Loneliness and onset of depressive symptoms in older adults: Evaluating the utility of the 1-item, 3-item, and 20-item versions of the university of California, Los Angeles loneliness scale

AIM: In this study, we aimed to clarify the predictive ability of the 1-item, 3-item, and 20-item versions of the University of California, Los Angeles Loneliness Scale (UCLA-LS) for the onset of depressive symptoms in older adults. METHODS: We included 3081 participants. The 15-item version of the Geriatric Depression Scale was used for screening depressive symptoms. Loneliness was assessed using the UCLA-LS (version 3). Demographic, socioeconomic, and health-related variables were incorporated as covariates in the analysis. The area under the curve (AUC) of the receiver operating characteristic curve was calculated to evaluate the predictive ability of each individual item, the 3-item UCLA-LS, and the 20-item UCLA-LS for the onset of depressive symptoms. We compared the predictive ability of each model for the onset of depressive symptoms using the AUC and compared participants' characteristics. RESULTS: Overall, 595 (19.3%) participants developed depressive symptoms during follow-up. The models incorporating the 15 single items, 3-item UCLA-LS, or 20-item UCLA-LS and background factors had better AUC values than the model comprising only the background factors. The model comprising the 20-item UCLA-LS and background factors had the highest AUC (0.771). CONCLUSIONS: Loneliness was an important predictor of the onset of depressive symptoms in older adults. The 20-item UCLA-LS demonstrated the highest predictive accuracy for depressive symptom onset. Assessing older adults for loneliness is essential, regardless of the number of questionnaire items.