Skip to main content
Download PDF

Early-life circumstances and late life loneliness trajectories among Finnish older adults

BMC Geriatrics volume 24, Article number: 459 (2024) Cite this article

Abstract

Background

Later life loneliness has become a significant public health concern worldwide. Research has focused on the prevalence, risk factors and consequences of loneliness in different age groups. This study aimed to advance the understanding of the impact of early-life circumstances on later life loneliness by examining the associations between adversities in childhood and youth and loneliness trajectories in Finnish older adults.

Methods

The data were derived from the 10-year follow-up survey study Good Aging in the Lahti Region (n = 1552, mean age 64.89 years). The baseline study was conducted in 2002 with a regionally and locally stratified random sample of older persons living in the Lahti Region located in southern Finland. The follow-up surveys were carried out in 2005, 2008 and 2012. Loneliness was measured using a single question at the three follow-ups. Childhood conditions were retrospectively assessed at baseline with questions regarding the death of parents, household affection, relocation, and fear of a family member. Latent class growth analysis with time invariant covariates was used to identify loneliness trajectories and to examine the associations between loneliness trajectories and adverse circumstances in childhood and youth.

Results

The results identified three distinct loneliness trajectories: low, moderate, and severe, including 36%, 50% and 14%, respectively, of the study population. The non-significant slopes of the three trajectories indicate that trajectories were stable during the seven years of follow-up. Being afraid of a family member, having a cold childhood, and death of a father or mother in childhood or youth significantly increased the odds of having a severe loneliness trajectory as compared to low loneliness trajectory. None of the early-life circumstances differentiated between severe and moderate levels of loneliness.

Conclusions

The findings suggest that some adverse early-life circumstances increase the odds of an unfavorable loneliness trajectory in later life. The results highlight the need to recognize the role of diverse life-course adversities in loneliness research and interventions. The study also underscores the importance of identifying individuals who are at risk of long-term and severe loneliness and providing them with appropriate support to decrease and/or prevent the negative health consequences of loneliness in old age.

Peer Review reports

Introduction

Loneliness has been referred to as one of the new “geriatric giants”, leading to severe health consequences in old age [1]. Among the many negative outcomes are a lower level of cognitive functioning and faster cognitive decline [2, 3], cardiovascular diseases [4], cancer incidence [5], increased use of social and health services [6, 7], and mortality [8].

The prevalence of loneliness is known to vary with age and place. Several studies have shown that the highest prevalence of loneliness occurs in the youngest (< 30) and oldest (> 75) age groups [9, 10]; others find a linear decrease in loneliness with age worldwide [11]; others indicate that age differences in the prevalence of loneliness depend on the country or culture in which people live [9, 12, 13]. The factors consistently found to be associated with loneliness are partner status and widowhood, social network size, depression, self-perceived health, and social activities [14].

Despite a substantial amount of related research, only a few studies have grasped the temporal changes and/or stability of loneliness in old age [15, 16]. Moreover, very little is known about how different life-course factors shape the intensity and duration of loneliness later in life. Our study aims to fill these gaps by examining how trajectories of loneliness vary in older people and how adverse early-life circumstances are associated with different loneliness trajectories.

Based on existing conceptualizations, we understand loneliness as a negative and unpleasant emotional state expressing a mismatch between an individual’s desires or expectations toward social relationships and the perceived reality of one’s social life. This evaluation process is affected by past experiences and the experiences of others [17, 18]. Moreover, we recognize that there is strong variation in the ways people cope with loneliness and that people can go in and out of states of loneliness [17, 19].

Typologies, such as situational and chronic loneliness [15, 20] and trait and state loneliness [21], indicate that the duration of loneliness varies between stable and nonstable during the life course, leading to diverse health impacts. Empirical longitudinal studies, on the other hand, have shown three to five different loneliness trajectories in older adults, including forms of increasing, decreasing and stable loneliness and, in some cases, fluctuating loneliness [22,23,24,25,26].

Compared to studies among younger age groups [27, 28], only a few studies on older adults have established factors influencing different trajectories. In a five-year follow-up, Newall et al. [26] found that persistent loneliness was associated with living alone, being widowed or divorced, having poor health, and experiencing low perceptions of control. In a 20-year follow-up study, Solomon et al. [29] found that loneliness remained stable among veterans with antecedent combat stress reaction (CSR) but decreased among veterans without CSR. Persistent loneliness was also associated with higher levels of posttraumatic symptoms and lower levels of social support. Both studies highlight the importance of examining loneliness from a longitudinal perspective but focus only on adult or later life conditions and not on previous life circumstances.

Early-life circumstances and loneliness

As early as the 1950s, at the dawn of loneliness research, Sullivan [30] suggested that loneliness in childhood foreshadows loneliness later in life [31]. Later, empirical evidence started to support this idea. Marangoni and Ickes [32] emphasized the relevance of childhood circumstances for later life loneliness and suggested that different subgroups of people exist and that for some people, feelings of loneliness persist throughout the life course since childhood.

Quantitative studies on childhood circumstances and loneliness have revealed various factors that are associated with loneliness in different age groups, such as poverty [33, 34], parents’ substance abuse [34, 35], sexual abuse [36], quality of relation with parents [37], and divorce or death of the parents [38]. Moreover, some qualitative studies have examined associations between trajectories of loneliness and early-life circumstances and found that severe and long-term loneliness are influenced by childhood events and experiences, such as being bullied in peer relations, the death of a parent and sexual abuse [35, 39].

