NEW RESEARCH from the Irish Longitudinal Study on Ageing at Trinity College Dublin has shown that loneliness in older adults is associated with an increased risk of individuals wishing for their own death.
The study was published today in the peer-reviewed journal Frontiers in Public Health and it explores the issue of social disconnection and its link to a ‘wish to die’ among older adults.
The ‘Wish to Die’ involves thoughts of or wishes for one’s own death, or that one would be better off dead.
It is a commonly used indicator to capture death ideation and has been shown to be as predictive of future suicide attempts as active suicide ideation.
The study is based on a nationally representative survey among around 8,000 adults aged over 50 in the Republic of Ireland – the mean age of participants was 62.8.
Some 10% of respondents exhibited clinically significant levels of depression.
Participants were also asked: “In the last month, have you felt that you would rather be dead?”
Some 3.6% of respondents answered “yes”.
A significantly higher percentage of participants who completed only primary level education reported a ‘wish to die’ (WTD).
Meanwhile, older adults who reported a WTD also reported higher levels of loneliness and social isolation.
The report’s authors said this demonstrates that the subjective feeling of loneliness is more strongly associated with death ideation than other measures of social disconnection, including social isolation or living alone.
The authors further explained: “Our findings suggest that loneliness – the subjective assessment of the quality of an individuals’ social relationships, as opposed to a count of their social contacts (social isolation) – is the more important of the two.”
Older adults with a WTD were also significantly more likely to live alone and be unmarried, and also reported less social participation – they never volunteered and did not regularly attend religious services.
This latter group, which included older adults with or without a religion who never attended church services, reported the highest prevalence of a WTD at 8.7%.
This is 2.4 times the overall proportion of 3.6%.
Overall, 88.6% of participants were Catholic, with Anglicanism the next largest group at 3.4%.
The report’s authors said it is “not clear whether it is the spiritual or the social aspect of attending church” that provides the protective barrier.
However, they added that the finding of the “strong protective role of religious attendance also suggests a potential coping strategy that may be amenable to older adults” and that secular social activities could confer the same benefit.
“If it is the sociality rather than the spirituality of attending church regularly that is more important, then social activities not only those associated with religious practice may be a more attractive proposition, particularly if the current trend of increasing secularity continues.”
The authors added: “While attendance at religious attendance is provided here as an example of a beneficial prosocial activity, there are of course numerous examples of secular prosocial activities.”
However, the authors also noted that a decrease in religious attendance after the Covid pandemic could result in a “greater number of older adults experiencing a WTD”.
The authors remarked that the pandemic “saw religious attendance severely curtailed for long periods”.
“While we do not have information on WTD among this cohort post-pandemic, it is fair to suspect that the combination of an increase in risk via depression and social disconnection coupled with a decrease in the protective role of religious attendance, may have resulted in a greater number of older adults experiencing a WTD”.
The authors also acknowledged that the prevalence of a WTD among this cohort is possibly an “under-estimation of the true population value” given that “participants experience of a WTD was only asked for the last month and individuals who have had WTD outside this timeframe are therefore excluded”.
It was also noted that the findings “provide important information on a cohort of older adults who have expressed a WTD” in the context of the Dying with Dignity Bill that would legalise assisted dying for those with terminal illnesses.
The authors added that given the strength of the association between loneliness and WTD, existing interventions to address loneliness may have the additional benefit of protecting against death ideation.
Dr Mark Ward, lead author of the paper, said the study adds to a “growing body of evidence” that “clearly shows that loneliness in later life is associated with an increased risk of individuals wishing for their own death”
He added: “Uniquely, we also show that attending religious services regularly can protect against death ideation among older adults in Ireland.”
He also remarked that the findings highlight the importance of promoting social activities and networks to safeguard against loneliness and related psychological distress.
Meanwhile, Dr Robert Briggs, Consultant Geriatrician at St James’s Hospital and co-author of the study, said the study highlights the importance of “maintaining social connectedness in later life”.
Briggs added that an “enhanced focus on improving access to mental health care and addressing social isolation in older people should therefore be a priority for policymakers”.
Elsewhere, Regius Professor Rose Anne Kenny, Consultant Geriatrician and Principal Investigator of TILDA, remarked that “loneliness accelerates biological ageing and disease” and that “addressing this problem is urgent”.
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