Long-term development of loneliness in older people and associations with stringency of COVID-19 measures: an observational cohort study

Abstract

Background: Most longitudinal studies found heightened feelings of loneliness in older people in spring 2020 compared to times before the pandemic. However, longer-term effects are more disputed. We, therefore, investigated changes in loneliness in older people throughout the first 21 months of the COVID-19 pandemic in Switzerland and examined the association between the stringency of COVID-19 measures and feelings of loneliness.

Methods: We assessed loneliness (3-item University of California Los Angeles (UCLA) loneliness scale) in a nationally representative longitudinal observational online survey. Older people (65-79 years) were surveyed between March 2020 and December 2021. Proportions of people feeling lonely (UCLA loneliness scale >6) were compared in two stringent phases ('lockdown', Oxford University stringency index ≥55) and two less restricted phases. Additionally, we explored the situation of potentially more susceptible subgroups (living alone, women, chronic and mental diseases, low educational level and low income).

Results: Phases with stringent measures were associated with higher levels of loneliness in older people. People living alone, women, people with noncommunicable or mental disease diagnoses and lower income show consistently higher levels of loneliness. However, the differences are not accentuated in phases with more stringent measures. We found little differences between subgroups with varying educational levels.

Conclusions: Even in a country with relatively less stringent COVID-19 measures like Switzerland, an increase in the proportion of older people that feel lonely could be found during phases with more stringent COVID-19 measures. Lockdown phases should, therefore, be accompanied by evidence-based interventions to relieve loneliness to avoid adverse short- and long-term consequences.

Keywords: longitudinal study; older people; pandemic; social isolation; vulnerable subgroups.

Figure 1

UCLA loneliness scale over the first 21 months of the pandemic and Oxford University stringency index. Phases I and III: more stringent: Oxford University stringency index: ≥55; phases II and IV: less stringent: Oxford University stringency index: <55. The blue dashed line shows the values of the Oxford University stringency index; the purple line with shorter dashes shows the Oxford University stringency index cut-off point of 55.

Figure 2

High feelings of loneliness (UCLA loneliness scale >6) in four phases with more versus less stringent measures. Phases I and III: more stringent: Oxford University stringency index: ≥55; phases II and IV: less stringent: Oxford University stringency index: <55.

Figure 3

High feelings of loneliness (UCLA loneliness scale >6) according to the four phases of more versus less stringent measures by subgroups. Phases I and III: more stringent: Oxford University stringency index: ≥55; phases II and IV: less stringent: Oxford University stringency index: <55.