Theoretically, associations between loneliness and early-life circumstances have been interpreted through John Bowlby’s [40] concept of early attachment, for example, suggesting that attachment failures in childhood and challenges in early attachments can lead to loneliness later in life [41]. Moreover, these associations can be explained through childhood influences on personality characteristics, such as self-esteem and self-efficacy [18, 42], and from the perspective of cumulative disadvantages [43], through which long-term hardship may impact psychological and social well-being in later life [34]. However, knowledge of adverse early-life circumstances and later life loneliness has been limited and particularly scarce from the perspective of long-term loneliness.

Study aim and hypotheses

Adding to the existing understanding of life course influences on healthy aging [44], in this study, we examine associations between adverse early-life circumstances and seven-year loneliness trajectories in later life. In line with previous findings, we hypothesize that adverse circumstances in childhood and youth are associated with higher trajectories of loneliness (H1), irrespective of the type of event or experience (H2).

Research design and methods

Data

The data used in this study is derived from a longitudinal study in Finland: Good Aging in the Lahti Region (GOAL program, in Finnish: Ikihyvä Päijät-Häme) [45]. The baseline study was conducted in 2002 with a regionally and locally stratified random sample. The program approached 4,272 persons living in the Lahti Region located in southern Finland, and the response rate was 65.8%, leading to a baseline sample of 2814 persons. The participants were born between 1926 and 1930, 1936–1940, and 1946–1950, with ages of 52–56, 62–66 and 72–76 years, respectively, at baseline in 2002. The follow-up surveys were carried out in 2005, 2008 and 2012, and during the first follow-up in 2005, the sample was increased by 102 persons due to the inclusion of one new municipality in the study region. At baseline, the basic characteristics of the participants and retrospective information on circumstances in childhood and youth were assessed, while loneliness was introduced in the questionnaire in 2005 and was also part of the follow-ups of 2008 and 2012. The participation rate at the follow-ups ranged between 49% and 66% [46].

Included in the study sample are participants who participated at baseline (2002) and who had at least two follow-up observations of loneliness (N = 1829). In the latent class growth models, a further selection of people without missing observations on the covariates resulted in a final study sample of 1,552 people. Missing values on the loneliness variable were taken into account by means of the MLR estimator, which is robust to non-normality. Dropout during follow-up was associated with employment and current life situation: in the youngest cohort, the unemployed were more likely to drop out of the study, and those most likely to continue were people living with a partner. Overall, the older population in this study is socially and physically somewhat more active, more educated, and has better health and well-being than the total sample [46].

Measurements

Loneliness

Loneliness was measured with a single question, “Do you feel lonely?” with five alternative answers: “never (1),” “seldom (2),” “occasionally (3),” “often (4)” and “all the time (5)”. The limitations and benefits of the single question are examined in the discussion section.

Predictors of loneliness trajectory

Guided by previous studies and availability in the dataset, we included characteristics of childhood and youth as predictors of loneliness trajectories in later life. As the survey did not include a validated measure of childhood adversities, we included a set of individual questions, including the death of the father, death of the mother, household level of affection, relocation in childhood, being afraid of a family member, and the total number of adverse early-life circumstances. All measures related to childhood and youth were based on retrospective information asked in 2002.

Early-life circumstances

Parental bereavement was measured with two separate questions inquiring about the year when the participant lost the mother and the father. Death of mother was recoded into (1) if the mother died before the age of 18, and into (0) if the mother did not die before the age of 18. A similar procedure was used for the death of the father.

Household level of affection reflects the way respondents describe their childhood home. They were asked to indicate to what extent each of the following characteristics described their childhood home: Warm, caring; Inspiring, encouraging; Quarrelsome; Trusting, understanding; Strict; Open; Unfair; Happy and Indifferent, not interested with five alternative answers (1) Describes well (2), Describes fairly well (3), Describes to some extent (4), Describes poorly, and (5) Doesn’t describe it at all. To reduce the number of factors and increase the reliability of household affection, we calculated a scale of cold childhood based on the sum score of four individual items: Quarrelsome, Strict, Unfair, Indifferent, not interested (Cronbach alpha = 0.72). Scale scores ranged from 5 to 20, with higher scores indicating higher affection.

Relocation in childhood was measured using the question, “When you were of school age [7–16 years], did you move to a different municipality so that your best friends changed?” followed by a specifying question, “How many times during school age?”. The latter variable was re-coded into three categories: (0) No moves; (1) One move, and (2) Two or more moves during school age.

Being afraid of a family member was also used as an indicator of adverse early-life circumstances. For this we used the question, “When you think back to your childhood and youth: Were you afraid of a family member?” with three answering categories: (1) Not at all; (2) Sometimes, and (3) Often.

The total number of adversities in early-life is a count variable, reflecting the total number of the following adversities: death of the mother before the age of 18, death of the father before the age of 18, at least one relocation in childhood, having had often financial hardships, having been at least sometimes afraid of a family member, having had a family member with alcohol-related problems at least sometimes, and two indicators of the level of family affection; that is belonging to the 10% of people who had the lowest scores on a warm childhood (based on five items: Warm, caring; Inspiring, encouraging; Trusting, understanding; Open; and Happy) and belonging to the 10% of people who had the coldest childhood household.

Statistical analysis

The analysis consisted of several steps. After describing the basic characteristics of the study sample, we conducted Latent Class Growth Analyses (LCGA), which is a person-centered approach used to (1) identify distinctive loneliness trajectories, and (2) estimate the proportion of the study population following each trajectory. By including covariates (childhood characteristics and other demographic variables), we (3) related the probability of a certain trajectory to individual characteristics for each covariate by means of a multinomial regression [47]. The LCGA was conducted in a stepwise manner. First, we estimated an unconditional single latent class growth model, i.e., a model that includes only the loneliness observations at the subsequent waves and only one class or trajectory to derive the estimates for the growth parameters. Factor loadings of the intercept were fixed to be equal across time to ensure that the same concept is measured over time (factorial invariance).

