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Impact of the COVID-19 Pandemic on Loneliness Among Older Adults

Impact of the COVID-19 Pandemic on Loneliness Among Older Adults BRIEF RESEARCH REPORT published: 30 October 2020 doi: 10.3389/fsoc.2020.590935 Impact of the COVID-19 Pandemic on Loneliness Among Older Adults Alexander Seifert and Benedikt Hassler School of Social Work, Institute for Integration and Participation, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland The COVID-19 pandemic has created a pattern of everyday physical distancing worldwide, particularly for adults aged 65+. Such distancing can evoke subjective feelings of loneliness among older adults, but how this pandemic has influenced that loneliness is not yet known. This study, therefore, explored the association between subjective loneliness and different time phases of the COVID-19 pandemic to explain the pandemic’s impact on loneliness among older adults. The analysis employed a sample of 1,990 community-dwelling older adults aged 65–95 (mean age = 72.74 years; 43% female) in Switzerland. Data collection occurred both before and after Switzerland’s first confirmed COVID-19 case. Regression models allowed the researchers to determine the binary and multivariate effects of different pandemic time phases on loneliness. The descriptive analysis revealed that loneliness increased after the Swiss government recommended physical distancing and slightly decreased after the Federal Council Edited by: Hailay Abrha Gesesew, decided to ease these measures. According to the multivariate analysis, women, Flinders University, Australia lower-income individuals, individuals living alone, individuals with no children, individuals Reviewed by: unsatisfied with their contact with neighbors, and individuals interviewed after the physical Anne Ouma, Umeå University, Sweden distancing recommendations were more likely to report greater loneliness. The results Felismina Rosa Mendes, suggest the pandemic has affected older adults’ subjective evaluations of their subjective University of Evora, Portugal loneliness, and these findings help illustrate the pandemic’s outcomes. *Correspondence: Alexander Seifert Keywords: social isolation, SARS-CoV-2, social contact, Switzerland, older adult, COVID-19, corona alexander.seifert@fhnw.ch Specialty section: INTRODUCTION This article was submitted to Medical Sociology, The current coronavirus disease 2019 (COVID-19) and the governmental recommendations a section of the journal stemming from it have created a pattern of physical distancing worldwide, particularly for adults Frontiers in Sociology aged 65+. Millions of people either have been or remain quarantined in their homes as countries Received: 03 August 2020 have implemented physical distancing measures to contain COVID-19 infections. This social Accepted: 28 September 2020 isolation can lead to feelings of loneliness, which, if prolonged, can be detrimental to mental health Published: 30 October 2020 and well-being (Banerjee and Rai, 2020). Citation: Although previous research has shown that subjective loneliness can be intensified in older Seifert A and Hassler B (2020) Impact adults by negative, stressful situations (Hensley et al., 2012), less is known about the COVID-19 of the COVID-19 Pandemic on pandemic’s influence on loneliness in this population (Vahia et al., 2020). This research, therefore, Loneliness Among Older Adults. investigated differences in loneliness before and during the pandemic to explain COVID-19’s effects Front. Sociol. 5:590935. doi: 10.3389/fsoc.2020.590935 on subjective loneliness among adults aged 65+ in Switzerland. Frontiers in Sociology | www.frontiersin.org 1 October 2020 | Volume 5 | Article 590935 Seifert and Hassler COVID-19 and Loneliness Among Older Adults Theoretical Assumptions • Phase 1 (Jan 27–Mar 6): Start of survey to Federal Council Loneliness is a complex psychosocial concept (Dykstra, 2009). “call for special protection of older adults” (FOPH, 2020a), This study defined loneliness as “the unpleasant experience that (n = 391). occurs when a person’s network of social relations is deficient • Phase 2 (Mar 7–Mar 16): Up to Federal Council declaring an in some important way, either quantitatively or qualitatively” “extraordinary situation” (FOPH, 2020b), (n = 582). (Perlman and Peplau, 1981, p. 31). Loneliness can, therefore, • Phase 3 (Mar 17–Apr 8): Up to Federal Council deciding to gradually ease the shutdown (FOPH, 2020c), (n = 757). be considered the subjective feeling of lacking social contact. Previous research has shown that socially isolated persons are • Phase 4 (Apr 9–May 5): Up to the end of data collection, at a greater risk of loneliness (de Jong Gierveld et al., 2006). (n = 260). However, socially isolated people are not necessarily lonely, and Table 1 describes the sample and subgroups. lonely people are not necessarily socially isolated (Hawkley and Cacioppo, 2010). Where people rest on the subjective loneliness continuum depends on their expectations and current situations Measures (Dykstra, 2009). Subjective loneliness was assessed via a shortened, six-item Age is not a valid predictor of loneliness; nevertheless, version of the (de Jong Gierveld and van Tilburg, 1999) meaningful social contacts are important for healthy aging Loneliness Scale: There are plenty of people I can lean on when (Holmén and Furukawa, 2002). COVID-19 has confronted older I have problems; I often feel rejected; There are many people I can adults, first, with social isolation and, second, with the stress trust completely; I miss the pleasure of the company of others; There of not seeing family or friends and of finding themselves in are enough people I feel close to; I miss having a really close friend. the “at risk group.” Stressful reminders of “being in need” Participants answered the items on a five-point scale (1 = does may produce negative self-perceptions, resulting in loneliness not apply at all, 5 = fully applies). The six items loaded on one (Hwang et al., 2020). factor, with factor loadings from 0.63 to 0.74. Cronbach’s alpha for the scale was 0.783. The mean (M: 1.78, SD: 0.724) of all items was calculated, with higher scores reflecting greater loneliness. Research Aim Time-related subgroups were selected via FOPH media releases, This research investigated the