Identifying Factors Associated With Loneliness in Older United States Veterans: An Ecological Systems Approach.
JoAnn Jabbari, Rachael Beard, Amy McQueen and 5 others
PMID 41615071WHAT IT FOUND
Loneliness in hospitalized older Veterans is driven by community vulnerability and lack of emotional support, not military history.
Widowed Veterans and those living alone had significantly higher odds of loneliness. Clinical care should prioritize assessing perceived emotional support and social isolation over service-connected diagnoses.
Key findings
01Veterans living in areas with moderate or high social vulnerability were significantly more likely to report loneliness compared to those in low vulnerability areas.
02Greater emotional and informational social support was a significant protective factor against loneliness, whereas tangible support lost significance in adjusted models.
03Living alone and being widowed were associated with higher odds of loneliness, but no military characteristics, including PTSD or combat exposure, showed significant associations.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design prevents causal inferences. The sample consisted only of hospitalized Veterans with specific chronic conditions, limiting generalizability to community-dwelling Veterans. Data were collected during the COVID-19 pandemic, which may have exacerbated feelings of isolation. PTSD status was derived from electronic health records and may be under-diagnosed or not attributed to military service.
Declared interests
The authors declared no conflicts of interest. The study was approved by IRBs at Washington University in St. Louis and the VA Medical Center.
The easy way to misread this
Do not assume that military service factors like PTSD or combat exposure are primary drivers of loneliness in this population, as they showed no significant association in adjusted models. The risk is more strongly linked to current social context and community vulnerability.