Perceived Risk of Solitary Death and Depressive Symptoms Among Older Adults Living Alone in Seoul: Moderating Role of Social Support

Background and Purpose: Solitary death, also known as lonely death or unattended death, refers to the phenomenon wherein people without relatives or family die alone and remain undiscovered for a long duration. Older adults living alone are at a greater risk of solitary death as they are more likely to experience social isolation. However, there is a death of literature on solitary death among older adults living alone, with only a few studies describing the phenomenon of solitary death itself or exploring the risk factors pertaining to solitary death using administrative data such as death certificate records. In this regard, we examined the extent to which older adults living alone in Seoul perceived the risk of solitary death. We also examined the impact of the perceived risk of solitary death on the psychological well-being among older adults living alone.

Methods: The 2018 Seoul Elderly Survey was used for this study. Using a proportional stratified random sampling technique, a representative sample of 3,034 individuals aged 65 or older in Seoul were recruited. The final sample was restricted to older adults living alone (n=691; 22.78% of the total sample). A series of multiple linear regression analyses were used to examine the association between the perceived risk of solitary death and depressive symptoms. The moderating role of social support in that association was also explored.

Results: Approximately 56% of the respondents perceived that their risk of solitary death was very high (15.17%) or above average (40.65%). Also, the perceived risk of solitary death was associated with depressive symptoms (B=.420, p=.001) after adjusting for socioeconomic status, health conditions, housing quality, religion, etc. The results indicated the moderating role of social support (B=-.672, p<.001). Specifically, the effect of the perceived risk of solitary death on depressive symptoms was greater among those with less frequent social contact.

Conclusions and Implications: In Korea, the Act on the Prevention and Management of Lonely Death was enacted in March 2020 and has been in effect since April 2021. It stipulates that the State and local governments should endeavor to aid individuals at risk of solitary death. However, the Act focuses more on building a reporting system to prevent solitary death by reducing the period of undiscovered after death. Greater attention should be paid to the psychological impact of the phenomenon among vulnerable populations such as older adults living alone. Greater assistance should be provided to older adults living alone who may be afraid of solitary death to promote their well-being and healthy aging in the community.