association between subjective as described above. loneliness and different time phases of the pandemic to explain Covariates, evaluated as important loneliness predictors in COVID-19’s impact on subjective loneliness among adults previous research (Vozikaki et al., 2018), included chronological aged 65+. The authors expected that individuals interviewed age in years; sex (0 = male, 1 = female); educational level (1 = after Switzerland’s first governmental recommendations preprimary education, 5 = second state of tertiary education); for maintaining physical distancing would report greater monthly household income (1 = up to 1,200 CHF [Swiss subjective loneliness. francs], 9=over 15,000 CHF); living alone (0 = no, 1 = yes); having children (0 = no, 1 = yes); living in a rural area (0 = no, 1 = yes); and overall subjective satisfaction about contact with neighbors [one item( “How satisfied are you about your MATERIALS AND METHODS contact with your neighbors?”) measured on an 11-point scale Participants (0 = completely dissatisfied, 10 = completely satisfied)]. This study was based on data from a representative survey (Swiss Survey 65+) of 1,990 adults aged 65+ living in Switzerland. Analytical Strategy The survey initially focused on older adults’ resources for maintaining autonomy in their own households; therefore, it First, the Loneliness Scale mean values, divided into the four was not constructed as a pandemic-related survey. Nevertheless, time-related subgroups, were graphically presented to show value data collection occurred both before and after the first confirmed changes. Second, single regression models were calculated to COVID-19 case in Switzerland (February 25, 2020), the first determine the binary effects of all independent variables on confirmed COVID-19-related death in Switzerland (March 5, loneliness. Third, a multiple hierarchical linear regression model 2020), and the Swiss Federal Council’s decision (March 16, was employed to analyze the predictors of loneliness. Missing 2020) to introduce “extraordinary situation” measures for data were excluded. All analyses were conducted using SPSS public protection. 26 software. From January to May 2020, 1,900 people aged 65+ were interviewed using a computer-assisted telephone interview (CATI) approach supplemented by paper-and-pencil surveys. RESULTS The mean age of the sample was 72.74 years (SD: 5.18; age range: 65–95), and 42.8% of respondents were female. Based Table 1 shows the descriptive statistics for the sample and the on media releases from the Swiss Federal Office of Public four subgroups. Figure 1 presents the Loneliness Scale means Health (FOPH) regarding the government’s COVID-19 response, for each time-related sub-group. Loneliness increased from the sample was divided into four subgroups according to the first to third subgroups and decreased from the third to interview date. fourth subgroups. Frontiers in Sociology | www.frontiersin.org 2 October 2020 | Volume 5 | Article 590935 Seifert and Hassler COVID-19 and Loneliness Among Older Adults TABLE 1 | Descriptive characteristics of the sample and subgroups. Parameter Scale Study sample Subgroup 1 [Jan 27 Subgroup 2 [Mar 7 to Subgroup 3 [Mar 17 Subgroup 4 [Apr 9 to (N = 1,990) to Mar 6] (n = 391) Mar 16] (n = 582) to Apr 8] (n = 757) May 5] (n = 260) % or mean % or mean % or mean % or mean % or mean Gender Female 42.8 56.0 33.5 37.1 60.4 Male 57.2 44.0 66.5 62.9 39.6 Age Mean 72.74 74.51 72.10 72.24 72.95 Living alone Yes 26.5 30.7 23.8 27.5 23.3 No 73.5 69.3 76.2 72.5 76.7 Education Mean 2.94 3.18 2.93 2.77 3.04 Income Mean 5.33 5.11 5.56 5.36 5.14 Children Yes 85.6 88.0 85.6 85.1 83.8 No 14.4 12.0 14.4 14.9 16.2 Living area Non-rural 76.7 69.3 78.4 80.2 74.2 Rural 23.3 30.7 21.6 19.8 25.8 Satisfaction about contact Mean 7.90 7.98 7.91 7.74 8.22 with neighbors Loneliness Mean 1.79 1.69 1.78 1.84 1.79 a b c d Age range: 65–95; Education scale (1 = preprimary education, 5 = second state of tertiary education); Income scale (1 = up to 1,200 CHF, 9 = over 15,000 CHF); Satisfaction with contact with neighbors (0 = completely dissatisfied, 10 = completely satisfied); Loneliness scale (1 = low, 5 = high). FIGURE 1 | Differences in loneliness between the four time groups. Table 2 shows the bivariate relationships between the statistically significantly associated with the differences between four subgroups and the covariates with the independent the first subgroup and the third subgroup, revealing that the variable “loneliness.” In the single gross models, loneliness was increase in loneliness was significant for comparing the first Frontiers in Sociology | www.frontiersin.org 3 October 2020 | Volume 5 | Article 590935 Seifert and Hassler COVID-19 and Loneliness Among Older Adults TABLE 2 | Linear Regression analyses with loneliness as dependent variable. Parameter Scale Single gross models Model A: standard Model B: living situation Model C: full model demographics Beta Beta Beta Beta Age 65–95 0.026 0.019 −0.023 −0.008 Gender Female (ref. −0.015 0.003 0.050* 0.059* male) Education 1–5 −0.086*** −0.005 −0.047 −0.036 Income 1–9 −0.180*** −0.183*** −0.064* −0.073** Living alone Yes (ref. no) 0.217*** 0.198*** 0.198*** Children Yes (ref. no) −0.112*** −0.060** −0.059* Rural area Yes (ref. no) −0.029 −0.006 0.002 Satisfaction about contact 0–10 −0.367*** −0.371*** −0.369*** with neighbors Subgroup 2 [Mar 7–Mar 16] (ref. subgroup 1 0.052 0.089** [Jan 27–Mar 6]) Subgroup 3 [Mar 17–Apr 8] (ref. subgroup 1 0.099** 0.095** [Jan 27–Mar 6]) Subgroup 4 [Apr 9–May 5] (ref. subgroup 1 0.044 0.064* [Jan 27–Mar 6]) Model fit F (4, 1638) = 14.811; F (8, 1609) = 52.593; F (11, 1609) = 39.602; 2 2 2 p < 0.001; R = 0.035 p < 0.001; R = 0.208 p < 0.001; R = 0.214 * ** *** Dependent variable: Loneliness scale (scale 1–5); p < 0.05; p < 0.01; p < 0.001. TABLE 3 | Linear Regression Analyses with Loneliness in Comparison with Different Subgroups as Reference. Parameter Model A: ref. subgroup 1 Model B: ref. subgroup 2 Model C: ref. subgroup 3 Model D: ref. subgroup 4 Beta Beta Beta Beta Subgroup 1 [Jan 27–Mar 6] – −0.082** −0.081** −0.079** Subgroup 2 [Mar 7–Mar 16] 0.089** – 0.001 0.004 Subgroup 3 [Mar 17–Apr 8] 0.095** −0.001 – 0.002 Subgroup 4 [Apr 9–May 5] 0.064* −0.003 −0.002 – Model fit F (11,1609) = 39.602; F (11,1609) = 39.602; F (11,1609) = 39.602; F (11,1609) = 