Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Geriatrics
Published in: BMC Geriatrics 1/2020

Open Access 01-12-2020 | Research article

The association between sleep quality and loneliness in rural older individuals: a cross-sectional study in Shandong Province, China

Authors: Gaizhen Jia, Ping Yuan

Published in: BMC Geriatrics | Issue 1/2020

Login to get access

Abstract

Background

There is a evidence of negative association between loneliness and sleep quality in older adults. However, little is known regarding the relationship between loneliness and sleep quality among Chinese rural older adults. This study examined the associations of loneliness and sleep quality in a cross-sectional study of older adults.

Methods

A face-to-face questionnaire survey was conducted among 1658 rural older adults in Shandong Province, China. Loneliness was assessed using the University of California at Los Angeles Loneliness Scale. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Ordinal logistic regression was conducted to examine the association of loneliness and sleep quality after adjustment for multiple confounding variables.

Results

After variables such as age, marriage, education, occupation, economic income, family relationships, living arrangement, smoking behavior, alcohol consumption, chronic disease experience, and quality of life were controlled in a multivariable analysis, poor sleep quality was still associated with loneliness in the rural older population.

Conclusion

This finding implied an adverse effect of sleep quality on the loneliness of older adults. Poor sleep quality was associated with increased odds of loneliness in Chinese rural older adults. Sleep-based interventions should be developed to prevent loneliness in rural older adults in China.
Literature
1.
Zhao M, Gao J, Li M, Wang K. Relationship between loneliness and frailty among older adults in nursing homes: the mediating role of activity engagement. J Am Med Dir Assoc. 2019;20(6):759–64.PubMedCrossRef
2.
Domenech-Abella J, Mundo J, Haro JM, Rubio-Valera M. Anxiety, depression, loneliness and social network in the elderly: longitudinal associations from the Irish longitudinal study on ageing (TILDA). J Affect Disord. 2018;246:82–8.PubMedCrossRef
3.
4.
Wang G, Hu M, Xiao SY, Zhou L. Loneliness and depression among rural empty-nest elderly adults in Liuyang, China:a cross-sectional study. BMJ open. 2017;7:e016091.PubMedPubMedCentralCrossRef
5.
Cheng P, Jin Y, Sun H, Tang Z, Zhang C, Chen Y, Zhang Q, Zhang Q, Huang F. Disparities in prevalence and risk indicators of loneliness between rural empty nest and non-empty nest older adults in Chizhou. China Geriatr Gerontol Int. 2015;15(3):356–64.PubMedCrossRef
6.
Michela JL, Peplau LA, Weeks DG. Perceived dimensions of attributions for loneliness. J Pers Soc Psychol. 1982;43(5):929–36.PubMedCrossRef
7.
Weeks DG, Michela JL, Peplau LA, Bragg ME. Relation between loneliness and depression:a structural equation analysis. J Pers Soc Psychol. 1980;39(6):1238–44.PubMedCrossRef
8.
Hawkley LC, Hughes ME, Waite LJ, Masi CM, Thisted RA, Cacioppo JT. From social structural factors to perceptions of relationship quality and loneliness: the Chicago health, aging, and social relations study. J Gerontol B Psychol Sci Soc Sci. 2008;63(6):S375–84.PubMedCrossRef
9.
Boomsma DI, Willemsen G, Dolan CV, Hawkley LC, Cacioppo JT. Genetic and environmental contributions to loneliness in adults: the Netherlands twin register study. Behav Genet. 2005;35(6):745–52.PubMedCrossRef
10.
Cacioppo JT, Fowler JH, Christakis NA. Alone in the crowd: the structure and spread of loneliness in a large social network. J Pers Soc Psychol. 2009;97(6):977–91.PubMedPubMedCentralCrossRef
11.
Wang G, Zhang X, Wang K, Li Y, Shen Q, Ge X, Hang W. Loneliness among the rural older people in Anhui, China: prevalence and associated factors. Int J Geriatr Psychiatry. 2011;26(11):1162–8.PubMed
12.
Hacihasanoglu R, Yildirim A, Karakurt P. Loneliness in elderly individuals, level of dependence in activities of daily living (ADL) and influential factors. Arch Gerontol Geriatr. 2012;54(1):61–6.PubMedCrossRef
13.
Dahlberg L, Andersson L, Lennartsson C. Long-term predictors of loneliness in old age: results of a 20-year national study. Aging Ment Health. 2018;22(2):190–6.PubMedCrossRef
14.
Aanes MM, Hetland J, Pallesen S, Mittelmark MB. Does loneliness mediate the stress-sleep quality relation? The Hordaland Health Study Int Psychogeriatr. 2011;23(6):994–1002.PubMedCrossRef
15.
Visser MA, El Fakiri F. The prevalence and impact of risk factors for ethnic differences in loneliness. Eur J Pub Health. 2016;26(6):977–83.CrossRef
