Prevalence and risk factors of loneliness among older adults in China: a nationally representative study

Loneliness is increasingly recognized as a significant public health concern, yet limited research has examined its prevalence and risk factors among older adults in China. This study investigated the prevalence and risk factors of loneliness among older adults in China using data from the 2018 China Longitudinal Aging Social Survey (CLASS), a nationally representative study. The sample included 9,951 participants aged 60 and older (mean age = 71.3 years, SD = 7.3; 49.94% female). Loneliness was measured using the Chinese version of the three-item UCLA Loneliness Scale, which was validated as a reliable and effective tool for assessing loneliness in this population. Overall, 19.6% of older Chinese adults reported experiencing loneliness. Logistic regression models identified demographic factors (older age, living in rural areas, lower income, and lower education), health factors (depressive symptoms and functional limitations), and social factors (living alone, reduced social support and social participation) as being associated with loneliness. Among these, higher levels of depressive symptoms (OR 1.29, 95% CI 1.26–1.32), living alone (OR 1.37, 95% CI 1.14–1.65), and reduced social participation (OR 1.51, 95% CI 1.35–1.71) emerged as the strongest predictors of loneliness. The findings highlight the high prevalence of loneliness among older Chinese adults and underscore the need for targeted interventions, especially for individuals with depressive symptoms, those living alone, or those with limited social engagement.