39.602; 2 2 2 2 p < 0.001; R = 0.214 p < 0.001; R = 0.214 p < 0.001; R = 0.214 p < 0.001; R = 0.214 Dependent variable: Loneliness scale (scale 1–5); Controlled for: Age, gender, education, income, living alone, children, rural area, and satisfaction about contact with neighbors; * ** *** p < 0.05; p < 0.01; p < 0.001. subgroup to the third subgroup. All covariates, except age, who were interviewed after March 6, 2020, were more likely to gender, and rural area, were statistically significantly associated report greater loneliness. with loneliness. Supplementary analysis addressed potential differential Table 2 also shows the hierarchical linear regression analyses findings with other subgroups as references in the linear for the multivariate predictors of loneliness. In model (A), only regression analysis. Findings from those additional analyses income was a statistically significant loneliness predictor. In confirmed the previous results; only the difference between the model (B), gender, income, living alone, having children, and first time phase and time phases two through four significantly being satisfied about contact with neighbors were statistically predicted loneliness (Table 3). significant loneliness predictors. In the full model (C), subgroups two through four, compared to the first subgroup and the same covariates as in (B), were statistically significant loneliness DISCUSSION predictors. Females, individuals with lower incomes, individuals This study explored the impact of different COVID- living alone, individuals with no children, individuals who were 19-related time phases on subjective loneliness among dissatisfied about their contacts with neighbors, and individuals Frontiers in Sociology | www.frontiersin.org 4 October 2020 | Volume 5 | Article 590935 Seifert and Hassler COVID-19 and Loneliness Among Older Adults adults aged 65+. As the authors hypothesized, loneliness Despite this study’s strengths, several limitations must be was associated with the time periods in which the noted. First, this research focused on Switzerland, so the interviews took place. Individuals interviewed before findings have limited generalizability. Second, the existing data the Federal Council called for the special protection provided only a cross-sectional view. Third, because of the of older adults reported lower loneliness than those study variables’ limited width, the authors could not control for interviewed later. Thus, the results suggest that the other important background factors, such as measurements of pandemic—more specifically, the Federal Council’s call quantity/quality and valuations of social contacts, personality, for the special protection of older adults through physical or attitudes toward COVID-19 governmental restrictions. distancing—affected older adults’ subjective evaluations of Furthermore, those additional variables could help to set the their loneliness. new COVID-19-contextual findings in relation to the existing Subjective loneliness increased between the first and second research literature about subjective loneliness among older and between the second and third subgroups, but it slightly adults. Clearly, further studies with longitudinal designs and decreased, as a possible “normalization” of loneliness, after wider variable ranges are required to examine this topic in the Federal Council called for easing the official COVID- more detail. related restrictions. Other recent studies have also found these up-and-down movements, indicating that loneliness increased DATA AVAILABILITY STATEMENT during the first weeks of the COVID-19 lockdown and decreased thereafter (Buecker et al., 2020; Höglinger et al., The raw data supporting the conclusions of this article will be 2020). However, the present data collection ended on May 5, made available by the authors, without undue reservation. 2020, and, therefore, further research is needed to evaluate future developments. ETHICS STATEMENT Nevertheless, from the available data, it may be assumed that recommendations for older people to maintain physical Ethical review and approval was not required for the study distancing directly or indirectly affected their loneliness— on human participants in accordance with the local legislation probably by (a) limiting social contact opportunities; (b) and institutional requirements. Written informed consent for making older individuals reflect on their social/support participation was not required for this study in accordance with networks, potentially evaluating them as frail; (c) labeling the national legislation and the institutional requirements. older adults as “at risk,” possibly causing them to be shunned; and (d) making older individuals feel lonely AUTHOR CONTRIBUTIONS because society considered them old and frail and, therefore, lonely. All authors listed have made a substantial, direct and intellectual In addition to this time-related effect, loneliness factors contribution to the work, and approved it for publication. known from previous research—being female, having low income, living alone, having no children, and having no FUNDING good contact with neighbors—were also found. COVID-19 has affected subjective loneliness, but this does not eliminate This work was supported by the State Secretariat for Education, existing inequalities. Current research states that, during Research and Innovation (SERI; project number: PgB 2017-2020- a pandemic, woman, and people with low incomes are P-13), by the National Innovation Network Aging in Society likely to be loneliest (Bu et al., 2020). Therefore, existing (AGE-NT), and by the School of Social Work, University of inequalities among older adults should also not be neglected Applied Sciences and Arts Northwestern Switzerland (FHNW). during the pandemic. Though the media often considers older adults as a homogeneous “at risk group,” this study found no age-related association with loneliness. Older adults ACKNOWLEDGMENTS should not be viewed as a homogenous “vulnerable” group, The authors would like to acknowledge and thank the Swiss and undifferentiated, blanket measures that disproportionately exclude older adults are often based on grossly simplified Survey 65+ project team members—Andreas Pfeuffer and Klaus R. Schroeter (Head of the Aging & Living in Place cluster of age stereotypes, which can reproduce age