Submitted:
09 September 2025
Posted:
10 September 2025
You are already at the latest version
Abstract
Keywords:
Introduction
Quality of Life in Old Age: A Multidimensional Concept and Its Challenges
Loneliness as a Challenge for Public Health
The relationship Between Loneliness and Quality Of Life
Purpose and Objective
Materials and Methods
Participants
Procedure
Measurements
Personal Wellbeing Index for Adults (PWI-A)
UCLA Loneliness Scale (UCLA Scale)
Statistical Analyses
Results
Socio-Demographic Characteristics of the Participants
Correlation Analysis

Differences in Subjective Well-Being and Loneliness by Gender and Living Arrangments
Differences in Subjective Well-Being and Loneliness According to Living Arrangments
Discussion
Conclusions
Declaration of Helsinki STROBE reporting guidelines
Author Contributions
Institutional Review Board Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Vuletić G, et al. Quality of life and health. Osijek: Faculty of Humanities and Social Sciences, J. J. Strossmayer University; 2011. Available from: http://bib.irb.hr/datoteka/592441.KVALITETA_IVOTA_I_ZDRAVLJE.pdf Accessed 2025 January 15.
- Torres Z, Oliver A, Tomás JM. Understanding the effect of loneliness on quality of life in older adults from longitudinal approaches. Psychosoc Interv [Internet]. 2024 [cited 2025 Jun 10];33(3):171–8. Available from: https://doi.org/10.5093/pi2024a11. Accessed 2025 January 10. [CrossRef]
- Brajković L. Indicators of life satisfaction in older adulthood [dissertation]. Zagreb: University of Zagreb, Faculty of Medicine; 2010.
- Sulandari S, Okely JA, Bandelow S, Farrow M, Galvin JE, Fielding R, et al. A systematic review and meta-analysis of the association between physical capability, social support, loneliness, mental health, and life satisfaction in older adults. Gerontologist. 2024;64(5):e295–309. [CrossRef]
- Salari N, Kazeminia M, Shohaimi S, Vaisi-Raygani A, Mohammadi M, Hallajzadeh J, et al. The global prevalence and associated factors of loneliness among older adults: a systematic review and meta-analysis. Humanit Soc Sci Commun. 2025;12:104. [CrossRef]
- Nakou A, Daskalopoulou C, Niarchou M, Stefanis C, Chrousos G, Chrysohoou C. Loneliness, social isolation, and mortality in older adults: a systematic review and meta-analysis. Aging Ment Health. 2025;29(3):399–412. [CrossRef]
- Di Perna G, Rossi E, Chiorri C. A systematic literature review of loneliness in community-dwelling older adults. Soc Sci. 2023;12(1):21. [CrossRef]
- Slavuj L. Objective and subjective indicators in the study of the concept of quality of life. Geoadria. 2012;17(1):73–92. Available from: https://doi.org/10.15291/geoadria.238. Accessed 2025 January 10. [CrossRef]
- Vuletić G, Stapić M. Quality of life and loneliness among elderly people. Klinička psihologija [Internet]. 2013 [cited 2025 Jun 10];6(1–2):61–61. Available from: https://hrcak.srce.hr/167454 Accessed 2025 January 15.
- Salić N. Quality of life of older persons in institutional care from the user’s perspective. Soc Humanit Stud. 2024;7(1):1067–96. [CrossRef]
- Jovičić A. Quality of life of pensioners in the Republic of Croatia: Differences by gender, education and marital status [Internet]. 2023. Available from: https://www.researchgate.net/publication/372666333. Accessed 2025 February 6.
- Ellwardt L, Aartsen M, Deeg D, Steverink N. Does loneliness mediate the relation between social support and cognitive functioning in later life? Soc Sci Med. 2013;98:116–24. [CrossRef]
- UNFPA. Loneliness and social isolation of older adults in Eastern Europe and Central Asia: Survey among people aged 65+. Sarajevo: UNFPA; 2021. Available from: https://ba.unfpa.org/sites/default/files/pub-pdf/survey_on_loneliness_final_bcs_0.pdf. Accessed 2024 October 15.
- CRORIS. Loneliness of older adults as an increasingly important public health issue [Internet]. 2022. Available from: https://www.croris.hr/crosbi/publikacija/prilog-skup/679059. Accessed 2024 October 15.
- Gardiner C, Geldenhuys G, Gott M. Interventions to reduce social isolation and loneliness among older adults: an integrative review. Health Soc Care Community. 2018;26(2):147–57. [CrossRef]
- Lacković-Grgin K. Loneliness – phenomenology, theories and research. Jastrebarsko: Naklada Slap; 2008.
