A new UCL-led prospective cohort study suggests that loneliness may partly explain the higher rates of depression experienced by sexual minority older adults. Researchers found that loneliness accounted for around 15% of the increased risk of later depressive symptoms among sexual minority participants compared with heterosexual older adults, highlighting loneliness as a potentially modifiable target for intervention.
The study, published in the Journal of Affective Disorders, analysed data from the English Longitudinal Study of Ageing (ELSA), following adults aged over 50 between 2010 and 2014. Sexual orientation and loneliness were assessed first, while depressive symptoms were measured around three years later, allowing researchers to examine whether loneliness contributed to later depression risk.
Researchers analysed data from 6,794 participants, including 478 people classified as belonging to sexual minority groups. Loneliness was measured using a short UCLA loneliness scale, while depressive symptoms were assessed later using the CES-D depression scale. Analyses adjusted for several possible confounding factors, including age, sex, ethnicity, employment, relationship status, health, and baseline depression symptoms.
Sexual minority older adults reported higher levels of loneliness and depressive symptoms than heterosexual participants. Loneliness was strongly associated with future depressive symptoms and mediation analyses suggested it explained approximately 15% of the association between sexual orientation and depression. While modest, the authors note that reducing even small modifiable risk factors can have meaningful public health benefits. Broader factors such as discrimination, minority stress, and social exclusion are also likely to contribute to poorer mental health outcomes.
The findings suggest that reducing loneliness may help lower depression risk among sexual minority older adults. Suggested approaches include peer support groups, community activities, social prescribing, and inclusive digital communities. The authors emphasise that interventions should focus not only on increasing social contact, but also on fostering acceptance, identity affirmation, and belonging.
Strengths of the study include its nationally representative sample and longitudinal design, which helps clarify the relationship between loneliness and later depression. However, sexual orientation was measured through sexual behaviour rather than identity or attraction, and transgender and gender-diverse older adults were not adequately represented.
The study adds to growing evidence that loneliness should be treated as a public health issue rather than an inevitable part of ageing. Tailored interventions that promote inclusion and culturally safe spaces for LGBTQ+ older adults may help reduce mental health inequalities later in life.
This information was published in The Mental Elf: Tackling loneliness could reduce depression for sexual minority older adults
Primary paper: Talen Wright, Francesca Solmi, Olesya Ajnakina, Elizabeth Ingram, Aaron Kandola, Stephen Lee, Eleonora Iob, Andrew Steptoe, Ben Thomas and Gemma Lewis (2025). The role of loneliness in the association between sexual orientation and depressive symptoms among older adults: A prospective cohort study. Journal of Affective Disorders, 356, 137 144.
Image: Priscilla Cezar