discrimination (Ayalon et al., 2020; Losada-Baltar et al., 2020). AGE-NT and head of the Aging and Social Work research unit at the University of Applied Sciences and Arts Northwestern Furthermore, these results confirmed that not all older adults reported loneliness; those who did should be asked what Switzerland (FHNW))—for their helpful discussion on the first draft of this paper. The authors would also like to thank could help them overcome those feelings. This calls for an individual—instead of a sweeping, group—view of loneliness, the National Innovation Network Aging in Society (AGE- and gerontological social work responses must be tailored to NT: www.age-netzwerk.ch) for its support of the Swiss Survey 65+ project. individual needs (Berg-Weger and Morley, 2020). Frontiers in Sociology | www.frontiersin.org 5 October 2020 | Volume 5 | Article 590935 Seifert and Hassler COVID-19 and Loneliness Among Older Adults REFERENCES Hensley, B., Martin, P., Margrett, J. A., MacDonald, M., Siegler, I. C., and Poon, L. W. (2012). Life events and personality predicting loneliness among Ayalon, L., Chasteen, A., Diehl, M., Levy, B. R., Neupert, S. D., Rothermund, K., centenarians: findings from the Georgia Centenarian Study. J. Psychol. 146, et al. (2020). Aging in times of the COVID-19 pandemic: avoiding ageism and 173–188. doi: 10.1080/00223980.2011.613874 fostering intergenerational solidarity. J. Gerontol. B Psychol. Soc. Sci. gbaa051. Höglinger, M., Moser, A., Carlander, M. J., Hämmig, O., Wieser, S., and Puhan, M. 1–4. doi: 10.1093/geronb/gbaa051 A. (2020). Zeitliche Entwicklung [Development over time]. Available online at: Banerjee, D., and Rai, M. (2020). Social isolation in Covid-19: the impact of https://csm.netlify.app/post/trend/ (accessed September 10, 2020). loneliness. Int. J. Soc. Psychiatry 66, 525–527. doi: 10.1177/0020764020922269 Holmén, K., and Furukawa, H. (2002). Loneliness, health and social network Berg-Weger, M., and Morley, J. E. (2020). Loneliness and social isolation in older among elderly people—a follow-up study. Arch. Gerontol. Geriatr. 35, 261–274. adults during the COVID-19 pandemic: implications for gerontological social doi: 10.1016/S0167-4943(02)00049-3 work. J. Nutr. Health Aging 24, 456–458. doi: 10.1007/s12603-020-1366-8 Hwang, T. J., Rabheru, K., Peisah, C., Reichman, W., and Ikeda, M. (2020). Bu, F., Steptoe, A., and Fancourt, D. (2020). Loneliness during lockdown: Loneliness and social isolation during the COVID-19 pandemic. Int. trajectories and predictors during the COVID-19 pandemic in 35,712 adults Psychogeriatr. 1–4. doi: 10.1017/S1041610220000988 in the UK. medRxiv. doi: 10.1101/2020.05.29.20116657 Losada-Baltar, A., Jiménez-Gonzalo, L., Gallego-Alberto, L., del Sequeros Pedroso- Buecker, S., Horstmann, K. T., Krasko, J., Kritzler, S., Terwiel, S., Kaiser, T., et al. Chaparro, M., Fernandes-Pires, J., and Márquez-González, M. (2020). “We (2020). Changes in daily loneliness during the first four weeks of the Covid-19 are staying at home”: association of self-perceptions of aging, personal lockdown in Germany. PsyArXiv Preprints. doi: 10.31234/osf.io/ytkx9 and family resources, and loneliness with psychological distress during de Jong Gierveld, J., and van Tilburg, T. (1999). Manual of the Loneliness Scale the lock-down period of COVID-19. J. Gerontol. B Psychol. Soc. Sci. 1–7. 1999. Available online at: https://home.fsw.vu.nl/TG.van.Tilburg/manual_ doi: 10.1093/geronb/gbaa048 loneliness_scale_1999.html (accessed September 10, 2020). Perlman, D., and Peplau, L. A. (1981). “Toward a Social Psychology of Loneliness,” de Jong Gierveld, J., van Tilburg, T., and Dykstra, P. A. (2006). “Loneliness in Personal Relationships 3: Personal Relationships in Disorder, eds. R. Gilmour and social isolation,” in Cambridge Handbook of Personal Relationships, eds. and S. Duck (London: Academic Press), 31–43. A. Vangelisti and D. Perlman (Cambridge: Cambridge University Press), Vahia, I. V., Blazer, D. G., Smith, G. S., Karp, J. F., Steffens, D. C., Forester, 485–500. B. P., et al. (2020). COVID-19, mental health and aging: a need for new Dykstra, P. A. (2009). Older adult loneliness: myths and realities. Eur. J. Ageing 6, knowledge to bridge science and service. Am. J. Geriatr. Psychiatry 28, 695–697. 91–100. doi: 10.1007/s10433-009-0110-3 doi: 10.1016/j.jagp.2020.03.007 FOPH (2020a). Coronavirus: Increased Protection of Particularly Vulnerable Vozikaki, M., Papadaki, A., Linardakis, M., and Philalithis, A. (2018). Persons and Evaluation of the Economic Impact. Available online at: https:// Loneliness among older European adults: results from the survey of www.bag.admin.ch/bag/en/home/das-bag/aktuell/medienmitteilungen.msg- health, aging and retirement in Europe. J. Public Health 26, 613–624. id-78381.html (accessed September 10, 2020). doi: 10.1007/s10389-018-0916-6 FOPH (2020b). Coronavirus: Federal Council declares “Extraordinary Situation” and Introduces More Stringent Measures. Available online at: https://www.bag. Conflict of Interest: The authors declare that the research was conducted in the admin.ch/bag/en/home/das-bag/aktuell/medienmitteilungen.msg-id-78454. absence of any commercial or financial relationships that could be construed as a html (accessed September 10, 2020). potential conflict of interest. FOPH (2020c). Coronavirus: Federal Council Extends Measures by a Week and Decides on Gradual Easing. Available online at: https://www.bag.admin.ch/bag/ Copyright © 2020 Seifert and Hassler. This is an open-access article distributed en/home/das-bag/aktuell/medienmitteilungen.msg-id-78744.html (accessed under the terms of the Creative Commons Attribution License (CC BY). The use, September 10, 2020). distribution or reproduction in other forums is permitted, provided the original Hawkley, L. C., and Cacioppo, J. T. (2010). Loneliness matters: a theoretical and author(s) and the copyright owner(s) are credited and that the original publication empirical review of consequences and mechanisms. Ann. Behav. Med. 40, in this journal is cited, in accordance with accepted academic practice. No use, 218–227. doi: 10.1007/s12160-010-9210-8 distribution or reproduction is permitted which does not comply with these terms. Frontiers in Sociology | www.frontiersin.org 6 October 2020 | Volume 5 | Article 590935 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Frontiers in Sociology Pubmed Central

