Loneliness among older adults in the community during COVID-19: a cross-sectional survey in Canada

  1. Rachel D Savage
  2. Wei Wu
  3. Joyce Li
  4. Andrea Lawson
  5. Susan E Bronskill
  6. Stephanie A Chamberlain
  7. Jim Grieve
  8. Andrea Gruneir
  9. Christina Reppas-Rindlisbacher
  10. Nathan M Stall
  11. Paula A Rochon

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Abstract

Physical distancing and stay-at-home measures implemented to slow transmission of novel coronavirus disease (COVID-19) may intensify feelings of loneliness in older adults, especially those living alone. Our aim was to characterise the extent of loneliness during the first wave in a sample of older adults living in the community and assess characteristics associated with loneliness.

Design

Online cross-sectional survey between 6 May and 19 May 2020.

Setting

Ontario, Canada.

Participants

Convenience sample of members of a national retired educators’ organisation.

Primary outcome measures

Self-reported loneliness, including differences between women and men.

Results

4879 respondents (71.0% women; 67.4% 65–79 years) reported that in the preceding week, 43.1% felt lonely at least some of the time, including 8.3% who felt lonely always or often. Women had increased odds of loneliness compared with men, whether living alone (adjusted OR (aOR) 1.52, 95% CI 1.13 to 2.04) or with others (2.44, 95% CI 2.04 to 2.92). Increasing age group decreased the odds of loneliness (aOR 0.69 (95% CI 0.59 to 0.81) 65–79 years and 0.50 (95% CI 0.39 to 0.65) 80+ years compared with <65 years). Living alone was associated with loneliness, with a greater association in men (aOR 4.26, 95% CI 3.15 to 5.76) than women (aOR 2.65, 95% CI 2.26 to 3.11). Other factors associated with loneliness included: fair or poor health (aOR 1.93, 95% CI 1.54 to 2.41), being a caregiver (aOR 1.18, 95% CI 1.02 to 1.37), receiving care (aOR 1.47, 95% CI 1.19 to 1.81), high concern for the pandemic (aOR 1.55, 95% CI 1.31 to 1.84), not experiencing positive effects of pandemic distancing measures (aOR 1.94, 95% CI 1.62 to 2.32) and changes to daily routine (aOR 2.81, 95% CI 1.96 to 4.03).

Conclusions

While many older adults reported feeling lonely during COVID-19, several characteristics—such as being female and living alone—increased the odds of loneliness. These characteristics may help identify priorities for targeting interventions to reduce loneliness.

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  1. Version published to 10.1136/bmjopen-2020-044517
  2. ScreenIT

    SciScore for 10.1101/2020.11.23.20237289: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: 23 The Research Ethics Board at Women’s College Hospital in Toronto, Canada approved this study [#2020-0051-E].
    Consent: A link to a study information sheet was provided on the survey’s home page and informed consent was obtained electronically.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableTo identify predictors of loneliness for older women and men, exploratory analyses using sex-stratified and sex-pooled multivariable logistic regression models were conducted.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: Our study leveraged a strong community-based partnership to obtain timely data from a large sample of older Canadians on the impacts of COVID-19. Analyses were exploratory and intended to identify characteristics and circumstances associated with loneliness to help target supports to those who could benefit from them. A limitation is that the data are based on a convenience sample of retired, educational staff, who are not fully representative of the Canadian population. The perspectives of vulnerable groups who may be at greater risk for loneliness (e.g. those with severe mental health illness, low income, no home internet access, etc.) are likely underrepresented in this sample. As such, our findings may be a conservative estimate of loneliness. Conclusions: While many older adults reported feeling lonely during COVID-19, several characteristics – in particular being female and living alone – increased the odds of loneliness. These characteristics may help guide targeting interventions to reduce loneliness as the pandemic persists.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.11.23.20237289v1 on medRxiv