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Typologies of loneliness, living alone and social isolation, and their associations with physical and mental health
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Abstract The relationship between living alone, loneliness and social isolation, and how they are associated with health remain contentious. We sought to explore typologies based on shared experiences of loneliness, social isolation and living alone using Latent Class Analysis and determine how these groups may differ in terms of their physical and mental health. We used Wave 7 of the English Longitudinal Study of Ageing (N = 7,032; mean age = 67.3) and responses to the University of California, Los Angeles (UCLA) loneliness scale, household composition, participation in social/societal activities plus frequency of contact with friends, family and relatives for the Latent Class Analysis. The optimal number of groups was identified using model-fit criteria. The socio-demographic characteristics of groups and health outcomes were explored using descriptive statistics and logistic regression. We identified a six-cluster typology: Group 1, no loneliness or isolation; Group 2, moderate loneliness; Group 3, living alone; Group 4, moderate isolation; Group 5, moderate loneliness, living alone; and Group 6, high loneliness, moderate isolation (with high likelihood of living alone). Groups experiencing loneliness and/or isolation were more likely to report poorer physical and mental health even after adjusting for socio-demographic confounders, this was particularly notable for Group 6. Our results indicate that different typologies of living alone, loneliness and isolation can be identified using data-driven techniques, and can be differentiated by the number and severity of issues they experience.
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“In between these two extremes were four groups that experienced either social isolation or loneliness. These groups were also more likely to have physical and mental health problems compared to the majority group.”
From Examining social isolation and loneliness in combination in relation to social support and psychological distress using Canadian Longitudinal Study of Aging (CLSA) data (2020) · cites this paper as [45]
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“The neither socially isolated nor lonely group was younger and had a higher household income than the other groups, similar to Smith and Victor’s findings [45]”
From Examining social isolation and loneliness in combination in relation to social support and psychological distress using Canadian Longitudinal Study of Aging (CLSA) data (2020) · cites this paper as [45]
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“They are also in line with results by Smith and Victor [45].”
From Examining social isolation and loneliness in combination in relation to social support and psychological distress using Canadian Longitudinal Study of Aging (CLSA) data (2020) · cites this paper as Smith and Victor [45]
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“Recently, Smith and Victor [45], using clustering analyses based on measures of social isolation, loneliness and living alone, found six groups of people. The largest group (47% of the sample) experienced no loneliness or social isolation. This group also had the least physical health problems and depressive symptoms.”
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“On the opposite side of the spectrum, a small proportion (4%) of the sample were both lonely and socially isolated and had a substantially increased likelihood of physical and mental health problems, relative to the majority group.”
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“The socially isolated and lonely group was clearly the most at risk group, as expected, consistent with previous research [18,45].”
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“Similarly, older adults who experience both social isolation and loneliness have been found to report poorer health quality, with worse depressive symptoms and a higher number of comorbidities (8, 48–50).”
From The impact of COVID-19 infection and enforced prolonged social isolation on neuropsychiatric symptoms in older adults with and without dementia: A review (2020) · cites this paper as [49]
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“A number of studies have pointed out that pandemic [3,4] and social isolation [5,6] could negatively influence the mental health of the general population.”
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“Policymakers and practitioners must understand perceived isolation as a construct, identify its determinants, and learn how it is linked to outcomes (Smith and Victor, 2019) like interpersonal deviance.”
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“…social isolation, social support, and loneliness (National Academies of Sciences & Medicine, 2020), because they have been found to have differential pathways to poor health and disease (Cacioppo & Hawkley, 2003; Menec et al., 2019; Shankar et al., 2011; Smith & Victor, 2019; Steptoe et al., 2013).”
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“It is worth noting that the opposite direction, in which loneliness, social exclusion and network size predict multimorbidity, has also been investigated previously and significant associations have been found [27, 55].”
