Loneliness, social inactivity and social isolation of older adults in assisted living facilities

OBJECTIVE: Health and well-being of older adults living in long-term care are affected by loneliness, social inactivity, and social isolation. We 1) investigated the prevalence and overlapping of concepts of loneliness, social inactivity, and/or social isolation in assisted living facilities (ALFs) and 2) compared residents' characteristics and psychological well-being (PWB) in three groups (Gr): Gr0: not lonely, socially inactive, or socially isolated; Gr1: lonely; and Gr2: not lonely, but socially inactive and/or socially isolated. METHODS: A cross-sectional survey including older adults (n = 854; 55+ years) living permanently in 25 ALFs in the Helsinki metropolitan area. Residents with advanced dementia were excluded. Participants were interviewed by a structured survey. Variables studied were demographics, health, physical functioning and mobility, and well-being. Loneliness was inquired with a single-item, well-validated question. For social inactivity and social isolation, a combination of questions from previous studies was used. RESULTS: Of the sample, 55% were lonely, 12% solely socially inactive/socially isolated and 33% neither. Only 3% were simultaneously lonely, socially inactive, and socially isolated. Lonely participants (Gr1) had more often worse self-rated health, physical functioning and mobility, pain, and poor sleep than those in Gr0. In the multivariate analysis, lonely participants had the poorest PWB of all three groups. Loneliness also predicted poor PWB even after adjusting for age, sex, and various health and functioning variables. CONCLUSIONS: Loneliness is very common in ALFs and indicates poor PWB. Loneliness, social inactivity, and social isolation are only partly overlapping. Loneliness should be asked about to intervene on it.