Esther Cabrera, Meritxell Puyané, Marc Terradellas, Esther Limón, Ester Mateo, Enric Camón, Carme Planas, Rosario Delgado, Chaimae Lamrani, Carolina Chabrera
Overall, 18.6% of participants reported moderate or severe loneliness. In crude analyses, loneliness was more frequent among women living alone, with lower income, weaker community belonging, greater social vulnerability, depressive symptoms, frailty, poorer physical performance, higher fall risk, and lower quality-of-life scores. In the fully adjusted model, living alone remained associated with higher loneliness prevalence (adjusted prevalence ratio 1.99, 95% confidence interval 1.13-3.50). Depressive symptoms showed the strongest associations, with adjusted prevalence ratios of 3.59 (95% confidence interval 2.27-5.68) for mild symptoms and 5.37 (95% confidence interval 2.72-10.61) for moderate symptoms, while other domains were not independently associated.
INTRODUCTION: Loneliness in older women is a major public health concern in ageing societies and a key determinant of healthy ageing. Despite its multidimensional nature, evidence on the relative contribution of social, health, and individual factors remains limited, particularly from a gender perspective.
METHODS: A cross-sectional population-based study was conducted in Catalonia using random sampling from the municipal census. Data were collected through face-to-face home interviews with 511 women. Loneliness was assessed with the 10-item Spanish version of the UCLA Loneliness Scale and analyzed as a binary outcome (moderate/severe vs. low or no loneliness). Explanatory variables were grouped into sociodemographic, social, clinical, functional, and quality-of-life domains. Crude and adjusted prevalence ratios were estimated using Poisson regression with robust variance.
RESULTS: Overall, 18.6% of participants reported moderate or severe loneliness. In crude analyses, loneliness was more frequent among women living alone, with lower income, weaker community belonging, greater social vulnerability, depressive symptoms, frailty, poorer physical performance, higher fall risk, and lower quality-of-life scores. In the fully adjusted model, living alone remained associated with higher loneliness prevalence (adjusted prevalence ratio 1.99, 95% confidence interval 1.13-3.50). Depressive symptoms showed the strongest associations, with adjusted prevalence ratios of 3.59 (95% confidence interval 2.27-5.68) for mild symptoms and 5.37 (95% confidence interval 2.72-10.61) for moderate symptoms, while other domains were not independently associated.
DISCUSSION: These findings suggest that emotional and social factors, particularly depressive symptoms and living alone, showed the strongest independent associations with loneliness among older women. These results provide evidence to inform the development of targeted and gender-sensitive strategies to prevent and address loneliness in later life.