Supplementary Material

The prevalence of loneliness across 113 countries: systematic review and meta-analysis
Daniel L Surkalim, MPH,1,2 Mengyun Luo, MPH,1,2 Robert Eres, PhD,3 Klaus Gebel, PhD,4,1
Adrian Bauman, PhD,1,2 Joseph Van Buskirk, MBiostat, MPH,1 Ding Ding, PhD1,2

1
Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney,

Camperdown, New South Wales, Australia

2
Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales,

Australia

3
Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Victoria,

Australia

4
Australian Centre for Public and Population Health Research, School of Public Health,

Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia

Correspondence to:

Associate Professor Ding Ding, 6N69, Charles Perkins Centre (D17), The University of

Sydney, Camperdown, New South Wales, 2006, Australia

melody.ding@sydney.edu.au

1
 Table of Contents
Page
Table S1: Example search strategy for EMBASE, MEDLINE, and PsycINFO 3
Figure S1: PRISMA flowchart for study selection 4
Table S2: Examples of excluded articles 5
Table S3: Studies included in the systematic review by type of measures 6
Table S4: Study counts for the systematic review by age groups 6
Table S5: Study counts for the meta-analysis by age groups 6
Table S6: Characteristics of studies that used scale measures of loneliness 7
Table S7: Characteristics of studies that used single-item measures of loneliness 8
Table S8: Risk of Bias Assessment using the Joanna Briggs Institute (JBI) Critical Appraisal
Checklist for Studies Reporting Prevalence Data 11
Table S9: Prevalence estimates of loneliness (%) based on scale measures for different age groups 13
Table S10: Prevalence estimates of loneliness (%) by direct single-item measures for different age
groups by World Health Organization regions 14
Figure S2: Sensitivity analysis: Meta-analysis of loneliness prevalence based on de Jong Gierveld
Loneliness Scale (6-item version) using the World Bank country income group for
subgroup analysis 19
Figure S3: Sensitivity analysis: Meta-analysis of loneliness prevalence based on single-item measures
in young adults (aged ~18-~29 years old) in Europe using the World Bank country income
group for subgroup analysis 20
Figure S4: Sensitivity analysis: Meta-analysis of loneliness prevalence based on single-item measures
in middle-aged adults (aged ~30-~59 years old) in Europe using the World Bank country
income group for subgroup analysis 21
Figure S5: Sensitivity analysis: Meta-analysis of loneliness prevalence based on single-item measures
in older adults (aged ~60+ years old) in Europe using the World Bank country income
group for subgroup analysis 22
Figure S6: Meta-analysis of loneliness prevalence using scale-based measures in older adults (aged
~60+ years old) (sensitivity analysis: based on Freeman-Tukey double arcsine
transformation) 23
Figure S7: Meta-analysis of loneliness prevalence based on single-item measures in adolescents
(aged ~12-~17 years old) by WHO region (sensitivity analysis: based on Freeman-Tukey
double arcsine transformation) 24
Figure S8: Meta-analysis of loneliness prevalence based on single-item measures in young adults
(aged ~18-~29 years old) in Europe (sensitivity analysis: based on Freeman-Tukey double
arcsine transformation) 25
Figure S9: Meta-analysis of loneliness prevalence based on single-item measures in middle-aged
adults (aged ~30-~59 years old) in Europe (sensitivity analysis: based on Freeman-Tukey
double arcsine transformation) 26
Figure S10: Meta-analysis of loneliness prevalence based on single-item measures in older adults
(aged ~60+ years old) in Europe (sensitivity analysis: based on Freeman-Tukey double
arcsine transformation) 27
References for included studies cited in Tables 1 and 2 28

2
Table S1 | Example search strategy for EMBASE, MEDLINE, and PsycINFO

# Search terms
1 loneliness/
2 lonel*.tw.
3 (social* adj4 isolat*).tw.
4 1 or 2 or 3
5 prevalence/
6 prevalen*.tw.
7 5 or 6
8 4 and 7

Limited to human studies

3
Figure S1 | PRISMA flow chart for study selection

4
Table S2 | Examples of excluded articles

Reason for exclusion Example Explanation

Not relevant to the research question of Vozikaki M, Linardakis M, Philalithis A. Reports on social isolation rather than
loneliness prevalence. Preventive health services utilization in loneliness.
relation to social isolation in older adults. J
Public Health 2017; 25(5): 545-56.

No loneliness prevalence reported.
Tobiasz-Adamczyk B, Galas A, Zawisza Loneliness and outcomes without reporting
K, Chatterji S, Haro JM, Ayuso-Mateos the prevalence.
JL, Koskinen S, Leonardi M. Gender-
related differences in the multi-pathway
effect of social determinants on quality of
life in older age—the COURAGE in
Europe project. Qual Life Res 2017; 26(7):
1865-78.

Not nationally representative samples Boyd, M, Calvert C, Tatton A, et al. Participants were residents of selected
Lonely in a crowd: Loneliness in New retirement villages.
Zealand retirement village residents. Int
Psychogeriatr 2021; 33(5): 481-493.

Timmermans EJ, Hoogendijk EO, Broese Participants were from Amsterdam only,
van Groenou MI, et al. Trends across 20 not the rest of he Netherlands.
years in multiple indicators of functioning
among older adults in the Netherlands. Eur
J Public Health 2019; 29(6): 1096-102.

Insufficiently defined or not previously
validated measures
Nzabona A, Ntozi J, Rutaremwa G.
Loneliness among older persons in
Uganda: examining social, economic and
demographic risk factors. Ageing Soc
2016; 36(4): 860-88.
Transient loneliness (not chronic or
loneliness at a problematic level)
measured. Overall loneliness being
assessed with no time frame.

Hawkins-Elder H, Milfont TL, Hammond

Prevalence data were from before Jan 2000
or after Dec 2019.
MD, Sibley CG. Who are the lonely? A
typology of loneliness in New Zealand.
Aust N Z J Psychiatry 2018; 52(4): 357-64.
Berg S, Mellström D, Persson G, Svanborg
A. Loneliness in the Swedish aged. J
Gerontol 1981; 36(3): 342-9.
Loneliness was measured using the New
Zealand Attitudes and Values Study
(NZAVS) loneliness scale which has not
been tested for reliability and validity.
The study was published in 1981.

Full text could not be obtained.
Kotwal A, Waite L, Dale W, Perissinotto Full text could not be identified.
CM, Covinsky K, Smith AK. Pain and
loneliness: results of a nationally-
representative survey of community-
dwelling older adults. J Am Geriatr Soc
2019; 67: S54-S55.