16.
Aylaz R, Akturk U, Erci B, Ozturk H, Aslan H. Relationship between depression and loneliness in elderly and examination of influential factors. Arch Gerontol Geriatr. 2012;55(3):548–54.PubMedCrossRef
17.
Jaremka LM, Andridge RR, Fagundes CP, Alfano CM, Povoski SP, Lipari AM, Agnese DM, Arnold MW, Farrar WB, Yee LD, et al. Pain, depression, and fatigue: loneliness as a longitudinal risk factor. Health Psychol. 2014;33(9):948–57.PubMedCrossRef
18.
Richard A, Rohrmann S, Vandeleur CL, Schmid M, Barth J, Eichholzer M. Loneliness is adversely associated with physical and mental health and lifestyle factors: results from a Swiss national survey. PLoS One. 2017;12(7):e0181442.PubMedPubMedCentralCrossRef
19.
Yang K. Longitudinal loneliness and its risk factors among older people in England. Can J Aging. 2018;37(1):12–21.PubMedCrossRef
20.
Tomstad S, Dale B, Sundsli K, Saevareid HI, Söderhamn U. Who often feels lonely? A cross-sectional study about loneliness and its related factors among older home-dwelling people. Int J Older People Nursing. 2017;12(4):e12162.CrossRef
21.
Arpin SN, Mohr CD, Brannan D. Having friends and feeling lonely: a daily process examination of transient loneliness, socialization, and drinking behavior. Personal Soc Psychol Bull. 2015;41(5):615–28.CrossRef
22.
Zhu YLJ, Qu B. Quality of life, loneliness and health-related characteristics among older people in Liaoning province, China: a cross-sectional study. BMJ Open. 2018;8(11):e0211822.CrossRef
23.
Beutel ME, Klein EM, Brähler E, Reiner I, Jünger C, Michal M, Wiltink J, Wild PS, Münzel T, Lackner KJ, et al. Loneliness in the general population: prevalence, determinants and relations to mental health. BMC Psychiatry. 2017;17(1):97.PubMedPubMedCentralCrossRef
24.
Zawadzki MJ, Graham JE, Gerin W. Rumination and anxiety mediate the effect of loneliness on depressed mood and sleep quality in college students. Health Psychol. 2013;32(2):212–22.PubMedCrossRef
25.
Segrin C, Burke TJ. Loneliness and sleep quality: dyadic effects and stress effects. Behav Sleep Med. 2015;13(3):241–54.PubMedCrossRef
26.
Cacioppo JT, Cacioppo S. Loneliness in the modern age: an evolutionary theory of loneliness (ETL). Adv Exp Soc Psychol. 2018;58:127–97.
27.
Wakefield JRH, Bowe M, Kellezi B, Butcher A, Groeger JA. Longitudinal associations between family identification, loneliness, depression, and sleep quality. Br J Health Psychol. 2020;25(1):1–16.PubMedCrossRef
28.
Matthews T, Danese A, Gregory AM, Caspi A, Moffitt TE, Arseneault L. Sleeping with one eye open: loneliness and sleep quality in young adults. Psychol Med. 2017;47(12):2177–86.PubMedPubMedCentralCrossRef
29.
McHugh JE, Lawlor BA. Perceived stress mediates the relationship between emotional loneliness and sleep quality over time in older adults. Br J Health Psychol. 2013;18(3):546–55.PubMedCrossRef
30.
Gu D, Sautter J, Pipkin R, Zeng Y. Sociodemographic and health correlates of sleep quality and duration among very old Chinese. Sleep. 2010;33(5):601–10.PubMedPubMedCentralCrossRef
31.
Jacobs JM, Cohen A, Hammerman-Rozenberg R, Stessman J. Global sleep satisfaction of older people: the Jerusalem cohort study. J Am Geriatr Soc. 2006;54(2):325–9.PubMedCrossRef
32.
33.
Eccles AM, Qualter P, Madsen KR, Holstein BE. Loneliness in the lives of Danish adolescents: associations with health and sleep. Scand J Public Health. 2020;23:1403494819865429.
34.
Yu B, Steptoe A, Niu K, Ku PW, Chen LJ. Prospective associations of social isolation and loneliness with poor sleep quality in older adults. Qual Life Res. 2018;27(3):683–91.PubMedCrossRef
35.
36.
John E, Ware J, Sherbourne CD. The MOS 36-item short-form health survey (SF36): I. conceptual framework and item selection. Med Care. 1992;30(6):473–83.CrossRef
37.
Arslantaş H, Adana F, Abacigil Ergin F, Kayar D, Acar G. Loneliness in elderly people, associated factors and its correlation with quality of life: a field study from Western Turkey. Iran J Public Health. 2015;44(1):43–50.PubMedPubMedCentral
38.
Russell DW. UCLA loneliness scale (version 3): reliability, validity, and factor structure. J Pers Assess. 1996;66(1):20–40.PubMedCrossRef
39.
Ponizovsky AM, Ritsner MS. Patterns of loneliness in an immigrant population. Compr Psychiatry. 2004;45(5):408–14.PubMedCrossRef
40.
Heinrich LM, Gullone E. The clinical significance of loneliness: a literature review. Clin Psychol Rev. 2006;26(6):695–718.PubMedCrossRef
41.
Perry GR. Loneliness and coping among tertiary-level adult cancer patients in the home. Cancer Nurs. 1990;13(5):293–302.PubMedCrossRef
42.
