The growing problem of loneliness
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The perception that we are connected to others is a basic human need that is linked to mental and physical well-being.
“The perception that we are connected to others is a basic human need that is linked to mental and physical well-being (Cacioppo & Cacioppo, 2018; Holt-Lunstad et al., 2010, 2015; Lyubomirsky et al., 2005).”
From Enhancing social connectedness in anxiety and depression through amplification of positivity: Preliminary treatment outcomes and process of change (2020) · cites this paper as Cacioppo & Cacioppo, 2018
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Cites
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“…2020; Miller, 2020).1 Even before the coronavirus crisis, loneliness was a public health issue because it is widespread and associated with increased risk of morbidity and mortality (Cacioppo & Cacioppo, 2018; Holt-Lunstad, 2017; National Academies of Sciences, Engineering, & Medicine, 2020).”
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“These issues may have a strong impact on perceived loneliness, a factor widely associated with psychological distress as well as an outcome in itself (Cacioppo & Cacioppo, 2018).”
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“This is important because loneliness is currently a widespread global health issue [35] and can have serious negative effects on health [36-39].”
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“Social isolation and loneliness appear to be widespread and growing phenomena with about a third of the population in industrialized countries being affected by perceived social isolation [71], albeit prevalence rates vary due to psychosocial and cultural differences between populations [73].”
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“This domestic public health crisis is heightened by the collision of the COVID-19 pandemic with the addiction (Volkow 2020) and loneliness (Cacioppo and Cacioppo 2018; Murthy 2017) epidemics that have affected the US for the past years.”
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“Loneliness has recently been identified as a significant public health problem (Cacioppo & Cacioppo, 2018), but one that can be addressed with financial and institutional support.”
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“Lonely individuals in comparison to others have been found to have increased all-cause morbidity and mortality (Cacioppo and Cacioppo, 2018), increased risk of cardiovascular diseases (Barth et al., 2010; Thurston and Kubzansky, 2009), impaired functional status and quality of life (Lee et al.,…”
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“In 2019, the World Health Organization declared that loneliness is a major health concern worldwide [4].”
Social isolation: an underappreciated determinant of physical health
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“Taken together, loneliness has been a significant and growing concern for a number of years (Cacioppo and Cacioppo, 2018); however, it is now being more widely recognized as a critical public health issue with the arrival and continued impact of the COVID-19 pandemic (Killgore et al., 2020).”
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“…concepts are transmitted more reliably than low-arousal concepts, and social concepts are transmitted more reliably than asocial concepts (Mesoudi & Whiten, 2008), illustrating the salience of high-arousal feelings (Kensinger, 2004) and sociality (Cacioppo & Cacioppo, 2018) to human experience.”
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“Many have argued that a sense of felt connection to self, other people and the world around us has a profound effect on our individual and collective wellbeing (Alexander 2008; Cacioppo and Cacioppo 2018; Hari 2019; Sorajjakool et al. 2008).”
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“Veteran status Veteran 2088 (10) 2320 (12) Nonveteran 18 008 (90) 17 776 (88) Education High school 4123 (21) 3692 (19) Some college 5018 (26) 4749 (24) College degree 7529 (38) 7699 (39) Graduate degree 2911 (15) 3448 (18) Employment status Employed 11 104 (57) 12 134 (63) Unemployed 2422 (13) 2100 (11) Homemaker 169…”
Emotional and social loneliness and their unique links with social isolation, depression and anxiety
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“In separate samples, social isolation has been associated with lone-liness (Cacioppo and Cacioppo, 2018b), depression (Cacioppo et al., 2006b), general anxiety (Santini et al., 2020), and social anxiety (Lim et al., 2016), however, no studies have examined these factors comprehensively in the same…”
Risk factors for loneliness: The high relative importance of age versus other factors
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“For example, low levels of social engagement [42, 113], poor mental health [110] and physical health [35] have been connected to loneliness.”
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“…use on other outcomes, including, but not limited to: (1) positive and negative anticipated emotions; (2) intentions to enact potentially harmful versus beneficial behaviours (results in Supplementary Table 14); and (3) loneliness and social connectedness (results in Supplementary Table 15).”
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“[6–8], is linked to an increased premature mortality risk [9, 10] and correlates to adverse health outcomes such as depression, psychosocial maladjustment, poor coping behavior, low health promotion behavior, compromised well-being, reduced quality of life, and self-actualization [11].”
