Living alone, lack of a confidant and psychological well-being of elderly women in Singapore: the mediating role of loneliness

Background: The "feminization of aging" and nuclearization of families calls for research to examine the mental health and well-being of elderly women living alone. This study examined a proposed heuristic model whereby the relationship between living alone and lack of a confidant and psychological well-being is mediated by feeling of loneliness. Methods: Path analysis was performed on data of 1,205 community-living older women aged 55 and above with psychological well-being assessed by depressive symptoms (15-items Geriatric Depression Scale) and SF-12 MCS (mental component summary scale of the 12-item Short-Form Health Survey) quality of life scores assessed at baseline and follow-up 1.5 years later. Results: Goodness-of-fit indices used for the model showed good fits. All of the path coefficients were meaningful in absolute magnitude and significant at P < 0.001. Living alone was associated concurrently with lack of a confidant (r = 0.11), both of which predicts loneliness (path coefficient = 0.09). Loneliness predicts more depressive symptoms (path coefficient = 0.25) and SF-12 MCS (path coefficient = -0.28) at baseline, as well as at follow-up. Conclusion: The findings suggest that loneliness mediates the relationship between living alone, lack of a confidant, and psychological well-being. Living alone becomes detrimental when it leads to loneliness. Social programs directed at elderly women who are living alone should alleviate loneliness through satisfactory interpersonal relationships, and emotional and spiritual support.