JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic significantly affected the mental health of older adults, particularly by increasing loneliness and psychological distress. While various contributing factors have been studied, the role of preferred solitude as a potential predictor and mediator remains poorly understood.

Objective:

This national cross-sectional study aimed to examine predictors of loneliness and psychological distress among older adults during the pandemic, with a specific focus on preferred solitude and its mediating role between pandemic-specific stressors and self-efficacy.

Methods:

A total of 2053 Croatian residents aged ≥65 were recruited using snowball sampling. Validated instruments were used: the UCLA Loneliness Scale, Preference for Solitude Scale, CORE-OM, GSE and PSQ-OA. Hierarchical regression and path analysis were employed, with statistical significance set at P<.05.

Results:

For loneliness, the final model explained 30.7% of the variance (R²=0.307, RMSE=0.708, P<.001). Significant predictors included marital status (e.g., never married: B=0.390, P<.001), psychological problems (B=0.020, P<.001), functionality (B=-0.037, P<.001), and social distancing (B=0.014, P<.001). Preferred solitude was also a significant predictor of loneliness (B=0.011, P<.001). For psychological distress, the final model explained 30.8% of the variance (R²=0.308, RMSE=14.872, P<.001). Self-efficacy emerged as the strongest negative predictor of distress (B=-1.066, P<.001), whereas preferred solitude was a positive predictor (B=2.403, P<.001). The variable “spending a few hours alone per day” was associated with lower distress levels (B=-3.509, P=.003), while “frequent or superficial interactions with acquaintances (e.g., at least once a week)” were related to higher distress (B=4.321, P=.002). Path analysis revealed that social distancing had a significant direct negative effect on self-efficacy (β=-.391, P<.001), whereas preferred solitude did not significantly mediate this relationship (indirect effect: β=-.006, P=.087).

Conclusions:

Psychological problems and reduced functionality emerged as the strongest predictors of loneliness in older adults during the pandemic. Self-efficacy was the most important protective factor against psychological distress. Although preferred solitude can have adaptive benefits, in the context of this study it was associated with increased loneliness and distress during enforced isolation. The findings suggest that public health interventions should balance respect for individual preferences with the provision of active support for vulnerable populations during crises.