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“On the contrary, social disconnection or poor social relationships, such as isolation and loneliness, enhance vulnerability to health negative outcomes which are added to other adverse events in the course of life [61].”
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Loneliness and emotion regulation
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Third-party evaluators perceive AI as more compassionate than expert humans
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“The gap between empathic supply and demand leaves recipients with unful fi lled needs for supportive care and contributes to heightened reports of social isolation, loneliness, and mental health concerns 18,35,36 , which have intensi fi ed since the COVID-19 pandemic, particularlyamong youth 35 .”
Big smile, small self: Awe walks promote prosocial positive emotions in older adults.
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“…for older adults and are associated with higher rates of social isolation, depression, cognitive impairment, cardiovascular disease, and mortality (Cacioppo & Cacioppo, 2018; Cacioppo & Hawkley, 2009; Golden et al., 2009; Kassem et al., 2017; Kubzansky & X Virginia E. Sturm, Department of…”
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“Loneliness is a significant public health concern in our aging society.(1)”
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“…EE, resulting in a growing problem of loneliness, which has increasingly been linked to a range of serious physical and emotional health problems (Cacioppo & Cacioppo, 2018; Cacioppo, Cacioppo, Capitanio, & Cole, 2015; Holt‐Lunstad & Smith, 2016; Layden et al., 2017; Miller, 2011; Murthy, 2017).”
BackgroundLoneliness and mental health: The mediating effect of perceived social support
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“(Cacioppo & Cacioppo, 2018) The extent to which findings in community-dwelling older adults hold for those living in congregate long term care settings is unclear.”
BackgroundChronic social isolation signals starvation and reduces sleep in Drosophila
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“It has been noted that ‘quick and valid measures of loneliness exist’ and diagnosis of loneliness is not difficult, and also that remedies to loneliness are also readily available (Cacioppo & Cacioppo, 2018).”
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Longitudinal associations between family identification, loneliness, depression, and sleep quality
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“In their Evolutionary Theory of Loneliness (ETL) Cacioppo and Caciopppo (2018b) propose that loneliness leads to poor sleep quality and insomnia (as well as other outcomes) because it signals that one exists in an environment where others are likely to behave selfishly.”
BackgroundResultInfluentialBody-Esteem, Self-Esteem and Loneliness among Social Media Young Users
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“Loneliness is defined as a unique condition in which an individual perceives himself or herself to be socially isolated even when among other people [5].”
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“The former is outwardly visible to an onlooker, inferred by the lack of social proximity and engagement with others, even though the individuals themselves may not feel alone (Cacioppo and Cacioppo, 2018; McClelland et al., 2020).”
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A global test of brief reappraisal interventions on emotions during the COVID-19 pandemicPreprint
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Connectome-based individualized prediction of loneliness
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“Loneliness is a negative emotional state induced by subjective perception of social isolation even when among other people (Weiss, 1973; Cacioppo and Cacioppo, 2018).”
BackgroundInfluentialRevisiting the social stigma of loneliness
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Predictors and consequences of loneliness during the COVID-19 Pandemic
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“Even prior to the COVID-19 pandemic, loneliness levels were cited to be at epidemic levels (Neill-Hall, 2013; Cacioppo and Cacioppo, 2018), with over half of Americans reporting feelings of loneliness and social isolation (Cigna et al., 2020).”
BackgroundLoneliness, ageism, and mental health: The buffering role of resilience in seniors
Ribeiro-Gonçalves, J. A., Costa, P. A., & Leal, I. M. P. (2022) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2022.100339 · Cited by 85 · see citing works
“…to factors such as the lack of post-retirement and post-widow’s social resources, changes in family configurations and family support, and changes in socialization resulting from digitalization (Cacioppo & Cacioppo, 2018; Chawla et al., Table 3 Direct and mediated effects on psychological distress.”
BackgroundResultEconomic Gradients in Social Health in Britain
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“Loneliness is highly prevalent across the life course, and is predicted to increase with demographic changes: ageing populations, more people living alone, and with chronic health conditions (Cacioppo and Cacioppo, 2018a).”
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“Social disconnection and loneliness increase risk for early mortality to a degree comparable with well-established health risk factors such as obesity and smoking (Cacioppo and Cacioppo 2018; Holt-Lunstad et al.”