Next, in accordance with other studies [47,48,49], we decided upon the optimal number of trajectories based on the Bayesian Information Criterion (BIC), the Bootstrapped LR difference test (b-LRT), an entropy summary statistic, the number of people assigned to each trajectory, and the meaningfulness of the trajectories. Extra trajectories were added to the model as long as the Bayesian Information Criterion (BIC) continued to decrease [49], and the b-LRT, which tests the − 2 log likelihood difference between a model with k classes and k − 1 classes, was significant.

The last indication for consideration about the number of classes is a high entropy value (near 1.0) and trajectories that contain at least 5% of the cases [48]. Entropy gives an indication of the classification accuracy of individuals into the trajectories [50]. The within-class variance of the growth parameters was fixed to zero, which makes sense since we assume that all individuals within a certain latent class have the same trajectory of loneliness [48].

Once the number of trajectories was defined, we added the early-life circumstances and control variables and regressed the latent class variable on the selected covariates to estimate the probability of a certain trajectory given the value of the covariates. Mplus version 8.4 [51] was used in the current study.

Results

Descriptive statistics of all study variables can be found in Table 1. 53.4% of the study population was female. The mean age at the first follow-up (2005) for all participants was 64.89 years. 5.3% of participants had lost their mother and 13.1% their father before the age of 18. 29.2% had at least one relocation during childhood, 19.9% of participants had often encountered financial difficulties in their childhood homes, and 31.6% had been at least sometimes afraid of a family member. The mean number of adversities experienced in childhood was 1.48.

Table 1 Descriptive statistics of the study population
Full size table

The correlations of the study variables are presented in Table 2. The bivariate correlations between the three loneliness measures were rather high, suggesting substantial stability over time. Death of the father or mother before the age of 18 was not significantly associated with later life loneliness. Relocation at T1 and T2 was associated with higher levels of loneliness. Being afraid of a family member was associated with higher levels of loneliness at all three time points, and the negative correlation between cold childhood environment and loneliness indicates that a higher score on the cold childhood scale (indicative of higher affection) was inversely associated with loneliness. The number of adverse childhood events was positively associated with the three loneliness observations, indicating that a higher number of events related to higher levels of loneliness. Associations between age and loneliness did not reach the level of significance.

Table 2 Bivariate Correlations between the study variables
Full size table

In the final models, we used 500 initial stage random sets of starting values and 40 final stage optimizations, and we used 20 starting iterations to avoid ending the estimation in a local optimum and found that the best loglikelihood value was repeated. The best solution for the Latent Class Growth Models was a model with three trajectories. Compared to a model with two trajectories, the three-class model had a lower BIC, the b-LRT was significant and the classification quality (entropy) was better. While also a four-class model has a significant b-LRT, all other indices were worse and one class was only observed in less than 0,01% of the study sample (Table 3).

Table 3 Fit indices and trajectory class proportions of the latent class growth analyses
Full size table

The proportions for the latent classes (Table 3) indicate that 36% (n = 556), 50% (n = 772) and 14% (n = 214) of the respondents could be assigned to class 1,2 and 3 respectively. Class one is the class with the lowest loneliness trajectory, class two refers to the moderate loneliness trajectory and class three refers to the severe loneliness trajectory.

The conditional latent class growth analysis indicated that, compared to people with a severe loneliness trajectory, people in the lowest loneliness trajectory scored low on all adverse early-life circumstances; they less often lost their mother (OR = 0.54, p = 0.04) or father (OR = 0.59, p = 0.02) before the age of 18 years, had less often been afraid of a family member in their youth (OR = 0.59, p < 0.001), and they less often indicated that household level of affection could be characterized as cold (OR = 1.16, p = 0.01). The total number of adversities, however, did not further raise the odds of having a severe loneliness trajectory beyond the impact of the single adversities in childhood and youth. None of the examined early-life circumstances differentiated a severe loneliness trajectory from the moderate trajectory (Table 4).

Table 4 Results from conditional latent class growth analyses (N = 1552)
Full size table

Discussion

In this study, we examined trajectories of later life loneliness and their associations with early life circumstances, including negative or adverse experiences in childhood and youth. In line with previous research, the findings on loneliness trajectories showed that there was substantial stability in the intensity and duration of loneliness, and that most older adults experienced loneliness rarely or occasionally over time. However, almost one in seven older adults experienced severe loneliness during the three follow-up measurements, suggesting chronic loneliness [52]. The findings also indicated some adverse experiences in childhood and youth that were associated with long-term loneliness (both moderate and severe). Being afraid of a family member, having a cold childhood household and death of parent in childhood or youth significantly increased the odds of having a high loneliness trajectory compared to people who were not lonely.

There may be several reasons why a child could be afraid of a family member or experience coldness in the childhood environment, for example, different forms of abuse, authoritative parenting styles, or parents’ mental health problems. Based on existing research in the Finnish context, it is known that older generations have often experienced adversities in childhood families due to the impact of Finnish wars between 1939 and 1945. During these wars, most Finnish fathers were forced to go to the war front and, if not deceased, many came back home with trauma that might have led to problems with alcohol and mental health [39, 53, 54]. The older adults who participated in this study were born before, during, or soon after the war. Moreover, they had lived their childhood and youth during a time when children’s wellbeing and rights were not yet systematically recognized [55], and therefore may not have received adequate care and support in family disruptions.

