Loneliness, social connectedness, and resilience during COVID pandemic among those with and without cognitive impairment.

BACKGROUND: Loneliness in older adults is multifactorial. Social connectedness and resilience are protective against loneliness and have been adversely affected by the COVID pandemic. The objective was to measure loneliness in older adults with and without cognitive impairment and to compare the interaction of loneliness with resilience and social connectedness in these subgroups.

METHODS: A cross-sectional study was conducted in community dwelling older adults (N=254) (November 2020-ongoing). Demographic data were collected along with variables related to social determinants of health. Loneliness was assessed with the 3-item loneliness questionnaire, resilience with the Brief Resilience Coping Scale (BRCS) and social connectedness using the 6-item Lubben social network scale.

RESULTS: Mean age was 74.6 (±8.0) years, 93.7% male, 50.8% rural, 79.5% Caucasian, and 17.3% African American. Mean education was 14 years (±2.4). The majority of the participants reported loneliness (57.5%). Mean Lubben social network score was 14.7 (±7.1) and mean resilience score was 15.0 (±4.1). Loneliness was higher in those living alone compared to those living with someone (5.6 vs. 4.6, p<0.001, 95% CI: -1.6, -0.48). There were strong negative correlations between social connectedness and loneliness (p<0.001, r=-0.43) and resilience and loneliness (p=0.001, r=-0.19). Compared to those without cognitive impairment (N=151), participants with cognitive impairment (N=101) had a significantly lower mean social network score (p=0.007, 95% CI: 0.69, 4.23). Compared to those without cognitive impairment, participants with cognitive impairment had lower mean resilience score, however the difference was not statistically significant (p=0.080, 95% CI: -0.11, 1.97). T-MoCA and FAQ mean scores for the cognitively impaired older adults were 15.2 (±4.6) and 8.0 (±9.3), respectively. The strong negative correlation between resilience and loneliness scores persisted in the subgroup with cognitive impairment (p=0.028, r=-0.22).

CONCLUSIONS: Loneliness was commonly reported among older adults during the COVID pandemic. Loneliness was negatively correlated with social connectedness and resilience. Compared to cognitively intact counterparts, those with cognitive impairment reported significantly lower social connectedness. This finding indicates that those with cognitive impairment may need more attention during natural disasters that foster physical separation.