Abstract: The purpose of this study was to identify the determinants of, and relationship between, subjective loneliness, general health and quality of life (QoL) among lonely community-dwelling older adults. A cross-sectional study was carried out among a sample of lonely (i.e. live alone without any assistance) older adults living in Gorgan city, Iran. The older adults were invited through a census sampling technique to complete six questionnaires, namely a 20-item UCLA loneliness scale, a six-item Lubben Social Network Scale, a 12-item Multidimensional Scale of Perceived Social Support, a 17-item Self-care Ability Scale for the Elderly (SASE), a General Health Questionnaire-12, and a Control, Autonomy, Self-Realization and Pleasure (CASP-19) questionnaire. Hierarchical multiple linear regressions were done with subjective loneliness and QoL as outcome variables. In total, 213 (91% females) lonely older adults (mean age: 68.2 ± 6.2) participated. Hierarchical multiple linear regressions yield socio-demographic characteristics (p < 0.001), predictor group 1 (p < 0.001), predictor group 2 (p < 0.001) explained 12.5, 13.5 and 46.6% of the observed variance in loneliness, respectively. Moreover, socio-demographic characteristics (p < 0.001), predictor group 1 (p < 0.001), predictor group 2 (p < 0.001) and feeling of loneliness (p < 0.001) accounted for 16.9, 21.1, 48.6 and 55.3% of the observed variance in quality of life, respectively. Both subjective loneliness and QoL were moderate in our sample. We suggest the presence of a probable causal inference between subjective loneliness, general health, and QoL; implying the need of population strategies for correcting subjective loneliness for its own sake as well as to help have an improved general health and QoL among older adults. Beside several non-modifiable factors (such as age, ethnic groups), we suggest that corrective measures should be based on social support and networking, self-care behavior, leisure activities, adapted for age, literacy and racial specifications. Given its population health relevance, there should be increased research and intervention on loneliness among older adults.
