It takes (more than) a village

Retirement villages are proliferating across the western world (Jeste and Childers, 2017). Retirement villages can involve social renting, leaseholds, or mixed tenure (Gray and Worlledge, 2018), and can be further characterized by the extent to which they are isolated or segregated within the broader community. A main motivating factor in relocating to a retirement village is social connection (Roy et al., 2018). However, as Boyd and colleagues (2020) found in their assessment of retirement village residents, levels of loneliness in this population remain high, and likely higher than those found in the broader older population (Gray, 2015; Taylor et al., 2018). Understanding why loneliness is higher among retirement village residents, and how to intervene is therefore a priority. As well as being unpleasant in its own right, loneliness is associated with a multitude of negative health consequences such as early mortality and cognitive decline (Boss et al., 2015; Holt-Lunstad et al., 2015). Specifically among retirement housing residents, loneliness is associated with increased levels of anxiety and depression (Bekhet and Zauszniewski, 2012). As a component of a broader, three-phase intervention study, Boyd and colleagues sought to measure loneliness and its correlates among residents of 33 retirement villages in NZ using a standardized assessment tool and a companion survey. Participants were recruited using both randomized andnon-randomized samplingmethods. In multivariate analyses, loneliness as a binary outcome was more likely among residents who werewidowed,divorced, separated, ornevermarried (relative to those partnered), who had a poor or fair quality of life, who reportedmoving to the retirement village to seek social connection, andwhowere using Selective Serotonin Reuptake Inhibitors (SSRIs) or had a higher risk of depression. Loneliness was not associated with family relationships, gender, pain, or informal support receipt. Boyd’s study (hereafter called the “original study”) is not without limitations. The cited registered intervention protocol does not mention loneliness, meaning that the current study may have been opportunistic, occluding the decision process in analytic design and hypothesis choice (see Gelman and Loken[2013]). Astheauthorsacknowledge, thereare further limitations associated with using single-item loneliness measures. As well as the issue with bias caused by stigma, cited by the authors, single-item measuresareunsuitablebecause loneliness is likely to be multidimensional (Weiss, 1973), thus not measurable with a single item. Longitudinal extension of this research is planned by the research team, which will overcome the limitation of the cross-sectional nature of the research (since loneliness is thought to have a bidirectional association with many of the correlates they explored). Methodologically, an absence of correction for multiple comparisons, particularly given the number of bivariate tests used, is likely to have inflated Type I error (as the authors acknowledge), an error type further inflated by the absence of preregistration of the study (Gelman and Loken, 2013). Despite these limitations, results are thoughtprovoking, and some key questions arise from the original study. Participant mean age was 81.3, and 57% of participants were aged 80 or over. An inflection point in the relationship between age and loneliness may exist around this point in life (Pinquart and Sorensen, 2001) such that these older individuals may be more likely to be lonely than their younger counterparts.Assuch itmaybethat retirementvillage residents are lonelier than their ordinary-housing counterparts because they are on average older (because of the non-randomized recruitment of some participants, it is not possible to meaningfully compare rates of loneliness in this study to those found in the broader aging population). A developmental perspective on loneliness in the retirement village context, taking into account age and life stage, would certainly yield further insights. Another issue arising from the original study concerns the association between loneliness and motivations to relocate. Individuals who relocated to retirement villages in order to seek social connection (over 1/3 of respondents) were most likely to be lonely. Qualter and colleagues (2015) have suggested that such social re-engagement (“reaffiliation”) is a key motivation among those wishing to offset the adverse experience of loneliness. Empirically, however, loneliness predicts later social disengagement in older adults (McHugh Power et al., 2019), creating a feedback loop (Hawkley and Cacioppo, 2010). Individuals who are motivated to relocate to a retirement village, however, may be particularly motivated to reaffiliate International Psychogeriatrics (2021), 33:5, 441–443 © International Psychogeriatric Association 2021