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Open Access 01-12-2020 | Affective Disorder | Research article

Prevalence of loneliness and association with depressive and anxiety symptoms among retirees in Northcentral Nigeria: a cross-sectional study

Authors: Chima C. Igbokwe, Veronica J. Ejeh, Olaoluwa S. Agbaje, Prince Ifeanachor Christian Umoke, Cylia N. Iweama, Eyuche L. Ozoemena

Published in: BMC Geriatrics | Issue 1/2020

Abstract

Background

Retirees face numerous challenges, including disassociation from persons in their social networks in Nigeria. Perceived social isolation or loneliness could impair the quality of life in old age, and lead to mental disorders. However, it is uncertain whether perceived loneliness has an independent association with depressive and anxiety symptoms and comorbid conditions in Nigerian retirees. Therefore, we aimed at examining the association between perceived loneliness, depressive and anxiety symptoms, including comorbid conditions among retirees in Northcentral Nigeria.

Methods

This community-based cross-sectional study enrolled retirees aged 60 years and above in different pension zones from February 2019 to August 2019. A two-stage sampling procedure was used to select the study participants. Data on perceived loneliness, depressive, and anxiety symptoms were collected using the 8-item University of California, Los Angeles Loneliness Scale (ULS-8), and the DASS 21-depression and anxiety subscales, respectively. We collected information on the demographic characteristics using a well-validated structured questionnaire. Descriptive statistics, binary and multivariable logistic regression were used to examine the independent associations between loneliness, depression, anxiety, and anxious depression. P-values below 0.05 were considered statistically significant.

Results

The mean age of participants was 71.3 (± 6.01) years, and 54.4% were men. The prevalence of loneliness, depression, anxiety, and anxious depression was 21.8, 52.0, 27.7, and 20.5%, respectively. Retirees with depression or anxiety symptoms perceived that they were lonelier than those without depression or anxiety. The multivariable logistic regression model showed that female gender (AOR 1.49; 95% CI (1.09, 2.00), having secondary education (AOR 2.24, 95% CI (1.40, 3.57) and having higher education (AOR 3.82, 95%CI (2.37, 6.16) were significantly associated with depression. Also, lonely retirees are 1.19 times (AOR 1.19; 95% CI (0.84, 1.69) more likely to be depressed compared to retirees that are not lonely, and the anxious depressed retirees are 314.58 times (AOR 314.58; 95% CI (508.05, 1941.70) more likely to be depressed than those without anxious depression.

Conclusion

The prevalence of loneliness, depression, anxiety, and anxious depression were relatively high among the older retirees. Female gender and advanced age were significantly associated with perceived loneliness, depression and anxiety.

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Cacioppo JT, Hawkley LC, Thisted RA. Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago health, aging, and social relations study. Psychol Aging. 2010;25(2):453–63. https://doi.org/10.1037/a0017216.CrossRefPubMedPubMedCentral

Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015;10(2):227–37. https://doi.org/10.1177/1745691614568352.CrossRefPubMed

Gureje O, Ogunniyi A, Kola L, Afolabi E. Functional disability in elderly Nigerians: results from the Ibadan study of aging. J Am Geriatr Soc. 2006 Nov;54(11):1784–9. https://doi.org/10.1111/j.1532-5415.2006.00944.x.CrossRefPubMedPubMedCentral

Peristera P, Platts LG, Magnusson Hanson LL, Westerlund H. A comparison of the B-spline group-based trajectory model with the polynomial group-based trajectory model for identifying trajectories of depressive symptoms around old-age retirement [published online ahead of print, 2018 Nov 30]. Aging Ment Health. 2018:1–8. https://doi.org/10.1080/13607863.2018.1531371.

Odaman MO, Ibiezugbe MI. Health seeking behavior among the elderly in Edo Central Nigeria. International Review of Social Sciences and Humanities. 2014;7(1):201–10.

National Council on Aging. Falls prevention: Fact sheet. 2016. Retrieved from https://www.ncoa.org/news/resources-for-reporters/.