Chen Y, Hicks A, While AE. Loneliness and social support of older people living alone in a county of Shanghai, China. Health Soc Care Community. 2014;22(4):429–38.PubMedCrossRef
43.
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.CrossRefPubMed
44.
Zhang HS, Xu YM, Zhu JH, Zhong BL. Poor sleep quality is significantly associated with low sexual satisfaction in Chinese methadone-maintained patients. Medicine. 2017;96(39):e8214.PubMedPubMedCentralCrossRef
45.
Li J, Yao YS, Dong Q, Dong YH, Liu JJ, Yang LS, Huang F. Characterization and factors associated with sleep quality among rural elderly in China. Arch Gerontol Geriatr. 2013;56(1):237–43.PubMedCrossRef
46.
Nyqvist F, Cattan M, Conradsson M, Näsman M, Gustafsson Y. Prevalence of loneliness over ten years among the oldest old. Scand J Public Health. 2017;45(4):411–8.PubMedCrossRef
47.
Hao SC, Zhou D, Fang Y. Interaction and joint influence of living style and loneliness on self-rated health of the elderly. Chin J Gerontol. 2016;36(10):2502–5.
48.
Hawkley LC, Kocherginsky M. Transitions in loneliness among older adults: a 5-year follow-up in the National Social Life, health, and aging project. Res Aging. 2017;40(4):365–87.PubMedPubMedCentralCrossRef
49.
Cacioppo JT, Hughes ME, Waite LJ, Hawkley LC, Thisted RA. Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. Psychol Aging. 2006;21(1):140–51.PubMedCrossRef
50.
Liu LJ, Guo Q. Loneliness and health-related quality of life for the empty nest elderly in the rural area of a mountainous county in China. Qual Life Res. 2007;16(8):1275–80.PubMedCrossRef
51.
Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, Rundle AG, Zammit GK, Malaspina D. Short sleep duration as a risk factor for hypertension: analyses of the first National Health and nutrition examination survey. Hypertension. 2006;47(5):833–9.PubMedCrossRef
52.
Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. Obesity. 2008;16(3):643–53.PubMedCrossRef
53.
Qian Y, Sun L, Zhou C, Ge D, Zhang L. The association between suicidal ideation and sleep quality in elderly individuals: a cross-sectional study in Shandong. China Psychiatry Res. 2017;256:453–7.PubMedCrossRef
54.
Kurina LM, Knutson KL, Hawkley LC, Cacioppo JT, Lauderdale DS, Ober C. Loneliness is associated with sleep fragmentation in a communal society. Sleep. 2011;34(11):1519–26.PubMedPubMedCentralCrossRef
55.
Cacioppo JT, Hawkley LC, Berntson GG, Ernst JM, Gibbs AC, Stickgold R, Hobson JA. Do lonely days invade the nights? Potential social modulation of sleep efficiency. Psychol Sci. 2002;13(4):384–7.PubMedCrossRef
56.
Levin R, Nielsen TA. Disturbed dreaming, posttraumatic stress disorder, and affect distress: a review and neurocognitive model. Psychol Bull. 2007;133(3):482–528.PubMedCrossRef
57.
Smith SS, Kozak N, Sullivan KA. An investigation of the relationship between subjective sleep quality, loneliness and mood in an Australian sample: can daily routine explain the links? Int J Soc Psychiatry. 2012;58(2):166–71.PubMedCrossRef
58.
Segrin C, Domschke T. Social support, loneliness, recuperative processes, and their direct and indirect effects on health. Health Commun. 2011;26(3):221–32.PubMedCrossRef
59.
Chopik WJ. The benefits of social technology use among older adults are mediated by reduced loneliness. Cyberpsychol Behav Soc Netw. 2016;19(9):551–6.PubMedPubMedCentralCrossRef
Metadata
Title
The association between sleep quality and loneliness in rural older individuals: a cross-sectional study in Shandong Province, China
Authors
Gaizhen Jia
Ping Yuan
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2020
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-020-01554-3

Other articles of this Issue 1/2020

BMC Geriatrics 1/2020 Go to the issue

Research article

Does working memory protect against auditory distraction in older adults?

Research article

Readmission of older acutely admitted medical patients after short-term admissions in Denmark: a nationwide cohort study

Research article

Hand grip strength variability during serial testing as an entropic biomarker of aging: a Poincaré plot analysis

Research article

The association between cognition and gait in a representative sample of very old people – the influence of dementia and walking aid use

Research article

Shorter length of hospital stay for hip fracture in those with dementia and without a known diagnosis of osteoporosis in the USA

Research article

Clinical characteristics on admission predict in-hospital fatal outcome in patients aged ≥75 years with novel coronavirus disease (COVID-19): a retrospective cohort study

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits