title: Changes in social engagement and depression predict incident loneliness among seriously ill home care clients.
abstract: ABSTRACTObjective:This study identified the predictors of incident loneliness in a group of seriously ill older adults (aged 65+) receiving home care.
  
  
  
  Existing data collected with the Resident Assessment Instrument for Home Care (RAI-HC) were utilized. A cohort of clients (N = 2,499) with two RAI-HC assessments and no self-reported loneliness at time 1 were included. Self-reported loneliness, upon reassessment, was the outcome of interest. Clients with a prognosis of less than six months or severe health instability were included.
  
  
  
  The average length of time between assessments was 5.9 months (standard deviation = 4.10). During that time, 7.8% (n = 181) of the sample developed loneliness. In a multivariate regression model, worsening symptoms of depression, a decline in social activities, and not living with a primary caregiver all increased the risk of loneliness.
  
  
  
  These results highlight how changes in psychosocial factors over time can contribute to loneliness, which can inform clinicians as they seek to identify those who may be at risk for loneliness.
authors.affiliation: Institute of Medical Science,Faculty of Medicine,University of Toronto,Toronto,Ontario,Canada.
authors.forename: Samantha
authors.initials: S
authors.lastname: Fernandes
authors.affiliation: Department of Kinesiology and Physical Education,Wilfrid Laurier University,Waterloo,Ontario,Canada.
authors.forename: Jacob G S
authors.initials: JGS
authors.lastname: Davidson
authors.affiliation: Department of Kinesiology and Physical Education,Wilfrid Laurier University,Waterloo,Ontario,Canada.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Guthrie
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008132:Loneliness / Q000523:psychology*; D008297:Male; D009864:Ontario; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D012934:Social Isolation / Q000523:psychology*
keywords: Home care; Loneliness; Older adults; Palliative care; RAI–HC