- Cummins RA. Personal Wellbeing Index Manual: 6th Edition, Version 2. Geelong: Australian Centre on Quality of Life, Deakin University; 2024. Available from: https://www.acqol.com.au/uploads/pwi-a/pwi-a-english.pdf. Accessed 2024 October 10.
- Lacković-Grgin K, et al. Collection of psychological scales and questionnaires. Zadar: University of Zadar, Faculty of Humanities and Social Sciences; 2019. p. 77–9. Available from: https://morepress.unizd.hr/books/index.php/press/catalog/view/28/24/365. Accessed 2024 October 20.
- Russell D, Peplau LA, Cutrona CE. The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. J Pers Soc Psychol. 1980;39:472–80. [CrossRef]
- Allen RL, Oshagan H. The UCLA Loneliness Scale: Invariance of social structural characteristics. Pers Individ Dif. 1995;19(2):185–95. [CrossRef]
- TIBCO Software Inc. Statistica (Version 14.0.0.15) [computer software]. 2020. Available from: https://www.tibco.com/products/tibco-statistica. Accessed 2025 March 10.
- Pinquart M, Sörensen S. Influences on loneliness in older adults: A meta-analysis. Basic Appl Soc Psych. 2001;23(4):245–66. [CrossRef]
- Victor CR, Bowling A. A longitudinal analysis of loneliness among older adults in Great Britain. J Psychol. 2012;146(3):313–31. [CrossRef]
- Cattan M, White M, Bond J, Learmouth A. Preventing social isolation and loneliness among older adults: A systematic review. Ageing Soc. 2005;25(1):41–67. [CrossRef]
- Grover S. Loneliness in older adults: Impact and interventions. Indian J Psychiatry. 2022;64(2):98–106. [CrossRef]
- Fokkema T, De Jong Gierveld J, Dykstra PA. Cross-national differences in older adult loneliness. J Psychol. 2012;146(1–2):201–28. [CrossRef]
- Tourani S, Behzadifar M, Martini M, Aryankhesal A, Taheri Mirghaed M, Salemi M, et al. Health-related quality of life among healthy elderly Iranians: A systematic review and meta-analysis of the literature. Health Qual Life Outcomes. 2018;16(1):18. [CrossRef]
- Wijesiri HSMSK, Wasalathanthri S, De Silva Weliange S, Ranathunga I, Sivayogan S. Quality of life and its associated factors among home-dwelling older adults residing in the District of Colombo, Sri Lanka: a community-based cross-sectional study. BMJ Open. 2023;13:e068773. [CrossRef]
- Xie J, Zhang B, Yao Z, Zhang W, Wang J, Zhao C, et al. The effect of subjective age on loneliness in older adults: The chain mediating role of resilience and self-esteem. Front Public Health. 2022;10:907934. [CrossRef]
- Kousha M, Shahraki M, Askarizadeh G, Mohammadi M, Abdollahi E. Loneliness and quality of life in older adults living alone. BMC Geriatr. 2022;22(1):401. [CrossRef]
- Zarei M, Bakhshi S, Bahrami F, Ghaedi Heidari F. Relationship between loneliness and quality of life in older adults: The mediating role of social support and depression. BMC Psychol. 2023;11(1):281. [CrossRef]
- Shpakou A, Klimatckaia L, Furiaeva T, Piatrou S, Zaitseva O. Ageism and loneliness in the subjective perceptions of elderly people from nursing homes and households. Fam Med Prim Care Rev. 2021;23(4):475–480. [CrossRef]
- Attafuah PYA, Everink I, Abuosi AA, Birt L, van der Vorst M, Stiekema AP, et al. Quality of life of older adults and associated factors in Ghanaian urban slums: a cross-sectional study. BMJ Open. 2022;12:e057264. [CrossRef]
- Stevens N. Combating loneliness: A friendship enrichment programme for older women. Ageing Soc. 2001;21(2):183–202. [CrossRef]
- Newman-Norlund RD, Ball A, Beeler A, et al. Situational social isolation during COVID-19 in older adults. Gerontol Geriatr Med. 2022;8:1–10. [CrossRef]
- Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015;10(2):227–37. [CrossRef]
- Cacioppo JT, Cacioppo S. The growing problem of loneliness. Lancet. 2018;391(10119):426. [CrossRef]
- Mushtaq R, Shoib S, Shah T, Mushtaq S. Relationship between loneliness, psychiatric disorders and physical health: A review on the psychological aspects of loneliness. J Clin Diagn Res. 2014;8(9):WE01–WE04. [CrossRef]
- Field A. Discovering statistics using IBM SPSS statistics. 4th ed. London: SAGE Publications; 2013.