Tanyi PL, André P, Mbah P, Tong KW. Care of the elderly in Nigeria: implications for policy. Cogent Social Sciences. 2018;4:1. https://doi.org/10.1080/23311886.2018.1555201.CrossRef

Gureje O, Kola L, Afolabi E. Epidemiology of major depressive disorder in elderly Nigerians in the Ibadan study of ageing: a community-based survey. Lancet. 2007;370(9591):957–64. https://doi.org/10.1016/S0140-6736(07)61446-9.CrossRefPubMedPubMedCentral

Ojagbemi A, Gureje O. Social relationships and the association of loneliness with major depressive disorder in the Ibadan study of aging. World Social Psychiatry. 2019;1:82–8. https://doi.org/10.4103/WSP.WSP_6_19.CrossRef

10.

Ojembe BU, Ebe KM. Describing reasons for loneliness among older people in Nigeria. J Gerontol Soc Work. 2018;61(6):640–58. https://doi.org/10.1080/01634372.2018.1487495.CrossRefPubMed

11.

Okoye UO. Family caregiving for ageing parents in Nigeria: gender differences, cultural imperatives and the role of education. Int J Education Ageing. 2012;2(2):139–54.

12.

Perlman D, Peplau LA. Toward a social psychology of loneliness. In S. duck & R. Gilmour (Eds.), personal relationships in disorder (pp. 31–56). London: Academic Press; 1981.

13.

Fokkema T, Gierveld JD, Dykstra PA. Cross-national differences in older adult loneliness. J Psychol. 2012;146(1–2):201–28. https://doi.org/10.1080/00223980.2011.631612.CrossRefPubMed

14.

Wheeler L, Reis H, Nezlek J. Loneliness, social interaction, and sex roles. J Pers Soc Psychol. 1983;45(4):943–53. https://doi.org/10.1037//0022-3514.45.4.943.CrossRefPubMed

15.

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. https://doi.org/10.1093/geronb/63.6.s375.CrossRefPubMedPubMedCentral

16.

Barg FK, Huss-Ashmore R, Wittink MN, Murray GF, Bogner HR, Gallo JJ. A mixed-methods approach to understanding loneliness and depression in older adults. J Gerontol B Psychol Sci Soc Sci. 2006;61(6):S329–39. https://doi.org/10.1093/geronb/61.6.s329.CrossRefPubMedPubMedCentral

17.

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. https://doi.org/10.1037/0882-7974.21.1.140.CrossRefPubMed

18.

Luo Y, Hawkley LC, Waite LJ, Cacioppo JT. Loneliness, health, and mortality in old age: a national longitudinal study. Soc Sci Med. 2012;74(6):907–14. https://doi.org/10.1016/j.socscimed.2011.11.028.CrossRefPubMedPubMedCentral

19.

Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003;58(3):249–65. https://doi.org/10.1093/gerona/58.3.m249.CrossRefPubMed

20.

Bogner HR, Morales KH, Reynolds CF 3rd, Cary MS, Bruce ML. Course of depression and mortality among older primary care patients. Am J Geriatr Psychiatry. 2012;20(10):895–903. https://doi.org/10.1097/JGP.0b013e3182331104.CrossRefPubMedPubMedCentral

21.

Jeuring HW, Huisman M, Comijs HC, Stek ML, Beekman ATF. The long-term outcome of subthreshold depression in later life. Psychological Med. 2016;46(13):2855–65. https://doi.org/10.1017/S0033291716001549.CrossRef

22.

Rurup ML, Deeg DJ, Poppelaars JL, Kerkhof AJ, Onwuteaka-Philipsen BD. Wishes to die in older people: a quantitative study of prevalence and associated factors. Crisis. 2011;32(4):194–203. https://doi.org/10.1027/0227-5910/a000079.CrossRefPubMed

23.

Heikkinen RL, Kauppinen M. Mental well-being: a 16-year follow-up among older residents in Jyvaskyla. Arch Gerontol Geriatr. 2011;52(1):33–9. https://doi.org/10.1016/j.archger.2010.01.017.CrossRefPubMed

24.

Ionescu DF, Niciu MJ, Henter ID, Zarate CA. Defining anxious depression: a review of the literature. CNS Spectr. 2013;18(5):252–60. https://doi.org/10.1017/S1092852913000114.CrossRefPubMedPubMedCentral

25.

Baumeister H, Parker G. A second thought on subtyping major depression. Psychother Psychosom. 2010;79(6):388–9. https://doi.org/10.1159/000320896.CrossRefPubMed

26.

Fava M, Alpert JE, Carmin CN, et al. Clinical correlates and symptom patterns of anxious depression among patients with major depressive disorder in STAR*D. Psychol Med. 2004;34(7):1299–308. https://doi.org/10.1017/s0033291704002612.CrossRefPubMed

27.

