Loneliness and Psychosocial Well-Being in Nursing Homes: A Cross-Sectional Study of Older Adults

Background/Objectives: Loneliness is a major public health concern in later life and may be especially prevalent among older adults living in nursing homes. Evidence from Spain remains limited regarding modifiable correlates of different loneliness dimensions. This study aimed to describe social and existential loneliness among nursing home residents and examine their associations with sociodemographic, institutional, functional, and psychosocial factors. Methods: We conducted a cross-sectional study in Spanish nursing homes using face-to-face structured interviews with residents aged ≥65 years (n = 139). Social loneliness was assessed with the ESTE-II scale and existential loneliness with the existential loneliness subscale of the ESTE-R. Functional dependence was measured with the Barthel Index. Health literacy, locus of control, institutional variables, and suicidality-related items were also collected. Spearman correlations and multiple linear regression models with BCa bootstrapped 95% confidence intervals (5000 resamples) were used. Results: Social and existential loneliness were moderately correlated (ρ = 0.481, p < 0.001). Greater activity engagement was independently associated with lower social (B = -1.105, p < 0.001) and existential loneliness (B = -0.732, p = 0.029). Receiving visits regularly was associated with lower social loneliness (B = -4.083, p = 0.002), but not existential loneliness. Greater functional independence was associated with lower existential loneliness (B = -0.044, p = 0.023). Conclusions: Activity engagement was a consistent correlate across loneliness dimensions, whereas regular visits were mainly related to social loneliness and functional independence to existential loneliness. These findings support feasible long-term care strategies focused on meaningful activities, relational contact, and functional support.