Sample size < 292 Losada A, Márquez-González M, García- n = 272

Ortiz L, Gómez-Marcos MA, Fernández-
Fernández V, Rodríguez-Sánchez E.
Loneliness and mental health in a
representative sample of community-
dwelling Spanish older adults. J Psychol
2012; 146(3): 277-92.

5
Table S3 | Studies included in the systematic review by type of measures
Type of measures No. of studies No. of countries/territories No. of prevalence estimates
Scale measures 11 16 30
UCLA Loneliness Scale 9 6 18
de Jong Gierveld Loneliness Scale 2 12 12

Single-item measures 46 110 295

Measuring loneliness for unspecified time 13 19 44
Measuring loneliness in the past year 23 78 152
Measuring loneliness in the past week 10 35 99

Table S4 | Study counts for the systematic review by age groups

No. studies No. countries/territories No. prevalence estimates

Scale measures
Adolescent 1 1 1
Middle-aged adults 2 1 3
Older adult 8 15 26

Single-item measures
Adolescent 28 76 132
Young adult 5 30 34
General/middle-aged adult 4 32 36
Older adult 17 38 93

Total 57 113 325

Table S5 | Study counts for the meta-analysis by age groups

No. studies No. countries/territories No. prevalence estimates

Scale measures
Older adult 7 15 25

Single-item measures
Adolescent 17 68 76
Young adult 4 30 33
General/middle-aged adult 3 32 35
Older adult 5 30 43

Total 24 106 212

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Table S6 | Characteristics of studies that used scale measures of loneliness

Sample Response Sample characteristics: Measure of Cut-off point for Conflict of

Author (year) Country Study
size (n) rate (%) Age (% Female) loneliness loneliness interest
Adolescents and young adults
Cigna (2020) USA NA 10,441 Unspecified ≥18 20-item UCLA ≥43 Did not disclose
Young Australian Loneliness
Lim (2018) Australia 1,520 Unspecified 12-25 (63.2%) 20-item UCLA ≥52 No conflict disclosed
Survey
Middle-aged and older adults
Health and Retirement Study
Crowe (2021) USA 11,302 Unspecified ≥50 (60.0%) 3-item UCLA ≥7 No conflict disclosed
[HRS]
Must note ‘Severe’ in at
Das (2019)* USA HRS 3,663-3,999 88.6-87.9 ≥50 (59.8-60.5%) 3-item UCLA No conflict disclosed
least one category
English Longitudinal Study of Must note ‘Severe’ in at
England 4,299-4,468 84.3-87.3 ≥50 (55.8-56.1%) 3-item UCLA No conflict disclosed
Ageing [ELSA] least one category
One co-author is a
Collaborative Research on consultant for a
Domènech-Abella (2017) Spain 3,535 69.9 ≥50 (54.1%) 3-item UCLA ≥6
Ageing in Europe [COURAGE] pharmaceutical
company
3
Domènech-Abella (2018) COURAGE 1,433-3,623 53.0-70.0 ≥50 (23.7-28.5%) 3-item UCLA ≥6 No conflict disclosed
countries†
11
Hansen (2016) Generations and Gender Survey 1,807-6,524 42.0-97.0 60-80 (49.7-69.6%) 6-item de Jong Gierveld ≥6 Did not disclose
countries‡
Longitudinal Study Aging in
Simpson (2019) Spain 962 Unspecified ≥50 (52.3%) 6-item de Jong Gierveld 5/6 No conflict disclosed
Spain [ELES]
Smith (2019) England ELSA 9,299 Unspecified ≥50 (55.6%) 3-item UCLA ≥6 No conflict disclosed

Victor (2020)* England ELSA 4,663 Unspecified ≥50 (56.2%) 3-item UCLA ≥6 No conflict disclosed

Wilson (2010) USA NA 3,012 65.3 ≥45 (53.0%) 20-item UCLA ≥44 Did not disclose
NA: Not applicable.
* Estimates calculated by authors of the systematic review and meta-analysis based on reported information or additional information obtained by contacting the authors of the original studies.
† Finland, Poland, Spain.
‡ Belgium, Bulgaria, Czech Republic, France, Georgia, Germany, Lithuania, Norway, Poland, Romania, Russia.

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Table S7 | Characteristics of studies that used single-item measures of loneliness

Sample
Sample Response rate Time Operational definition of
Author Country Study characteristics: Conflict of Interest
Size (n) (%) Scale loneliness/scores
Age (% Female)
Adolescents and young adults
Global School-Based
Aboagye (2021) Ghana 1,342 71.0 10-19 (44.8%) Past year ‘Always’/’Most of the time’ No conflict disclosed
Health Survey [GSHS]
Amu (2021) Tanzania GSHS 2,449 87.0 10-18 (51.0%) Past year ‘Always’/’Most of the time’ No conflict disclosed
The National
Adolescent School-
Antunes (2021) Brazil 10,926 97.6 13-17 (49.7%) Past year ‘Always’/’Most of the time’ No conflict disclosed
based Health Survey
(PeNSE)
Baiden (2019) Ghana GSHS 1,633 84.0 14-18 (49.4%) Past year ‘Always’/’Most of the time’ No conflict disclosed

Dema (2019) Bhutan GSHS 5,809 95.0 13-17 (53.5%) Past year ‘Always’/’Most of the time’ No conflict disclosed

Dendup (2020) Bhutan GSHS 7,576 95.0 13-18 (51.3%) Past year ‘Always’/’Most of the time’ No conflict disclosed
20
Elia (2020) GSHS 943-27,988 60.0-90.0 13-17 (46.0-56.0%) Past year ‘Always’/’Most of the time’ No conflict disclosed
countries/territories*†
Health Behaviour in
Favotto (2019) Canada School-aged Children 23,218 77.0 11-15 (50.7%) Unspecified ‘Strongly agree’/’Agree’ No conflict disclosed
[HBSC]
Youth Risk and
Fox (2009) Jamaica Resiliency Behaviour 3,003 Unspecified 10-15 (52.6%) Unspecified ‘All of the time’/’Most’ Did not disclose
Survey
Hernandez-Vasquez (2019) Peru GSHS 2,882 85% ~13-16 (49.7%) Past year ‘Always’/’Mostly’ No conflict disclosed

Khan (2020) Bangladesh GSHS 76,982 91.0 11-18 (34.7%) Past year ‘Always’/’Most of the time’ No conflict disclosed