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“Loneliness is associated with detrimental solitude (or self-isolation) and has substantial implications for mental and physical health (Victor et al., 2000; Matias et al., 2011; O'Súilleabháin et al., 2019; Smith and Victor, 2019).”
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Ding, X., Yuan, L., & Zhou, Y. (2023) · China Economic Review · doi:10.1016/j.chieco.2023.102047 · Cited by 54
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“…later life does not equal loneliness – among the top factors that enhance older people’s vulnerability to loneliness are living alone or in aged-care facilities while experiencing health conditions and circumstances that affect social interaction (Gardiner et al., 2020; Smith and Victor, 2019).”
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Sherman, D. W., Alfano, A. R., Alfonso, F., Duque, C. R., Eiroa, D., Marrero, Y., Muñecas, T., Radcliffe-Henry, E., Rodríguez, A. L., & Sommer, C. L. (2024) · Healthcare · doi:10.3390/healthcare12111135 · Cited by 64
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“Evidence is mounting of frail older people with unmet needs for support (Humphries et al., 2016) and who are at risk of social isolation and loneliness (Smith and Victor, 2019).”
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A quarantined lodging stay: The buffering effect of service quality
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“In essence, feeling social rejection from society is a key factor that leads to worries and panic, which further exacerbates one’s feeling of being isolated from social ties and even human interaction (Smith and Victor, 2019).”
Family, Collectivism, and Loneliness from a Cross-Country Perspective
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“Loneliness is associated with lower self-esteem, higher depression, and physiological decline (Hawkley et al., 2010; Shankar et al., 2011; Smith & Victor, 2019).”
BackgroundExploring the determinants and mitigating factors of loneliness among older adults
Smale, B. J. A., Wilson, J., & Akubueze, N. (2022) · Wellbeing Space and Society · doi:10.1016/j.wss.2022.100089 · Cited by 48
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“Previous studies show that social isolation caused by public health crises or natural disasters can negatively influence the mental health of the general population (Hall & Chapman, 2008; Rohde et al., 2016; Rubin et al., 2010; Smith & Victor, 2019).”
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“While overlapping, loneliness, living alone and social isolation are distinguishable concepts and living alone is not a reliable measure of loneliness (Smith & Victor, 2019).”
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Jung, A.-R., Lee, K., & Park, E.-A. (2023) · Geriatric Nursing · doi:10.1016/j.gerinurse.2023.07.011 · Cited by 33
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“Yet it is surrounded with definitional ambiguity and even conflated with social isolation or living alone, despite a body of research showing those concepts differ (Shanas et al., 1968; Smith & Victor, 2019).”
Ansari, S., Muhammad, T., & Dhar, M. (2021) · Journal of Population Ageing · doi:10.1007/s12062-021-09343-5 · Cited by 31
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“This is because older people living alone lack the company and care of their families, and they are more likely to feel lonely in the face of aging and loss [65].”
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“Social isolation and loneliness have negative impacts on physical and mental health and survival (Holt-Lunstad et al., 2010, 2015; Ye Luo et al., 2012; Rico-Uribe et al., 2016; Courtin and Knapp, 2017; Smith and Victor, 2019).”
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“This result is in line with previous literature that has showed that people living alone did not show poor mental health, but people living alone and feeling alone did (Smith & Victor, 2019).”
ResultPandemic Diaries: Lived Experiences of Loneliness, Loss, and Hope Among Older Adults During COVID-19
Neves, B. B., Colón-Cabrera, D., Sanders, A., & Warren, N. (2022) · The Gerontologist · doi:10.1093/geront/gnac104 · Cited by 32
“Interactions between loneliness and personal contexts have also been documented (Cohen-Mansfield et al., 2016; O’Sullivan, Burns, et al., 2021; Smith & Victor, 2019).”