BackgroundInfluentialAn integrative health framework for wellbeing in the built environment
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Social reward and support effects on exercise experiences and performance: Evidence from parkrun
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“Although evidence on the prevalence of loneliness is less well established, loneliness as the perception of social isolation (even when among other people), is also widely recognized as a “real mental health challenge for the nations” [6] and a growing problem worldwide [7, 8].”
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“loneliness and depression are frequently regarded as just symptoms of chronic physical diseases rather than the mental health problems per se among seniors (Bruce & Sirey, 2018; Cacioppo, 2018).”
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“Our findings highlight the importance of developing successful preventive measures for loneliness per se, which has been claimed as a 21st century epidemic [62, 63].”
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Loneliness in psychosis: A practical review and critique for clinicians.
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“- Anxiety [4,47,58,59] - Increased use of healthcare services [49,60–62]”
BackgroundScreening for loneliness in representative population samples: Validation of a single-item measure
Reinwarth, A. C., Ernst, M., Krakau, L., Brähler, E., & Beutel, M. E. (2023) · PLoS ONE · doi:10.1371/journal.pone.0279701 · Cited by 73 · see citing works
Significantly increased risk of all-cause mortality among cardiac patients feeling lonely
Christensen, A. V., Juel, K., Ekholm, O., Thrysøe, L., Thorup, C. B., Borregaard, B., Mols, R. E., Rasmussen, T. B., & Berg, S. K. (2019) · Heart · doi:10.1136/heartjnl-2019-315460 · Cited by 72 · see citing works
Han, Z., Wang, Z., & Li, Y. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.664612 · Cited by 71 · see citing works
“…is a solid need to re-investigate Frontiers in Psychology | www.frontiersin.org 2 June 2021 | Volume 12 | Article 664612 the loneliness of children and adolescents, especially in the context of lockdown due to the pandemic (Weeks and Asher, 2012; Cacioppo and Cacioppo, 2018; Loades et al., 2020).”
BackgroundRodrigues, B. K. A. B., David, C., Costa, J. N., Ferreira, J. J., Pinto, F. J., & Caldeira, D. (2019) · Heart · doi:10.1136/heartjnl-2019-315193 · Cited by 71 · see citing works
Friendship jealousy: One tool for maintaining friendships in the face of third-party threats?
Krems, J. A., Williams, K. E. G., Aktipis, A., & Kenrick, D. T. (2020) · Journal of Personality and Social Psychology · doi:10.1037/pspi0000311 · Cited by 69 · see citing works
Liebmann, M., Pitman, A., Hsueh, Y.-C., Bertotti, M., & Pearce, E. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08656-1 · Cited by 68 · see citing works
“Loneliness is a global public health issue [1] and, in the UK, it has attracted considerable policy attention with the introduction of a governmental loneliness strategy in 2018 [8].”
BackgroundAbelsen, S. N., Vatne, S.-H., Mikalef, P., & Choudrie, J. (2021) · Information Technology and People · doi:10.1108/itp-12-2020-0870 · Cited by 72 · see citing works
ElliQ, an AI-Driven Social Robot to Alleviate Loneliness: Progress and Lessons Learned
Broadbent, E., Loveys, K., Ilan, G., Chen, G., Chilukuri, M. M., Boardman, S. G., Doraiswamy, P. M., & Skuler, D. (2024) · Journal of Aging Research and Lifestyle · doi:10.14283/jarlife.2024.2 · Cited by 66 · see citing works
“It is a feeling of social isolation even when one is surrounded by other people (6).”
BackgroundLoneliness as a risk factor for frailty transition among older Chinese people
Sha, S., Xu, Y., & Chen, L. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01714-5 · Cited by 65 · see citing works
Holding, E., Thompson, J., Foster, A., & Haywood, A. (2020) · Health & Social Care in the Community · doi:10.1111/hsc.12976 · Cited by 64 · see citing works
“Loneliness is increasingly recognised as a global public health concern associated with a range of negative health outcomes (Cacioppo & Cacioppo, 2018; Holt-Lunstad, Smith, Baker, Harris, & Stephenson, 2015).”
BackgroundPhysical Contact and Loneliness: Being Touched Reduces Perceptions of Loneliness
Tejada, A. H., Dunbar, R., & Montero, M. (2020) · Adaptive Human Behavior and Physiology · doi:10.1007/s40750-020-00138-0 · Cited by 69 · see citing works
“Loneliness is an increasing concern in individualistic and low-contact societies (Cacioppo and Cacioppo 2018; Griffin 2010; Murthy 2017)1 even though people are used to reduced physical contact and most of them strive to become independent and self-reliant.”
