Determinants of loneliness in older immigrants: A scoping review

• Age and gender were significant determinants of loneliness in half of the studies that examined their role in feeling socially isolated. Low income or financial difficulties were associated with increased loneliness. Some older immigrants may have retired prior to immigration but may not be able to access their pensions in their country of origin while residing in another country; and they are not eligible for pensions in the new country. They may not be able to work due to ageism and discrimination. 
• Being married was a protective factor against loneliness while being single, divorced, or widowed were risk factors. Higher education, at least a high school level, and having more children, were protective factors. 

• Research consistently showed that poor general health and/or mental health are risk factors. In 57% of studies investigating physical function, limitations in physical activities were associated with increased loneliness. Similar to the native population, older immigrants may face decline in physical, cognitive, and psychological functioning leading them to reduce social interactions with others outside their household in an effort to avoid embarrassment. This in turn leads to loneliness.

• Older immigrants that had a large social network size, engaged in frequent contact with members of their network, and participated in social activities inside and outside their household, experienced low levels of loneliness. Longer stay in the new country was associated with high levels of loneliness. Low levels of acculturation, operationalized as limited English proficiency, was a risk factor for loneliness.
  Racialized older immigrants experience racism and discrimination in subtle and overt forms, which amplified their feelings of loneliness.
• Older immigrants' ability to build new networks may be impacted by personal, family, community, and societal factors such as, language barriers and dependence on others.

• The personal determinants associated with loneliness may indicate the need for adapting interventions to different subgroups of the older immigrant population; for instance, the adaptations may involve providing interventions in the older immigrants' language, and/or modifying the intervention content and activities to be responsive to their cultural beliefs.
• Service providers can use community engagement approaches to collaborate with older immigrants to select, and culturally adapt evidence-based interventions that target the specific determinants. For example, engagement of a group of older immigrants in culturally acceptable forms of physical activity may promote their physical functioning and interactions with others.