A mixed-methods approach to understanding loneliness and depression in older adults

J Gerontol B Psychol Sci Soc Sci. 2006 Nov;61(6):S329-39. doi: 10.1093/geronb/61.6.s329.


Objective: Depression in late life may be difficult to identify, and older adults often do not accept depression treatment offered. This article describes the methods by which we combined an investigator-defined definition of depression with a person-derived definition of depression in order to understand how older adults and their primary care providers overlapped and diverged in their ideas about depression.

Methods: We recruited a purposive sample of 102 persons aged 65 years and older with and without significant depressive symptoms on a standardized assessment scale (Center for Epidemiologic Studies-Depression scale) from primary care practices and interviewed them in their homes. We applied methods derived from anthropology and epidemiology (consensus analysis, semi-structured interviews, and standardized assessments) in order to understand the experience and expression of late-life depression.

Result: Loneliness was highly salient to older adults whom we asked to describe a depressed person or themselves when depressed. Older adults viewed loneliness as a precursor to depression, as self-imposed withdrawal, or as an expectation of aging. In structured interviews, loneliness in the week prior to interview was highly associated with depressive symptoms, anxiety, and hopelessness.

Discussion: An improved understanding of how older adults view loneliness in relation to depression, derived from multiple methods, may inform clinical practice.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Attitude*
  • Demography
  • Depression / epidemiology*
  • Female
  • Humans
  • Interpersonal Relations*
  • Interviews as Topic
  • Loneliness / psychology*
  • Male
  • Reinforcement, Psychology
  • Surveys and Questionnaires