Research programme on Ageing, Loneliness, and Mental health (REALM)

To effectively address loneliness and its consequences, e.g., for mental health and care use, there must be a better understanding of factors placing people at risk. While many factors have been found to increase the risk of loneliness, the evidence-base is relatively strong for only a few. There are also notable gaps in the evidence, e.g., concerning inequalities, meso-level factors such place of residence and care use. WP1 will examine inequalities in risk factors and consequences of loneliness, with specific focus on mental health and care use. There will also be a thorough analysis of which mental health consequences that may follow from widowhood, a life event that is one of the key risk factors of loneliness in old age.

• Are there inequalities in loneliness, e.g., by factors such as gender, socioeconomic position, functional ability and place of residence? Are there trends in these inequalities?
• What is the relationship between loneliness and mental health in later life? How shall we understand the causal nature of the relationship?
• What are the consequences of loneliness and mental health on care and medication use? Do these consequences vary across subgroups of the older population?
• What is the effect of widowhood on transient and/or chronic mental health?

Loneliness is a subjective experience, but there is relatively little research in which older adults themselves describe their experience of loneliness and its links to mental health. Furthermore, there is no internationally recognised instrument to measure loneliness that has been developed on the basis of older adults’ own accounts of loneliness and for use by practitioners. Facilitating for practitioners to identify older adults who are experiencing loneliness is important if support is to be delivered that can reduce loneliness and the risk of associated mental health problems. Based on older adults’ experiences, this WP will develop an instrument to assess loneliness aimed for use in social and health care practice.

• What are older adults’ experiences of loneliness from a life course perspective?
• What connections do they see between their experiences of loneliness and their mental health from a life course perspective?
• Does an instrument measuring loneliness in older adults demonstrate satisfactory reliability and validity?
• Does an instrument measuring loneliness in older adults demonstrate satisfactory suitability, acceptability, and feasibility for use from the perspective of older adults and practitioners? 

Common stereotypes about loneliness in old age may contribute to older adults themselves seeing loneliness as a natural part of ageing and prevent them from seeking support. Care professionals may also hold such stereotypes. Thus, it is important that care professionals have an adequate level of loneliness literacy to recognise and respond to signs of loneliness, i.e., that they have skills to access, understand, and use loneliness-related information to prevent and reduce loneliness and promote good health. Hardly any research has been done on loneliness literacy in Sweden, and little internationally. In this WP, a training programme to enhance loneliness literacy will be developed and piloted with the aim of improving care professionals’ ability to identify and respond to loneliness.

• What loneliness literacy knowledge and competencies do care professionals have and what do they lack in relation to recognising and responding to loneliness in older adults?
• What content and structure should a loneliness literacy programme for care professionals have?
• How do care professionals experience participating in a loneliness literacy training programme?

There will be close collaboration across the WPs, facilitated by WP4. In this WP, research quality will also be monitored. Finally, this WP addresses the relevance of the research programme for older adults and other stakeholders and ensures that the knowledge generated is possible to implement in practice. Stakeholders will inform specific research questions and assist in interpretation and dissemination of findings. Through this collaboration, the WP will also explore what can be done to enhance the recognition and response of care
professionals to prevent and reduce loneliness in older adults:

• How can new methods and ways of working be implemented?
• How can communication and collaboration across services be improved?