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A brief review of loneliness: Correlates, consequences, and considerations for recreational therapists

Ellen Rozek, PhD, Nancy E. Richeson, PhD


Loneliness is a complex human experience that most people experience in their lifetimes. The authors review how the construct of loneliness is defined and how it is distinguished from the concept of social isolation. Common risk factors that predict loneliness such as gender, marital status, and age are discussed. Potential consequences for people who are lonely can be emotional, physical, and cognitive. Research on these functional outcomes is reviewed. Because loneliness is a prevalent human experience, recreational therapists are likely to encounter individuals who may be dealing with loneliness. The authors discuss how recreational therapists can use this information in clinical practice.


loneliness, older adults, social isolation, therapeutic recreation

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Weiss RS: Loneliness: The Experience of Emotional and Social Isolation. Cambridge: MIT Press, 1973.

de Jong Gierveld J, Van Tilburg T, Dykstra PA: Loneliness and social isolation. In Vangelisti A, Perlman D (eds.): Cambridge Handbook of Personal Relationships. Cambridge: Cambridge University Press, 2006: 485-500.

Pinquart M, Sorensen S: Influences on loneliness in older adults: A meta-analysis. Basic Appl Soc Psychol. 2001; 23(4): 245-266.

Rokach A: Loneliness updated: An introduction. J Psychol. 2012; 146(1-2), 1-6.

Rubinstein C, Shaver P, Peplau LA: Loneliness. Hum Nat. 1979; 2(2): 58-65.

Hawkley LC, Cacioppo JT: Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2010; 40(2): 218-227.

Hawthorne G: Perceived social isolation in a community sample: Its prevalence and correlates with aspects of peoples’ lives. Soc Psychiatry Psychiatr Epidemiol. 2008; 43(2): 140-150.

O’Luanaigh C, O’Connell H, Chin AV, et al.: Loneliness and cognition in older people: The Dublin Healthy Ageing study. Ageing Ment Health. 2012; 16(3): 347-352.

Weeks DJ: A review of loneliness concepts, with particular reference to old age. Int J Geriatr Psychiatry. 1994; 9(5): 345-355.

Routasalo P, Pitkala KH: Loneliness among older people. Rev Clin Gerontol. 2003; 13(4): 303-311.

Victor C, Scambler S, Bond J, et al.: Being alone in later life: Loneliness, social isolation and living alone. Rev Clin Gerontol. 2000; 10(04): 407-417.

Russell DW: UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure. J Pers Assess. 1996; 66(1): 20-40.

Pinquart M: Loneliness in married, widowed, divorced, and never-married older adults. J Soc Pers Relat. 2003; 20(1): 31-53.

Dugan E, Kivett VR: The importance of emotional and social isolation to loneliness among very old rural adults. Gerontologist. 1994; 34(3): 340-346.

Cornwell B, Laumann EO, Schumm LP: The social connectedness of older adults: A national profile. Am Sociol Rev. 2008; 73(2): 185.

Van Baarsen B, Snijders TAB, Smit JH, et al.: Lonely but not alone: Emotional isolation and social isolation as two distinct dimensions of loneliness in older people. Educ Psychol Meas. 2001; 61(1): 119-135.

Borys S, Perlman D: Gender differences in loneliness. Pers Soc Psychol Bull. 1985; 11(1): 63-74.

Cacioppo JT, Hawkley LC: Perceived social isolation and cognition. Trends Cogn Sci. 2009; 13(10): 447-454.

Hawkley LC, Hughes ME, Waite LJ, et al.: 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-S384.

Street D, Burge S, Quadagno J, et al.: The salience of social relationships for resident well-being in assisted living. J Gerontol B: Psychol Sci Soc Sci. 2007; 62(2): S129-S134.

Park NS: The relationship of social engagement to psychological well-being of older adults in assisted living facilities. J Appl Gerontol. 2009; 28(4): 461-481.

VanderWeele TJ, Hawkley LC, Cacioppo JT: On the reciprocal association between loneliness and subjective well-being. Am J Epidemiol. 2012; 176(9): 777-784.

Alpass FM, Neville S: Loneliness, health and depression in older males. Aging Ment Health. 2003; 7(3): 212-216.

van Tilburg TG: The size of the supportive network in association with the degree of loneliness. In Knipscheer CPM, Antonucci TC (eds.): Social Network Research: Substantive Issues and Methodological Questions. Amsterdam: Swets & Zeitlinger, 1990: 137-150.

Green LR, Richardson DS, Lago T, et al.: Network correlates of social and emotional loneliness in young and older adults. Pers Soc Psychol Bull. 2001; 27(3): 281-288.

Liebler CA, Sandefur GD: Gender differences in the exchange of social support with friends, neighbors, and coworkers at midlife. Soc Sci Res. 2002; 31(3): 364-391.

Shankar A, Hamer M, McMunn A, et al.: Social isolation and loneliness: Relationships with cognitive function during 4 years of follow-up in the English Longitudinal Study of Ageing. Psychosom Med. 2013; 75: 161-170.

Boehlen F, Herzog W, Quinzler R, et al.: Loneliness in the elderly is associated with the use of psychotropic drugs. Int J Geriatr Psychiatry. 2015; 30(9): 957-964.

Cacioppo JT, Hawkely LC, Brentson GG, et al.: Do lonely days invade the nights?. Potential social modulation of sleep efficiency. Psychol Sci. 2002; 13(4): 384-387.

Holt-Lunstad J, Smith TB, Layton JB: Social relationships and mortality risk: A meta-analytic review. PLoS Med. 2010; 7(7): 1-20.

Seeman TE, Lusignolo TM, Albert M, et al.: Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur studies of successful aging. Health Psychol. 2001; 20(4): 243-255.

Holtzman RE, Rebok GW, Saczynski JS, et al.: Social network characteristics and cognition in middle-aged and older adults. J Gerontol B: Psychol Sci Soc Sci. 2004; 59(6): P278-P284.

CTRS Professional Profile Brochure [brochure]. New City, NY: National Council of Therapeutic Recreation Certification, n.d.

Cattan M, White M, Bond J, et al.: Preventing social isolation and loneliness among older people: A systematic review of the health promotion intervention. Ageing Soc. 2005; 25: 41-67.

Findlay RA: Interventions to reduce social isolation amongst older people: Where is the evidence? Ageing Soc. 2003; 23: 657-658.

Stevens N: Combating loneliness: A friendship enrichment programme for older women. Ageing Soc. 2001; 21(2): 183-191.

Banks M, Banks WA: The effects of animal-assisted therapy on loneliness in an elderly population in long-term care facilities. J Gerontol. 2002; 57(7): 428-432.

Martina CMS, Stevens NL: Breaking the cycle of loneliness: Psychological effects of a friendship enrichment program for older women. Ageing Ment Health. 2006; 10(5): 467-475.

Passmore T, Lindenmeier D, Tapps T, et al.: Impact of participation in community-based recreation programs on reported loneliness and feelings of usefulness of individuals diagnosed with early stage Alzheimer's disease. Am J Recreat Ther. 2007; 6(4): 27-39.

Hughes ME, Waite LJ, Cacioppo J: A short scale for measuring loneliness in large surveys: Results from two population-based studies. Res Aging. 2004; 26(6): 655-672.

Buettner L, Richeson NE, Connoly P: Content validity, reliability, and treatment outcomes of the Buettner assessment of needs, diagnoses, and interests for recreational therapy in long-term care (BANDI-RT). Am J Recreat Ther. 2011; 10(3): 39-54.



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