Khan (2020) Bangladesh GSHS 2,989 94.0 11-18 (34.7%) Past year ‘Always’/’Most of the time’ No conflict disclosed
‘Very often’/’Quite
Lyyra (2018)‡ Finland HBSC 5,925 85.2 ~11-16 (50.8%) Unspecified No conflict disclosed
often’/’Sometimes’
‘Very often’/ ‘Often’ or
Lyyra (2021) 4 countries§ HBSC 5,717-5,861 Unspecified 11-15 (49.0-52.0%) Unspecified No conflict disclosed
‘Always’/’Most of the time’
Madsen (2018) Denmark HBSC 3,941-5,007 88.7 11-15 (51.5-52.1%) Unspecified ‘Very often’/’Often’ No conflict disclosed
14,518-
Myhr (2020) Norway Ungdata 66.0-69.0 ~13-19 (49.7-51.0%) Past week ‘Very much’ No conflict disclosed
30,040
Pandey (2019) Nepal GSHS 6,531 75.0 ~12-16 (53.0%) Past year ‘Always’/’Most of the time’ No conflict disclosed

Pengpid (2019) Guatemala GSHS 4,274 82.0 ~13-16 (50.6%) Past year ‘Always’/’Most of the time’ No conflict disclosed

Pengpid (2019) 5 countries¶ GSHS 3,675-11,105 72.0-94.0 Mean age 14.3 Past year ‘Always’/’Most of the time’ No conflict disclosed

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Pengpid (2020) Liberia GSHS 2,744 71.0 ~14-18 (48.2%) Past year ‘Always’/’Most of the time’ No conflict disclosed

Pengpid (2020) Timor-Leste GSHS 3,704 79.0 ~14-17 (49.3%) Past year ‘Always’/’Most of the time’ No conflict disclosed

Pengpid (2020)‡ United Arab Emirates GSHS 2,581-15,790 80.0-91.0 ~11-16 (50.0-57.9%) Past year ‘Always’/’Most of the time’ No conflict disclosed

Refaeli (2020)‡ Israel Israeli Social Survey 1,508 Unspecified 20-29 (49.0%) Unspecified ‘Often’ No conflict disclosed
24
Sauter (2020) countries/territories|| GSHS 951-28,368 70.0-93.0 ~12-16 (51.0%) Past year ‘Always’/’Most of the time’ No conflict disclosed
**
Seidu (2019) Tanzania GSHS 3,048 80.0 ~11-14 (52.4%) Past year ‘Always’/’Most of the time’ Did not disclose

Seidu (2020) Ghana GSHS 1,266 Unspecified ~12-18 (19.5%) Past year ‘Always’/’Most of the time’ Did not disclose

Shahedifar (2020)‡ Brunei GSHS 2,599 65.0 ~11-18 (49.9%) Past year ‘Always’/’Most of the time’ No conflict disclosed
National Health and
Tan (2019) Malaysia 27,420 89.2 13-17 (52.3%) Past year ‘Always’/’Most of the time’ No conflict disclosed
Morbidity Survey
Vancampfort (2019) 52 countries†† GSHS 668-21,528 67.0-100.0 12-15 (48.5%) Past year ‘All of the time’/’Most’ No conflict disclosed

Middle-aged and older adults

Survey of Health,
Arsenijevic (2018) 10 countries‡‡ Ageing and Retirement Unspecified Unspecified ≥65 Past year ‘Often’/’Sometimes’ No conflict disclosed
in Europe [SHARE]
Swedish Panel Study of
Dahlberg (2015) Sweden Living Conditions of the 587 86.0-87.3 ≥ 70 (61.8%) Unspecified ‘Nearly always’/’Often’ Did not disclose
Oldest Old [SWEOLD]
Dahlberg (2018) Sweden SWEOLD 518-1,041 84.4-95.4 ≥ 70 (54.9-60.1%) Unspecified ‘Nearly always’/’Often’ No conflict disclosed
China Health and
Li (2019) China Retirement Longitudinal 12,417 80.5 ≥ 45 (50.8%) Past week ‘Most or all of the time [5-7 days] No conflict disclosed
Study [CHARLS]
Canadian Longitudinal ‘All of the time [5-7
Menec (2019) Canada 47,818 Unspecified 45-85 (51.5%) Past week No conflict disclosed
Study on Aging [CLSA] days]’/’Occasionally [3-4 days]’
Brazilian Longitudinal
Neri (2018) Brazil Study of Aging [ELSI- 7,651 Unspecified ≥50 (46.8%) Unspecified ‘Always’ No conflict disclosed
Brazil]
Life Course,
Nicolaisen (2014)‡§§ Norway Generation, and Gender 14,743 60.0 18-81 (50.7%) Unspecified ‘Often’ Did not disclose
Study [LOGG]
Severe = ‘All the
Pengpid (2021)‡ India Unnamed survey 72,262 87.0 ≥45 (58.0%) Past week No conflict disclosed
time/Occasionally’
Health in Times of
Stickley (2013) 9 countries¶¶ 1,605-2,553 47.0-83.0 ≥18 (51.7-63.6%) Unspecified ‘Often’ No conflict disclosed
Transition [HITT]
Severe = ‘almost all of the time’
Sundström (2009)‡ 12 countries|||| SHARE 316-1,145 39.0-79.0 ≥65 (51.0-60.0%) Past week Did not disclose
Moderate = ‘most of the time’
Health and Retirement
Theeke (2008) USA 13,812 Unspecified ≥50 (61.3%) Past week ‘Yes’ to ‘I often feel lonely’ Did not disclose
Study [HRS]