Contrary to our expectations, we did not find an association between moving to a new municipality when comparing the severe loneliness trajectory to the low loneliness trajectory. One reason could be that the question did not fully capture the social aspects of relocation in childhood we had in mind, including the negative influence of the loss of friends. It may also indicate that, compared to later life, a young person is more flexible to changes in the living environment and that peer relations have a shorter history and can therefore be compensated through new relationships more easily. Interestingly, our finding regarding the death of father or mother in childhood or youth differed from previous research in Finland, where no association was found between parental bereavement and later life loneliness [56]. A possible explanation for this is the difference in the study population (the participants were born at a different time) and the previously discussed societal factors, including the impacts of war, which may have been different for younger cohorts in the older population. The impacts of parental bereavement on loneliness may also differ depending on the cause and circumstances following death [39].

We did not find that the total number of adversities increased the odds of a severe loneliness trajectory beyond the impact of a single adversity in early life. This differs from previous research underlining the co-occurring nature of childhood adversities [57] and their cumulative negative effect on physical health in older age [58, 59]. The predictive variables we used – death of parents, moving to a new municipality, being afraid of a family member, and a cold childhood – are all factors that by their nature are likely to be disruptive to social well-being in childhood and youth. Therefore, it is possible that even one of these experiences during early life is sufficient to increase the odds of developing high loneliness in older age. In the bivariate correlations the number of childhood events has a high correlation with a cold childhood (r = 0.56) and being afraid for a family member (r = 0.65). Since these two variables entered the equation first, the effect of the number of events may already be covered by these two variables. An alternative interpretation is that negative and adverse experiences in early life have a life-long impact, as they compromise the development of social and emotional skills needed to build satisfying relationships in later life [60].

Overall, the main findings of this study are in line with previous research, which found connections between loneliness and different adverse early life circumstances, such as violent environments, family members’ mental illnesses, and substance abuse [34, 61,62,63,64]. Broadening from our focus on loneliness, there is increasing evidence of an association between adverse childhood circumstances and mental health conditions, such as depression and anxiety [63, 65,66,67,68]. Both factors have critical impacts on the health and well-being of older adults. The connection between depression and loneliness is known to be particularly strong in later life [69, 70], but there are differences in the interpretation of the relationship and its direction [71,72,73]. In future research, it would be important to examine the relationship between depression and long-term loneliness in more detail from the perspective of early-life circumstances.

Limitations and strengths

This study has some limitations that are important to consider when interpreting the results. The measurement of loneliness was based on a single question, “Do you feel lonely?”. This approach might not only underestimate nuances in the severity of loneliness but also limit variation in loneliness compared to multi-item scales and, therefore, statistical power. A more nuanced scale and more detailed estimation of the level of loneliness could better detect the interconnections of different childhood circumstances. The low association between loneliness and the total number of adverse early-life circumstances may also be a sign of weakness in the measurements and their interpretation as childhood adversities.

In this study, we were unable to use validated measures, such as the Prevalence of Childhood Exposure to Abuse and Household Dysfunction Scale (ACE; [58]) or the Childhood Trauma Questionnaire (CTQ; [74]), which have been commonly used when investigating childhood adversities. However, the set of questions we used was somewhat comparable to the items used in both scales (e.g., being afraid of a family member and household affection). Moreover, we were able to combine two approaches often used in studies on childhood adversities: examining different types of maltreatment in early life [75,76,77] and measuring the cumulative effects of negative childhood experiences and conditions [58, 78].

From the perspective of limitations, it is important to note that, as the follow-up period was only seven years and loneliness was measured only three times, the chronicity of loneliness in the group with higher loneliness trajectories is uncertain, as we do not know how long they had experienced loneliness before the first measurement. Moreover, as mentioned, a single question on loneliness may detect differences and changes in loneliness more poorly than multiple question scales. However, previous studies have also shown that single loneliness questions classifying respondents as lonely when they express feeling “often” or “always” are highly similar to single questions and aggregated scales [79], and that the single-item scale is suitable for assessing change and does not have major shortcomings when compared to longer scales [80].

In our study, information on childhood circumstances was gathered retrospectively and subjectively when respondents were aged 52 years and older. This is common in research on later life influences of childhood adversities, but it is important to note that such retrospective accounts may be compromised by poor recall [81]. Current loneliness may also affect the recall of childhood events, leading respondents to emphasize their negative experiences [34]. In this study, questions related to childhood circumstances were asked at baseline and not at the same time as questions about loneliness, which were assessed only in the follow-up surveys. Therefore, it may be assumed that reminiscing about childhood conditions did not impact how questions about loneliness were answered.

Despite the limitations of validated and multidimensional measurements, a key strength of this study is the inclusion of diverse retrospective questions regarding childhood conditions and experiences in the baseline. Early life circumstances and life course influences are still often ignored in gerontological research, despite the growing understanding of the “long arm” of childhood conditions on the health and well-being of older adults. Another strength of the study is the acknowledgement of different temporalities of loneliness and the inclusion of loneliness trajectories in the analysis, as later life loneliness is often examined with cross-sectional data focusing on loneliness during a single time point. In future research, more nuanced research strategies are needed to identify individuals who are at risk of long-term and severe loneliness and are exposed to the consequences of its chronicity [82].

Conclusions and implications

The findings of this study show a connection between adverse early-life circumstances and long-term loneliness in later life, underlining the role of critical life course factors in the health and wellbeing of older adults. With respect to practical implications, the findings call for both preventive and corrective measures when aiming to reduce loneliness and prevent the negative health consequences of loneliness in older age. As for preventive measures across generations, focus is needed on ensuring well-being in childhood and youth and the provision of adequate support for families faced with diverse adversities. As for corrective measures, it is important that loneliness interventions are targeted and tailored for older adults experiencing long-term and severe loneliness, and that within these interventions, older adults are provided with the possibility to discuss and address past life events and experiences. For this, interventions implementing narrative and/or life-course-oriented practices may be especially beneficial.

