title: Correlates and predictors of loneliness in older-adults: a review of quantitative results informed by qualitative insights.
abstract: BACKGROUND
  Older persons are particularly vulnerable to loneliness because of common age-related changes and losses. This paper reviews predictors of loneliness in the older population as described in the current literature and a small qualitative study.
  
  
  METHODS
  Peer-reviewed journal articles were identified from psycINFO, MEDLINE, and Google Scholar from 2000-2012. Overall, 38 articles were reviewed. Two focus groups were conducted asking older participants about the causes of loneliness.
  
  
  RESULTS
  Variables significantly associated with loneliness in older adults were: female gender, non-married status, older age, poor income, lower educational level, living alone, low quality of social relationships, poor self-reported health, and poor functional status. Psychological attributes associated with loneliness included poor mental health, low self-efficacy beliefs, negative life events, and cognitive deficits. These associations were mainly studied in cross-sectional studies. In the focus groups, participants mentioned environmental barriers, unsafe neighborhoods, migration patterns, inaccessible housing, and inadequate resources for socializing. Other issues raised in the focus groups were the relationship between loneliness and boredom and inactivity, the role of recent losses of family and friends, as well as mental health issues, such as shame and fear.
  
  
  CONCLUSIONS
  Future quantitative studies are needed to examine the impact of physical and social environments on loneliness in this population. It is important to better map the multiple factors and ways by which they impact loneliness to develop better solutions for public policy, city, and environmental planning, and individually based interventions. This effort should be viewed as a public health priority.
authors.affiliation: Department of Health Promotion,School of Public Health,Sackler Faculty of Medicine,Tel Aviv University,Tel Aviv,Israel.
authors.forename: Jiska
authors.initials: J
authors.lastname: Cohen-Mansfield
authors.affiliation: Herczeg Institute on Aging,Tel Aviv University,Tel Aviv,Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Hazan
authors.affiliation: Geriatric Division,Tel-Aviv Medical Center,Tel-Aviv,Israel.
authors.forename: Yaffa
authors.initials: Y
authors.lastname: Lerman
authors.affiliation: The Counseling Services Division for The Elderly,National Insurance Institute of Israel.
authors.forename: Vera
authors.initials: V
authors.lastname: Shalom
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D008132:Loneliness / Q000523:psychology*; D008297:Male; D017533:Marital Status; D009043:Motor Activity; D036301:Qualitative Research; D011788:Quality of Life; D012111:Residence Characteristics; D012737:Sex Factors; D012931:Social Environment; D012934:Social Isolation / Q000523:psychology*; D012959:Socioeconomic Factors
keywords: aging; literature review; loneliness risk factors; mental health; qualitative research