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 Theeke (2009) USA HRS 8,932 Unspecified ≥50 (59.0%) Past week ‘Yes’ to ‘Felt lonely’ No conflict disclosed
Study on Global Ageing
‘Yes’ to ‘Did you feel lonely for
Vancampfort (2019) 6 countries*** and Adult Health 2,313-13,175 53.0-93.0 ≥50 (47.6-61.1%) Past week No conflict disclosed
much of the day yesterday?’
[SAGE]
Office for National
Victor (2005)‡ UK Statistics Omnibus 997 Unspecified ≥65 Unspecified ‘Always’/’Often’ Did not disclose
Survey
European Social Survey
Victor (2012) UK 2,393 52.0 ≥ 15 Past week ‘All or almost all’/’Most’ Did not disclose
[ESS]
Survey of the Aged
‘Yes’ to ‘Do you feel lonely?’ or
Yang (2008) China Population in China 19,857 Unspecified ≥60 (47.1%) Unspecified Did not disclose
‘I often feel lonely’
[SAP]
Yang (2011)‡ 25 countries††† ESS 995-2,915 50.0-70.0 15-101 Past week ‘All or almost all’/’Most’ Did not disclose
NA: Not applicable.
* 21 countries/territories reported in original article, but loneliness prevalence for Chile not provided.
† Argentina, Anguilla, Antigua & Barbuda, Bahamas, Barbados, Belize, Bolivia, British Virgin Islands, Costa Rica, Dominica, El Salvador, Guatemala, Guyana, Honduras, Jamaica, Peru, St Kitts & Nevis, Suriname, Trinidad &Tobago,
Uruguay.
‡ Estimates calculated by authors of the systematic review and meta-analysis based on reported information or additional information obtained by contacting the authors of the original studies.
§ Denmark, Iceland, Finland, Sweden.
¶ Indonesia, Thailand, Timor Leste, Laos, Philippines.
|| 25 countries/territories reported in original article, but Montserrat excluded due to n<292.
** Anguilla, Antigua & Barbuda, Argentina, Bahamas, Barbados, Belize, Bolivia, British Virgin Islands, Cayman Islands, Costa Rica, Dominica, El Salvador, Grenada, Guatemala, Guyana, Honduras, Jamaica, Peru, St. Kitts & Nevis,
St. Lucia, St. Vincent & the Grenadines, Suriname, Trinidad & Tobago, Uruguay.
†† Benin, Botswana, Ghana, Kenya, Mauritania, Mozambique, Namibia, Tanzania, Uganda, Zambia, Antigua & Barbuda, Argentina, Belize, Bolivia, Costa Rica, El Salvador, Grenada, Guyana, Honduras, Peru, St. Lucia, St. Vincent &
the Grenadines, Suriname, Afghanistan, Egypt, Iraq, Jordan, Lebanon, Morocco, Pakistan, Tunisia, Yemen, Macedonia, Bangladesh, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor Leste, Fiji, Kiribati, Laos,
Malaysia, Mongolia, Philippines, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu.
‡‡ Austria, Belgium, Denmark, France, Germany, Italy, Netherlands, Spain, Sweden, Switzerland.
§§ Both scale and single item measures provided, but only single item estimate is used for mapping and calculations, as no clear de Jong Gierveld Loneliness Scale cut-off points were included in the study.
¶¶ Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Ukraine.
|||| Austria, Belgium, Denmark, France, Germany, Greece, Israel, Italy, Netherlands, Spain, Sweden, Switzerland.
***Ghana, South Africa, Mexico, Russia, India, China
††† Austria, Belgium, Bulgaria, Cyprus, Denmark, Estonia, Finland, France, Germany, Hungary, Ireland, Latvia, Netherlands, Norway, Poland, Portugal, Romania, Russia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Ukraine,
United Kingdom.

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Table S8 | Risk of Bias Assessment using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data

Ref# First author JBI Critical Appraisal Checklist Item

1. 2. 3. 4. 5. 6. 7. 8. 9.
Sampling Appropriate Sample Subject and Analysis Valid Standardised Statistical Response Total
Frame Sampling Size Setting Coverage Measures Measures Analysis Rate
1 Lim Y Unclear Y Y N Y Y Y N 6
2 Hansen Y Unclear Y Y Unclear Y Y N Mixed* 5/6
3 Das Y Y Y Y Y Y Y Y Y 9
4 Smith Y Unclear Y Y Unclear Y Y N N 5
5 Victor Y Unclear Y Y Unclear Y Y N N 5
6 Domènech-Abella Y Y Y Y Y Y Y N Mixed† 7/8
7 Domènech-Abella Y Y Y Y Y Y Y N Y 8
8 Simpson Y Unclear Y Y Unclear Y Y N N 5
9 Wilson Y Y Y N Unclear Y Y N Y 6
10 Cigna Y Unclear Y N Y Y Y N N 5
11 Crowe Y Y Y N Unclear Y Y N N 5
12 Vancampfort Y Y Y Y Y Y Y N Y 8
13 Vancampfort Y Unclear Y Y Y Y Y N Y 7
14 Baiden Y Y Y Y Y Y Y N Y 8
15 Aboagye Y Y Y N Unclear Y Y N Y 6
16 Seidu Y Y Y Y Unclear Y Y N N 6
17 Pengpid Y Unclear Y N Unclear Y Y N Y 5
18 Seidu Y Y Y Y Y Y Y N Y 8
19 Amu Y Unclear Y Y Unclear Y Y N Y 6
20 Sauter Y Y Y Y Y Y Y N Y 8
21 Elia Y Unclear Y N Unclear Y Y N Y 5
22 Antunes Y Unclear Y Y Y Y Y Y Y 8
23 Neri Y Unclear Y N Y Y Y Y N 6
24 Favotto Y Unclear Y Y Y Y Y Y Y 8
25 Menec Y Unclear Y Y Y Y Y Y N 7
26 Pengpid Y Unclear Y Y Unclear Y Y Y Y 7
27 Fox Y Y Y Y Y Y Y N N 7
28 Hernandez-Vasquez Y Y Y Y Y Y Y N Y 8
29 Theeke Y Unclear Y Y Unclear Y Y N N 5
30 Theeke Y Unclear Y Y Unclear Y Y N N 5
31 Pengpid Y Y Y Y Y Y Y N Y 8
32 Stickley Y Unclear Y Y Unclear Y Y N Mixed‡ 5/6
33 Yang Y Y Y N Y Y Y N Mixed§ 6/7
34 Arsenijevic Y Unclear Y N Y Y Y N N 5
35 Sundström Y Unclear Y Y Unclear Y Y N Mixed¶ 5/6
36 Madsen Y Y Y Y Y Y Y N Y 8
37 Lyyra Y Y Y N Unclear Y Y N N 5
38 Lyyra Y Unclear Y N Unclear Y Y N Y 5
39 Refaeli Y Y Y Y Unclear Y Y N N 6
40 Nicolaisen Y Unclear Y Y Unclear Y Y N Y 6
41 Myhr Y Unclear Y N Unclear Y Y N Y 5
42 Dahlberg Y Unclear Y Y Unclear Y Y N Y 6
43 Dahlberg Y Unclear Y Y Unclear Y Y N Y 6

11
 44 Victor Y Unclear Y N Y Y Y N N 5
45 Victor Y Unclear Y N Unclear Y Y N Y 5
46 Khan Y Y Y Y Y Y Y Y Y 9
47 Khan Y Y Y N Y Y Y N Y 7
48 Dema Y Y Y Y Y Y Y N Y 8
49 Dendup Y Y Y N Y Y Y N Y 7
50 Pengpid Y Unclear Y N Unclear Y Y N Y 5
51 Pengpid Y Y Y Y Y Y Y N Y 8
52 Pandey Y Y Y Y Y Y Y N Y 8
53 Pengpid Y Unclear Y N Unclear Y Y N Y 5
54 Shahedifar Y Y Y N Y Y Y N Y 7
55 Yang Y Y Y Y Y Y Y N Y 8
56 Li Y Y Y Y Unclear Y Y N Y 7
57 Tan Y Y Y Y Y Y Y N Y 8
References are listed at the end of the Supplementary File (pp. 27-30).
Studies with multiple countries: response rates for countries ranged *42.0-97.0%, †53.0-70.0%, ‡47.0-83.0%, §50.0-70.0%, ¶39.0-79.0%; total scores may differ across countries within the same study (e.g., 5/6, 7/8).

