Psycho-social and health predictors of loneliness in older primary care patients and mediating mechanisms linking comorbidities and loneliness

Ljiljana Majnarić Trtica; Mile Volarić; Tomislav Kurevija; Silvio Mihaljević; Zdravka Krivdić Dupan; Thomas Wittlinger

doi:10.1186/s12877-023-04436-6

Psycho-social and health predictors of loneliness in older primary care patients and mediating mechanisms linking comorbidities and loneliness

BMC Geriatr. 2023 Dec 4;23(1):801. doi: 10.1186/s12877-023-04436-6.

Authors

Ljiljana Majnarić Trtica¹, Mile Volarić^{2

3}, Tomislav Kurevija¹, Silvio Mihaljević⁴, Zdravka Krivdić Dupan⁵, Thomas Wittlinger⁶

Affiliations

¹ Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia.
² Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia.
³ School of Medicine, University of Mostar, University Hospital Mostar, Mostar, Bosnia and Herzegovina.
⁴ Department of Internal Medicine and the History of Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia.
⁵ Department of Radiology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia.
⁶ Department of Cardiology, Asklepios Hospital, 38642, Goslar, Germany. dr.wittlinger@gmx.de.

Abstract

Background: Aging is associated with many personal, social, and environmental challenges that increase the risk of loneliness. Loneliness is a painful emotional experience associated with a perceived lack of connection and intimacy. Loneliness accelerates health deterioration, but the presence of chronic health conditions (comorbidities) in older individuals may potentiate the feeling of loneliness. The relationships between health status and loneliness in older individuals have not been assessed in an integrated manner, although it is necessary for planning efficient interventions. The aim of this study was to fill in this knowledge gap, by attempting to create an integrated model of loneliness in older individuals.

Methods: The sample consisted of 189 (58% F) older individuals (> 60 years) (mean ± SD, 78.47 ± 6.65), attendees in Primary Health Care. Different factors associated with loneliness in the older population were assessed, and classified as demographic, environmental, physical (health-related), and psychological, in addition to functional abilities. A set of standard questionnaires was used to assess psychological factors and functional abilities. The hierarchical regression model assessed the effect of particular blocks of factors on status loneliness. The second aim was to analyze how psychological factors mediate associations between health status (comorbidity level) and loneliness.

Results: Indicated that increasing comorbidity, anxiety, lack of positive moods, not having hobbies/activities, low perception of social support, impaired cognitive function, and suppression of emotion expression, are significant predictors of loneliness. Mediation analysis informed us of how to help patients with comorbidities feel less lonely. Interventions that were suggested were those that can reduce anxiety and depression, improve cognitive abilities and emotional regulation control, and enhance social support.

Conclusions: Results can help understand the pathophysiology loops linking poor health status (comorbidity level) of older individuals and loneliness, and have significant potentials from the translational perspectives, as a decision-support tool.

Keywords: Aging; Comorbidities; Integrated research approach; Interventions; Loneliness; Psychological factors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aging* / psychology
Comorbidity
Humans
Loneliness* / psychology
Pain
Primary Health Care

Grants and funding

IP2 - 2021 and IP-29-2023/Sveučilište Josipa Jurja Strossmayera u Osijeku