Influencing factors of loneliness among older adults in China: a systematic review and meta-analysis
Abstract
China has a large and rapidly growing older population. Loneliness is associated with a range of negative health outcomes in older adults. However, to date, there is still a lack of comprehensive and systematic evidence on the factors influencing loneliness among older adults in China. Nine Chinese and English databases were searched by computer from inception to March 2022: China Knowledge Network, WanFang Data, Chinese Scientific Journal Database, SinoMed, PubMed, Embase, Web of Science, PsycINFO, and Cochrane Library. Studies on factors influencing loneliness among older adults in China were included. Two reviewers independently completed the literature screening, quality evaluation, and data extraction, and statistical analyses were performed using Review Manager 5.4 software. A total of 15 studies were included in the review, with 47 066 participants in total. Fifty-nine influencing factors of loneliness in older Chinese were involved. Twenty factors with a total of 30 subfactors that were involved in two or more studies and with extractable data were included in the data synthesis. Eleven subfactors were not statistically significantly associated with loneliness, namely, male, female, lower age, higher education level, health status-fair, health status-poor, social support-none/low, no health insurance, smoking, alcohol consumption, and body mass index-overweight and above (all P > 0.05), while the remaining 19 subfactors (concerning 15 factors) were significantly associated with loneliness in older adults in China (all P < 0.05). This study suggested that age, education level, marital status, living arrangement, having (no) children, receiving family support, relationship with family members, being with or without chronic diseases, health status, activities of daily living, social support, social activities, financial status, satisfaction with housing conditions, and the decision-making right for major household expenditures were the main influencing factors of loneliness among older adults in China.
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This study did not find a significant association between having no children and loneliness.
“this study did not find a significant association”
From Factors associated with loneliness in a national study among persons 80 years and older in India in 2017-2018 (2025) · cites this paper as [38]
In a systematic review on correlates of loneliness among older adults in China, having no children was identified as being associated with loneliness.
“In a systematic review on correlates of loneliness among older adults in China, having no children was identified as being associated with loneliness [38]”
From Factors associated with loneliness in a national study among persons 80 years and older in India in 2017-2018 (2025) · cites this paper as [38]
Cites
The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · BMJ · doi:10.1136/bmj.n71 · Cited by 108,283 · see citing works
World health statistics 2016 : monitoring health for the SDGs, sustainable development goals
de la Salud, O. M. (2016) · Virtual Defense Library (Ministerio de Defensa) · Cited by 3,358 · see citing works
Valtorta, N. K., Kanaan, M., Gilbody, S., Ronzi, S., & Hanratty, B. (2016) · Heart · doi:10.1136/heartjnl-2015-308790 · Cited by 1,971 · see citing works
Loneliness: human nature and the need for social connection
(2008) · Choice Reviews Online · doi:10.5860/choice.46-1765 · Cited by 1,572 · see citing works
Social isolation, loneliness and health in old age: a scoping review
Courtin, E., & Knapp, M. (2017) · Health & Social Care in the Community · doi:10.1111/hsc.12311 · Cited by 1,463 · see citing works
Influences on Loneliness in Older Adults: A Meta-Analysis
Pinquart, M., & Sorensen, S. (2001) · Basic and Applied Social Psychology · doi:10.1207/s15324834basp2304_2 · Cited by 1,036 · see citing works
