Depression, anxiety, anger, and loneliness in older adults: comparing residential contexts and examining the role of loneliness

Abstract

Background Population ageing increases the need to understand psychosocial determinants of emotional wellbeing in later life. Loneliness is a key predictor of depression and anxiety in older adults, yet other emotions such as anger—less frequently investigated in gerontological research—may also contribute to distress when social needs are unmet. Although residential context has been linked to emotional health, the extent to which loneliness helps explain this relationship remains unclear. This study aimed to (1) explore differences in depression, anxiety, anger, and loneliness between institutionalized and community-dwelling older adults, and (2) examine the role of loneliness in the relationship between residential status, age, and emotional outcomes. Method A cross-sectional study was conducted with 190 participants aged 60 years and older (M = 79.0, SD = 9.15). Participants were recruited from nursing homes, senior centers, and community settings in Spain through institutional collaboration and snowball sampling. Measures included the Geriatric Depression Scale (GDS-15), Geriatric Anxiety Inventory (GAI), State–Trait Anger Expression Inventory (STAXI-2, trait anger scale), and the UCLA Loneliness Scale (10- item version). Data analyses comprised ANCOVAs controlling for age and three explanatory models estimated with Jamovi (GLM Mediation, version 2.6.24). Results Institutionalized participants reported significantly higher depression scores, with mean scores at the commonly used GDS-15 screening threshold. They also showed a tendency toward greater anger and loneliness, while no group differences were found in anxiety. The models indicated that loneliness was a consistent and robust factor associated with depression, anxiety, and anger. However, neither age nor residential status showed significant indirect effects through loneliness. The total effect of residential status on depression was significant, whereas no significant direct or indirect effects of residential status or age were observed for anxiety and anger. The models explained 27.4% of the variance in depression, 23.4% in anxiety, and 17.7% in anger. Conclusions Loneliness emerged as the factor most consistently associated with emotional distress in older adults. These findings underscore the importance of designing public policies and psychosocial interventions focused on reducing unwanted loneliness and strengthening social connectedness in both institutional and community settings.