Use of Direct Versus Indirect Approaches to Measure Loneliness in Later Life

Shiovitz-Ezra, Sharon; Ayalon, Liat

doi:10.1177/0164027511423258

Cited by 201Health disparities and outcomesPsychometric Methodologies and TestingAging and Gerontology Research

Use of Direct Versus Indirect Approaches to Measure Loneliness in Later Life

Shiovitz-Ezra, Sharon, Ayalon, Liat·2012·Research on Aging

DOI 10.1177/0164027511423258

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Abstract

The aim of the current investigation was to compare a direct versus an indirect approach for measuring loneliness by comparing the one-item Center for Epidemiologic Studies Depression Scale, representing the direct approach, with the shortened version of the Revised UCLA Loneliness Scale, representing the indirect approach, using approximately 2,000 observations from the 2002 Health and Retirement Study. The authors artificially identified a cut point of ≥6 on the three-item Revised UCLA Loneliness Scale to potentially yield the most similar results to the single-item scale and demonstrate the best sensitivity and specificity. Nonetheless, a high rate of respondents (57%) who reported being lonely on the direct item were classified as not lonely on the indirect scale. Inconsistency between the two approaches was also evident with regard to the associations between loneliness and age, as well as with education. These findings indicate that the different measures of loneliness provide a somewhat different picture of both the prevalence of loneliness and the characteristic of the people who suffer from it.

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Previous research using a sample of individuals aged 50 years and older has revealed differences in prevalence rates of loneliness when using direct vs. indirect measures.
“previous research using a sample of individuals aged 50 years and older has also revealed differences in prevalence rates of loneliness when using direct vs. indirect measures (Shiovitz-Ezra and Ayalon, 2012).”
From Feasibility, acceptability, and preliminary efficacy of an internet-based CBT intervention for loneliness in older adults: A pilot RCT (2024) · cites this paper as Shiovitz-Ezra and Ayalon, 2012
Single-item direct measures of loneliness are likely to underreport loneliness because of the stigma associated with being identified as lonely.
“the use of single-item direct measures is likely to result in underreporting due to the stigma associated with being identified as lonely [9, 10].”
From Loneliness and health in older adults: a mini-review and synthesis (2016) · cites this paper as [9]

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Authors: Shiovitz-Ezra, S., & Ayalon, L.
Affiliations: The Hebrew University of Jerusalem, Jerusalem, Israel
Bar-Ilan University (IL)
ORCID: Ayalon, Liat
Venue: Research on Aging
Publisher: SAGE Publications
Published: 2011-12-14
Volume: 34
Issue: 5
Pages: 572-591
ISSN: 0164-0275 (ISSN-L)
1552-7573
DOI: 10.1177/0164027511423258
OpenAlex: W1981133259
Cited by: 201
References: 55
Citations by year: 2026: 20 · 2025: 29 · 2024: 34 · 2023: 25 · 2022: 24 · 2021: 19 · 2020: 12 · 2019: 12 · 2018: 5 · 2017: 6 · 2016: 6 · 2015: 4 · 2014: 3 · 2013: 2
FWCI: 1.65
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Research on Aging (publishedVersion)
Topics: Social Sciences › Health › Health disparities and outcomes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
Keywords: loneliness, old age, older adults, sensitivity and specificity, prevalence of loneliness

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Use of Direct Versus Indirect Approaches to Measure Loneliness in Later Life

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