Pittman, M., & Reich, B. (2016) · Computers in Human Behavior · doi:10.1016/j.chb.2016.03.084 · Cited by 907 · see citing works
Loneliness around the world: age, gender, and cultural differences in loneliness
Barreto, M., Victor, C., Hammond, C., Eccles, A., Richins, M. T., & Qualter, P. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2020.110066 · Cited by 828 · see citing works
Chudasama, Y., Gillies, C. L., Zaccardi, F., Coles, B., Davies, M. J., Seidu, S., & Khunti, K. K. (2020) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2020.06.042 · Cited by 639 · see citing works
VICTOR, C. R., SCAMBLER, S. J., BOWLING, A., & BOND, J. (2005) · Ageing and Society · doi:10.1017/s0144686x04003332 · Cited by 572 · see citing works
Lee, S. L., Pearce, E., Ajnakina, O., Johnson, S., Lewis, G., Mann, F., Pitman, A., Solmi, F., Sommerlad, A., Steptoe, A., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30383-7 · Cited by 545 · see citing works
A systematic review of longitudinal risk factors for loneliness in older adults
Dahlberg, L., McKee, K., Frank, A., & Naseer, M. (2021) · Aging & Mental Health · doi:10.1080/13607863.2021.1876638 · Cited by 539 · see citing works
How the COVID-19 pandemic is focusing attention on loneliness and social isolation
Smith, B., & Lim, M. (2020) · Public Health Research and Practice · doi:10.17061/phrp3022008 · Cited by 460 · see citing works
Gender differences in loneliness across the lifespan: a meta-analysis
Maes, M., Qualter, P., Vanhalst, J., Van den Noortgate, W., & Goossens, L. (2019) · European Journal of Personality · doi:10.1002/per.2220 · Cited by 405 · see citing works
Loneliness Is Associated with Sleep Fragmentation in a Communal Society
Kurina, L. M., Knutson, K. L., Hawkley, L. C., Cacioppo, J. T., Lauderdale, D. S., & Ober, C. (2011) · SLEEP · doi:10.5665/sleep.1390 · Cited by 236 · see citing works
The Neurobiology of Social Distance
Bzdok, D., & Dunbar, R. (2020) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2020.05.016 · Cited by 234 · see citing works
Prenatal Social Support, Postnatal Social Support, and Postpartum Depression
Xie, R., He, G., Koszycki, D., WALKER, M. C., & Wen, S. W. (2009) · Annals of Epidemiology · doi:10.1016/j.annepidem.2009.03.008 · Cited by 233 · see citing works
Living Alone, Loneliness, and Psychological Well-Being of Older Persons in Singapore
Lim, L. L., & Kua, E. H. (2011) · Current Gerontology and Geriatrics Research · doi:10.1155/2011/673181 · Cited by 200 · see citing works
Risk factors for loneliness in adulthood and old age--a meta-analysis.
Pinquart, M., & Sörensen, S. (2003) · Cited by 179 · see citing works
Adapting Maslow's Hierarchy of Needs as a Framework for Resident Wellness
Hale, A. J., Ricotta, D. N., Freed, J., Smith, C. C., & Huang, G. C. (2019) · Teaching and Learning in Medicine · doi:10.1080/10401334.2018.1456928 · Cited by 174 · see citing works
Gierveld, J. D. J., & van Tilburg, T. G. (1999) · Journal of Cross-Cultural Gerontology · doi:10.1023/a:1006600825693 · Cited by 159 · see citing works
Salinas, J., Beiser, A. S., Samra, J. K., O'Donnell, A., DeCarli, C. S., Gonzales, M. M., Aparicio, H. J., & Seshadri, S. (2022) · Neurology · doi:10.1212/wnl.0000000000200039 · Cited by 127 · see citing works
Associations of loneliness with risk of Alzheimer's disease dementia in the Framingham Heart Study
Akhter‐Khan, S. C., Tao, Q., Ang, T. F. A., Itchapurapu, I. S., Alosco, M. L., Mez, J., Piers, R. J., Steffens, D. C., Au, R., & Qiu, W. Q. (2021) · Alzheimer's & Dementia · doi:10.1002/alz.12327 · Cited by 126 · see citing works
Social Embeddedness and Late-Life Parenthood
Wenger, G. C., Dykstra, P. A., Melkas, T., & Knipscheer, K. (2007) · Journal of Family Issues · doi:10.1177/0192513x07303895 · Cited by 125 · see citing works
Loneliness and type 2 diabetes incidence: findings from the English Longitudinal Study of Ageing
Hackett, R. A., Hudson, J. L., & Chilcot, J. (2020) · Diabetologia · doi:10.1007/s00125-020-05258-6 · Cited by 108 · see citing works
Correlates of loneliness in older adults in Shanghai, China: does age matter?
