Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-22T18:11:29.920Z Has data issue: false hasContentIssue false
  • English
  • Français

“Being all alone makes me sad”: loneliness in older adults with depressive symptoms

Published online by Cambridge University Press:  09 April 2014

Ilse M. J. van Beljouw ,
Eric van Exel ,
Jenny de Jong Gierveld ,
Hannie C. Comijs ,
Marjolijn Heerings ,
Max L. Stek  and
Harm W. J. van Marwijk
Ilse M. J. van Beljouw
Affiliation:
Department of Psychiatry, VU University Medical Center / GGZ inGeest and EMGO+ Institute for Health and Care Research, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
Eric van Exel*
Affiliation:
Department of Psychiatry, VU University Medical Center / GGZ inGeest and EMGO+ Institute for Health and Care Research, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
Jenny de Jong Gierveld
Affiliation:
Netherlands Interdisciplinary Demographic Institute (NIDI), P.O. Box 11650, 2502 AR, The Hague, the Netherlands
Hannie C. Comijs
Affiliation:
Department of Psychiatry, VU University Medical Center / GGZ inGeest and EMGO+ Institute for Health and Care Research, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
Marjolijn Heerings
Affiliation:
Department of Psychiatry, VU University Medical Center / GGZ inGeest and EMGO+ Institute for Health and Care Research, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
Max L. Stek
Affiliation:
Department of Psychiatry, VU University Medical Center / GGZ inGeest and EMGO+ Institute for Health and Care Research, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands
Harm W. J. van Marwijk
Affiliation:
Department of General Practice, VU University Medical Center and EMGO+ Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
*
Correspondence should be addressed to: E. van Exel, Department of Psychiatry, VU University Medical Center/GGZ inGeest and EMGO+ Institute for Health and Care Research, A.J. Ernststraat 1187, 1081 HL Amsterdam, the Netherlands. Phone: +0031 20 788 45 35. Email: [email protected].
Get access

Abstract

Background:

The consequences of co-occurring persistent loneliness and late life depression are yet unknown. The aim of this study was to get a deeper insight into the mental health consequences of loneliness in older persons with depressive symptoms and their perspectives of emotional distress by using a mixed-methods study design.

Methods:

Two hundred and forty nine community-dwelling older persons with depressive symptoms according to the Patient Health Questionnaire-9 (≥6) were included. A validated cut-off score on the Loneliness Scale was used to distinguish lonely elders from elders who were not lonely. Quantitative and qualitative data were used to examine differences in mental health and perspectives on emotional distress between lonely and not lonely older persons with depressive symptoms.

Results:

Loneliness was highly prevalent among older persons with depressive symptoms (87.8%). Lonely people suffered from worse mental ill-health (e.g., more severe depressive symptoms, more often a depressive disorder and a lower quality of life) compared to not lonely individuals. Depressive symptoms were regarded as a logical consequence of loneliness. Lonely people perceived little command over their situation: causes of loneliness were attributed externally to perceived deficits in their social networks and they mainly expressed the need to be listened to.

Conclusion:

Our findings underline the importance of paying considerable attention to (severe) loneliness in older adults with depressive symptoms given its high prevalence and serious mental health consequences. Future studies should look into whether addressing loneliness when discussing depressive symptoms in clinical practice may provide an opportunity to better adjust to older persons’ depression perceptions and might therefore improve care utilization.