BackgroundFinley, A. J., & Schaefer, S. M. (2022) · Journal of Psychiatry and Brain Science · doi:10.20900/jpbs.20220011 · Cited by 70 · see citing works
Boucher, E. M., McNaughton, E. C., Harake, N., Stafford, J. L., & Parks, A. C. (2021) · JMIR Mental Health · doi:10.2196/26617 · Cited by 61 · see citing works
Arts engagement supports social connectedness in adulthood: findings from the HEartS Survey
Perkins, R., Mason-Bertrand, A., Tymoszuk, U., Spiro, N., Gee, K., & Williamon, A. (2021) · BMC Public Health · doi:10.1186/s12889-021-11233-6 · Cited by 61 · see citing works
“Loneliness is a public health problem, associated with a 26% increase in the risk of premature mortality [4, 5] as well as poorer cardiovascular and mental health outcomes [6].”
BackgroundLaslo‐Roth, R., Bareket‐Bojmel, L., & Margalit, M. (2020) · European Journal of Special Needs Education · doi:10.1080/08856257.2020.1862339 · Cited by 60 · see citing works
“Recently, loneliness has come to be considered a public health problem associated with increased risk of mental health problems, morbidity, and mortality (Cacioppo and Cacioppo 2018; National Academies of Sciences, Engineering & Medicine 2020).”
BackgroundYang, M., Wei, W., Ren, L., Pu, Z., Zhang, Y., Li, Y., Li, X., & Wu, S. (2023) · BMC Public Health · doi:10.1186/s12889-023-17435-4 · Cited by 67 · see citing works
“Consequently, it is regarded as a global public health concern [14, 15].”
BackgroundLoneliness and Facebook use: the role of social comparison and rumination
Dibb, B., & Foster, M. (2021) · Heliyon · doi:10.1016/j.heliyon.2021.e05999 · Cited by 58 · see citing works
“This supports other studies showing this association [1, 4] and highlights the importance of controlling for depression in studies on loneliness.”
BackgroundResultInfluentialVolunteering and loneliness in older adults: A parallel mediation model
Lee, S. (2021) · Aging & Mental Health · doi:10.1080/13607863.2021.1913477 · Cited by 63 · see citing works
“Numerous studies provide evidence that loneliness and social isolation in later life plays a detrimental role in older adults’ health and quality of life (e.g. Cacioppo & Cacioppo, 2018; Cohen-Mansfield & Parpura-Gill, 2007; Holt-Lunstad, Robles, & Sbarra, 2017; Poscia et al., 2018).”
BackgroundLoneliness and health expectancy among older adults: A longitudinal population‐based study
Malhotra, R., Tareque, M. I., Saito, Y., Ma, S., Chiu, C., & Chan, A. W.-M. (2021) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17343 · Cited by 58 · see citing works
Azhari, A., Toms, Z., Pavlopoulou, G., Esposito, G., & Dimitriou, D. (2022) · Acta Psychologica · doi:10.1016/j.actpsy.2022.103706 · Cited by 70 · see citing works
“…it is ironic that these digital platforms have also been argued to contribute to the loneliness epidemic plaguing the youths of today (Cacioppo & Cacioppo, 2018; Caplan, 2007), with an estimated one-third of respondents of a large survey on adolescents and young adults from the United Kingdom…”
Torrente, F. M., Yoris, A., Low, D. M., López, P. L., Bekinschtein, P., Manes, F. F., & Cetkovich, M. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.12.124 · Cited by 56 · see citing works
“Furthermore, we can assume that the group of older adults who completed the online survey is an active group connected to others through technology, which could operate in some cases as a protective factor for loneliness (Nowland, Necka & Cacioppo, 2018).”
InfluentialGe, M., Hu, F., Jia, Y., Tang, W. H., Zhang, W., Zhao, D., Shen, W., & Chen, H. (2023) · Psychological Reports · doi:10.1177/00332941231180119 · Cited by 58 · see citing works
“Loneliness is a common public health problem (Cacioppo & Cacioppo, 2018), which refers to a negative and subjective experience (Lim et al., 2020).”
Loveys, K., Fricchione, G., Kolappa, K., Sagar, M., & Broadbent, E. (2019) · Journal of Medical Internet Research · doi:10.2196/13664 · Cited by 54 · see citing works
“Loneliness is a widespread global health issue that approximately affects a third of people in industrialized countries [3].”
