ArticleJournal of the American Medical Directors Association2026
Understanding Differences in Resident Loneliness/Isolation Across US Nursing Homes: A Multilevel Analysis of MDS 3.0 Data.
Article in Journal of the American Medical Directors Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesLoneliness/isolation is known to result in negative health outcomes among older adults in US nursing homes. Understanding the variation in loneliness/isolation among long-stay nursing residents and the individual and facility-level characteristics associated with loneliness/isolation can help guide care planning and ultimately lead to the development of effective interventions.
designCross-sectional. SETTING AND
participantsLong-stay residents aged ≥50 years (n = 732,808) living in US nursing homes (n = 13,491) between October 1, 2023 and December 31, 2023.
methodsData from the Minimum Data Set 3.0 provided resident-level characteristics. Residents able to self-report were asked: "How often do you feel lonely or isolated from those around you?" Responses were dichotomized as sometimes, often, always vs never or rarely. Facility-level variables came from the long-term care focus and Nursing Home Compare datasets. Multilevel logistic regression estimated proportional change in cluster variance and variance partitioning coefficients (VPCs) to assess contributions of resident-, facility-, and county-level factors, and the fully adjusted model identified characteristics associated with loneliness/isolation.
resultsThe overall prevalence of loneliness/isolation was 20.7%, with most variation driven by differences between facilities rather than counties (VPC CONCLUSIONS AND IMPLICATIONS: Interventions to reduce loneliness/isolation should focus on helping facilities address contextual factors. Staffing levels may be associated with loneliness/isolation and warrant further investigation. Future research should focus on the development, implementation, and evaluation of evidence-based practices to reduce resident loneliness/isolation.
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