12
Table S9 | Prevalence estimates of loneliness (%) based on scale measures for different age groups

Adolescent/young adult population General/middle-aged adult population Older adult population

Country UCLA UCLA UCLA de Jong Gierveld
Australia (H) 28.1 (25.8 to 30.3)12018 .. .. ..
Belgium (H) .. .. .. 12.6 (11.0 to 14.1)22011
Bulgaria (UM) .. .. .. 37.2 (35.3 to 39.1)22011
Czech Republic (H) .. .. .. 23.5 (21.8 to 25.2)22011
United Kingdom (England) (H) .. .. 9.4 (8.6 to 10.3)32005 ..
19.3 (18.5 to 20.1)42005
11.5 (10.5 to 12.4)32009
11.6 (10.6 to 12.6)32013
14.6 (13.6 to 15.7)52014
Finland (H) .. .. 5.9 (4.7 to 7.1)62012 ..
France (H) .. .. .. 13.6 (12.3 to 14.9)22011
Georgia (UM) .. .. .. 43.3 (41.3 to 45.3)22011
Germany (H) .. .. .. 12.7 (11.4 to 13.9)22011
Lithuania (H) .. .. .. 28.5 (26.9 to 30.1)22011
Norway (H) .. .. .. 8.3 (7.4 to 9.1)22011
Poland (H) .. .. 13.3 (15.7 to 18.5)62012 13.3 (12.4 to 14.1)22011
Romania (UM) .. .. .. 29.4 (27.9 to 30.9)22011
Russia (UM) .. .. .. 25.6 (24.0 to 27.2)22011
Spain (H) .. .. 13.4 (12.3 to 14.5)72012 9.0 (7.2 to 10.9)82012
13.0 (11.9 to 14.1)62012
United States (H) .. 35.0 (33.0 to 37.0)92010 16.1 (15.0 to 17.3)32005 ..
54.0 (53.0 to 55.0)102018* 10.0 (9.45 to 10.55)112006
61.0 (60.0 to 62.0)102019* 13.0 (11.9 to 14.0)32009
14.4 (13.2 to 15.5)32013
18.0 (17.4 to 18.8)112014
UM: Upper Middle; H: High-income countries based on the World Bank country income group classification.
Confidence intervals provided within brackets.
Bold dace indicates estimates that were included in the meta-analysis.
* Sample: general adults ≥18 years old.
References: 1Lim 2018; 2Hansen 2016; 3Das 2019; 4Smith 2019; 5Victor 2020; 6Domènech-Abella 2018; 7Domènech-Abella 2017; 8Simpson 2019; 9Wilson 2010; 10Cigna 2020; 11Crowe 2021.
Full references of the studies are provided in the supplementary files (pp. 28-31).

13
 Table S10 | Prevalence estimates of loneliness (%) by direct single-item measures for different age groups by World Health Organization regions

Adolescent/young adult population General/middle-aged adult population Older adult population

Country Unspecified Past year Past week Unspecified Past week Unspecified Past year Past week
African Region
Benin (L) .. 10.5 (8.3 to 12.7)122016 .. .. .. .. .. ..
Botswana (UM) .. 14.4 (12.6 to 16.2)122005 .. .. .. .. .. ..
Ghana (LM) .. 12.7 (10.7 to 14.7)122012 .. .. .. .. .. 10.7 (9.8 to 11.6)132010
17.8 (15.9 to 19.7)142012
18.0 (16.0 to 20.1)152012
18.4 (16.3 to 20.5)162012
Kenya (LM) .. 17.8 (16.4 to 19.2)122003 .. .. .. .. .. ..
Liberia (L) .. 13.9 (12.6 to 15.2)172017 .. .. .. .. .. ..
Mauritania (LM) .. 16.4 (14.4 to 18.4)122010 .. .. .. .. .. ..
Mozambique (L) .. 8.0 (5.9 to 10.1)122015 .. .. .. .. .. ..
Namibia (UM) .. 12.5 (11.0 to 14.0)122013 .. .. .. .. .. ..
South Africa (UM) .. .. .. .. .. .. .. 9.9 (9.0 to 10.8)132010
Tanzania (L) .. 6.7 (5.5 to 7.9)122014 .. .. .. .. .. ..
6.9 (5.6 to 8.2)182015
17.4 (15.9 to 18.9)192017
Uganda (L) .. 9.3 (8.0 to 10.6)122003 .. .. .. .. .. ..
Zambia (LM) .. 23.6 (21.3 to 25.9)122004 .. .. .. .. .. ..
Americas Region
Anguilla (BT) (H) .. 9.6 (7.7 to 11.5)202009 .. .. .. .. .. ..
9.6 (7.7 to 11.5)212009
Antigua &
.. 11.8% (10.0 to 13.6)122009 .. .. .. .. .. ..
Barbuda (H)
13.1 (11.2 to 15.0)202009
13.5 (11.6 to 15.4)212009
Argentina (UM) .. 8.5 (9.1 to 8.9)122012 .. .. .. .. .. ..
9.6 (9.3 to 9.9)202012
10.0 (9.6 to 10.4)212012
Bahamas (H) .. 11.2 (9.5 to 12.9)202013 .. .. .. .. .. ..
11.2 (9.5 to 12.9)212013
Barbados (H) .. 11.3 (9.8 to 12.8)212011 .. .. .. .. .. ..
12.0 (10.4 to 13.6)202011
Belize (UM) .. 12.4 (11.0 to 13.8)122011 .. .. .. .. .. ..
13.1 (11.7 to 14.5)202011
13.2 (11.8 to 14.6)212011
Bolivia (LM) .. 9.9 (9.9 to 11.0)122012 .. .. .. .. .. ..
10.9 (9.9 to 11.9)202012
11.1 (10.1 to 12.1)212012
Brazil (UM) .. 15.5 (10.9 to 12.1)222015* .. .. .. 14.9 (14.1 to 15.7)232016 .. ..
British Virgin 20
.. 10.9 (9.4 to 12.4) 2009 .. .. .. .. .. ..
Islands (BT) (H)
10.9 (9.4 to 12.4)212009
Canada (H) 24.6 (23.6 to 25.7)242014* .. .. .. .. .. .. 10.2 (9.9 to 10.5)252016
Cayman
.. 13.6 (11.7 to 14.5)202007 .. .. .. .. .. ..
Islands (BT) (H)
14
Costa Rica (UM) .. 5.5 (4.6 to 6.4)122009 .. .. .. .. .. ..
6.6 (5.7 to 7.5)212009
6.7 (5.8 to 7.6)202009
Dominica (UM) .. 13.2 (11.6 to 14.8)202009 .. .. .. .. .. ..
13.2 (11.6 to 14.8)212009
El Salvador (LM) .. 7.9 (6.6 to 9.2)122013 .. .. .. .. .. ..
9.0 (7.7 to 10.3)202013
9.5 (8.2 to 10.8)212013
Grenada (UM) .. 13.4 (11.5 to 15.3)122008 .. .. .. .. .. ..
15.3 (13.5 to 17.1)202008
Guatemala (UM) .. 9.5 (8.7 to 10.3)202009 .. .. .. .. .. ..
10.7 (9.9 to 11.5)212009
8.9 (8.0 to 9.8)262015
Guyana (UM) .. 12.2 (10.9 to 13.5)212010 .. .. .. .. .. ..
16.6 (15.0 to 18.2)122010
17.8 (16.3 to 19.3)202010
Honduras (LM) .. 14.8 (13.1 to 16.5)212010 .. .. .. .. .. ..
10.1 (8.6 to 11.6)122012
10.7 (9.3 to 12.1)202012
Jamaica (UM) .. 19.5 (17.6 to 21.4)202010 .. .. .. .. .. ..
13.7 (12.5 to 14.9)272005
10.5 (9.1 to 11.9)212012
Mexico (UM) .. .. .. .. .. .. .. 15.3 (13.8 to 16.8)132010
Peru (UM) .. 9.9 (8.7 to 11.1)122010 .. .. .. .. .. ..
10.2 (9.0 to 11.4)282010
10.5 (9.4 to 11.6)202010
10.7 (9.6 to 11.8)212010
St. Kitts & Nevis (H) .. 12.2 (10.7 to 13.7)202011 .. .. .. .. .. ..
12.2 (10.7 to 13.7)212011
St. Lucia (UM) .. 13.6 (11.5 to 15.7)122007 .. .. .. .. .. ..
16.0 (14.0 to 18.0)202007
St. Vincent &
.. 15.4 (13.3 to 17.5)122007 .. .. .. .. .. ..
the Grenadines (UM)
20
15.7 (13.7 to 17.7) 2007
Suriname (UM) .. 13.7 (11.6 to 15.8)122009 .. .. .. .. .. ..
14.8 (13.1 to 16.5)212009
15.0 (13.3 to 16.7)202009
Trinidad &
.. 9.8 (8.7 to 10.9)202011 .. .. .. .. .. ..
Tobago (H)
21
10.5 (9.4 to 11.6) 2011
United States (H) .. .. .. .. .. .. .. 16.9 (16.3 to 17.5)292002
19.0 (18.2 to 19.8)302002
Uruguay (H) .. 7.0 (6.2 to 7.8)212012 .. .. .. .. .. ..
7.1 (6.3 to 7.9)202012
Eastern Mediterranean Region
Afghanistan (L) .. 28.5 (26.2 to 30.8)122014 .. .. .. .. .. ..
Egypt (LM) .. 8.0 (7.2 to 8.8)122006 .. .. .. .. .. ..
Iraq (UM) .. 15.9 (14.1 to 17.7)122012 .. .. .. .. .. ..
Jordan (UM) .. 15.0 (13.3 to 16.7)122007 .. .. .. .. .. ..
Lebanon (UM) .. 11.8 (10.4 to 13.2)122011 .. .. .. .. .. ..

