BACKGROUND AND OBJECTIVE Loneliness is associated with increased rates of morbidity and mortality, and is a growing public health concern in later life. This study aimed to produce an evidence-based estimate of the prevalence of loneliness amongst older people (aged 60 years and above). STUDY DESIGN AND SETTING Systematic review and random-effects meta-analysis of observational studies from high income countries 2008 to 2020, identified from searches of five electronic databases (Medline, EMBASE, PsychINFO, CINAHL, Proquest Social Sciences Premium Collection). Studies were included if they measured loneliness in an unselected population. RESULTS Thirty-nine studies reported data on 120,000 older people from 29 countries. Thirty-one studies were suitable for meta-analysis. The pooled prevalence estimate of loneliness was 28.5% (95%CI: 23.9% - 33.2%). In twenty-nine studies reporting loneliness severity, the pooled prevalence was 25.9% (95%CI: 21.6% - 30.3%) for moderate loneliness and 7.9% (95%CI: 4.8% - 11.6%) for severe loneliness (z = -6.1, p < 0.001). Similar pooled prevalence estimates were observed for people aged 65-75 years (27.6%, 95%CI: 22.6% - 33.0%) and over 75 years (31.3%, 95%CI: 21.0% - 42.7%, z = 0.64, p = 0.52). Lower levels of loneliness were reported in studies from Northern Europe compared to South and Eastern Europe. CONCLUSIONS Loneliness is common amongst older adults affecting approximately one in four in high income countries. There is no evidence of an increase in the prevalence of loneliness with age in the older population. The burden of loneliness is an important public health and social problem, despite severe loneliness being uncommon. PROSPERO REGISTRATION CRD42017060472.

中文翻译：

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高收入国家老年人的孤独感：系统评价和荟萃分析。

背景和目标孤独与发病率和死亡率的增加有关，并且是晚年日益增长的公共卫生问题。本研究旨在对老年人（60 岁及以上）的孤独感进行基于证据的估计。研究设计和设置 对 2008 年至 2020 年高收入国家观察性研究的系统评价和随机效应荟萃分析，通过搜索五个电子数据库（Medline、EMBASE、PsychINFO、CINAHL、Proquest Social Sciences Premium Collection）确定。如果研究在未选择的人群中测量了孤独感，则包括在内。结果 三十九项研究报告了来自 29 个国家的 120,000 名老年人的数据。31 项研究适合进行荟萃分析。孤独感的汇总患病率估计值为 28.5%（95%CI：23.9% - 33。2%）。在报告孤独严重程度的 29 项研究中，中度孤独的汇总患病率为 25.9% (95%CI: 21.6% - 30.3%)，重度孤独的汇总患病率为 7.9% (95%CI: 4.8% - 11.6%) (z = - 6.1，p < 0.001）。在 65-75 岁 (27.6%, 95%CI: 22.6% - 33.0%) 和 75 岁以上 (31.3%, 95%CI: 21.0% - 42.7%, z = 0.64, p = 0.52）。与南欧和东欧相比，北欧的研究报告的孤独程度较低。结论 在高收入国家，孤独感在老年人中很常见，影响到大约四分之一。没有证据表明老年人的孤独感随着年龄的增长而增加。尽管严重的孤独并不常见，但孤独的负担是一个重要的公共卫生和社会问题。