Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA.
Department of Psychiatry, University of California San Diego, La Jolla, California, USA.
J Clin Psychiatry. 2020 Nov 10;81(6):20m13378. doi: 10.4088/JCP.20m13378.
Loneliness is a prevalent and serious public health problem due to its effects on health, well-being, and longevity. Understanding correlates of loneliness is critical for guiding efforts toward the development of evidence-based strategies for prevention and intervention. Considering that patterns of association between age and loneliness vary, the present study sought to examine age-related differences in risk and protective factors for loneliness.
Correlates of loneliness were examined through a large web-based survey of 2,843 participants (aged 20-69 years) from across the United States from April 10, 2019, through May 10, 2019. Participants completed the 4-item UCLA Loneliness Scale, San Diego Wisdom Scale (with the following subscales measuring components of wisdom: Prosocial Behaviors, Emotional Regulation, Self-Reflection, Acceptance of Divergent Values, Decisiveness, and Social Advising), and other scales measuring psychosocial variables. Multivariate regression analyses were conducted to identify the best model of loneliness and examine potential age-related differences.
Age demonstrated a nonlinear quadratic relationship with loneliness (Wald statistic = 5.48, P = .019); levels were highest in the 20s and lowest in the 60s with another peak in the mid-40s. Across all decades, loneliness was associated with not having a spouse or partner (P < .001), sleep disturbance (P < .02), lower prosocial behaviors (P < .001), and smaller social network (P < .001). Lower social self-efficacy (P < .001) and higher anxiety (P < .005) were associated with worse loneliness in all age decades, except the 60s. Loneliness was uniquely associated with decisiveness in the 50s (P = .012) and with education (P = .046) and memory complaints (P = .013) in the 60s.
Our findings identify several potentially modifiable targets related to loneliness, including several aspects of wisdom and social self-efficacy. Differential predictors at different decades suggest a need for a personalized and nuanced prioritizing of prevention and intervention targets.
孤独感是一个普遍而严重的公共卫生问题,因为它会影响健康、幸福感和寿命。了解孤独感的相关因素对于指导制定基于证据的预防和干预策略至关重要。考虑到年龄与孤独感之间的关联模式存在差异,本研究旨在探讨孤独感的风险和保护因素与年龄的关系。
通过 2019 年 4 月 10 日至 5 月 10 日期间对来自美国各地的 2843 名参与者(年龄在 20-69 岁之间)进行的大型网络调查,研究孤独感的相关因素。参与者完成了 4 项 UCLA 孤独量表、圣地亚哥智慧量表(包括以下衡量智慧组成部分的子量表:亲社会行为、情绪调节、自我反思、接受不同价值观、果断和社会建议)以及其他衡量心理社会变量的量表。进行多元回归分析以确定孤独感的最佳模型,并探讨潜在的年龄相关差异。
年龄与孤独感呈非线性二次关系(Wald 统计量=5.48,P=.019);20 多岁时水平最高,60 多岁时最低,40 多岁时再次出现高峰。在所有年龄段,孤独感与没有配偶或伴侣(P<.001)、睡眠障碍(P<.02)、较低的亲社会行为(P<.001)和较小的社交网络(P<.001)相关。较低的社交自我效能感(P<.001)和较高的焦虑感(P<.005)与所有年龄段的孤独感较差相关,除了 60 多岁以外。在 50 多岁时,孤独感与果断性(P=.012)相关,在 60 多岁时与教育(P=.046)和记忆问题(P=.013)相关。
我们的研究结果确定了几个与孤独感相关的潜在可改变目标,包括智慧和社交自我效能感的几个方面。不同年龄段的不同预测因素表明,需要个性化和细致地确定预防和干预目标的优先级。