Overview of the prevalence of loneliness and associated risk factors among older adults across six continents: A meta-analysis.

Background: Globally, loneliness is a growing public health concern associated with poor mental and physical health among older adults. Therefore, we performed a meta-analysis to explore the prevalence of loneliness and associated risk factors among older adults across six continents.

Methods: Web of Science, PubMed, Embase, CINAHL, Cochrane Library, and references lists were comprehensively searched until April 2024. Data analysis was performed using Logit Transformation model in R-Software for pooled prevalence and DerSimonian-Lard random-effects model in Comprehensive Meta-Analysis for associated factors of loneliness. Heterogeneity was quantified by I and τ statistics. The funnel plot and Egger's regression test assessed publication bias.

Results: A total of 70 studies with 462,083 older adults were included. The pooled prevalence of loneliness was 26 % (95 %CI, 23 %-30 %) with 38 % for North America, 34 % for Africa, 32 % for Asia and South America, 23 % for Europe, and 13 % for Oceania. Cognitive impairment (2.98; 95 %CI, 1.30-6.81), poor health (2.35; 95 %CI, 1.59-3.45), female (1.92; 95 %CI, 1.53-2.41), depression (1.74; 95 %CI, 1.40-2.16), widowed (1.67; 95 %CI, 1.13-2.48), single (1.51; 95 %CI, 1.06-2.17), institutionalization (2.95; 95 %CI, 1.48-5.88), rural residency (1.18; 95 %CI, 1.04-1.34) were associated with increased risk of loneliness. Being married (0.51; 95 %CI, 0.31-0.82), male (0.55; 95 %CI, 0.43-0.70), and non-institutionalization (0.34; 95 %CI, 0.17-0.68) were associated with lower risk of loneliness.

Conclusion: Approximately, three among ten older adults aged ≥ 60 years are lonely worldwide. Early detection, prevention, and management of loneliness among older adults should consider diverse needs using gender-specific approaches.