Loneliness and Its Correlates Among Bangladeshi Older Adults During the COVID-19 Pandemic

Abstract

The present study aims to investigate the prevalence of loneliness and its associated factors among older adults during the COVID-19 pandemic in Bangladesh. This cross-sectional study was conducted in October 2020 among 1032 older Bangladeshi adults aged 60 years and above through telephone interviews. A semi-structured questionnaire was used to collect information on participants’ characteristics and COVID-19-related information. Meanwhile, the level of loneliness was measured using a 3-item UCLA Loneliness scale. More than half (51.5%) of the older adults experienced loneliness. We found that participants formally schooled [adjusted odds ratio (aOR= 0.62, 95% CI 0.43–0.88)] and received COVID-19-related information from health workers (aOR= 0.33, 95% CI 0.22–0.49) had lower odds of being lonely during the pandemic. However, older adults living alone (aOR: 2.57, 95% CI 1.34–4.94), residing distant from a health facility (aOR= 1.46, 95% CI 1.02–2.08) and in rural areas (aOR= 1.53, 95% CI 1.02–2.23) had higher odds of loneliness than their counterparts. Likewise, odds of loneliness were higher among those overwhelmed by COVID-19 (aOR= 1.93, 95% CI 1.29–2.86), who faced difculty in earning (aOR= 1.77, 95% CI 1.18–2.67) and receiving routine medical care during pandemic (aOR= 2.94, 95% CI 1.78–4.87), and those perceiving requiring additional care during the pandemic (aOR= 6.01, 95% CI 3.80–9.49). The fndings suggest that policies and plans should be directed to reduce loneliness among older adults who require additional care. Loneliness is one of the most common psychological issues encountered by the older population worldwide1 . Loneliness is an emotional and mental state2 that an individual faces in terms of subjective feelings of stress3 , sadness, low self-esteem4 , and hopelessness5 . Globally, around one-third of the older adults reported being lonely6 . A high level of loneliness has negative health consequences, including increased risk for heart disease, stroke, premature death, mental stress, chronic depression, dementia, and even a tendency to suicide7–10. Evidence suggests that the sense of loneliness raises stroke and dementia risk by 30% and 50%, respectively11. Among the older population (aged 60 years and above), loneliness can result in serious public health consequences, including increased hospital visits12, decreased quality of life13, and mortality14. According to a meta-analysis, among older adults, loneliness increases the risk of all-cause mortality by 26%7 . Te older population is at increased risk for COVID-19 and associated physical and mental health consequences and deaths15. More than half of the COVID-19 deaths in China, Italy16, and India17, and almost 39% in Bangladesh18 were reported among the older population. Tey are also disproportionately afected by loneliness during this pandemic19,20. In line with this, recent evidence indicating a drastic increase in the global prevalence of mental health-related issues21–23. A longitudinal study conducted on US adults aged 50–80 years reported that the prevalence of isolation was more than doubled in 2020 compared to 2018 (56% vs. 27% in 2018)24. Te most commonly reported factors associated with loneliness among older people include chronic diseases, retirement OPEN 1 ARCED Foundation, 13/1 Pallabi, Mirpur‑12, Dhaka, Bangladesh. 2 Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia. 3 BRAC James P Grant School of Public Health, BRAC University, Medona Tower, Bir Uttam AK Khandakar Road, Dhaka 1213, Bangladesh. 4 National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia. 5 Translational Health Research Institute, School of Medicine, Western Sydney University, Campbeltown, NSW 2560, Australia. 6 Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA. 7 Department of Human‑Centred Computing, Faculty of Information Technology, Monash University, Clayton, VIC 3145, Australia. 8 Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh. 9 Department of Public Health, Dafodil International University, Dhaka, Bangladesh. *email: smitra411@gmail.com from work, staying alone away from children and family, widowhood, lack of social engagement and entertainment activities, sedentary lifestyle25, and physical disabilities26,27. In Bangladesh, the frst COVID-19 case was reported at the beginning of March 2020, and since then, the cases have constantly been increasing28. As of 13 July 2022, there were more than 1,992,058 confrmed COVID19 cases with 29,217 deaths related to COVID-19 in Bangladesh29. Te government of Bangladesh implemented restrictive measures such as lockdown and shutdowns30 to control the spread of the infection. While important to curb the spread of the infection, such measures also resulted in increased discomfort in getting everyday necessities and health care, in addition to creating an environment not conducive to mental health28. Some recent studies also documented increased mental health conditions such as stress, anxiety, fear, and depression among the older population in Bangladesh during the COVID-19 pandemic31–34. However, no study has explored the level of loneliness among the older population in Bangladesh during the COVID-19 pandemic, who are one of the most vulnerable population groups to the ongoing pandemic. Terefore, the present study aimed to investigate the prevalence of loneliness and its associated factors among older Bangladeshi adults amid the COVID-19 pandemic.