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Project eARTh: participatory arts and mental health recovery, a qualitative study
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Omari, O. A., Sabei, S. D. A., Rawajfah, O. A., Sharour, L. M. A., Hashmi, I. A., Qadire, M. I. A., & Khalaf, A. (2021) · Journal of the American Psychiatric Nurses Association · doi:10.1177/10783903211017640 · Cited by 29
“…Shevlin, 2012), belonging to an ethnic minority, being gay or lesbian, having poor health, suffering from cognitive disability or sensory impairment, having reduced mobility, and being male (Age Concern New Zealand, 2020; Ozben, 2013; Smith & Victor, 2019) are examples of predictors of loneliness.”
BackgroundEdberg, A., & Bolmsjö, I. (2019) · JMIR Research Protocols · doi:10.2196/13607 · Cited by 27
“Loneliness is often related to either physical aspects of life, where a need for closeness and touch are in focus, or to social isolation, where a need for human relationships are in focus [6].”
Zhang, X., Han, H., Lin, Q., Zhuang, J., Ren, Z., Su, Y., & Xia, Y. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192013308 · Cited by 27
“During the COVID-19 pandemic, almost all countries imposed strict regulations, such as social distancing and movement restrictions [1,2], which had a negative effect on mental health, leading to symptoms such as depression and anxiety [3,4].”
BackgroundKraut, R. E., Li, H. Z., & Zhu, H. (2022) · PLoS ONE · doi:10.1371/journal.pone.0277562 · Cited by 28
Pouso, S., Borja, Á., Fleming, L. E., Gómez‐Baggethun, E., White, M. P., & Uyarra, M. C. (2020) · SocArXiv (OSF Preprints) · doi:10.31235/osf.io/gpt3r · Cited by 25
Tsai, T.-Y., Chiu, C., Wang, T., Tseng, H., Chen, K., Chen, P. S., & Yang, Y.-K. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03824-3 · Cited by 24
“Although loneliness and social isolation have been linked with depression, cardiovascular disease and declined physical function, when researchers simultaneously examine loneliness and social isolation with health, the results are often mixed [20].”
BackgroundBanerjee, S., & Boro, B. (2022) · BMC Public Health · doi:10.1186/s12889-022-14329-9 · Cited by 23
Evaluation of an intervention targeting loneliness and isolation for older people in North Wales
Roberts, J. R., & Windle, G. (2019) · Perspectives in Public Health · doi:10.1177/1757913919868752 · Cited by 26
“Health Soc Care Community 2017; 25(3): 799–812.”
BackgroundInfluentialCarrasco, P. M., Crespo, D. P., García, A. I. R., Ibáñez, M. L., Rubio, B. M., & Montenegro-Peña, M. (2024) · BMC Psychology · doi:10.1186/s40359-024-01708-7 · Cited by 29
“Other findings support this data, and in a longitudinal study of 7,032 older adults, those who lived alone and did not feel lonely were less at risk of depressive disorders, chronicity (2 or more chronic diseases), impaired activities of daily living or poor health status [29].”
ResultToze, M., Westwood, S., & Hafford‐Letchfield, T. (2021) · International Journal of Transgender Health · doi:10.1080/26895269.2021.1977210 · Cited by 23
Impact of the COVID-19 Pandemic on Canadian Social Connections: A Thematic Analysis
Lowe, C. T., Rafiq, M., MacKay, L. J., Letourneau, N. L., Ng, C. F., Keown-Gerrard, J., Gilbert, T., & Ross, K. M. (2022) · Journal of Social and Personal Relationships · doi:10.1177/02654075221113365 · Cited by 25
“This impact may be because lack of access to social connections changes access to resources and influences health behaviours (Levula et al., 2016; Smith & Victor, 2019).”