Impact of the COVID-19 Pandemic on Loneliness Among Older Adults

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Abstract

BRIEF RESEARCH REPORT published: 30 October 2020 doi: 10.3389/fsoc.2020.590935 Impact of the COVID-19 Pandemic on Loneliness Among Older Adults Alexander Seifert and Benedikt Hassler School of Social Work, Institute for Integration and Participation, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland The COVID-19 pandemic has created a pattern of everyday physical distancing worldwide, particularly for adults aged 65+. Such distancing can evoke subjective feelings of loneliness among older adults, but how this pandemic has influenced that loneliness is not yet known. This study, therefore, explored the association between subjective loneliness and different time phases of the COVID-19 pandemic to explain the pandemic’s impact on loneliness among older adults. The analysis employed a sample of 1,990 community-dwelling older adults aged 65–95 (mean age = 72.74 years; 43% female) in Switzerland. Data collection occurred both before and after Switzerland’s first confirmed COVID-19 case. Regression models allowed the researchers to determine the binary and multivariate effects of different pandemic time phases on loneliness. The descriptive analysis revealed that loneliness increased after the Swiss government recommended physical distancing and slightly decreased after the Federal Council Edited by: Hailay Abrha Gesesew, decided to ease these measures. According to the multivariate analysis, women, Flinders University, Australia lower-income individuals, individuals living alone, individuals with no children, individuals Reviewed by: unsatisfied with their contact with neighbors, and individuals interviewed after the physical Anne Ouma, Umeå University, Sweden distancing recommendations were more likely to report greater loneliness. The results Felismina Rosa Mendes, suggest the pandemic has affected older adults’ subjective evaluations of their subjective University of Evora, Portugal loneliness, and these findings help illustrate the pandemic’s outcomes. *Correspondence: Alexander Seifert Keywords: social isolation, SARS-CoV-2, social contact, Switzerland, older adult, COVID-19, corona alexander.seifert@fhnw.ch Specialty section: INTRODUCTION This article was submitted to Medical Sociology, The current coronavirus disease 2019 (COVID-19) and the governmental recommendations a section of the journal stemming from it have created a pattern of physical distancing worldwide, particularly for adults Frontiers in Sociology aged 65+. Millions of people either have been or remain quarantined in their homes as countries Received: 03 August 2020 have implemented physical distancing measures to contain COVID-19 infections. This social Accepted: 28 September 2020 isolation can lead to feelings of loneliness, which, if prolonged, can be detrimental to mental health Published: 30 October 2020 and well-being (Banerjee and Rai, 2020). Citation: Although previous research has shown that subjective loneliness can be intensified in older Seifert A and Hassler B (2020) Impact adults by negative, stressful situations (Hensley et al., 2012), less is known about the COVID-19 of the COVID-19 Pandemic on pandemic’s influence on loneliness in this population (Vahia et al., 2020). This research, therefore, Loneliness Among Older Adults. investigated differences in loneliness before and during the pandemic to explain COVID-19’s effects Front. Sociol. 5:590935. doi: 10.3389/fsoc.2020.590935 on subjective loneliness among adults aged 65+ in Switzerland. Frontiers in Sociology | www.frontiersin.org 1 October 2020 | Volume 5 | Article 590935 Seifert and Hassler COVID-19 and Loneliness Among Older Adults Theoretical Assumptions • Phase 1 (Jan 27–Mar 6): Start of survey to Federal Council Loneliness is a complex psychosocial concept (Dykstra, 2009). “call for special protection of older adults” (FOPH, 2020a), This study defined loneliness as “the unpleasant experience that (n = 391). occurs when a person’s network of social relations is deficient • Phase 2 (Mar 7–Mar 16): Up to Federal Council declaring an in some important way, either quantitatively or qualitatively” “extraordinary situation” (FOPH, 2020b), (n = 582). (Perlman and Peplau, 1981, p. 31). Loneliness can, therefore, • Phase 3 (Mar 17–Apr 8): Up to Federal Council deciding to gradually ease the shutdown (FOPH, 2020c), (n = 757). be considered the subjective feeling of lacking social contact. Previous research has shown that socially isolated persons are • Phase 4 (Apr 9–May 5): Up to the end of data collection, at a greater risk of loneliness (de Jong Gierveld et al., 2006). (n = 260). However, socially isolated people are not necessarily lonely, and Table 1 describes the sample and subgroups. lonely people are not necessarily socially isolated (Hawkley and Cacioppo, 2010). Where people rest on the subjective loneliness continuum depends on their expectations and current situations Measures (Dykstra, 2009). Subjective loneliness was assessed via a shortened, six-item Age is not a valid predictor of loneliness; nevertheless, version of the (de Jong Gierveld and van Tilburg, 1999) meaningful social contacts are important for healthy aging Loneliness Scale: There are plenty of people I can lean on when (Holmén and Furukawa, 2002). COVID-19 has confronted older I have problems; I often feel rejected; There are many people I can adults, first, with social isolation and, second, with the stress trust completely; I miss the pleasure of the company of others; There of not seeing family or friends and of finding themselves in are enough people I feel close to; I miss having a really close friend. the “at risk group.” Stressful reminders of “being in need” Participants answered the items on a five-point scale (1 = does may produce negative self-perceptions, resulting in loneliness not apply at all, 5 = fully applies). The six items loaded on one (Hwang et al., 2020). factor, with factor loadings from 0.63 to 0.74. Cronbach’s alpha for the scale was 0.783. The mean (M: 1.78, SD: 0.724) of all items was calculated, with higher scores reflecting greater loneliness. Research Aim Time-related subgroups were selected via FOPH media releases, This research investigated the association