Yang, F., Zhang, J., & Wang, J. (2018) · BMC Geriatrics · doi:10.1186/s12877-018-0994-x · Cited by 81 · see citing works
Verstraten, P. F. J., Brinkmann, W. L. J. H., STEVENS, N. L., et al. (2005) · International Congress Series · doi:10.1016/j.ics.2005.04.017 · Cited by 79 · see citing works
The Concise Dictionary of Psychology
Statt, D. A. (2002) · Routledge eBooks · doi:10.4324/9780203450529 · Cited by 78 · see citing works
Zhang, J., Xu, L., Li, J., Sun, L., Ding, G., Qin, W., Wang, Q., Zhu, J., Yu, Z., & Xie, S. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15071468 · Cited by 77 · see citing works
Loneliness in Chinese older adults in primary care: prevalence and correlates
Zhong, B., Liu, X., Chen, W., Chiu, H. F. K., & Conwell, Y. (2018) · Psychogeriatrics · doi:10.1111/psyg.12325 · Cited by 73 · see citing works
Tian, X., Jin, Y., Chen, H., Tang, L. L., & Herrera, M. (2021) · Asia-Pacific Journal of Oncology Nursing · doi:10.4103/apjon.apjon_59_20 · Cited by 71 · see citing works
Bai, Z., Wang, Z., Shao, T., Qin, X., & Hu, Z. (2021) · BMC Geriatrics · doi:10.1186/s12877-020-01973-2 · Cited by 65 · see citing works
Self-citationLoneliness 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
Jia, G., & Yuan, P. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01554-3 · Cited by 46 · see citing works
Risk Factors for Loneliness in Elderly Adults
Emerson, K. G., & Jayawardhana, J. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14053 · Cited by 33 · see citing works
Present Situation of the Empty Nest Elderly’s Mental Health and Research Commentary
Muxue, L. U., & Guo, C. (2013) · Advances in Psychological Science · doi:10.3724/sp.j.1042.2013.00263 · Cited by 13 · see citing works
Loneliness is associated with higher risk of stroke and heart disease, study finds
Mayor, S. (2016) · BMJ · doi:10.1136/bmj.i2269 · Cited by 3 · see citing works
The epidemiologic studies on loneliness among elderly:A review
Zhou, L. (2012) · Zhongguo xinli weisheng zazhi · Cited by 2 · see citing works
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Pengpid, S., Peltzer, K., Hajek, A., & Gyasi, R. M. (2025) · International Psychogeriatrics · doi:10.1016/j.inpsyc.2024.100019 · Cited by 8 · see citing works
- Authors
- Zuo, S., Lin, L., Chen, S., Wang, Z., Tian, L., Li, H., & Xu, Y.
- Affiliations
- Soochow University (CN)
- School of Nursing Suzhou Medical College of Soochow University Suzhou China
- Venue
- Psychogeriatrics
- Publisher
- Wiley
- Published
- 2022-10-21
- Volume
- 23
- Issue
- 1
- Pages
- 164-176
- ISSN
- 1346-3500 (ISSN-L)
- 1479-8301
- OpenAlex
- W4307024067
- Cited by
- 36
- References
- 38
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 12 · 2023: 2
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychogeriatrics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Humanities and Social Sciences Youth Foundation, Ministry of Education of the People's Republic of China (20YJCZH088)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Health Sciences › Health Professions › General Health Professions › Aging, Elder Care, and Social Issues
- Keywords
- loneliness, older adults, risk factors, social support, marital status, living arrangements, family support, chronic disease, health status, activities of daily living, social activity, financial conditions, housing conditions, China
- MeSH terms
- Activities of Daily Living, Aged, China, Female, Health Status, Humans, Loneliness, Male, Social Support
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