BackgroundRyu, S. I., Park, Y., Kim, J., Huh, I., Chang, S. J., Jang, S., & Noh, E.-Y. (2022) · PLoS ONE · doi:10.1371/journal.pone.0270260 · Cited by 22
Ooi, L. L., Liu, L., Roberts, K. C., Gariépy, G., & Capaldi, C. A. (2023) · Health Promotion and Chronic Disease Prevention in Canada · doi:10.24095/hpcdp.43.4.02 · Cited by 24
Trajectories of Early Adolescent Loneliness: Implications for Physical Health and Sleep
Eccles, A. M., Qualter, P., Panayiotou, M., Hurley, R., Boivin, M., & Tremblay, R. E. (2020) · Journal of Child and Family Studies · doi:10.1007/s10826-020-01804-3 · Cited by 27
“Loneliness is related, but distinct from social isolation (Smith and Victor 2019); it is characterised by dissatisfaction with current relationships (Cacioppo and Cacioppo 2014) and a feeling of emotional or physical disconnection from others (Qualter et al. 2015).”
BackgroundSocial isolation during the COVID-19 pandemic in Spain: a population study
Martínez-Garcia, M., Sansano‐Sansano, E., Castillo-Hornero, A., Femenía, R., Roomp, K., & Oliver, N. (2022) · Scientific Reports · doi:10.1038/s41598-022-16628-y · Cited by 23
Loneliness, older people and a proposed social work response
Hagan, R. J. (2020) · Journal of Social Work · doi:10.1177/1468017320927630 · Cited by 26
A latent class analysis of health lifestyles and health outcomes among Chinese older adults
Zhang, L. (2020) · Ageing and Society · doi:10.1017/s0144686x20001063 · Cited by 20
“…as ADL and recurrent falling (see e.g. Peres et al., 2008; Morrow-Howell, 2010; Murtaugh et al., 2010; Peeters et al., 2010; Li et al., 2013; Smith and Victor, 2019); (d) mental health, including physiological wellbeing, depression and cognitive function (see e.g. Wang et al., 2002;…”
BackgroundResultInfluentialVismara, L., Lucarelli, L., & Sechi, C. (2022) · BMC Psychology · doi:10.1186/s40359-022-00767-y · Cited by 20
“Quite a few studies have demonstrated that loneliness has a negative effect on psychological health [50, 62].”
BackgroundBallesio, A., Zagaria, A., Ottaviani, C., Steptoe, A., & Lombardo, C. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105770 · Cited by 21
Sabatini, S., Martyr, A., Hunt, A., Gamble, L. D., Matthews, F. E., Thom, J. M., Jones, R. W., Allan, L. M., Knapp, M. R. J., Quinn, C., et al. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04707-w · Cited by 22
Jing, J., Dahlberg, L., Canter, D. V., & Plater-Zyberk, E. (2024) · Health & Social Care in the Community · doi:10.1155/2024/4172682 · Cited by 27
“Te closer the points were, the more similar their representing places were conceptualised, and vice versa [67].”
BackgroundMethodHong, S., Lee, S., Song, K., Kim, M.-J., Kim, Y., Kim, H., & Kim, H. (2022) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2022.104431 · Cited by 22
Social exclusion and social isolation in later life
Huisman, M. A., & van Tilburg, T. G. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-815970-5.00007-3 · Cited by 21
Sung, P., Lee, J., & Chan, A. W.-M. (2022) · Journal of Aging and Health · doi:10.1177/08982643221137939 · Cited by 21
“Email: pildoosung@gmail.com United Kingdom, Smith and Victor (2019) found six social isolation profiles: (1) no loneliness or disconnectedness; (2) moderate loneliness; (3) living alone; (4) moderate disconnectedness; (5) moderate loneliness, living alone; and (6) high loneliness, moderate disconnectedness (with a hig…”
BackgroundMethodResultInfluentialVolunteering and Depression among Older Adults: An Empirical Analysis Based on CLASS 2018
Wu, Z., Chen, X., Zhang, L., Wang, Y., Leeson, G. W., Chen, G., Baker, J. S., & Yue, G. X.-G. (2023) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2023.024638 · Cited by 20
Han, S. H., Kim, K., & Burr, J. A. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114081 · Cited by 17
Fernández‐Carro, C., & Gumà, J. (2022) · Social Indicators Research · doi:10.1007/s11205-022-02885-x · Cited by 21
“Although research has repeatedly shown that higher education protects against late-life loneliness (Smith & Victor, 2019), the reasons for this association have remained unexplored.”
