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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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“Similarly, the construct of loneliness, social support or co-habitation may share common aspects, but can also be theoretically di ff erent (Smith & Victor, 2018).”
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“…outcomes including increased risk of cardiovascular disease, hypertension, stroke, cognitive decline, depression, and premature mortality (Desai et al., 2020; Evans et al., 2019; Holt-Lunstad et al., 2015; Jensen et al., 2019; Pantell et al., 2013; Smith & Victor, 2019; Valtorta et al., 2016).”
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“Moreover, a longitudinal study by Smith and Victor (2019) demonstrated that loneliness predicted a decline in self-perceived health over time, emphasizing the long-term consequences of loneliness on health perceptions (Smith & Victor, 2019).”
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“This concerned primarily old age (Toepoel, 2013; Havens et al., 2004; Savikko et al., 2005; De Koning, Stathi and Richards, 2017; Smith and Victor, 2019) and, to a lesser extent, adolescence (Rokach and Neto, 2000; Yang and Victor, 2011).”
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“Living alone has been unhelpfully conflated with social isolation which is a distinct but related issue [4].”
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“…allocation (Shinkai, 2000); at the individual level, living alone may be associated with one’s loneliness, anxiety, social isolation, unhealthy lifestyles, and many other psychological and physical problems (Chen and Short, 2008; Liu et al., 2021; Raymo, 2015; Smith and Victor, 2019; Snell, 2017).”
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“Moreover, a study from the ELSA grouped social isolation and loneliness into six types based on a living arrangement, loneliness, and social isolation using cluster analysis [13].”
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“As it stands, there is no universal definition of social isolation, but most scholars tend to agree that it involves objectively low social support and/or few social contacts, whereas loneliness is typically described as a subjective feeling (Smith & Victor, 2018; Victor et al., 2000).”
BackgroundLoneliness, Parenting Stress, and the Buffering Effect of Social Connectedness
Garcia, A. S., Lavender‐Stott, E. S., Carotta, C. L., Liu, H., Nguyen, V. O., & Timm-Davis, N. (2024) · The Family Journal · doi:10.1177/10664807241251433 · Cited by 10
“In fact, there is only a moderate association between loneliness and social isolation, and a mix of evidence of the relationship across the domains (Smith & Victor, 2019).”
InfluentialBean, M., McLaren, S., & Kinkead, R. (2024) · Clinical Gerontologist · doi:10.1080/07317115.2024.2349678 · Cited by 5
“Thwarted belongingness (Guidry & Cukrowicz, 2016; Mournet et al., 2020) and associated constructs such as loneliness, social isolation (Smith & Victor, 2019), and low levels of sense of belonging (McLaren, 2020) have been associated with depressive symptoms among older adults.”
Braig, S., Denkinger, M. D., Dallmeier, D., Klenk, J., Rothenbacher, D., & for the ActiFE Study Group (2025) · Aging Clinical and Experimental Research · doi:10.1007/s40520-025-03041-4 · Cited by 6
“Also, the study of Smith and Victor for example where the authors compared associations between different types of lonely/isolated participants and physical/mental health outcomes pointed in the same direction [50].”
Perceived need for treatment for mental disorders: A review and critical evaluation
Kazdin, A. E. (2025) · Clinical Psychology Review · doi:10.1016/j.cpr.2025.102591 · Cited by 5
A Short-Form Measure of Loneliness to Predict Depression Symptoms Among Adolescents
Kyron, M. J., Houghton, S. J., Lawrence, D. M., Page, A. C., Hunter, S. C., & Gunasekera, S. (2022) · Child Psychiatry & Human Development · doi:10.1007/s10578-022-01370-3 · Cited by 7
Ojembe, B. U., Kapiriri, L., Griffin, M., & Schormans, A. F. (2023) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980823000594 · Cited by 5
Exploring the human consequences of crisis in the hospitality sector: a study from India
Abas, B., Srikanth, V., Bukhari, S., & Fayaz, I. (2024) · IIMT Journal of Management · doi:10.1108/iimtjm-08-2023-0003 · Cited by 5
de Menezes-Júnior, L. A. A., de Moura, S. S., Machado-Coelho, G. L. L., & Meireles, A. L. (2025) · Scientific Reports · doi:10.1038/s41598-025-98004-0 · Cited by 7
“In addition, anxiety and depression can decrease self-esteem, self-efficacy, motivation, and hope, as well as increase pessimism, social isolation, and psychological distress, leading to a negative perception of health 35 .”
Fox‐Harding, C., Harris, S. A., Rogers, S., Vial, S., Beranek, P., Turner, M., & Cruickshank, T. M. (2021) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2021.624267 · Cited by 5
“Additionally, Australia had shorter lockdown periods, therefore limiting inperson physical distancing and social isolation, which are known to adversely impact on mental health and coping mechanisms (Smith and Victor, 2019; Usher et al., 2020).”
BackgroundGroarke, J. M., McKeown, L., McKenna-Plumley, P. E., & Graham‐Wisener, L. (2024) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2023.2298082 · Cited by 5
“Living alone is often included as an indicator of isolation (Klinenberg, 2016; Smith & Victor, 2019) and has been found to be a predictor of loneliness at all ages (Hawkley et al., 2022).”
