The mediating role of loneliness between psychosocial and physiological well-being in older adults.

Publication date: Feb 01, 2026

Loneliness is a risk factor for mental but also physical health concerns in older adults. This study aimed to examine the temporal associations among social relationships, mindfulness, and physiological functioning and the potential mediating role of loneliness. The present study recruited 141 older adults experiencing loneliness (M = 64. 1 years, 76 % female) during the COVID-19 pandemic in Hong Kong. Participants completed a questionnaire that assessed loneliness, social network, perceived social support, and mindfulness, and provided six saliva samples for cortisol and C-reactive protein (CRP) over two days at baseline (T0) and 6-month follow-up (T1). Path analysis was conducted to examine the associations of changes in psychosocial and physiological variables via change in loneliness. The participants showed small to moderate increases in perceived social support and mindfulness and small to moderate decreases in loneliness and pre-lunch cortisol. Greater improvements in social relationships were significantly associated with changes toward steeper diurnal cortisol slopes, indicating a healthier cortisol pattern. Greater improvements in mindfulness and social relationships were indirectly associated with greater reductions in CRP via a decrease in loneliness. The present findings provided empirical support for temporal associations between social relationships, mindfulness, and physiological markers, with loneliness acting as a mediator, in older adults. The results suggest that interventions targeting loneliness, while promoting social engagement and mindfulness, could improve both psychosocial and physiological well-being in this population.

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