Within contemporary Western (post) modern societies, loneliness is seen as a problem that is particularly associated with old age. Much less attention has been given to examining variations in loneliness across age groups. We examine patterns of loneliness across adults aged 15 years and older in the United Kingdom using data from the European Social Survey. We first consider the prevalence of loneliness among the adult population; then the relationship between loneliness and a range of key risk factors, and finally the relationship with age for each of our risk factors. Loneliness demonstrates a nonlinear U-shaped distribution, with those aged under 25 years and those aged over 65 years demonstrating the highest levels of loneliness. Depression is associated with loneliness for all age groups. Poor physical health is associated with loneliness in young adult and midlife but not later life. For those in mid and later life, the quality of social engagement is protective against loneliness, while for young adults it is the quantity of social engagement. This indicates that different factors may endow vulnerability (or protect) against loneliness at different stages of life and suggests that preventative strategies or interventions that reflect these variations need to be developed.

IntroductionThe context for the review of loneliness and social isolation in later life is that of ‘successful aging’ and ‘quality of life’. The term ‘quality of life‘ includes a broad range of areas of life and there is little agreement about the definition of the term. Models of quality of life range from identification of ‘life satisfaction’ or ‘social wellbeing’ to models based upon concepts of independence, control, and social and cognitive competence. However, regardless of how the concept of quality of life is defined, research has consistently demonstrated the importance of social and family relationships in the definition of a ‘good quality of life’.

The relationship between age and loneliness is intriguing. While loneliness has been widely perceived as a problem of old age, there is evidence suggesting that adolescence is the peak age for experiencing loneliness and there are demonstrable variations between nations in reported rates of loneliness. However, comparative data for examining both the prevalence of loneliness across age groupsandacross nations are sparse. As the first phase of a larger project, we explore the prevalence of loneliness across different age groups in 25 European nations, with a focus on people of an advanced age. After discussing issues of comparability, we present our empirical findings employing data collected in the third round (2006–07) of the European Social Survey (total sample size 47,099, age range 15–101) which included a ‘self-rating’ loneliness scale. Our results suggest that the prevalence of loneliness does increase with age for the combined sample. However, the nation in which one lives shows a greater impact than age on reported levels of loneliness, with Russia and Eastern European nations having the highest proportions of lonely people (about 10–34% for different age groups) and Northern European nations the lowest (mostly below 6%). Possible explanatory factors are identified and discussed, which provides the groundwork of a subsequent and formal study.

This study examines the prevalence of loneliness amongst older people in Great Britain, and makes comparisons with the findings of studies undertaken during the last five decades. In addition, the risk factors for loneliness are examined using a conceptual model of vulnerability and protective factors derived from a model of depression. Loneliness was measured using a self-rating scale, and measures of socio-demographic status and health/social resources were included. Interviews were undertaken with 999 people aged 65 or more years living in their own homes, and the sample was broadly representative of the population in 2001. Among them the prevalence of ‘severe loneliness’ was seven per cent, indicating little change over five decades. Six independent vulnerability factors for loneliness were identified: marital status, increases in loneliness over the previous decade, increases in time alone over the previous decade; elevated mental morbidity; poor current health; and poorer health in old age than expected. Advanced age and possession of post-basic education were independently protective of loneliness. From this evidence we propose that there are three loneliness pathways in later life: continuation of a long-established attribute, late-onset loneliness, and decreasing loneliness. Confirmation of the different trajectories suggests that policies and interventions should reflect the variability of loneliness in later life, for undifferentiated responses may be neither appropriate nor effective.

Objectives To evaluate the evidence for strategies to prevent falls or fractures in residents in care homes and hospital inpatients and to investigate the effect of dementia and cognitive impairment. Design Systematic review and meta-analyses of studies grouped by intervention and setting (hospital or care home). Meta-regression to investigate the effects of dementia and of study quality and design. Data sources Medline, CINAHL, Embase, PsychInfo, Cochrane Database, Clinical Trials Register, and hand searching of references from reviews and guidelines to January 2005. Results 1207 references were identified, including 115 systematic reviews, expert reviews, or guidelines. Of the 92 full papers inspected, 43 were included. Meta-analysis for multifaceted interventions in hospital (13 studies) showed a rate ratio of 0.82 (95% confidence interval 0.68 to 0.997) for falls but no significant effect on the number of fallers or fractures. For hip protectors in care homes (11 studies) the rate ratio for hip fractures was 0.67 (0.46 to 0.98), but there was no significant effect on falls and not enough studies on fallers. For all other interventions (multifaceted interventions in care homes; removal of physical restraints in either setting; fall alarm devices in either setting; exercise in care homes; calcium/vitamin D in care homes; changes in the physical environment in either setting; medication review in hospital) meta-analysis was either unsuitable because of insufficient studies or showed no significant effect on falls, fallers, or fractures, despite strongly positive results in some individual studies. Meta-regression showed no significant association between effect size and prevalence of dementia or cognitive impairment. Conclusion There is some evidence that multifaceted interventions in hospital reduce the number of falls and that use of hip protectors in care homes prevents hip fractures. There is insufficient evidence, however, for the effectiveness of other single interventions in hospitals or care homes or multifaceted interventions in care homes.

Objective To investigate the impact of childbirth on the sexual health of primiparous women and identify factors associated with dyspareunia.Design Cross‐sectional study using obstetric records, and postal survey six months after delivery.Setting Department of Obstetrics and Gynaecology, St George's Hospital, London.Population All primiparous women (n= 796) delivered of a live birth in a six month period.Methods Quantitative analysis of obstetric and survey data.Main outcome measures Self reported sexual behaviour and sexual problems (e.g. vaginal dryness, painful penetration, pain during sexual intercourse, pain on orgasm, vaginal tightness, vaginal looseness, bleeding/irritation after sex, and loss of sexual desire); consultation for postnatal sexual problems.Results Of the 484 respondents (61% response rate), 89% had resumed sexual activity within six months of the birth. Sexual morbidity increased significantly after the birth: in the first three months after delivery 83% of women experienced sexual problems, declining to 64% at six months, although not reaching pre‐pregnancy levels of 38%. Dyspareunia in the first three months after delivery was, after adjustment, significantly associated with vaginal deliveries (P= 0.01) and previous experience of dyspareunia (P= 0.03). At six months the association with type of delivery was not significant (P= 0.4); only experience of dyspareunia before pregnancy (P < 0.0001) and current breastfeeding were significant (P= 0.0006). Only 15% of women who had a postnatal sexual problem reported discussing it with a health professional.Conclusions Sexual health problems were very common after childbirth, suggesting potentially high levels of unmet need.