Fava M, Rush AJ, Alpert JE, et al. Difference in treatment outcome in outpatients with anxious versus nonanxious depression: a STAR*D report. Am J Psychiatry. 2008;165(3):342–51. https://doi.org/10.1176/appi.ajp.2007.06111868.CrossRefPubMed

28.

Farabaugh A, Alpert J, Wisniewski SR, et al. Cognitive therapy for anxious depression in STAR(*) D: what have we learned? J Affect Disord. 2012;142(1–3):213–8. https://doi.org/10.1016/j.jad.2012.04.029.CrossRefPubMedPubMedCentral

29.

Hays RD, DiMatteo MR. A short-form measure of loneliness. J Pers Assess. 1987;51(1):69–81. https://doi.org/10.1207/s15327752jpa5101_6.CrossRefPubMed

30.

Russell DW. UCLA loneliness scale (version 3): reliability, validity, and factor structure. J Pers Assess. 1996;66(1):20–40. https://doi.org/10.1207/s15327752jpa6601_2.CrossRefPubMed

31.

Russell D, Peplau LA, Cutrona CE. The revised UCLA loneliness scale: concurrent and discriminant validity evidence. J Pers Soc Psychol. 1980;39(3):472–80. https://doi.org/10.1037//0022-3514.39.3.472.CrossRefPubMed

32.

Wu C.-h, Yao G. Psychometric analysis of the short-form UCLA loneliness scale (ULS-8) in Taiwanese undergraduate students. Personal Individ Differ 2008; 44(8):1762–1771. https://doi.org/10.1016/j.paid.2008.02.003.

33.

Cramer KM, Barry JE. Conceptualizations and measures of loneliness: a comparison of subscales. Personal Individ Differ. 1999;27(3):491–502. https://doi.org/10.1016/s0191-8869(98)00257-8.CrossRef

34.

Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT. A short scale for measuring loneliness in large surveys: results from two population-based studies. Res Aging. 2004;26(6):655–72. https://doi.org/10.1177/0164027504268574.CrossRefPubMedPubMedCentral

35.

Wang J, Lloyd-Evans B, Marston L, et al. Epidemiology of loneliness in a cohort of UK mental health community crisis service users [published online ahead of print, 2019 Jun 20]. Soc Psychiatry Psychiatr Epidemiol. 2019;https://doi.org/10.1007/s00127-019-01734-6.

36.

Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the Beck depression and anxiety inventories. Behav Res Ther. 1995;33(3):335–43. https://doi.org/10.1016/0005-7967(94)00075-u.CrossRefPubMed

37.

Crawford JR, Henry JD. The depression anxiety stress scales (DASS): normative data and latent structure in a large non-clinical sample. Br J Clin Psychol. 2003;42(Pt 2):111–31. https://doi.org/10.1348/014466503321903544.CrossRefPubMed

38.

Henry JD, Crawford JR. The short-form version of the depression anxiety stress scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br J Clin Psychol. 2005;44(Pt 2):227–39. https://doi.org/10.1348/014466505X29657.CrossRef

39.

Beuke CJ, Fischer R, McDowall J. Anxiety and depression: why and how to measure their separate effects. Clin Psychol Rev. 2003;23(6):831–48. https://doi.org/10.1016/s0272-7358(03)00074-6.CrossRefPubMed

40.

Gloster AT, Rhoades HM, Novy D, et al. Psychometric properties of the depression anxiety and stress Scale-21 in older primary care patients. J Affect Disord. 2008;110(3):248–59. https://doi.org/10.1016/j.jad.2008.01.023.CrossRefPubMedPubMedCentral

41.

Wood BM, Nicholas MK, Blyth F, Asghari A, Gibson S. The utility of the short version of the depression anxiety stress scales (DASS-21) in elderly patients with persistent pain: does age make a difference? Pain Med. 2010;11(12):1780–90. https://doi.org/10.1111/j.1526-4637.2010.01005.x.CrossRefPubMed

42.

Lovibond SH, Lovibond PF. Manual for the depression anxiety and stress scales. 2nd ed. Psychology Foundation: Sydney; 1995.

43.

Hosmer DW, Lemeshow S. Goodness-of-fit tests for the multiple logistic regression model. Comm Stat A. 1980;9:1043–69.CrossRef

44.