Data availability

Access to the data is maintained by the Good Ageing in Lahti (GOAL, in Finnish Ikihyvä Päijät-Häme) research team. Requests to access these datasets should be directed to Professor Mikael Fogelholm, mikael.fogelholm@helsinki.fi.

References

  1. Freedman A, Nicolle J. Social isolation and loneliness: the new geriatric giants: Approach for primary care. Can Fam Physician. 2020;66:176–82.

    PubMed  PubMed Central  Google Scholar 

  2. Boss L, Kang DH, Branson S. Loneliness and cognitive function in the older adult: a systematic review. Int Psychogeriatr. 2015. https://doi.org/10.1017/S1041610214002749.

    Article  PubMed  Google Scholar 

  3. Lara E, Caballero FF, Rico-Uribe LA, Olaya B, Haro JM, Ayuso‐Mateos JL, Miret M. Are loneliness and social isolation associated with cognitive decline? Int J Geriatr Psychiatry. 2019. https://doi.org/10.1002/gps.5174.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart. 2016;102:1009–16.

    Article  CAS  PubMed  Google Scholar 

  5. Kraav S-L, Lehto SM, Kauhanen J, Hantunen S, Tolmunen T. Loneliness and social isolation increase cancer incidence in a cohort of Finnish middle-aged men. A longitudinal study. Psychiatry Res. 2021. https://doi.org/10.1016/j.psychres.2021.113868.

    Article  PubMed  Google Scholar 

  6. Zhang J, Xu L, Li J, Sun L, Ding G, Qin W, Wang Q, Zhu J, Yu Z, Xie S. Loneliness and health service utilization among the rural elderly in Shandong, China: a cross-sectional study. Int J Environ Res Public Health. 2018. https://doi.org/10.3390/ijerph15071468.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Sirois FM, Owens J. A meta-analysis of loneliness and use of primary health care. Health Psychol Rev. 2023. https://doi.org/10.1080/17437199.2021.1986417.

    Article  PubMed  Google Scholar 

  8. 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. https://doi.org/10.1177/1745691614568352.

    Article  PubMed  Google Scholar 

  9. Yang K, Victor C. Age and loneliness in 25 European nations. Ageing Soc. 2011. https://doi.org/10.1017/S0144686X1000139X.

    Article  Google Scholar 

  10. Hawkley LC, Buecker S, Kaiser T, Luhmann M. Loneliness from young adulthood to old age: explaining age differences in loneliness. Int J Behav Dev. 2022. https://doi.org/10.1177/0165025420971048.

    Article  PubMed  Google Scholar 

  11. Barreto M, Victor C, Hammond C, Eccles A, Richins MT, Qualter P. Loneliness around the world: age, gender, and cultural differences in loneliness. Pers Individ Differ. 2021. https://doi.org/10.1016/j.paid.2020.110066.

    Article  Google Scholar 

  12. Hansen T, Slagsvold B. Late-life loneliness in 11 European countries: results from the generations and gender survey. Soc Indic Res. 2015. https://doi.org/10.1007/s11205-015-1111-6.

    Article  Google Scholar 

  13. Fokkema T, De Jong Gierveld J, Dykstra PA. Cross-national differences in older adult loneliness. J Psychol. 2012. https://doi.org/10.1080/00223980.2011.631612.

    Article  PubMed  Google Scholar 

  14. Dahlberg L, McKee KJ, Frank A, Naseer M. A systematic review of longitudinal risk factors for loneliness in older adults. Aging Ment Health. 2022. https://doi.org/10.1080/13607863.2021.1876638.

    Article  PubMed  Google Scholar 

  15. Shiovitz-Ezra S, Ayalon L. Situational versus chronic loneliness as risk factors for all-cause mortality. Int Psychogeriatr. 2010. https://doi.org/10.1017/S1041610209991426.

    Article  PubMed  Google Scholar 

  16. Martín-María N, Caballero FF, Miret M, Tyrovolas S, Haro JM, Ayuso-Mateos JL, Chatterji S. Differential impact of transient and chronic loneliness on health status. A longitudinal study. Psychol Health. 2020. https://doi.org/10.1080/08870446.2019.1632312.

    Article  PubMed  Google Scholar 

  17. Perlman D, Peplau LA. Loneliness. In: Friedman HS, editor. Encyclopedia of Mental Health. Volume 2. San Diego: Academic; 1998. pp. 571–81.

    Google Scholar 

  18. De Jong Gierveld J. A review of loneliness: concept and definitions, determinants and consequences. Rev Clin Gerontol. 1998. https://doi.org/10.1017/S0959259898008090.

    Article  Google Scholar 

  19. Morgan DJ, Burholt V. Loneliness as a Biographical disruption—theoretical implications for understanding changes in loneliness. J Gerontol B Psychol Sci Soc Sci. 2020. https://doi.org/10.1093/geronb/gbaa097.

    Article  PubMed  PubMed Central  Google Scholar 

  20. De Jong-Gierveld J, Raadschelders J. Types of loneliness. In: Peplau LA, Perlman D, editors. Loneliness: a sourcebook of current theory, research and therapy. New York: Wiley; 1982. pp. 105–19.

    Google Scholar 

  21. Lee Y, Lay J, Mahmood A, Graf P, Hoppmann C. Loneliness and Social Engagement: the unique roles of State and Trait Loneliness for Daily Prosocial behaviors. Innov Aging. 2020. https://doi.org/10.1093/geroni/igaa057.2140.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Wenger GC, Burholt V. Changes in levels of social isolation and loneliness among older people in a rural area: a twenty–year longitudinal study. Can J Aging. 2014. https://doi.org/10.1353/cja.2004.0028.

