Persistent loneliness due to COVID-19 over 18 months of the pandemic: A prospective cohort study

Ashwin A. Kotwal*, Stephanie Batio, Michael S. Wolf, Kenneth E. Covinsky, Julia Yoshino Benavente, Carla M. Perissinotto, Rachel M. O'Conor

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background: Loneliness was common early in the COVID-19 pandemic due to physical distancing measures, but little is known about how loneliness persisted into later stages of the pandemic. We therefore examined longitudinal trajectories of loneliness over 18 months of the pandemic and subgroups at risk for persistent loneliness. Methods: We used data from the COVID-19 & Chronic Conditions study collected between March 27, 2020 to December 10, 2021, including 641 predominantly older adults with ≥1 chronic condition who completed six interviews at approximately 3 month intervals. Participants reported loneliness (defined as some, most, or all of the time) during the past week due to COVID-19. We used trajectory mixture models to identify clusters of individuals following similar trajectories of loneliness, then determined subgroups likely to be classified in different loneliness trajectories using multivariable regression models adjusted for sociodemographic and clinical covariates. Results: Participants were on average 63 years old, 61% female, 30% Black, 20% Latinx, and 29% were living below the poverty level. There was an overall reduction in loneliness over time (March to April/2020: 51% to September to December/2021: 31%, p = 0.01). Four distinct trajectory groups emerged: (1) “Persistent Loneliness” (n = 101, 16%); (2) “Adapted” (n = 141, 22%), individuals who were initially lonely, with feelings of loneliness decreasing over time; (3) “Occasional loneliness” (n = 189, 29%); and (4) “Never lonely” (n = 211, 33%). Subgroups at highest risk of the “Persistently Lonely” trajectory included those identifying as Latinx (aOR 2.5, 95% CI: 1.2, 5.2), or living in poverty (aOR 2.5; 95% CI: 1.4, 4.6). Conclusions: Although loneliness declined for a majority of older adults during the pandemic in our sample, persistent loneliness attributed to the COVID-19 pandemic was common (1 in 6 adults), particularly among individuals identifying as Hispanic/Latinx or living in poverty. Interventions addressing loneliness can ease pandemic-related suffering, and may mitigate long-term mental and physical health consequences.

Original languageEnglish (US)
Pages (from-to)3469-3479
Number of pages11
JournalJournal of the American Geriatrics Society
Volume70
Issue number12
DOIs
StatePublished - Dec 2022

Funding

AK and CP report grants from Humana Inc. and receive personal consulting fees from Papa Health outside of the submitted research. MW reports grants from the NIH (NIA, NIDDK, NINR, NHLBI, NINDS), Gordon and Betty Moore Foundation, and Eli Lilly, and personal fees from Pfizer, Sanofi, Luto UK, University of Westminster, and Lundbeck outside of the submitted research. This research was supported by a grant from the National Institute on Aging (R01AG030611\u2010S1) and Claude D. Pepper Older American Independence Center Coordinating Center Multi Center Collaborative grant (U24AG059693; P30AG044281; P30AG059988). Dr. Ashwin Kotwal's effort on this project was supported by grants from the National Institute on Aging (K23AG065438; R03AG064323). Dr. O'Conor is supported by a training grant from the National Institute on Aging (K01AG070107). This research was supported by a grant from the National Institute on Aging (R01AG030611-S1) and Claude D. Pepper Older American Independence Center Coordinating Center Multi Center Collaborative grant (U24AG059693; P30AG044281; P30AG059988). Dr. Ashwin Kotwal's effort on this project was supported by grants from the National Institute on Aging (K23AG065438; R03AG064323). Dr. O'Conor is supported by a training grant from the National Institute on Aging (K01AG070107).

Keywords

  • COVID-19 pandemic
  • chronic illness
  • loneliness

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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