Social isolation/vulnerability and support for loneliness in a rural Japanese cohort: a questionnaire-based...

Objective: To explore the effects of social isolation and vulnerability on loneliness among rural residents of Japan by testing the hypothesis that social support can alleviate loneliness. Materials and Methods: A questionnaire-based cross-sectional survey was conducted using the University of California, Los Angeles Loneliness Scale score as the outcome to analyze the correlation between loneliness and social support. Results: Among the 975 respondents, 46.7% were men, the mean age was 63.9 years, and 58.1% were aged ≥65 years. The three most common risk factors for loneliness and social vulnerability were living alone (29%), eating alone (15.4%), and mobility issues (12.6%). The three most frequent emotional support factors were spouses (62%), friends (45%), and siblings (32.4%), whereas the three most frequent physical support factors were spouses (65.5%), siblings (36.6%), and children living together (30.9%). Our multivariate analysis showed a significant correlation with the Loneliness Scale score in people with mobility issues (coefficient 0.47) and a trend towards an association with the score in childcare and elderly care households. The correlation coefficient was higher for childcare households than for eldercare households. Multivariate analysis of social support showed that emotional support from friends (coefficient -0.71) and instrumental support from a spouse (coefficient -0.62), siblings (coefficient -0.24), and friends (coefficient -0.37) reduced the Loneliness Scale score. Conclusion: Mobility issues should be prioritized to alleviate loneliness in rural areas. Among societies with a declining birthrate and an aging population, loneliness may be a more serious problem for childcare than for older-person care households. To alleviate loneliness, emotional support from spouses or siblings and emotional and instrumental support from friends may be effective. It is important to promote social support and create systems that enable acquaintances and neighbors to become friends.