    Article  Google Scholar 

  23. Jylhä M. Old age and loneliness: cross-sectional and longitudinal analyses in the Tampere Longitudinal Study on Aging. Can J Aging. 2004. https://doi.org/10.1353/cja.2004.0023.

    Article  PubMed  Google Scholar 

  24. Dykstra PA, Van Tilburg TG, Gierveld JDJ. Changes in older adult loneliness: results from a seven-year longitudinal study. Res Aging. 2005. https://doi.org/10.1177/0164027505279712.

    Article  Google Scholar 

  25. Victor C. Loneliness and later life. Concepts, prevalence and consequences. In: Sha’ked A, Rokach A, editors. Addressing loneliness. Coping, prevention and clinical interventions. London and New York: Routledge; 2015. pp. 185–204.

    Google Scholar 

  26. Newall NE, Chipperfield JG, Bailis DS. Predicting stability and change in loneliness in later life. J Soc Pers Relat. 2014. https://doi.org/10.1177/0265407513494951.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Vanhalst J, Goossens L, Luyckx K, Scholte RH, Engels RC. The development of loneliness from mid-to late adolescence: trajectory classes, personality traits, and psychosocial functioning. J Adolesc. 2013. https://doi.org/10.1016/j.adolescence.2012.04.002.

  28. Schinka KC, Van Dulmen MH, Mata AD, Bossarte R, Swahn M. Psychosocial predictors and outcomes of loneliness trajectories from childhood to early adolescence. J. Adolesc. 2013; https://doi.org/10.1016/j.adolescence.2013.08.002 28a.

  29. Solomon Z, Bensimon M, Greene T, Horesh D, Ein-Dor T. Loneliness trajectories: the role of posttraumatic symptoms and social support. J Loss Trauma. 2015. https://doi.org/10.1080/15325024.2013.815055.

  30. Sullivan HS. The interpersonal theory of psychiatry. New York: Norton; 1953.

  31. Peplau LA. Loneliness research: basic concepts and findings. In: Sarason IG, Sarason B, editors. Social support: theory, research and applications. Dordrecht: Springer Netherlands; 1985. pp. 269–86.

    Chapter  Google Scholar 

  32. Marangoni C, Ickes W, Loneliness. A theoretical review with implications for measurement. J Soc Pers Relat. 1989. https://doi.org/10.1177/026540758900600107.

    Article  Google Scholar 

  33. Nicolaisen M, Thorsen K. Loneliness among men and women–a five-year follow-up study. Aging Ment Health. 2014. https://doi.org/10.1080/13607863.2013.821457.

    Article  PubMed  Google Scholar 

  34. Kamiya Y, Doyle M, Henretta JC, Timonen V. Early-life circumstances and later-life loneliness in Ireland. Gerontologist. 2014. https://doi.org/10.1093/geront/gnt097.

    Article  PubMed  Google Scholar 

  35. Rönkä AR. Experiences of loneliness from childhood to young adulthood: study of the Northern Finland Birth Cohort 1986. Acta Universitatis Ouluensis E, 172, 2017.

  36. Kamiya Y, Timonen V, Kenny RA. The impact of childhood sexual abuse on the mental and physical health, and healthcare utilization of older adults. Int Psychogeriatr. 2016. https://doi.org/10.1017/S1041610215001672.

    Article  PubMed  Google Scholar 

  37. Merz EM, Jak S. The long reach of childhood. Childhood experiences influence close relationships and loneliness across life. Adv Life Course Res. 2013. https://doi.org/10.1016/j.alcr.2013.05.002.

    Article  PubMed  Google Scholar 

  38. Ejlskov L, Bøggild H, Kuh D, Stafford M. Social relationship adversities throughout the lifecourse and risk of loneliness in later life. Ageing Soc. 2020. https://doi.org/10.1017/S0144686X19000345.

    Article  Google Scholar 

  39. Tiilikainen E. Narratives of long-term loneliness: case study of two older men. In: Willis P, Pietilä I, Seppänen M, editors. Aging, men and Social relations. Bristol University: Policy; 2023. pp. 188–201.

    Google Scholar 

  40. Bowlby J. Attachment and loss, Vol. 2: separation. London: Hogarth; 1972.

    Google Scholar 

  41. Tiilikainen E, Seppänen M. Lost and unfulfilled relationships behind emotional loneliness in old age. Ageing Soc. 2017. https://doi.org/10.1017/S0144686X16000040.

    Article  Google Scholar 

  42. Young J. Loneliness, depression and cognitive therapy: theory and application. In: Peplau LA, Perlman D, editors. Loneliness: a sourcebook of current theory, research and therapy. New York: Wiley; 1982. pp. 379–406.

    Google Scholar 

  43. Dannefer D. Cumulative advantage/disadvantage and the life course: cross-fertilizing age and social science theory. J Gerontol B Psychol Sci Soc Sc. 2003. https://doi.org/10.1093/geronb/58.6.S327.

    Article  Google Scholar 

  44. Lu N, Nie P, Siette J. The roots of healthy aging: investigating the link between early-life and childhood experiences and later-life health. BMC Geriatr. 2023. https://doi.org/10.1186/s12877-023-04297-z.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Fogelholm M, Valve R, Absetz P, et al. Rural—urban differences in health and health behaviour: a baseline description of a community health-promotion programme for the elderly. Scand J Public Health. 2006. https://doi.org/10.1080/14034940600616039.

    Article  PubMed  Google Scholar 

  46. Haapola I, Vaara E. Käytetyt aineistot [Used data]. In: Haapola I, Karisto A, Fogelholm M, editors. Vanhuusikä muutoksessa: Ikihyvä Päijät-Häme -tutkimuksen tuloksia 2002–2012 [Changing old-age: findings from GOAL program 2002–2012]. Päijät-Hämeen sosiaali- ja terveysyhtymänjulkaisuja 72. Lahti: Päijät-Hämeen sosiaali- ja terveysyhtymä; 2013. pp. 17–26.