BackgroundByrne, K. A., Anaraky, R. G., Dye, C., Ross, L. A., Chalil Madathil, K., Knijnenburg, B., & Levkoff, S. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.723925 · Cited by 54 · see citing works
Stickley, A., & Ueda, M. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.114318 · Cited by 58 · see citing works
“This is worrying given the growing recognition of the detrimental effect that loneliness can have on public health (Cacioppo and Cacioppo, 2018).”
Giné‐Garriga, M., Jerez‐Roig, J., Coll‐Planas, L., Skelton, D. A., Inzitari, M., Booth, J., & de Souza, D. L. B. (2020) · Maturitas · doi:10.1016/j.maturitas.2020.11.010 · Cited by 55 · see citing works
“Loneliness is emerging as a public health issue [22], and is associated with a 26% increase in the risk of premature mortality [23].”
BackgroundHyland, K. A., Small, B. J., Gray, J. E., Chiappori, A., Creelan, B., Tanvetyanon, T., Nelson, A. M., Cessna, J. M., Jim, H., & Jacobsen, P. B. (2019) · Psycho-Oncology · doi:10.1002/pon.5072 · Cited by 53 · see citing works
“Loneliness is receiving increasing attention as a public health problem in the context of the current age shift in the population.(40) Given that the majority of cancers occur in older adults, continued study of loneliness and potentially modifiable factors related to loneliness in cancer patients is warranted.”
BackgroundChoukèr, A., & Stahn, A. C. (2020) · npj Microgravity · doi:10.1038/s41526-020-00122-8 · Cited by 52 · see citing works
Economic Aspects of Loneliness in Australia
Kung, C. S. J., Kunz, J., & Shields, M. A. (2021) · Australian Economic Review · doi:10.1111/1467-8462.12414 · Cited by 52 · see citing works
“It has been suggested that the prevalence of loneliness is increasing, driven by more people living alone, longer and with chronic health conditions (Cacioppo and Cacioppo 2018a).”
BackgroundProspective effects of loneliness on frequency of alcohol and marijuana use
Gutkind, S., Gorfinkel, L., & Hasin, D. S. (2021) · Addictive Behaviors · doi:10.1016/j.addbeh.2021.107115 · Cited by 52 · see citing works
Sha, S., Pan, Y., Xu, Y., & Chen, L. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-03044-0 · Cited by 49 · see citing works
Ascanio, J. H., de Torres, L. Á. P., Rich‐Ruiz, M., González‐Santos, J., Mielgo‐Ayuso, J., Gonzalez-Bernal, J. J., & ASyS Study Collaborative Group (2022) · Nursing Open · doi:10.1002/nop2.1277 · Cited by 47 · see citing works
Reconceptualising men's loneliness: An interpretivist interview study of UK-based men
Ratcliffe, J., Kanaan, M. N., & Galdas, P. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116129 · Cited by 44 · see citing works
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Site, A., Lohan, E. S., Jolanki, O. H., Valkama, O., Hernández, R. R., Latikka, R., Alekseeva, D., Vasudevan, S., Afolaranmi, S. O., Ometov, A., et al. (2022) · Sensors · doi:10.3390/s22031108 · Cited by 48 · see citing works
“While not all older people are lonely, loneliness has been shown to have serious effects, such as the decline of well-being and functional ability and increased risk of morbidity and mortality [11,42,43].”
BackgroundMočnik, Š., Moogoor, A., & Yuen, B. (2022) · Journal of Transport & Health · doi:10.1016/j.jth.2022.101386 · Cited by 46 · see citing works
- Authors
- Cacioppo, J. T., & Cacioppo, S.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Cacioppo, John T
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2018-02
- Volume
- 391
- Issue
- 10119
- Pages
- 426
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC6530780
- OpenAlex
- W2787145468
- Cited by
- 897
- References
- 7
- Citations by year
- 2026: 107 · 2025: 155 · 2024: 134 · 2023: 131 · 2022: 117 · 2021: 126 · 2020: 94 · 2019: 28 · 2018: 5
- FWCI
- 67.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R01AG033590)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
- Keywords
- loneliness, social isolation, premature mortality, depression, irritability, self-centeredness, social contagion, socioeconomic factors
- MeSH terms
- Humans, Loneliness, Public Health, Social Isolation
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