Aida, J

Cable, N

Kondo, K

Saito, M

Saito, T

Shirai, K

English

UCL Discovery

9 Kemppainen NM, Aalto S, Wilson IA et al. PET amyloid ligand [11C]PIBuptake is increased in mild cognitive impairment. Neurology 2007; 68:1603–1606.10 Li Y, Rinne JO, Mosconi L et al. Regional analysis of FDG and PIB-PETimages in normal aging, mild cognitive impairment, and Alzheimer’sdisease. Eur J Nucl Med Mol Imaging 2008; 35: 2169–2181.How to cite this article: Takenoshita N, Shimizu S,Fukasawa R, et al. Amyloid burden in diabetes-relateddementia. Geriatr. Gerontol. Int. 2019;19:1066–1068.https://doi.org/10.1111/ggi.13745Validation study on a Japanese version of the three-itemUCLA Loneliness Scale among community-dwelling olderadultsDear Editor,Loneliness, a major psychosocial predictor of health decline, isa form of subjective distress caused by a discrepancy between thesocial relationships people actually have and those they desire tohave.1 The global issue of loneliness has received particular atten-tion in the UK, where social policies to address it have beenstressed.2 Numerous studies have been carried out to validatemeasures of loneliness, including the original and revised versionsof the University of California, Los Angeles (UCLA) LonelinessScale3 and its Japanese version.4However, the large number of items contained in lonelinessscales could make it impractical to apply them as self-administeredquestionnaire surveys, particularly in older adults who are at riskof health decline. Hughes et al. validated the three-item version ofthe revised UCLA Loneliness Scale, modifying the number ofoptions from four to three; however, no validation study exists forits Japanese version.5 Our aim, therefore, was to validate the Japa-nese version of the three-item UCLA Loneliness Scale forcommunity-dwelling older adults.We obtained data from 537 respondents aged ≥65 years, livingin large-scale public housing in Nagoya. Data were collected in2018 through a self-administered questionnaire survey. Weobtained permission from the primary investigators of the Englishthree-item5 and Japanese 20-item version4 for utilizing the itemsand wording in those versions. The three items used in the pre-sent study had already been confirmed to have relatively highitem–total correlations with the Japanese 20-item version,4 andhigh correlation with the revised UCLA scale (full version).5Although we basically applied the translation by Masuda et al.,4 weslightly changed the wording of one item through back-translationby one of the co-authors (NC), who specializes in gerontologicalstudies, and is also fluent in both Japanese and English (Doc S1).We assessed Cronbach’s alpha coefficients and item–total corre-lations for internal consistency for the scale and unidimensionalityof the scale through principal component analysis. We also exam-ined its convergent validity6 by replicating the findings of the associ-ations between the loneliness scale and related variables observed inthe previous validation studies.4,5 The variables assessed were:depressive symptoms as measured by a 15-item Japanese version ofthe Geriatric Depression Scale,7 self-rated health and social relation-ships. The study protocol was approved by the National Center forGeriatrics and Gerontology Ethics Committee (approval no. 854).The total mean score was 4.30 (range 3–9; standard deviation1.65), ranging between 1.33 and 1.62 for each item. The missingcases for each item were 11 (2.0%) at most. Cronbach’s alphacoefficient was 0.84, with item–total correlations ranging between0.85 and 0.89 (Table 1). Principal component analysis showed thatthe three items’ loadings to the first component were between0.81 and 0.91. The eigenvalue of this component was 2.31 (77.0%of the total variance), whereas it was less than one for the othercomponent, confirming the unidimensionality of this scale.6A t-test showed that the total score was significantly higher(Welch’s t [428.02] = 2.233; P = 0.026) for men (4.49  1.76) thanwomen (4.16  1.55), with no significant difference across age groups(t [521] = −1.19; P = 0.234), consistent with the previous study.4 Thethree-item loneliness scale was significantly correlated with the Geriat-ric Depression Scale, similar to the English version (r = 0.48, note: thestudy used a different depression scale)5 and the 20-item Japanese ver-sion (rs = 0.52),4 of which the association with self-rated health wasTable 1 Correlation between loneliness scale and selectedvariablesVariables (score range) Coefficients P-valuesScale item 1: How often do you feelthat you lack companionship? (1–3)0.85† <0.001Scale item 2: How often do you feelleft out? (1–3)0.89† <0.001Scale item 3: How often do youfeel isolated from others? (1–3)0.89† <0.001Geriatric Depression Scale (0–15) 0.58‡ <0.001Self-rated health (1–4) −0.29‡ <0.001Emotional support (received) (0–1) −0.29‡ <0.001Emotional support (provided) (0–1) −0.22‡ <0.001Instrumental support (received) (0–1) −0.20‡ <0.001Instrumental support (provided) (0–1) −0.23‡ <0.001Living alone (0–1) −0.03‡ 0.494Monthly face-to-face contact withchildren and relatives (0–1)−0.02‡ 0.608Monthly non-face-to-face contactwith children and relatives (0–1)§−0.15‡ 0.001Monthly face-to-face contact withfriends (0–1)−0.28‡ <0.001Monthly non-face-to-face contactwith friends (0–1)§−0.30‡ <0.001†Pearson’s correlation coefficients show item-total correlations of thethree-item loneliness scale. ‡Spearman’s correlation coefficients, usedfollowing the previous validation study,4 show the associationsbetween the three-item loneliness scale and related variables.