    Google Scholar 

  47. Nagin DS. Analyzing developmental trajectories: a semiparametric, group-based approach. Psychol Methods. 1999. https://doi.org/10.1037/1082-989X.4.2.139.

    Article  Google Scholar 

  48. Jung T, Wickrama KA. An introduction to latent class growth analysis and growth mixture modeling. Soc Personal Psychol Compass. 2008. https://doi.org/10.1111/j.1751-9004.2007.00054.x.

    Article  Google Scholar 

  49. Audrain-McGovern J, Rodriguez D, Tercyak KP, Cuevas J, Rodgers K, Patterson F. Identifying and characterizing adolescent smoking trajectories. Cancer Epidem Biomar. 2014. https://doi.org/10.1158/1055-9965.2023.13.12.

    Article  Google Scholar 

  50. Luyckx K, Schwartz S, Goossens L, Soenens B, Beyers W. Developmental typologies of identity formation and adjustment in female emerging adults: a latent class growth analysis approach. J Res Adolesc. 2008. https://doi.org/10.1111/j.1532-7795.2008.00573.x.

    Article  Google Scholar 

  51. Muthén LK, Muthén BO. Mplus User’s Guide. Sixth Edition. Los Angeles, CA: Muthén & Muthén, 1998–2011.

  52. Cacioppo JT, Ernst JM, Burleson MH, McClintock MK, Malarkey WB, Hawkley LC, Kowalewski RB, Paulsen A, Hobson JA, Hugdahl K, Spiegel D, Berntson GG. Lonely traits and concomitant physiological processes: the MacArthur social neuroscience studies. Int J Psychophysiol. 2000. https://doi.org/10.1016/S0167-8760(99)00049-5.

    Article  PubMed  Google Scholar 

  53. Nivala S, Sarvimäki A. The lifelong struggle of Finnish World War II veterans. Aging Ment Health. 2015. https://doi.org/10.1080/13607863.2014.954525.

    Article  PubMed  Google Scholar 

  54. Kivimäki V. Between defeat and victory: Finnish memory culture of the Second World War. Scand J Hist. 2012. https://doi.org/10.1080/03468755.2012.680178.

    Article  Google Scholar 

  55. Ellonen N, Lucas S, Tindberg Y, Janson S. Parents’ self-reported use of Corporal punishment and other Humiliating Upbringing practices in Finland and Sweden–A comparative study. Child Abuse Rev. 2017. https://doi.org/10.1002/car.2482.

    Article  Google Scholar 

  56. Savikko N, Routasalo P, Tilvis R, Strandberg T, Pitkälä K. Loss of parents in childhood – associations with depression, loneliness and attitudes towards life in older Finnish people. Int J Older People Nurs. 2006. https://doi.org/10.1111/j.1748-3743.2006.00001.x.

    Article  PubMed  Google Scholar 

  57. Dong M, Anda RF, Felitti VJ, Dube SR, Williamson DF, Thompson TJ, Loo CM, Giles WH. The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse Negl. 2004. https://doi.org/10.1016/j.chiabu.2004.01.008.

    Article  PubMed  Google Scholar 

  58. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and Household Dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 2019. https://doi.org/10.1016/S0749-3797(98)00017-8.

    Article  PubMed  Google Scholar 

  59. Anderson EL, Fraser A, Caleyachetty R, Hardy R, Lawlor DA, Howe LD. Associations of adversity in childhood and risk factors for cardiovascular disease in mid-adulthood. Child Abuse Negl. 2018. https://doi.org/10.1016/j.chiabu.2017.10.015.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Poole JC, Dobson KS, Pusch D. Do adverse childhood experiences predict adult interpersonal difficulties? The role of emotion dysregulation. Child Abuse Negl. 2018. https://doi.org/10.1016/j.chiabu.2018.03.006.

    Article  PubMed  Google Scholar 

  61. Choi H, Gyul Hwang S. Patterns of adverse childhood experiences and social isolation in young adulthood: evidence from South Korea. Child Youth Serv Rev. 2023. https://doi.org/10.1016/j.childyouth.2023.107083.

    Article  Google Scholar 

  62. Lin W-H, Chiao C. Relationship between adverse childhood experiences and problematic internet use among young adults: the role of the feeling of loneliness trajectory. JBA. 2021. https://doi.org/10.1556/2006.2022.00074.

    Article  Google Scholar 

  63. Luo S, Liu Y, Zhang D. Psychological maltreatment and loneliness in Chinese children: the role of perceived social support and self-esteem. Child Youth Serv Rev. 2020. https://doi.org/10.1016/j.childyouth.2019.104573.

    Article  Google Scholar 

  64. Wong AE, Dirghangi SR, Hart SR. Self-concept clarity mediates the effects of adverse childhood experiences on adult suicide behavior, depression, loneliness, perceived stress, and life distress. Self Identity. 2019. https://doi.org/10.1080/15298868.2018.1439096.

    Article  Google Scholar 

  65. Lian J, Kiely KM, Callaghan BL, Anstey KJ. Childhood adversity is associated with anxiety and depression in older adults: a cumulative risk and latent class analysis. J Affect Disord. 2024. https://doi.org/10.1016/j.jad.2024.03.016.

    Article  PubMed  Google Scholar 

  66. Inoue Y, Stickley A, Yazawa A, Aida J, Koyanagi A, Kondo N. Childhood adversities, late-life stressors and the onset of depressive symptoms in community-dwelling older adults. Aging Ment Health. 2022. https://doi.org/10.1080/13607863.2021.1875190.

