Associations of living alone and loneliness with neuropsychiatric symptoms in individuals with mild cognitive impairment: A retrospective cross‐sectional study

Aim: Living alone and loneliness are recognized risk factors for neuropsychiatric symptoms in older adults. However, the distinct of the objective condition of living alone and subjective loneliness on specific neuropsychiatric symptoms in individuals with mild cognitive impairment (MCI) remains unclear. Methods: In this retrospective study, we analyzed data from 312 older adults with MCI (74 living alone and 238 living with family) who attended a university psychiatry clinic. Neuropsychiatric symptoms and subjective loneliness were assessed using the Neuropsychiatric Inventory and the UCLA Loneliness Scale, respectively. Living arrangement (living alone vs. living with family) was recorded. Negative binomial regression with a log link function examined associations of depression, anxiety, delusions, and hallucinations with living alone and loneliness, adjusting for potential confounders. Furthermore, sensitivity analyses were performed by excluding variables with highly unbalanced distributions. Results: Patients living alone showed significantly higher delusions, hallucinations, and disinhibition scores than those living with family, whereas apathy scores were significantly lower. Multivariate analyses showed that loneliness, but not living alone, was significantly associated with depression and anxiety. Delusions were significantly associated with both loneliness and living alone. In contrast, no significant associations were found between hallucinations and either living alone or loneliness. The significant associations for all neuropsychiatric symptoms were maintained in the sensitivity analysis, except for hallucinations. Conclusion: Neuropsychiatric symptoms in individuals with MCI show differential associations with loneliness and living alone. These findings suggest that useful non-pharmacological interventions may differ depending on the symptoms.