Brislin RW. (1970). Back-translation for cross-cultural research. J Cross-Cult Psychol. 1970;1(3):185–216. https://doi.org/10.1177/135910457000100301.CrossRef

45.

Adams KB, Sanders S, Auth EA. Loneliness and depression in independent living retirement communities: risk and resilience factors. Aging Ment Health. 2004;8(6):475–85. https://doi.org/10.1080/13607860410001725054.CrossRefPubMed

46.

Tiikkainen P, Heikkinen RL. Associations between loneliness, depressive symptoms and perceived togetherness in older people. Aging Ment Health. 2005;9(6):526–34. https://doi.org/10.1080/13607860500193138.CrossRefPubMed

47.

Evans IEM, Llewellyn DJ, Matthews FE, Woods RT, Brayne C, Clare L. Social isolation, cognitive reserve, and cognition in older people with depression and anxiety. Aging Ment Health. 2019;23(12):1691–700. https://doi.org/10.1080/13607863.2018.1506742.CrossRefPubMed

48.

Luanaigh CO, Lawlor BA. Loneliness and the health of older people. Int J Geriatr Psychiatry. 2008;23(12):1213–21. https://doi.org/10.1002/gps.2054.CrossRefPubMed

49.

Routasalo P, Pitkala KH. Loneliness among older people. Rev Clin Gerontol. 2003;13:303–11. https://doi.org/10.1017/S095925980400111X.CrossRef

50.

Dykstra PA. Older adult loneliness: myths and realities. Eur J Ageing. 2009;6(2):91–100. https://doi.org/10.1007/s10433-009-0110-3.CrossRefPubMedPubMedCentral

51.

Cohen-Mansfield J, Shmotkin D, Goldberg S. Loneliness in old age: longitudinal changes and their determinants in an Israeli sample. Int Psychogeriatr. 2009;21(6):1160–70. https://doi.org/10.1017/S1041610209990974.CrossRefPubMed

52.

Dahlberg L, Andersson L, McKee KJ, Lennartsson C. Predictors of loneliness among older women and men in Sweden: a national longitudinal study. Aging Ment Health. 2015;19(5):409–17. https://doi.org/10.1080/13607863.2014.944091.CrossRefPubMed

53.

Victor CR, Scharf T. Social isolation and loneliness. In a. Walker (Ed.), understanding quality of life in old age (pp. 100–116). Buckingham: Open University Press; 2005.

54.

Savikko N, Routasalo P, Tilvis RS, Strandberg TE, Pitkälä KH. Predictors and subjective causes of loneliness in an aged population. Arch Gerontol Geriatr. 2005;41(3):223–33. https://doi.org/10.1016/j.archger.2005.03.002.CrossRefPubMed

55.

Dahlberg L, McKee KJ. Correlates of social and emotional loneliness in older people: evidence from an English community study. Aging Ment Health. 2014;18(4):504–14. https://doi.org/10.1080/13607863.2013.856863.CrossRefPubMed

56.

Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S. Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry. 2018;18(1):156. https://doi.org/10.1186/s12888-018-1736-5.CrossRefPubMedPubMedCentral

57.

Population Reference Bureau. World population data sheet. Washington, DC: Author; 2012.

58.

Hawkley L. Loneliness and social embeddedness in old age. In encyclopedia of geropsychology. Singapore: Springer Science + Business Media; 2015.

59.

Beaudreau SA, O'Hara R. Late-life anxiety and cognitive impairment: a review. Am J Geriatr Psychiatry. 2008;16(10):790–803. https://doi.org/10.1097/JGP.0b013e31817945c3.CrossRefPubMed

Title: Prevalence of loneliness and association with depressive and anxiety symptoms among retirees in Northcentral Nigeria: a cross-sectional study
Authors: Chima C. Igbokwe
Veronica J. Ejeh
Olaoluwa S. Agbaje
Prince Ifeanachor Christian Umoke
Cylia N. Iweama
Eyuche L. Ozoemena
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Affective Disorder
Affective Disorder
Anxiety
Published in: BMC Geriatrics / Issue 1/2020
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-020-01561-4

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Prevalence of loneliness and association with depressive and anxiety symptoms among retirees in Northcentral Nigeria: a cross-sectional study

Abstract

Background

Methods

Results

Conclusion

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Abstract

Background

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Results

Conclusion

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