BackgroundWorry about debt is related to social loneliness in older adults in the Netherlands
Loibl, C., Drost, M., Huisman, M., Suanet, B., de Bruin, W. B., McNair, S., & Summers, B. (2021) · Ageing & Society · doi:10.1017/s0144686x21000325 · Cited by 14
“Both anxiety and depression are associated with loneliness (O’Luanaigh and Lawlor, 2008; Smith and Victor, 2019).”
BackgroundTime- and place-dependent experiences of loneliness in assisted living facilities
Jansson, A. H., Karisto, A., & Pitkälä, K. H. (2019) · Ageing and Society · doi:10.1017/s0144686x19001211 · Cited by 19
“Furthermore, it may be difficult for survey data, on which studies are for the most part based, to provide a sufficiently rich and diverse picture of loneliness (Smith and Victor, 2019).”
BackgroundInfluentialZaccaria, D., Cavalli, S., Masotti, B., da Rocha, C. G., von Gunten, A., & Jopp, D. S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19105940 · Cited by 18
“Consistent with Smith and Victor’s findings [47], this group may be the least at risk of suffering adverse outcomes of social isolation and loneliness (i.”
BackgroundRelationship Status and Well-Being in the Context of the COVID-19 Pandemic
Carotta, C. L., Lavender‐Stott, E. S., Garcia, A. S., & Liu, H. (2022) · Journal of Family Issues · doi:10.1177/0192513x221105242 · Cited by 16
“Although overlapping features exist between loneliness and social isolation, they are separate constructs (Smith & Victor, 2019).”
BackgroundInfluentialFive ways to wellbeing at the zoo: improving human health and connection to nature
Rose, P. E., & Riley, L. M. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1258667 · Cited by 16
“…mental health (Patel et al., 2007; Tiwari, 2023), in part caused by contemporary challenges to living (Jakovljevic et al., 2020) modern ways of communicating and living (Kelly et al., 2018; Smith and Victor, 2019), and a widespread disconnection with nature and the natural world (Gelsthorpe, 2017).”
Forward, C., Khan, H. T. A., & Fox, P. (2020) · Journal of Women & Aging · doi:10.1080/08952841.2020.1788365 · Cited by 17
“In the UK, a third of those aged 80+ years reported they feel lonely on a daily basis (Thomas, 2015) and research have made headlines dubbing Britain the loneliest country in Europe raising concerns regarding the impact this has on individuals’ health (Holt-Lunstad et al., 2015; Orr, 2014; Smith and Victor, 2018).”
Background
Metadata
- Authors
- SMITH, K. J., & VICTOR, C.
- Affiliations
- University of Surrey (GB)
- Brunel University of London (GB)
- Corresponding author
- SMITH, KIMBERLEY J.
- Venue
- Ageing and Society
- Publisher
- Cambridge University Press (CUP)
- Published
- 2018-04-10
- Volume
- 39
- Issue
- 8
- Pages
- 1709-1730
- ISSN
- 0144-686X (ISSN-L)
- 1469-1779
- OpenAlex
- W2785718018
- Cited by
- 337
- References
- 78
- Citations by year
- 2026: 28 · 2025: 34 · 2024: 61 · 2023: 68 · 2022: 46 · 2021: 48 · 2020: 35 · 2019: 14 · 2018: 3
- FWCI
- 26.77
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Ageing and Society (publishedVersion, cc-by)
- Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
- Brunel University Research Archive (BURA) (Brunel University London) (submittedVersion)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Life-span and Life-course Studies › Aging, Elder Care, and Social Issues
- Keywords
- loneliness, social isolation, living alone, typology, older adults, physical health, mental health, social networks, household composition, English Longitudinal Study of Ageing
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