Front Public Health. 2026 Jul 31;14:1846531. doi: 10.3389/fpubh.2026.1846531. eCollection 2026.
ABSTRACT
BACKGROUND: Loneliness is increasingly recognized as an important psychosocial health issue among older adults. Older adults with chronic diseases and multimorbidity may be particularly vulnerable because long-term disease burden, coexisting chronic conditions, functional limitations, and reduced social participation often interact. This scoping review aimed to map the available evidence on assessment tools, prevalence estimates, and factors associated with loneliness among older adults with chronic diseases and multimorbidity.
METHODS: A systematic search was conducted in CNKI, Wanfang, VIP, China Biomedical Literature Database, Embase, The Cochrane Library, PubMed, Web of Science, and CINAHL from database inception to November 2025. Eligible studies were screened and extracted according to predefined criteria. Descriptive statistics, narrative synthesis, and thematic analysis were used to summarize the findings.
RESULTS: Twenty-one studies involving 26,140 participants were included. Five loneliness assessment approaches were identified, including the UCLA Loneliness Scale, the 3-item UCLA Loneliness Scale, the ULS-8 Scale, the De Jong Gierveld Loneliness Scale, and a single-item loneliness question. Thirteen studies reported prevalence estimates, ranging from 25.0 to 97%. When stratified by assessment instrument, estimates were generally higher in studies using the full UCLA Loneliness Scale and lower in studies using single-item loneliness questions. Factors associated with loneliness were grouped into four categories: sociodemographic factors, health status and disease-related factors, lifestyle and social support factors, and psychological and cognitive factors. Insufficient social support, chronic disease burden, multimorbidity, functional impairment, depression, anxiety, living alone, and widowhood were repeatedly reported.
CONCLUSION: Loneliness among older adults with chronic diseases and multimorbidity is common but heterogeneous across studies. Future research should standardize measurement approaches and conduct longitudinal and intervention studies to inform integrated and personalized management strategies.
SYSTEMATIC REVIEW REGISTRATION: Identifier md2je. The review was registered with the Open Science Framework. The publicly accessible registration URL is: https://osf.io/md2je/.
PMID:42601983 | PMC:PMC13472916 | DOI:10.3389/fpubh.2026.1846531