15
Morocco (LM) .. 17.0 (15.5 to 18.5)122010 .. .. .. .. .. ..
Pakistan (LM) .. 11.9 (11.0 to 12.8)122009 .. .. .. .. .. ..
Tunisia (LM) .. 17.0 (15.5 to 18.5)122008 .. .. .. .. .. ..
United Arab
14.9 (14.1 to 15.7)312005
Emirates (H)
16.6 (14.3 to 18.9)312010
14.0 (12.7 to 15.3)312016
Yemen (L) .. 14.2 (12.5 to 15.9)122014 .. .. .. .. .. ..
European Region
Armenia (UM) 7.7 (5.3 to 10.1)322010† .. .. 9.8 (7.8 to 11.8)322010 .. .. .. ..
Austria (H) .. .. 9.5 (7.3 to 11.7)332006† .. 6.4 (5.1 to 7.7)332006 .. 7.5342004‡ 10.2 (8.1 to 12.3)352006
17.7342011‡ 10.5 (7.5 to 13.5)332006
17.1342013‡
Azerbaijan (UM) 3.2 (1.8 to 4.6)322010† .. .. 4.0 (2.7 to 5.3)322010 .. .. .. ..
Belarus (UM) 3.8 (2.1 to 5.5)322010† .. .. 7.0 (5.3 to 8.7)322010 .. 20.3 (16.1 to 24.5)322010 .. ..
Belgium (H) .. .. 6.2 (3.9 to 8.5)332006† .. 6.5 (4.9 to 8.1)332006 .. 11.6342004‡ 13.8 (11.8 to 15.8)352006
28.8342011‡ 8.7 (6.1 to 11.3)332006
25.0342013‡
Bulgaria (UM) .. .. .. .. 8.1 (6.1 to 10.1)332006 .. .. 18.9 (15.1 to 22.7)332006
Cyprus (H) .. .. .. .. 5.8 (3.8 to 7.8)332006 .. .. ..
Denmark (H) 7.2 (6.5 to 7.9)362006 .. .. .. 1.9 (1.0 to 2.8)332006 .. 3.7342004‡ 5.4 (3.4 to 7.5)352006
7.2 (6.4 to 8.0)362014 11.0342011‡ 3.2 (1.6 to 4.8)332006
7.7 (6.0 to 9.4)372018 10.0342013‡
Estonia (H) .. .. 6.1 (3.6 to 8.6)332006† .. 5.6 (3.9 to 7.3)332006 .. .. 14.0 (10.8 to 17.2)332006
Finland (H) 12.3 (11.5 to 13.1)382014 .. 2.6 (1.0 to 4.2)332006† .. 3.7 (2.5 to 4.9)332006 .. .. 6.1(4.2 to 8.0)332006
19.2 (16.9 to 21.5)372018
France (H) .. .. 8.2 (5.5 to 10.9)332006† .. 8.8 (7.2 to 10.4)332006 .. 13.9342004‡ 15.1 (11.9 to 18.3)352006
26.1342011‡ 11.4 (8.5 to 14.3)332006
30.2342013‡
Georgia (UM) 4.2 (2.2 to 6.2)322010† .. .. 9.7 (8.0 to 11.4)322010 .. 25.3 (21.4 to 29.2)322010 .. ..
Germany (H) .. .. 5.1 (3.2 to 7.0)332006† 4.4 (3.4 to 5.4)332006 .. 6.8342004‡ 8.4 (6.5 to 10.3)352006
16.8342011‡ 7.0 (5.3 to 8.7)332006
16.8342013‡
Greece (H) .. .. .. .. .. .. .. 20.5 (17.8 to 23.2)352006
Hungary (H) .. .. 9.6 (6.3 to 12.9)332006† .. 13.3 (10.9 to 15.7)332006 .. .. 21.1 (17.3 to 24.9)332006
Iceland (H) 17.1 (15.5 to 18.7)372018 .. .. .. .. .. .. ..
Ireland (H) .. .. 4.1 (2.2 to 6.0)332006† .. 5.0 (3.6 to 6.4)332006 .. .. 5.4 (3.3 to 7.5)332006
Israel (H) 3.5 (2.6 to 4.4)392017† .. .. .. .. .. .. 15.0 (12.3 to 17.6)352006
Italy (H) .. .. .. .. .. .. 15.4342004‡ 18.2 (15.2 to 21.2)352006
31.4342011‡
33.4342013‡
Kazakhstan (UM) 2.4 (1.1 to 3.7)322010† .. 5.6 (4.1 to 7.1)322010 .. .. .. ..
Kyrgyzstan (LM) 4.3 (2.7 to 5.9)322010† .. .. 7.7 (6.0 to 9.4)322010 .. .. .. ..
Latvia (H) .. .. 7.8 (5.8 to 9.8)332006† .. 10.9 (8.8 to 13.0)332006 .. .. 18.8 (15.3 to 22.3)332006
Macedonia (UM) .. 5.8 (4.6 to 7.0)122007 .. .. .. .. .. ..
Moldova (LM) 9.5 (6.8 to 12.2)322010† .. .. 16.0 (13.6 to 18.4)322010 .. 34.9 (29.7 to 40.1)322010 .. ..
Netherlands (H) .. .. 3.4 (1.4 to 5.4)332006† .. 3.3 (2.2 to 4.4)332006 .. 6.5342004‡ 9.5 (7.4 to 11.5)352006
16.0342011‡ 6.0 (3.9 to 8.1)332006
22.0342013‡
Norway (H) 2.1 (1.5 to 2.7)402008† .. 2.2 (0.7 to 3.7)332006† 2.6 (2.3 to 2.9)402008 2.6 (1.6 to 3.6)332006 3.7 (2.9 to 4.5)402008 .. 5.0 (2.9 to 7.1)332006

