Loneliness among older adults in Latin America, China, and India: prevalence, correlates and association with mortality

Abstract BackgroundResearch carried out in high income countries suggests that loneliness may be a common experience among older adults living in these settings. Loneliness is correlated with poor socioeconomic status, living alone, being widowed and is associated with adverse health outcomes, including mortality. There is still a lack of evidence about the epidemiology of loneliness among older adults living in low- and middle-income countries. This study was designed to explore prevalence and correlates of self-reported loneliness and to investigate whether loneliness predicts mortality in Latin America, China and India. MethodsThe study investigated population-based cross-sectional (2003-2007) and longitudinal surveys (follow-up 2007-2010) from the 10/66 Dementia Research Group project carried out among 16685 older adults in urban and rural catchment areas in Cuba, Dominican Republic, Puerto Rico, Venezuela, Peru, Mexico, China and India. Poisson regression and Cox regression analyses were conducted to analyse correlates of loneliness and its association with mortality. ResultsThe standardised prevalence of loneliness varied between 25.3% and 32.4% in Latin America and was 18.3% in India. China showed a low prevalence of loneliness (3.8%). In pooled meta-analyses, there was robust evidence to support an association between loneliness and mortality across Latin America (HR=1.13, 95% CI 1.01-1.26, I2=10.1%) and China (HR=1.58, 95% CI 1.03-2.41), but there were no associations in India. ConclusionsOur findings suggest potential cultural variances may exist in the concept of loneliness in older age. The effect of loneliness upon mortality is consistent across different cultural settings excluding India. Loneliness should therefore be considered as a potential dimension of public health among older populations.