The Role of Loneliness in the Cross-Lagged Relationship Between Functional Disability and Informal Caregiving Intensity Among Older Adults

Author : Man-Man Peng, Pengfei Wang'

Abstract : Aims: This study aims to explore how loneliness trajectories shape the longitudinal relationship between functional disability and informal care intensity among Chinese older adults. Methods: Using three-wave data (2011, 2014, and 2018) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study included 596 participants aged 65 years or older. We used latent class growth analysis to identify distinct trajectories of loneliness, and cross-lagged panel models examined bidirectional associations between functional disability and informal caregiving intensity across time based on different loneliness trajectory groups. Results: Two distinct loneliness trajectories were identified: a persistently low loneliness group (77.56%) and a high-increasing loneliness group (22.45%). Cross-lagged analyses showed that IADL disability significantly predicted higher subsequent informal caregiving intensity, but this effect varied by loneliness trajectory. Among older adults with persistently low loneliness, IADL disability increased caregiving intensity across waves. By contrast, in the high-increasing loneliness group, the effect of IADL disability on informal caregiving intensity emerged only in two waves (β(2014→2018)=0.111, p<0.001). Conclusions: Findings highlight that subjective loneliness moderates the bidirectional association between IADL disability and informal caregiving intensity among Chinese older adults. These results underscore the need to integrate loneliness screening into long-term care policies and to promote social engagement to improve the well-being of older adults and strengthen informal care systems in aging societies

Keywords : loneliness, functional disability, informal caregiving, older adults, aging, long-term care, and social engagement.

Conference Name : International Conference on Neuropsychology, Psychiatry and Mental Health (ICNPMH - 26)

Conference Place : Wellington, New Zealand

Conference Date : 2nd Jun 2026