    Article  PubMed  Google Scholar 

  67. Xiang X, Wang X. Childhood adversity and major depression in later life: a competing-risks regression analysis. Int J Geriatr Psychiatry. 2021. https://doi.org/10.1002/gps.5417.

    Article  PubMed  Google Scholar 

  68. Raposo SM, Mackenzie CS, Henriksen CA, Afifi TO. Time does not heal all wounds: older adults who experienced childhood adversities have higher odds of mood, anxiety, and personality disorders. Am J Geriatr Psychiatry. 2014. https://doi.org/10.1016/j.jagp.2013.04.009.

    Article  PubMed  Google Scholar 

  69. Luanaigh CÓ, Lawlor BA. Loneliness and the health of older people. Int J Geriatr Psychiatry. 2008. https://doi.org/10.1002/gps.2054.

    Article  PubMed  Google Scholar 

  70. 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; doi;10.1371/journal.pone.0181442.

  71. McHugh Power J, Hannigan C, Hyland P, Brennan S, Kee F, Lawlor B. Depressive symptoms predict increased social and emotional loneliness in older adults. Aging Ment Health. 2020. https://doi.org/10.1080/13607863.2018.1517728.

    Article  PubMed  Google Scholar 

  72. Kraav SL, Lehto SM, Junttila N, Ruusunen A, Kauhanen J, Hantunen S, Tolmunen T. Depression and loneliness may have a direct connection without mediating factors. Nord J Psychiatry. 2021. https://doi.org/10.1080/08039488.2021.1894231.

    Article  PubMed  Google Scholar 

  73. Dahlberg L, Agahi N, Lennartsson C. Lonelier than ever? Loneliness of older people over two decades. Arch Gerontol Geriatr. 2018. https://doi.org/10.1016/j.archger.2017.11.004.

    Article  PubMed  Google Scholar 

  74. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, Stokes J, Handelsman L, Medrano M, Desmond D, Zule W. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003. https://doi.org/10.1016/S0145-2134(02)00541-0.

    Article  PubMed  Google Scholar 

  75. Musetti A, Starcevic V, Boursier V, Corsano P, Billieux J, Schimmenti A. Childhood emotional abuse and problematic social networking sites use in a sample of Italian adolescents: the mediating role of deficiencies in self-other differentiation and uncertain reflective functioning. J Clin Psychol. 2021. https://doi.org/10.1002/jclp.23138.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Li ET, Luyten P, Midgley N. Psychological Mediators of the Association between Childhood Emotional Abuse and depression: a systematic review. Front Psychiatry. 2020. https://doi.org/10.3389/fpsyt.2020.559213.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Kraav SL, Tolmunen T, Kärkkäinen O, Ruusunen A, Viinamäki H, Mäntyselkä P, Koivumaa-Honkane H, Valkonen-Korhonen M, Honkalampi K, Herzig KH, Lehto S. Decreased serum total cholesterol is associated with a history of childhood physical violence in depressed outpatients. Psychiatry Res. 2019. https://doi.org/10.1016/j.psychres.2018.12.108.

    Article  PubMed  Google Scholar 

  78. Miller GE, Chen E, Parker KJ. Psychological stress in childhood and susceptibility to the chronic diseases of aging: moving toward a model of behavioral and biological mechanisms. Psychol Bull. 2011. https://doi.org/10.1037/a0024768.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Victor C, Grenade L, Boldy D. Measuring loneliness in later life: a comparison of differing measures. Rev Clin Gerontol. 2005; doi:1 0.1017/S0959259805001723.

  80. Kotwal AA, Cenzer IS, Waite LJ, Smith AK, Perissinotto CM, Hawkley LC. A single question assessment of loneliness in older adults during the COVID-19 pandemic: a nationally‐representative study. J Am Geriatr Soc. 2022. https://doi.org/10.1111/jgs.17700.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Looker ED. Accuracy of proxy reports of parental status characteristics. Sociol Educ. 1989. 0.2307/2112830.

  82. Kim J, Park G-R. Chronic loneliness, gender, and trajectories of change in hand grip strength in older adults. J Gerontol B. 2023. https://doi.org/10.1093/geronb/gbac191.

    Article  Google Scholar 

Download references

Acknowledgements

We would like to aknowledge and thank the research team of Good Aging in the Lahti Region (GOAL program, in Finnish: Ikihyvä Päijät-Häme) for making this study possible.

Funding

The work done in this study has been funded by Academy of Finland, 342267 (Elisa Tiilikainen) and Norway Grants 2014–2021, 16/2020 (Marja Aartsen).

Author information

Authors and Affiliations

  1. Department of Social Sciences, University of Finland, Helsinki, Finland

    Elisa Tiilikainen & Siiri-Liisi Kraav

  2. NOVA - Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway

    Marja Aartsen

Authors
  1. Elisa Tiilikainen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marja Aartsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Siiri-Liisi Kraav
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

E.T.: Conceptualization, Writing - original draft, Writing - review & editing; M.A.: Conceptualization, Formal analysis, Methodology, Visualization; Writing - review & editing; S.K: Methodology, Visualization; Writing - review & editing.

Corresponding author

Correspondence to Elisa Tiilikainen.

Ethics declarations

Ethics approval and consent to participate

The study was approved by the Ethical Committee of the hospital district of Päijät-Häme. Informed consent was obtained from all the participants.

Consent for publication

The authors confirm their consent for publication.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tiilikainen, E., Aartsen, M. & Kraav, SL. Early-life circumstances and late life loneliness trajectories among Finnish older adults. BMC Geriatr 24, 459 (2024). https://doi.org/10.1186/s12877-024-04967-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12877-024-04967-6

Keywords

BMC Geriatrics

ISSN: 1471-2318

Contact us