The Economic Consequences of Loneliness Among the Elderly

NCT04225845 | Completed

• 2 other identifiers: 172020P01AG005842
• Study Type: interventional
• Target: 1,120
• Locations: 1 country
• Sites: 1

Brief Summary

Elderly individuals across the world are increasingly living alone. However, little is known about the effects of loneliness on economic and health outcomes. The elderly living alone (i.e., in a household of size 1) will be randomized into one of two cross-randomized intervention arms or a control condition to improve older individuals' mental wellbeing as well as ability to cover basic needs, particularly in times of COVID (including health). The first intervention will focus on improving the elderly's outlook on life and relationships through problem-solving therapy (PST) delivered over the phone. The second will deliver to them a one-time cash transfer of Rs.1000, equivalent to the emergency help amount distributed to ration card holder by the government of Tamil Nadu. Each intervention will be offered on its own in each of two treatment arms, and in combination in a third. A control group will receive no intervention. Investigators will track outcomes of the elderly at 3 weeks and 3 months after the intervention.

Conditions

Loneliness

Outcome Measures

Primary Outcomes (6)

• Difficulty in performing daily activities/Functional impairment score

  Participants will be asked the level of difficulty they have in doing each of the following tasks: standing for 30 minutes, walking a long distance (1km), concentrating for 10 minutes, learning a new task like getting to a new place, washing whole body, getting dressed, taking care of household activities, doing day-to-day work, dealing with people they do not know, maintaining a friendship, being emotionally affected by health problems, and joining in community activities. The scale is from 0-4, with 0 being no difficulty, 1 mild, 2 moderate, 3 severe, and 4 cannot do. The scores will be summed to create a cumulative score on a 0-48 scale.

  Assessed at 3 weeks after intervention

• Difficulty in performing daily activities/Functional impairment score

  Participants will be asked the level of difficulty they have in doing each of the following tasks: standing for 30 minutes, walking a long distance (1km), concentrating for 10 minutes, learning a new task like getting to a new place, washing whole body, getting dressed, taking care of household activities, doing day-to-day work, dealing with people they do not know, maintaining a friendship, being emotionally affected by health problems, and joining in community activities. The scale is from 0-4, with 0 being no difficulty, 1 mild, 2 moderate, 3 severe, and 4 cannot do. The scores will be summed to create a cumulative score on a 0-48 scale.

  Assessed at 3 months after intervention

• Mental health

  The geriatric depression index short form is used. Participants are asked yes/no questions: if they are satisfied with their lives, have dropped activities and interests, feel their life is empty, often get bored, in good spirits most of the time, afraid that something bad is going to happen to them, feel happy most of the time, often feel hopeless, prefer to stay at home, rather than going out and doing new things, have problems with memory, think it is wonderful to be alive, feel worthless, feel full of energy, feel lonely, feel their situation is hopeless, think that most people are better off than they are. Responses will be summed over these questions.

  Assessed at 3 weeks after intervention

• Mental health

  The geriatric depression index short form is used. Participants are asked yes/no questions: if they are satisfied with their lives, have dropped activities and interests, feel their life is empty, often get bored, in good spirits most of the time, afraid that something bad is going to happen to them, feel happy most of the time, often feel hopeless, prefer to stay at home, rather than going out and doing new things, have problems with memory, think it is wonderful to be alive, feel worthless, feel full of energy, feel lonely, feel their situation is hopeless, think that most people are better off than they are. Responses will be summed over these questions.

  Assessed at 3 months after intervention

• Food security

  Participants will be asked to report whether in the past week they had to skip or cut the size of meals in the past week.

  Assessed at 3 weeks after intervention

• Food security

  Participants will be asked to report whether in the past week they had to skip or cut the size of meals in the past week.

  Assessed at 3 months after intervention

Secondary Outcomes (18)

• Seeking or receiving COVID vaccine

  Assessed at 3 weeks after intervention

• Seeking or receiving COVID vaccine

  Assessed at 3 months after intervention

• Loneliness

  Assessed at 3 weeks after intervention

• Loneliness

  Assessed at 3 months after intervention

• Healthcare utilization

  Assessed at 3 weeks after intervention

Study Arms (4)

Phone therapy

EXPERIMENTAL

Weekly phone calls by lay trained personnel to deliver problem solving therapy.

Behavioral: Phone therapy

Phone therapy plus cash transfer

EXPERIMENTAL

Weekly phone calls by lay trained personnel to deliver problem solving therapy. Combined with a one-time cash transfer of Rs.1000.

Behavioral: Phone therapy; Behavioral: Cash transfer

Cash transfer

EXPERIMENTAL

One-time cash transfer of Rs.1000.

Behavioral: Cash transfer

Control

NO INTERVENTION

Control group.

Interventions

Phone therapy BEHAVIORAL

Weekly phone calls by lay trained personnel to deliver problem solving therapy.

Phone therapy; Phone therapy plus cash transfer

Cash transfer BEHAVIORAL

One-time cash transfer of Rs.1000.

Cash transfer; Phone therapy plus cash transfer

Eligibility Criteria

• Age: 55 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• At least 55 years of age
• Individuals living alone

Sponsors & Collaborators

• National Bureau of Economic Research, Inc.: lead
• National Institute on Aging (NIA): collaborator
• Abdul Latif Jameel Poverty Action Lab: collaborator

Study Sites (1)

JPAL SA at IFMR

Chennai, Tamil Nadu, India

Location

Related Publications (1)

• McKelway M, Banerjee A, Grela E, Schilbach F, Sequeira M, Sharma G, Vaidyanathan G, Duflo E. Effects of Cognitive Behavioral Therapy and Cash Transfers on Older Persons Living Alone in India : A Randomized Trial. Ann Intern Med. 2023 May;176(5):632-641. doi: 10.7326/M22-2496. Epub 2023 Apr 25.

  PMID: 37094349 DERIVED

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Associate, NBER; Abdul Latif Jameel Professor of Poverty Alleviation and Development Economics, MIT

Study Record Dates

• First Submitted: January 7, 2020
• First Posted: January 13, 2020
• Study Start: November 1, 2020
• Primary Completion: December 31, 2022
• Study Completion: December 31, 2023
• Last Updated: August 28, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

IN (1)