Stroke survivors experience elevated levels of loneliness: a multi-year analysis of the National Survey for Wales

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Description: Despite clinical observation that stroke survivors experience many symptoms of loneliness, there is no large-scale empirical evidence to support this observation. Before clinical interventions that target social needs are designed, tested and offered to stroke survivors, it is first important to establish the extent to which loneliness is elevated post-stroke, as well as the likely determinants. To address this issue, we completed two pre-registered analyses of a nationally representative survey that included a loneliness questionnaire (the National Survey for Wales, NSW 2016/17 and 2017/18; N>21000). We used the first year’s data to test our initial predictions and the second year’s data to provide confirmatory evidence. Using these data, we estimated the extent to which stroke survivors experience loneliness more than healthy individuals, how it compares to other common illnesses and whether it can be accounted for by demographic factors such as age, sex and objective measures of social isolation such as population density, size of household and internet access. Across both cohorts of data, the results consistently showed that stroke survivors report higher levels of loneliness compared to healthy individuals, and this relationship could not be accounted for by demographic factors or measures of social isolation. Levels of loneliness following stroke were not consistently different from a range of other comparison illnesses (e.g., Arthritis), or the average level of loneliness reported across all illnesses combined. These findings suggest that elevated levels of loneliness post-stroke are robust in that they replicate in large nationally representative samples, are of a similar magnitude to other common illnesses and cannot be reduced to objective measures of social isolation. The work has clinical and societal relevance by providing the first comprehensive estimate of how loneliness is shaped by stroke, which suggests that such experiences are unlikely to be adequately “treated” if only the quantity and not the quality of social experiences are considered.

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