; 53% in Sweden, n.s.), had a mean age of 76.7 years (77.3 in Spain and 76.2 in Sweden, p < 0.001). 27% of the sample lived alone (21% in Spain, 32% in Sweden, p < 0.001). 39% of the sample reported feeling lonely (35% in Spain, 42% in Sweden, p < 0.001). Depressive symptoms were present in 25% of the sample (31% in Spain, 20% in Sweden, p < 0.001). In the regression model, loneliness was the main determinant of depression in both countries (Spain: β = 0.44, p < 0.001; Sweden: β = 0.38, p < 0.001). Furthermore, in Sweden (but not in Spain), depression was also associated with chronic diseases (β = 0.24; p < 0.001) and social connectedness (β = 0.16; p < 0.031). Conclusions Loneliness and social isolation are important determinants of poor mental health in older people, although this relationship may be bidirectional. In addition, it is necessary to consider the socio-cultural factors that influence this association. Funding Instituto de Salud Carlos III (CASS Project, ref. PI22CIII/00043; RICAPPS, ref. RD21CIII/0003/0002 & RD24CIII/0001/0002), Comunidad de Madrid (ENCAGES-CM Programme, ref. PHS-2024/PH-HUM-169) Key messages • Loneliness and social isolation are associated to poor mental health in older people. • Socio-cultural factors that influence this association must be considered.