16
 9.0 (8.5 to 9.5)412014
12.1 (11.7 to 12.5)412018
Poland (H) .. .. 5.5 (3.5 to 7.5)332006† .. 11.0 (8.9 to 13.1)332006 .. .. 20.1 (16.1 to 24.1)332006
Portugal (H) .. .. 6.5 (4.2 to 8.8)332006† .. 9.0 (7.3 to 10.7)332006 .. .. 14.9 (12.2 to 17.6)332006
Romania (UM) .. .. 11.5 (8.6 to 14.4)332006† .. 10.7 (8.8 to 12.6)332006 .. .. 18.8 (15.7 to 21.9)332006
Russia (UM) 5.0 (3.3 to 6.7)322010† .. 11.3 (8.9 to 13.7)332006† 5.2 (4.0 to 6.4)322010 15.4 (13.4 to 17.4)332006 17.8 (14.7 to 20.9)322010 .. 24.4 (20.8 to 28.0)332006
10.9 (9.9 to 11.9)132010
Slovakia (H) .. .. 8.8 (6.2 to 11.4)332006† .. 10.5 (8.5 to 12.5)332006 .. .. 19.6 (15.6 to 23.6)332006
Slovenia (H) .. .. 4.6 (2.4 to 6.8)332006† .. 5.0 (3.4 to 6.6)332006 .. .. 15.2 (11.7 to 18.7)332006
Spain (H) .. .. 4.4 (2.5 to 6.3)332006† .. 6.5 (4.9 to 8.1)332006 .. 12.3342004‡ 14.1 (11.7 to 16.5)352006
20.1342011‡ 11.5 (8.7 to 14.3)332006
21.4342013‡
Sweden (H) 11.9 (10.3 to 13.5)372018 .. 6.0 (3.7 to 8.3)332006† .. 3.7 (2.5 to 4.9)332006 13.3 (10.4 to 16.2)422002§ 6.1342004‡ 7.4 (5.2 to 9.6)332006
7.2 (5.1 to 9.2)432004 24.0342011‡ 7.0 (5.3 to 8.6)352006
9.9 (8.0 to 11.8)422004§ 22.1342013‡
13.4 (10.5 to 16.3)422011§
17.2 (14.1-20.3)432011
7.7 (6.1-9.3)422014§
Switzerland (H) .. .. 1.3 (0.1 to 2.5)332006† .. 2.6 (1.6 to 3.6)332006 .. 4.2342004‡ 3.8 (1.7 to 5.9)352006
12.7342011‡ 4.8 (2.9 to 6.7)332006
14.1342013‡
Ukraine (LM) 4.9 (2.9 to 6.9)322010† .. 15.3 (11.8 to 18.8)332006† 6.7 (5.0 to 8.4)322010 19.8 (17.3 to 22.3)332006 23.0 (19.3 to 26.7)322010 .. 34.0 (30.3 to 37.7)332006
United Kingdom (H) .. .. 6.3 (4.2 to 8.4)442006† .. 5.5 (4.2 to 6.8)442006 9.3 (7.5 to 11.1)452001 .. 7.4 (5.4 to 9.4)442006
6.3 (4.2 to 8.4)332006† 5.5 (4.2 to 6.8)332006 7.4 (5.4 to 9.4)332006
South-East Asian Region
Bangladesh (LM) .. 10.3 (9.2 to 11.4)122014 .. .. .. .. .. ..
10.9 (9.8 to 12.0)462014
10.9 (9.8 to 12.0)472014
Bhutan (LM) .. 12.2 (11.4 to 13.0)482016 .. .. .. .. .. ..
12.8 (12.0 to 13.6)492016
India (LM) .. .. .. .. .. .. .. 13.2 (13.0 to 13.4)502017
17.8 (16.9 to 18.7)132010
Indonesia (LM) .. 6.3 (5.8 to 6.8)122015 .. .. .. .. .. ..
6.2 (5.8 to 6.6)512015
Maldives (UM) .. 18.4 (16.7 to 20.1)122009 .. .. .. .. .. ..
Myanmar (LM) .. 3.9 (3.1 to 4.7)122007 .. .. .. .. .. ..
Nepal (L) .. 5.6 (4.9 to 6.3)122015 .. .. .. .. .. ..
6.3 (5.7 to 6.9)522015
Sri Lanka (UM) .. 7.3 (6.3 to 8.3)122008 .. .. .. .. .. ..
Thailand (UM) .. 9.8 (8.9 to 10.7)122015 .. .. .. .. .. ..
9.7 (8.0 to 10.5)512015
Timor Leste (LM) .. 10.8 (9.3 to 12.3)122015 .. .. .. .. .. ..
14.9 (13.7 to 16.1)512015
14.9 (13.8 to 16.0)532015
Western Pacific Region
Brunei (H) .. 12.2 (10.8 to 13.2)542014 .. .. .. .. .. ..
China (UM) .. .. .. .. .. 29.6 (29.0 to 30.2)552000 .. 5.5 (5.1 to 5.9)132010
15.5 (14.9 to 16.1)56201
Fiji (UM) .. 12.1 (10.5 to 13.7)122016 .. .. .. .. .. ..

