Social relationships and the association of loneliness with major depressive disorder in the Ibadan study of aging

Abstract

Background: Socially disaffiliated elderly Nigerians are at higher risk for major depressive disorder (MDD). It is unclear whether subjective experience of loneliness has independent association with MDD. Methods: A household multistage probability sample of persons who were 65 years or older was drawn from a geographical area with approximately 25 million population. We measured loneliness using the three-item University of California at Los Angeles scale. Poor social engagement, social isolation, and MDD were assessed using the World Health Organization (WHO) Disability Assessment Schedule II and Composite International Diagnostic Interview (WHO), respectively. Results: Of 1704 respondents, 179 (16.7%) were classified as lonely. Lonely respondents were more likely to have poor social engagement (P < 0.001) and social isolation (P < 0.001). While loneliness (adjusted odds ratio [OR] = 2.3, 95% confidence interval [CI] = 1.3–4.0) and poor social engagement (adjusted OR = 3.1, 95% CI = 1.6–6.1) were independent correlates of MDD, the association of loneliness with MDD was substantially, but not totally, mediated by poor social engagement. Conclusion: The association of loneliness with late-life depression in this African sample is partly explained by poor social engagement. Interventions for loneliness based on social activity schedules and networking programs can be adapted to reduce loneliness and lower the burden of late-life depression in Africans.

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