Keywords

ageddepressionlonelinesshealth knowledgeattitudespracticequalitative research
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 9 , September 2014 , pp. 1541 - 1551
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, K. B., Sanders, S. and Auth, E. A. (2004). Loneliness and depression in independent living retirement communities: risk and resilience factors. Aging & Mental Health, 8, 475–485.Google Scholar
Alpass, F. M. and Neville, S. (2003). Loneliness, health and depression in older males. Aging & Mental Health, 7, 212–216.Google Scholar
Barbour, R. S. (2001). Checklists for improving rigour in qualitative research: a case of the tail wagging the dog? British Medical Journal, 322, 1115–1117.CrossRefGoogle ScholarPubMed
Barg, F. K., Huss-Ashmore, R., Wittink, M. N., Murray, G. F., Bogner, H. R. and Gallo, J. J. (2006). A mixed-methods approach to understanding loneliness and depression in older adults. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 61, S329–339.Google Scholar
Cacioppo, J. T. et al. (2006a). Loneliness within a nomological net: an evolutionary perspective. Journal of Research in Personality, 40, 1054–1085.Google Scholar
Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C. and Thisted, R. A. (2006b). Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychological and Aging, 21, 140–151.CrossRefGoogle ScholarPubMed
Cacioppo, J. T., Hawkley, L. C. and Thisted, R. A. (2010). Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychological Aging, 25, 453–463.Google Scholar
Cantril, H. (1966). The Pattern of Human Concerns. New Brunswick: Rutgers University Press.Google Scholar
Cohen-Mansfield, J. and Parpura-Gill, A. (2007). Loneliness in older persons: a theoretical model and empirical findings. International Psychogeriatriatrics, 19, 279–294.Google Scholar
De Jong-Gierveld, J. and Kamphuis, F. (1985). The development of a Rasch-type loneliness scale. Applied Psychological Measurement, 9, 289–299.CrossRefGoogle Scholar
de Jong Gierveld, J. and Havens, B. (2004). Cross-national comparisons of social isolation and loneliness: introduction and overview. Canadian Journal of Aging, 23, 109–113.Google Scholar
Heikkinen, R. L. and Kauppinen, M. (2004). Depressive symptoms in late life: a 10-year follow-up. Archives of Gerontology and Geriatrics, 38, 239–250.Google Scholar
Holwerda, T. J. et al. (2012). Increased risk of mortality associated with social isolation in older men: only when feeling lonely? Results from the Amsterdam Study of the Elderly (AMSTEL). Psychological Medicine, 42, 843–853.CrossRefGoogle ScholarPubMed
Kirkevold, M., Moyle, W., Wilkinson, C., Meyer, J. and Hauge, S. (2013). Facing the challenge of adapting to a life ‘alone’ in old age: the influence of losses. Journal of Advanced Nursing, 69, 394–403.Google Scholar
Luanaigh, C. O. and Lawlor, B. A. (2008). Loneliness and the health of older people. Intermational .Journal of Geriatric Psychiatry, 23, 1213–1221.Google Scholar
McInnis, G. J. and White, J. H. (2001). A phenomenological exploration of loneliness in the older adult. Archives of Psychiatric Nursing, 15, 128–139.CrossRefGoogle ScholarPubMed
Peplau, L. A. and Perlman, D. (eds.) (1982). Loneliness, a Sourcebook of Current Theory, Research and Therapy. New York: Wiley.Google Scholar
Sheehan, D. V. et al. (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59 (Suppl 20), 22–33.Google ScholarPubMed
Smith, J. M. (2012). Toward a better understanding of loneliness in community-dwelling older adults. Journal of Psychology, 146, 293–311.Google Scholar
Spitzer, R. L., Kroenke, K. and Williams, J. B. (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. Journal of the American Medical Association, 282, 1737–1744.CrossRefGoogle ScholarPubMed
Stek, M. L., Vinkers, D. J., Gussekloo, J., Beekman, A. T. F., van der Mast, R. C. and Westendorp, R. G. J. (2005). Is depression in old age fatal only when people feel lonely? American Journal of Psychiatry, 162, 178–180.Google Scholar
Strauss, A. and Corbin, J. (1990). Basics of Qualitative Research. Grounded Theory Procedures and Techniques. London: Sage.Google Scholar
Tong, A., Sainsbury, P. and Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal of Qualilty of Health Care, 19, 349–357.CrossRefGoogle ScholarPubMed
van Beljouw, I. M. J. et al. (submitted). Pulling out all the stops: What motivates 65+ year-olds with depressive symptoms to participate in an outreaching personalised intervention program? Ageing and Mental Health.Google Scholar
van Tilburg, T. G. and de Jong Gierveld, J. (1999). Cesuurbepaling van de eenzaamheidsschaal (Cutting scores on the De Jong Gierveld Loneliness Scale). Tijdschrift voor Gerontologie en Geriatrie, 30, 158–163.Google Scholar
Ware, J. E. J. and Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473–483.Google Scholar
Wilson, R. S. et al. (2007). Loneliness and risk of Alzheimer disease. Archives of General Psychiatry, 64, 234–240.Google Scholar