Lonely in a crowd: Overcoming loneliness with acceptance and wisdom

"Loneliness rivals smoking and obesity in its impact on shortening longevity," said senior author Dilip V. Jeste, MD, senior associate dean for the Center of Healthy Aging and Distinguished Professor of Psychiatry and Neurosciences at UC San Diego School of Medicine. "It is a growing public health concern, and it's important that we identify the underlying causes of loneliness from the seniors' own perspectives so we can help resolve it and improve the overall health, well-being and longevity of our aging population."

Jeste noted that there are few published qualitative studies about loneliness among older adults in the independent living sector of senior housing communities, where shared common areas, planned social outings and communal activities are intended to promote socialization and reduce isolation. "So why are many older adults living in this type of housing still experiencing strong feelings of loneliness?" asked Jeste.

The new study, published online in the January 10, 2020 issue of Aging and Mental Health, found that people's experience of living with loneliness is shaped by a number of personal and environmental factors.

Researchers conducted one-and-a-half-hour individual interviews of 30 adults ages 67 to 92, part of an overall study evaluating the physical, mental and cognitive functions of 100 older adults living in the independent living sector of a senior housing community in San Diego.

In this communal setting, 85 percent of the residents reported moderate to severe levels of loneliness. "Loneliness is subjective," said Jeste. "Different people feel lonely for different reasons despite having opportunities and resources for socialization. This is not a one size fits all topic."

Three main themes emerged from the study:

• Age-associated losses and inadequate social skills were considered to be primary risk factors for loneliness. "Some residents talked about the loss of spouses, siblings and friends as the cause of their loneliness. Others mentioned how making new friends in a senior community cannot replace deceased friends they grew up with," said first author Alejandra Paredes, PhD, a research fellow in the Department of Psychiatry at UC San Diego School of Medicine.
• The feeling of loneliness was frequently associated with a lack of purpose in life. "We heard powerful comments like, 'It's kind of gray and incarcerating,'" said Jeste. "Others expressed a sense of 'not being attached, not having very much meaning and not feeling very hopeful' or 'being lost and not having control.'"
• The research team also found that wisdom, including compassion, seemed to be a factor that prevented loneliness. "One participant spoke of a technique she had used for years, saying 'if you're feeling lonely, then go out and do something for somebody else.' That's proactive," said Jeste. Other protective factors were acceptance of aging and comfort with being alone. "One resident told us, 'I've accepted the aging process. I'm not afraid of it. I used to climb mountains. I want to keep moving, even if I have to crawl. I have to be realistic about getting older, but I consider and accept life as a transition,'" Jeste noted. "Another resident responded, 'I may feel alone, but that doesn't mean I'm lonely. I'm proud I can live by myself.'"

According to the National Center for Health Statistics, by 2029, more than 20 percent of the United States population will be over the age of 65. "It is paramount that we address the well-being of our seniors -- they are friends, parents and grandparents of the younger generations," said Jeste. "Our study is relevant to better understand loneliness within senior housing and other settings to so we can develop effective interventions."