17
 Kiribati (LM) .. 4.9 (3.7 to 6.1)122011 .. .. .. .. .. ..
Laos (LM) .. 2.3 (1.6 to 3.0)122015 .. .. .. .. .. ..
4.0 (3.4 to 3.6)512015
Malaysia (UM) .. 6.8 (6.4 to 7.2)122012 .. .. .. .. .. ..
9.0 (8.7 to 9.4)572017
Mongolia (LM) .. 11.4 (10.4 to 12.4)122013 .. .. .. .. .. ..
Philippines (LM) .. 15.1 (14.2 to 16.0)122015 .. .. .. .. .. ..
16.1 (15.3 to 16.9)512015
Samoa (UM) .. 23.1 (21.3 to 24.9)122011 .. .. .. .. .. ..
Solomon Islands (LM) .. 12.0 (9.9 to 14.1)122011 .. .. .. .. .. ..
Tonga (UM) .. 15.6 (14.0 to 17.2)122010 .. .. .. .. .. ..
Tuvalu (UM) .. 8.3 (6.2 to 10.4)122013 .. .. .. .. .. ..
Vanuatu (LM) .. 7.4 (5.6 to 9.2)122011 .. .. .. .. .. ..
BT: British Territory. L: Low; LM: Lower Middle; UM: Upper Middle; H: High-income countries based on the World Bank country income group classification.
Confidence intervals provided within brackets.
Bold dace indicates estimates that were included in the meta-analysis.
* Confidence intervals provided in the original study.
† Prevalence estimates in young adults (~18-29 years old).
‡ No confidence intervals calculated as no sample size was provided.
§ 2004 and 2014 sample age estimate is aged ≥70 years, whereas 2002 and 2011 is aged ≥77 years.
References: 12Vancampfort 2019; 13Vancampfort 2019; 14Baiden 2019; 15Aboagye 2021; 16Seidu 2020; 17Pengpid 2020; 18Seidu 2019; 19Amu 2020; 20Sauter 2020; 21Elia 2020; 22Antunes 2021; 23Neri 2018; 24Favotto 2019; 25Menec
2019; 26Pengpid 2019; 27Fox 2009; 28Hernandez-Vasquez 2019; 29Theeke 2008; 30Theeke 2009; 31Pengpid 2020; 32Stickley 2013; 33Yang 2011; 34Arsenijevic 2018; 35Sundström 2009; 36Madsen 2018; 37Lyyra 2021; 38Lyyra 2018;
39
Refaeli 2020; 40Nicolaisen 2014; 41Myhr 2020; 42Dahlberg 2018; 43Dahlberg 2015; 44Victor 2012; 45Victor 2005; 46Khan 2020; 47Khan 2020; 48Dema 2019; 49Dendup 2020; 50Pengpid 2020; 51Pengpid 2020; 52Pandey 2019; 53Pengpid
2020; 54Shahedifar 2020; 55Yang 2008; 56Li 2019; 57Tan 2019.
Full references of the studies are provided in the supplementary files (pp. 28-31).

18
Figure S2 | Sensitivity analysis: Meta-analysis of loneliness prevalence based on de Jong Gierveld Loneliness Scale (6-item
version) using the World Bank country income group for subgroup analysis
*Generalised linear mixed effects models with binomial-normal distribution were used.

19
Figure S3 | Sensitivity analysis: Meta-analysis of loneliness prevalence based on single-item
measures in young adults (aged ~18-~29 years old) in Europe using the World Bank
country income group for subgroup analysis
*Generalised linear mixed effects models with binomial-normal distribution were used.

20
Figure S4 | Sensitivity analysis: Meta-analysis of loneliness prevalence based on single-item
measures in middle-aged adults (aged ~30-~59 years old) in Europe using the World Bank
country income group for subgroup analysis
*Generalised linear mixed effects models with binomial-normal distribution were used.

21
Figure S5 | Sensitivity analysis: Meta-analysis of loneliness prevalence based on single-
item measures in older adults (aged ~60+ years old) in Europe using the World Bank
country income group for subgroup analysis
*Generalised linear mixed effects models with binomial-normal distribution were used.

22
Figure S6 | Meta-analysis of loneliness prevalence using scale-based measures in older adults (aged ~60+ years old) (sensitivity analysis: based on Freeman-Tukey double arcsine
transformation):

(a) studies that used the de Jong Gierveld Loneliness Scale (6-item version); and (b) UCLA Loneliness Scale (3-item version)
*Generalised linear mixed effects models with binomial-normal distribution were used.

23
(a) (b)

(c)

(e)

(d)

Figure S7 | Meta-analysis of loneliness prevalence based on single-item measures in adolescents (aged ~12-~17 years old) by WHO
region (sensitivity analysis: based on Freeman-Tukey double arcsine transformation):

(a) Africa; (b) The Americas; (c) Eastern Mediterranean; (d) South-East Asia; and (e) Western Pacific
*Generalised linear mixed effects models with binomial-normal distribution were used.

24
Figure S8 | Meta-analysis of loneliness prevalence based on single-item measures in young adults (aged ~18-
~29 years old) in Europe (sensitivity analysis: based on Freeman-Tukey double arcsine transformation)
*Generalised linear mixed effects models with binomial-normal distribution were used.

25
Figure S9 | Meta-analysis of loneliness prevalence based on single-item measures in middle-aged adults (aged
~30-~59 years old) in Europe (sensitivity analysis: based on Freeman-Tukey double arcsine transformation)
*Generalised linear mixed effects models with binomial-normal distribution were used.

26
Figure S10 | Meta-analysis of loneliness prevalence based on single-item measures in older adults (aged ~60+
years old) in Europe (sensitivity analysis: based on Freeman-Tukey double arcsine transformation)
*Generalised linear mixed effects models with binomial-normal distribution were used.

27
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