Overview

Objectives
The aims of the project were to investigate how pathways into living alone in later life affect subsequent mental health. In addition, it looked at whether the move to living alone has effects that are distinct from the consistent state of living alone, and whether factors such as social support or socio-economic circumstances mediate and/or moderate associations between the psychological distress associated with living alone. Finally, it looked at whether such factors can help identify those at risk of persistently poor mental health following the move to living alone.

Methods
The analysis used data from the British Household Panel Survey (BHPS), and included respondents aged 65 years or older; those who made a transition to living alone between two consecutive waves were initially identified. They were then followed up for a maximum of five years, provided they remained living alone. The final sample included a total of 1,991 and 2,596 women, contributing 9,404 and 12,131 person-years of data, respectively.

The General Health Questionnaire (GHQ-12), which is collected annually in BHPS, was used as a measure of psychological distress. Control variables were sex, age group, marital status, social support, health-related limitations to daily activities, self-assessed financial circumstances, change in financial circumstances, housing tenure and pension income availability. To examine how the relationship between transition to living alone and psychological distress develops over time, an interaction between time and living arrangements was included.

Findings
The findings suggest that living alone in later life is not in itself a strong risk factor for psychological distress, and the effects of a move to living alone on mental health tend to be transient, supporting the 'crisis' model with reference to widowhood.

Living with adult children is not necessarily a persistently stressful situation, but when co-residence is or becomes stressful, it will often result in a change in living arrangements. Based on the measures used, neither socioeconomic circumstances nor the availability of social support appear to be a major mediating factor explaining associations between living alone in later life and psychological distress.

The findings emphasise the need for a longitudinal approach when studying associations between living arrangements and health, given the importance of respondents' location along the trajectories of living arrangements. Future research and policy decisions should take into account that the relationship between living alone and mental health in later life is highly dependent on the preceding pathway and on the proximity of the move to living alone.