§Non-face-to-face contacts are those carried out by phone, letter,email and so on.Letters to the Editor - Research Studies1068 | © 2019 The Authors Geriatrics & Gerontology Internationalpublished by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics SocietyThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use anddistribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.also similar (rs = −0.26) to that in the present study. Correlation coeffi-cients, showing the associations between loneliness and social sup-port, were similar to the Japanese 20-item version (received emotionalsupport rs = −0.18).4 Although contact with friends, regarded as aselective relationship, was significantly, negatively associated with lone-liness, those with relatives or living alone did not show a significantassociation (Table 1). These findings were consistent with the Japa-nese 20-item version, suggesting the association of loneliness withqualitative rather than quantitative social relationships.4The present findings suggest the feasibility of the three-itemUCLA Loneliness Scale for self-administered questionnaire sur-veys among Japanese older adults. Furthermore, our findingsshow high internal consistency, unidimensionality and convergentvalidity, confirming similarity in the association between the lone-liness scale and related constructs in existing studies.4,5This newly validated loneliness scale will be implemented in anationwide large-scale survey in 2019. Using the validated loneli-ness scale, we can examine cross-national comparisons and theassociation of loneliness with health consequences – a topic thathas received limited attention in Japan, even though its risks havebeen broadly recognized in Western countries.8AcknowledgementsWe thank Dr Mary Elizabeth Hughes and Dr Etsuko Tadaka fortheir permission to utilize their loneliness scales for this study.This study was funded by the Research Funding for LongevitySciences from the National Center for Geriatrics and Gerontology(30-30) and by Japan Society for the Promotion of ScienceKAKENHI Grants (18H00953, 16KT0014).Disclosure statementThe authors declare no conflict of interest.Tami Saito,1 Noriko Cable,2 Jun Aida,3Kokoro Shirai,4 Masashige Saito5 andKatsunori Kondo6,71Department of Social Science, National Center for Geriatrics andGerontology, Obu, Japan2Department of Epidemiology and Public Health, UniversityCollege London, London, UK3Department of International and Community Oral Health,Tohoku University Graduate School of Dentistry, Sendai, Japan4Department of Public Health, Graduate School of Medicine,Osaka University, Suita, Japan5Department of Social Welfare, Nihon Fukushi University,Mihama, Japan6Department of Gerontological Evaluation, National Center forGeriatrics and Gerontology, Obu, Japan7Department of Social Preventive Medical Sciences, ChibaUniversity, Chiba, JapanReferences1 McWhirter BT. Loneliness: a review of current literature, with implica-tions for counseling. J Couns Dev 1990; 68: 417–422.2 HM Government. A connected society: a strategy for tackling loneliness:laying the foundations for change. Available from www.gov.uk/government/collections/governments-work-on-tackling-loneliness[Accessed 23 April 2019].3 Russell D. The revised UCLA loneliness scale: concurrent and discrimi-nant validity evidence. J Pers Soc Psychol 1983; 39: 472–480.4 Masuda Y, Tadaka E, Dai Y. Reliability and validity or the Japanese ver-sion of the UCLA loneliness scale version 3 among the older population.J Jpn Acad Commun Health Nurs 2012; 15: 25–32. (In Japanese.).5 Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT. A short scale for mea-suring loneliness in large surveys: results from two population-basedstudies. J Aging Res 2004; 26: 655–672.6 DeVellis RF. Scale Development: Theory and Applications, 2nd ed. ThousandOaks, CA: Sage Publications Ltd, 2003.7 Yesavage JA, Brink TL, Rose TL et al. Development and validation of ageriatric depression screening scale: a preliminary report. J Psychiatr Res1982; 17: 37–49.8 Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B. Loneliness andsocial isolation as risk factors for coronary heart disease and stroke: sys-tematic review and meta-analysis of longitudinal observational studies.Heart 2016; 102: 1009–1016.Supporting informationAdditional supporting information may be found in the onlineversion of this article at the publisher’s website:Appendix S1. Japanese version of the three-item University ofCalifornia, Los Angeles Loneliness Scale scale.How to cite this article: Saito T, Cable N, Aida J,Shirai K, Saito M, Kondo K. Validation study on a Japa-nese version of the three-item UCLA Loneliness Scaleamong community-dwelling older adults. Geriatr.Gerontol. Int. 2019;19:1068–1069. https://doi.org/10.1111/ggi.13758Determining caregiver burden using new technologies forinformal caregivers of people with dementia: A systematicreviewDear Editor,We aim to systematically review evidence from the existence ofcaregiver burden using new technology for informal caregivers ofpeople with dementia. This review was carried out in accordancewith the Preferred Reporting Items for Systematic Reviews andMeta-Analysis Statement.1 The protocol was registered in theLetters to the Editor - Research Studies© 2019 Japan Geriatrics Society | 1069

Validation study on a Japanese version of the three-item UCLA Loneliness Scale among community-dwelling older adults

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Validation study on a Japanese version of the three-item UCLA Loneliness Scale among community-dwelling older adults

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