Social and Mental Health Factors Involved in the Severity of Loneliness in Older Individuals in a Spanish Rural Area

Abstract

Background: Loneliness in older people, especially those living in rural areas, is a phenomenon that has received little attention in research and can have detrimental effects on quality of life. The aim of this study was to evaluate loneliness and the psychosocial factors associated with loneliness in rural Spain, which have been minimally studied. Methods: A cross-sectional study was carried out in a sample of permanently resident older people in the Rincón de Ademuz region (Valencia, Spain), a geographic area with very low population density. Emotional and social loneliness were assessed using the de Jong Gierveld Loneliness Scale. We also assessed whether loneliness is associated with sleep quality, depressive symptoms, and autonomy in basic and instrumental activities of daily living. Results: A total of 108 community-dwelling individuals aged 65 years and older participated in the study out of a total sample of 181. Of them, 30.6% experienced feelings of moderate loneliness, while 2.8% presented severe loneliness. A significant correlation was found between loneliness and age (Rho = 0.28, p = 0.003). Significant differences were also observed between emotional loneliness and gender (p = 0.03) but not between social loneliness and the total score on the de Jong Gierveld Scale. Men experienced more emotional loneliness than women. In the multivariate analyses, significant associations were found between the degree of loneliness and having sons/daughters (p = 0.03; odds ratio [OR] = 0.24; 95% CI 0.06-0.89) and the role of caring for a dependent person (p = 0.002; odds ratio [OR] = 0.05; 95% CI 0.009-0.36) but not living with sons/daughters or the presence of grandchildren. Conclusions: There is a high prevalence of loneliness among older people living in rural areas, which is associated with some social factors. Therefore, nursing care plans should include assessments and interventions to prevent or detect and address loneliness in older people. This study was retrospectively registered in ClinicalTrials on 24 April 2024 with registration number NCT06382181.

Keywords: loneliness; nursing care plans; older people; rural area; social factors.

Figure 1

Relationships between age and emotional (A), social (B), and total (C) loneliness on the de Jong Gierveld Loneliness Scale.

Figure 2

Emotional loneliness scores in men and women. An asterisk indicates a significant difference between the two groups.

Figure 3

Total loneliness scores in male and female caregivers of dependent people. An asterisk indicates a significant difference between the two groups.