between subjective as described above. loneliness and different time phases of the pandemic to explain Covariates, evaluated as important loneliness predictors in COVID-19’s impact on subjective loneliness among adults previous research (Vozikaki et al., 2018), included chronological aged 65+. The authors expected that individuals interviewed age in years; sex (0 = male, 1 = female); educational level (1 = after Switzerland’s first governmental recommendations preprimary education, 5 = second state of tertiary education); for maintaining physical distancing would report greater monthly household income (1 = up to 1,200 CHF [Swiss subjective loneliness. francs], 9=over 15,000 CHF); living alone (0 = no, 1 = yes); having children (0 = no, 1 = yes); living in a rural area (0 = no, 1 = yes); and overall subjective satisfaction about contact with neighbors [one item( “How satisfied are you about your MATERIALS AND METHODS contact with your neighbors?”) measured on an 11-point scale Participants (0 = completely dissatisfied, 10 = completely satisfied)]. This study was based on data from a representative survey (Swiss Survey 65+) of 1,990 adults aged 65+ living in Switzerland. Analytical Strategy The survey initially focused on older adults’ resources for maintaining autonomy in their own households; therefore, it First, the Loneliness Scale mean values, divided into the four was not constructed as a pandemic-related survey. Nevertheless, time-related subgroups, were graphically presented to show value data collection occurred both before and after the first confirmed changes. Second, single regression models were calculated to COVID-19 case in Switzerland (February 25, 2020), the first determine the binary effects of all independent variables on confirmed COVID-19-related death in Switzerland (March 5, loneliness. Third, a multiple hierarchical linear regression model 2020), and the Swiss Federal Council’s decision (March 16, was employed to analyze the predictors of loneliness. Missing 2020) to introduce “extraordinary situation” measures for data were excluded. All analyses were conducted using SPSS public protection. 26 software. From January to May 2020, 1,900 people aged 65+ were interviewed using a computer-assisted telephone interview (CATI) approach supplemented by paper-and-pencil surveys. RESULTS The mean age of the sample was 72.74 years (SD: 5.18; age range: 65–95), and 42.8% of respondents were female. Based Table 1 shows the descriptive statistics for the sample and the on media releases from the Swiss Federal Office of Public four subgroups. Figure 1 presents the Loneliness Scale means Health (FOPH) regarding the government’s COVID-19 response, for each time-related sub-group. Loneliness increased from the sample was divided into four subgroups according to the first to third subgroups and decreased from the third to interview date. fourth subgroups. Frontiers in Sociology | www.frontiersin.org 2 October 2020 | Volume 5 | Article 590935 Seifert and Hassler COVID-19 and Loneliness Among Older Adults TABLE 1 | Descriptive characteristics of the sample and subgroups. Parameter Scale Study sample Subgroup 1 [Jan 27 Subgroup 2 [Mar 7 to Subgroup 3 [Mar 17 Subgroup 4 [Apr 9 to (N = 1,990) to Mar 6] (n = 391) Mar 16] (n = 582) to Apr 8] (n = 757) May 5] (n = 260) % or mean % or mean % or mean % or mean % or mean Gender Female 42.8 56.0 33.5 37.1 60.4 Male 57.2 44.0 66.5 62.9 39.6 Age Mean 72.74 74.51 72.10 72.24 72.95 Living alone Yes 26.5 30.7 23.8 27.5 23.3 No 73.5 69.3 76.2 72.5 76.7 Education Mean 2.94 3.18 2.93 2.77 3.04 Income Mean 5.33 5.11 5.56 5.36 5.14 Children Yes 85.6 88.0 85.6 85.1 83.8 No 14.4 12.0 14.4 14.9 16.2 Living area Non-rural 76.7 69.3 78.4 80.2 74.2 Rural 23.3 30.7 21.6 19.8 25.8 Satisfaction about contact Mean 7.90 7.98 7.91 7.74 8.22 with neighbors Loneliness Mean 1.79 1.69 1.78 1.84 1.79 a b c d Age range: 65–95; Education scale (1 = preprimary education, 5 = second state of tertiary education); Income scale (1 = up to 1,200 CHF, 9 = over 15,000 CHF); Satisfaction with contact with neighbors (0 = completely dissatisfied, 10 = completely satisfied); Loneliness scale (1 = low, 5 = high). FIGURE 1 | Differences in loneliness between the four time groups. Table 2 shows the bivariate relationships between the statistically significantly associated with the differences between four subgroups and the covariates with the independent the first subgroup and the third subgroup, revealing that the variable “loneliness.” In the single gross models, loneliness was increase in loneliness was significant for comparing the first Frontiers in Sociology | www.frontiersin.org 3 October 2020 | Volume 5 | Article 590935 Seifert and Hassler COVID-19 and Loneliness Among Older Adults TABLE 2 | Linear Regression analyses with loneliness as dependent variable. Parameter Scale Single gross models Model A: standard Model B: living situation Model C: full model demographics Beta Beta Beta Beta Age 65–95 0.026 0.019 −0.023 −0.008 Gender Female (ref. −0.015 0.003 0.050* 0.059* male) Education 1–5 −0.086*** −0.005 −0.047 −0.036 Income 1–9 −0.180*** −0.183*** −0.064* −0.073** Living alone Yes (ref. no) 0.217*** 0.198*** 0.198*** Children Yes (ref. no) −0.112*** −0.060** −0.059* Rural area Yes (ref. no) −0.029 −0.006 0.002 Satisfaction about contact 0–10 −0.367*** −0.371*** −0.369*** with neighbors Subgroup 2 [Mar 7–Mar 16] (ref. subgroup 1 0.052 0.089** [Jan 27–Mar 6]) Subgroup 3 [Mar 17–Apr 8] (ref. subgroup 1 0.099** 0.095** [Jan 27–Mar 6]) Subgroup 4 [Apr 9–May 5] (ref. subgroup 1 0.044 0.064* [Jan 27–Mar 6]) Model fit F (4, 1638) = 14.811; F (8, 1609) = 52.593; F (11, 1609) = 39.602; 2 2 2 p < 0.001; R = 0.035 p < 0.001; R = 0.208 p < 0.001; R = 0.214 * ** *** Dependent variable: Loneliness scale (scale 1–5); p < 0.05; p < 0.01; p < 0.001. TABLE 3 | Linear Regression Analyses with Loneliness in Comparison with Different Subgroups as Reference. Parameter Model A: ref. subgroup 1 Model B: ref. subgroup 2 Model C: ref. subgroup 3 Model D: ref. subgroup 4 Beta Beta Beta Beta Subgroup 1 [Jan 27–Mar 6] – −0.082** −0.081** −0.079** Subgroup 2 [Mar 7–Mar 16] 0.089** – 0.001 0.004 Subgroup 3 [Mar 17–Apr 8] 0.095** −0.001 – 0.002 Subgroup 4 [Apr 9–May 5] 0.064* −0.003 −0.002 – Model fit F (11,1609) = 39.602; F (11,1609) = 39.602; F (11,1609) = 39.602; F (11,1609) = 39.602; 2 2 