| Variable | Category | N | % | Mean | SD | Min | Max | |
|---|---|---|---|---|---|---|---|---|
| Gender | Female | 107 | 69. | |||||
| Male | 46 | 30.1 | ||||||
| Living arrangments | Living alone | 51 | 33.3 | |||||
| With household members | 102 | 66.7 | ||||||
| Age | 153 | 100.0 | 75.32 | 7.23 | 63 | 96 |
| Measurement | Item | N | Nf | Nm | Mean (x̅) | SD | p1* |
p2* |
|---|---|---|---|---|---|---|---|---|
| PWI-A | How satisfied are you with your standard of living? | 153 | 107 | 46 | 7.23 | 1.94 | 0.469 | 0.252 |
| PWI-A | How satisfied are you with your health? | 153 | 107 | 46 | 6.03 | 2.34 | 0.646 | 0.641 |
| PWI-A | How satisfied are you with what you are achieve in life? | 153 | 107 | 46 | 7.97 | 1.80 | 0.140 | 0.197 |
| PWI-A | How satisfied are you with your personal relationships? | 152 | 106 | 46 | 8.22 | 1.88 | 0.598 | 0.744 |
| PWI-A | How satisfied are you with how safe you feel? | 152 | 106 | 46 | 7.62 | 1.88 | 0.038 | 0.139 |
| PWI-A | How satisfied are you with the feeling of being part of your community? | 153 | 107 |
46 | 7.79 | 1.97 | 0.003 | 0.884 |
| PWI-A | How satisfied are you with your future security? | 152 | 107 | 45 | 6.99 | 2.09 | 0.201 | 0.576 |
| UCLA | I feel a lack of companionship. | 152 | 106 | 46 | 2.39 | 1.42 | 0.390 | 0.061 |
| UCLA | I don’t feel close to anyone. | 153 | 107 | 46 | 2.28 | 1.38 | 0.857 | 0.123 |
| UCLA | I do not share my thoughts and ideas with others. | 153 | 107 | 46 | 2.77 | 1.41 | 0.005 | 0.097 |
| UCLA | Nobody knows me really well. | 152 | 106 | 46 | 2.58 | 1.36 | 0.424 | 0.024 |
| UCLA | My social relationships are superficial. | 153 | 107 | 46 | 2.31 | 1.27 | 0.662 | 0.889 |
| UCLA | I am unhappy because I am so withdrawn. | 153 | 107 | 46 | 1.90 | 1.21 | 0.769 | 0.680 |
| UCLA | There are adults around me, but not with me. | 152 | 106 | 46 | 2.41 | 1.44 | 0.354 | 0.027 |
| Scala | Kolmogorov–Smirnov statistic | df | Sig. | Shapiro–Wilk statistic | df | Sig. |
|---|---|---|---|---|---|---|
| PWI-A | 0.056 | 148 | .200* | 0.974 | 148 | .006 |
| UCLA | 0.115 | 148 | .000 | 0.935 | 148 | .000 |
| Variable | Gender | N | Mean Rank | Sum of ranks | Mann–Whitney U | Wilcoxon W | Z | Asymp. Sig. (2-tailed) |
|---|---|---|---|---|---|---|---|---|
| PWI-A | Female | 105 | 80.36 | 8437.50 | 1852.500 | 2887.500 | -2.093 | .036 |
| Male | 45 | 64.17 | 2887.50 | |||||
| UCLA | Female | 104 | 71.93 | 7480.50 | 2020.500 | 7480.500 | -1.518 | .129 |
| Male | 46 | 83.58 | 3844.50 |
| Variable | Living arrangments | N | Mean Rank | Sum of Ranks | Mann–Whitney U | Wilcoxon W | Z | Asymp. Sig. (2-tailed) |
|---|---|---|---|---|---|---|---|---|
| PWI-A | Living alone | 50 | 73.33 | 3666.50 | 2391.500 | 3666.500 | - 0.433 | .665 |
| Living with household members | 100 | 76.58 | 7658.50 | |||||
| UCLA | Living alone | 50 | 82.47 | 4123.50 | 2151.500 | 7201.500 | -1.393 | .164 |
| Living with household members | 100 | 72.02 | 7201.50 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).