Wosko, P., Pfabigan, J., Trukeschitz, B., Reitinger, E., Pichler, B., & Pleschberger, S. (2024) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbae008 · Cited by 5
“In the Global North, living alone in old age, which means not having anyone else residing in the same household (Smith & Victor, 2018), is quite a common phenomenon in the 21st century.”
BackgroundBogart, K. V., Harrington, E. E., Witzel, D. D., Kang, J. E., Sliwinski, M. J., Engeland, C. G., & Graham‐Engeland, J. E. (2024) · Aging & Mental Health · doi:10.1080/13607863.2024.2368643 · Cited by 7
“…discrepancy between desired and actual social relationships (Peplau & Perlman, 1982), loneliness is distinct from objective social isolation (Smith & Victor, 2019) and often predicts health outcomes separately from objective measures of social isolation (Cacioppo et al. 2015; O’Súilleabháin…”
Deslauriers, V., & Levasseur, M. (2025) · Journal of Aging and Health · doi:10.1177/08982643241311632 · Cited by 5
“Coherent with a recent call for a holistic approach to social networks (Smith & Victor, 2019), such typology should use structural, that is, an objective assessment, and functional, that is, social support, actual or perceived, indicators (Holt-Lunstad, 2018).”
La soledad y el aislamiento social en las personas mayores
Vicente-Arruebarrena, A., & Cabaco, A. S. (2021) · Stvdia zamorensia · doi:10.5944/studiazamo.vol.19.2020.29363 · Cited by 5
Living Alone and Feelings of Depression Among Adults Ages 18 and older
Mykyta, L. (2023) · doi:10.15620/cdc:136451 · Cited by 5
Sandy, P. A., Borim, F. S. A., de Assumpção, D., & Neri, A. L. (2025) · Aging & Mental Health · doi:10.1080/13607863.2025.2452940 · Cited by 4
“Each cluster had distinct demographic, health, and psychosocial characteristics, consistent with previous research (Barnes et al., 2022; Hsu, 2020; Menec et al., 2019; Smith & Victor, 2019).”
InfluentialWhat Does “Living Alone” Mean? Exploring the Practices of Solo-Living
Karakayalı, N., & Azizoglu, C. (2025) · Sociological Quarterly · doi:10.1080/00380253.2024.2444255 · Cited by 5
“…however, many researchers have noted that living alone, social isolation, and feelings of loneliness do not necessarily interact with each other in a linear manner (Russell 2009; Smith and Victor 2019; Victor et al. 2000; see also: De Jong Gierveld and Van Tilburg 2016; Valtorta and Hanratty 2012).”
Johannessen, L. E. F., Engebretsen, E., Greenhalgh, T., Hughes, G., Köhler-Olsen, J., Rasmussen, E. B., & Haldar, M. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-047157 · Cited by 4
Smith, L., Morris-Eyton, H., Noorbhai, H., & Coopoo, Y. (2021) · African Health Sciences · doi:10.4314/ahs.v21i3.39 · Cited by 3
Pasqualini, M., Solé-Auró, A., & Arpino, B. (2022) · Ageing and Society · doi:10.1017/s0144686x22001040 · Cited by 4
“…a partner has recently received considerable attention for its consequences for an individual ’ s health and wellbeing (Djundeva et al ., 2019; Smith and Victor, 2019; Quashie et al ., 2021), the channels through which the absence of kin might affect an individual ’ s outcomes are still…”
Wannachot, W., Phukrongpet, P., Rattanasuteerakul, K., & Daovisan, H. (2023) · International Journal of Human Rights in Healthcare · doi:10.1108/ijhrh-09-2022-0096 · Cited by 4
Leskovar, V. Ž., & Klemenčič, V. S. (2023) · Journal of Housing and the Built Environment · doi:10.1007/s10901-023-10093-3 · Cited by 4
“Older adults who experience lone-liness and/or isolation are more likely to experience poor physical and mental health (Smith & Victor, 2018).”
Bobowik, P. Ż., Gajewski, J., Wiszomirska, I., Maciejewska, A., Leźnicka, K., & Kaczmarczyk, K. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13102747 · Cited by 3
“Many studies have shown that social isolation is related to physical health, from immune responses (e.g., increased pro-inflammatory activity) to clinical responses (e.g., increased risk of coronary heart disease and stroke) [36,37].”
BackgroundDo doctors appreciate that social isolation and loneliness are health issues?
LAWLOR, B. A., O’Sullivan, R., Leavey, G., & Lubben, J. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1477228 · Cited by 7
Gonçalves, N. C. D. A., dos Santos, R., Miyazaki, M. C. D. O. S., dos Santos, L. L., André, J. C., & Castiglioni, L. (2021) · Psicología Conocimiento y Sociedad · doi:10.26864/pcs.v11.n3.2 · Cited by 4
Tsuda, S., Inagaki, H., Sugiyama, M., Okamura, T., Miyamae, F., Ura, C., Edahiro, A., & Awata, S. (2023) · Health & Social Care in the Community · doi:10.1155/2023/7183821 · Cited by 4
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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