2 2 p < 0.001; R = 0.214 p < 0.001; R = 0.214 p < 0.001; R = 0.214 p < 0.001; R = 0.214 Dependent variable: Loneliness scale (scale 1–5); Controlled for: Age, gender, education, income, living alone, children, rural area, and satisfaction about contact with neighbors; * ** *** p < 0.05; p < 0.01; p < 0.001. subgroup to the third subgroup. All covariates, except age, who were interviewed after March 6, 2020, were more likely to gender, and rural area, were statistically significantly associated report greater loneliness. with loneliness. Supplementary analysis addressed potential differential Table 2 also shows the hierarchical linear regression analyses findings with other subgroups as references in the linear for the multivariate predictors of loneliness. In model (A), only regression analysis. Findings from those additional analyses income was a statistically significant loneliness predictor. In confirmed the previous results; only the difference between the model (B), gender, income, living alone, having children, and first time phase and time phases two through four significantly being satisfied about contact with neighbors were statistically predicted loneliness (Table 3). significant loneliness predictors. In the full model (C), subgroups two through four, compared to the first subgroup and the same covariates as in (B), were statistically significant loneliness DISCUSSION predictors. Females, individuals with lower incomes, individuals This study explored the impact of different COVID- living alone, individuals with no children, individuals who were 19-related time phases on subjective loneliness among dissatisfied about their contacts with neighbors, and individuals Frontiers in Sociology | www.frontiersin.org 4 October 2020 | Volume 5 | Article 590935 Seifert and Hassler COVID-19 and Loneliness Among Older Adults adults aged 65+. As the authors hypothesized, loneliness Despite this study’s strengths, several limitations must be was associated with the time periods in which the noted. First, this research focused on Switzerland, so the interviews took place. Individuals interviewed before findings have limited generalizability. Second, the existing data the Federal Council called for the special protection provided only a cross-sectional view. Third, because of the of older adults reported lower loneliness than those study variables’ limited width, the authors could not control for interviewed later. Thus, the results suggest that the other important background factors, such as measurements of pandemic—more specifically, the Federal Council’s call quantity/quality and valuations of social contacts, personality, for the special protection of older adults through physical or attitudes toward COVID-19 governmental restrictions. distancing—affected older adults’ subjective evaluations of Furthermore, those additional variables could help to set the their loneliness. new COVID-19-contextual findings in relation to the existing Subjective loneliness increased between the first and second research literature about subjective loneliness among older and between the second and third subgroups, but it slightly adults. Clearly, further studies with longitudinal designs and decreased, as a possible “normalization” of loneliness, after wider variable ranges are required to examine this topic in the Federal Council called for easing the official COVID- more detail. related restrictions. Other recent studies have also found these up-and-down movements, indicating that loneliness increased DATA AVAILABILITY STATEMENT during the first weeks of the COVID-19 lockdown and decreased thereafter (Buecker et al., 2020; Höglinger et al., The raw data supporting the conclusions of this article will be 2020). However, the present data collection ended on May 5, made available by the authors, without undue reservation. 2020, and, therefore, further research is needed to evaluate future developments. ETHICS STATEMENT Nevertheless, from the available data, it may be assumed that recommendations for older people to maintain physical Ethical review and approval was not required for the study distancing directly or indirectly affected their loneliness— on human participants in accordance with the local legislation probably by (a) limiting social contact opportunities; (b) and institutional requirements. Written informed consent for making older individuals reflect on their social/support participation was not required for this study in accordance with networks, potentially evaluating them as frail; (c) labeling the national legislation and the institutional requirements. older adults as “at risk,” possibly causing them to be shunned; and (d) making older individuals feel lonely AUTHOR CONTRIBUTIONS because society considered them old and frail and, therefore, lonely. All authors listed have made a substantial, direct and intellectual In addition to this time-related effect, loneliness factors contribution to the work, and approved it for publication. known from previous research—being female, having low income, living alone, having no children, and having no FUNDING good contact with neighbors—were also found. COVID-19 has affected subjective loneliness, but this does not eliminate This work was supported by the State Secretariat for Education, existing inequalities. Current research states that, during Research and Innovation (SERI; project number: PgB 2017-2020- a pandemic, woman, and people with low incomes are P-13), by the National Innovation Network Aging in Society likely to be loneliest (Bu et al., 2020). Therefore, existing (AGE-NT), and by the School of Social Work, University of inequalities among older adults should also not be neglected Applied Sciences and Arts Northwestern Switzerland (FHNW). during the pandemic. Though the media often considers older adults as a homogeneous “at risk group,” this study found no age-related association with loneliness. Older adults ACKNOWLEDGMENTS should not be viewed as a homogenous “vulnerable” group, The authors would like to acknowledge and thank the Swiss and undifferentiated, blanket measures that disproportionately exclude older adults are often based on grossly simplified Survey 65+ project team members—Andreas Pfeuffer and Klaus R. Schroeter (Head of the Aging & Living in Place cluster of age stereotypes, which can reproduce age discrimination (Ayalon et al., 2020; Losada-Baltar et al., 2020). AGE-NT and head of the Aging and Social Work research unit at the University of Applied Sciences and Arts Northwestern Furthermore, these results confirmed that not all older adults reported loneliness; those who did should be asked what Switzerland (FHNW))—for their helpful discussion on the first draft of this paper. The authors would also like to thank could help them overcome those feelings. This calls for an individual—instead of a sweeping, group—view of loneliness, the National Innovation Network Aging in Society (AGE- and gerontological social work responses must be tailored to NT: www.age-netzwerk.ch) for its support of the Swiss Survey 65+ project. individual needs (Berg-Weger and Morley, 2020). Frontiers in Sociology | www.frontiersin.org 5 October 2020 | Volume 5 | Article 590935 Seifert and Hassler COVID-19 and Loneliness Among Older Adults REFERENCES Hensley, B., Martin, P., Margrett, J. A., MacDonald, M., Siegler, I. C., and Poon, L. W. (2012). Life events and personality predicting loneliness among Ayalon, L., Chasteen, A., Diehl, M., Levy, B. R., Neupert, S. D., Rothermund, K., centenarians: findings from the Georgia Centenarian Study. J. Psychol. 146, et al. (2020). Aging in times of the COVID-19 pandemic: avoiding ageism and 173–188. doi: 10.1080/00223980.2011.613874 fostering intergenerational solidarity. J. Gerontol. B Psychol. Soc. Sci. gbaa051. Höglinger, M., Moser, A., Carlander, M. J., Hämmig, O., Wieser, S., and Puhan, M. 1–4. doi: 10.1093/geronb/gbaa051 A. (2020). Zeitliche Entwicklung [Development over time]. Available online at: Banerjee, D., and Rai, M. (2020). Social isolation in Covid-19: the impact of https://csm.netlify.app/post/trend/ (accessed September 10, 2020). loneliness. Int. J. Soc. Psychiatry 66, 525–527. doi: 10.1177/0020764020922269 Holmén, K., and Furukawa, H. (2002). Loneliness, health and social network Berg-Weger, M., and Morley, J. E. (2020). Loneliness and social isolation in older among elderly people—a follow-up study. Arch. Gerontol. Geriatr. 35, 261–274. adults during the COVID-19 pandemic: implications for gerontological social doi: 10.1016/S0167-4943(02)00049-3 work. J. Nutr. Health Aging 24, 456–458. doi: 10.1007/s12603-020-1366-8 Hwang, T. J., Rabheru, K., Peisah, C., Reichman, W., and Ikeda, M. (2020). Bu, F., Steptoe, A., and Fancourt, D. (2020). Loneliness during lockdown: Loneliness and social isolation during the COVID-19 pandemic. Int. trajectories and predictors during the COVID-19 pandemic in 35,712 adults Psychogeriatr. 1–4. doi: 10.1017/S1041610220000988 in the UK. medRxiv. doi: 10.1101/2020.05.29.20116657 Losada-Baltar, A., Jiménez-Gonzalo, L., Gallego-Alberto, L., del Sequeros Pedroso- Buecker, S., Horstmann, K. T., Krasko, J., Kritzler, S., Terwiel, S., Kaiser, T., et al. Chaparro, M., Fernandes-Pires, J., and Márquez-González, M. (2020). “We (2020). Changes in daily loneliness during the first four weeks of the Covid-19 are staying at home”: association of self-perceptions of aging, personal lockdown in Germany. PsyArXiv Preprints. doi: 10.31234/osf.io/ytkx9 and family resources, and loneliness with psychological distress during de Jong Gierveld, J., and van Tilburg, T. (1999). Manual of the Loneliness Scale the lock-down period of COVID-19. J. Gerontol. B Psychol. Soc. Sci. 1–7. 1999. Available online at: https://home.fsw.vu.nl/TG.van.Tilburg/manual_ doi: 10.1093/geronb/gbaa048 loneliness_scale_1999.html (accessed September 10, 2020). Perlman, D., and Peplau, L. A. (1981). “Toward a Social Psychology of Loneliness,” de Jong Gierveld, J., van Tilburg, T., and Dykstra, P. A. (2006). “Loneliness in Personal Relationships 3: Personal Relationships in Disorder, eds. R. Gilmour and social isolation,” in Cambridge Handbook of Personal Relationships, eds. and S. Duck (London: Academic Press), 31–43. A. Vangelisti and D. Perlman (Cambridge: Cambridge University Press), Vahia, I. V., Blazer, D. G., Smith, G. S., Karp, J. F., Steffens, D. C., Forester, 485–500. B. P., et al. (2020). COVID-19, mental health and aging: a need for new Dykstra, P. A. (2009). Older adult loneliness: myths and realities. Eur. J. Ageing 6, knowledge to bridge science and service. Am. J. Geriatr. Psychiatry 28, 695–697. 91–100. doi: 10.1007/s10433-009-0110-3 doi: 10.1016/j.jagp.2020.03.007 FOPH (2020a). Coronavirus: Increased Protection of Particularly Vulnerable Vozikaki, M., Papadaki, A., Linardakis, M., and Philalithis, A. (2018). Persons and Evaluation of the Economic Impact. Available online at: https:// Loneliness among older European adults: results from the survey of www.bag.admin.ch/bag/en/home/das-bag/aktuell/medienmitteilungen.msg- health, aging and retirement in Europe. J. Public Health 26, 613–624. id-78381.html (accessed September 10, 2020). doi: 10.1007/s10389-018-0916-6 FOPH (2020b). Coronavirus: Federal Council declares “Extraordinary Situation” and Introduces More Stringent Measures. Available online at: https://www.bag. Conflict of Interest: The authors declare that the research was conducted in the admin.ch/bag/en/home/das-bag/aktuell/medienmitteilungen.msg-id-78454. absence of any commercial or financial relationships that could be construed as a html (accessed September 10, 2020). potential conflict of interest. FOPH (2020c). Coronavirus: Federal Council Extends Measures by a Week and Decides on Gradual Easing. Available online at: https://www.bag.admin.ch/bag/ Copyright © 2020 Seifert and Hassler. This is an open-access article distributed en/home/das-bag/aktuell/medienmitteilungen.msg-id-78744.html (accessed under the terms of the Creative Commons Attribution License (CC BY). The use, September 10, 2020). distribution or reproduction in other forums is permitted, provided the original Hawkley, L. C., and Cacioppo, J. T. (2010). Loneliness matters: a theoretical and author(s) and the copyright owner(s) are credited and that the original publication empirical review of consequences and mechanisms. Ann. Behav. Med. 40, in this journal is cited, in accordance with accepted academic practice. No use, 218–227. doi: 10.1007/s12160-010-9210-8 distribution or reproduction is permitted which does not comply with these terms. Frontiers in Sociology | www.frontiersin.org 6 October 2020 | Volume 5 | Article 590935

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