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Background <p>Loneliness is an increasingly recognised determinant of health in older adults, associated with adverse outcomes and higher healthcare utilisation.</p> Purpose <p>This study aimed to evaluate the relationship between loneliness and healthcare use in an ageing rural population in southern Portugal.</p> Methods <p>A cross-sectional survey was conducted amongst community-dwelling individuals aged ≥ 65&#xa0;years, randomly selected from primary care records in the Baixo Alentejo region. Data collection included the validated Portuguese version of the UCLA Loneliness Scale and self-reported use of healthcare services over the previous year (primary care and emergency visits, and the number of daily prescribed medicines).</p> Results <p>A total of 318 participants were included (58.8% female), with a mean age of 75.5&#xa0;years, 28.9% over 80. Mild loneliness was reported by 52.2% and severe loneliness by 14.8%. Severe loneliness was significantly associated with increased primary care visits (OR = 6.8; 95%CI: 5.8–7.7; <i>p</i> &lt; 0.001), emergency department use (OR = 5.8; 95%CI: 4.4–7.1; <i>p</i> &lt; 0.001), and polypharmacy (OR = 2.0; 95%CI: 1.3–2.6; <i>p</i> &lt; 0.001). Depression, poor perceived health, family dysfunction, and urinary tract disease were associated with severe loneliness, whilst strong neighbourhood relationships appeared protective.</p> Conclusion <p>Loneliness is a measurable and clinically relevant determinant of healthcare use in older adults. These findings support the integration of loneliness screening and intervention into routine clinical care, regardless of geographic setting.</p>

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Loneliness as a determinant of healthcare utilisation in older adults: a cross-sectional study in a Portuguese rural region

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月16日

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  • Ângela Mira,
  • Cristina Galvão,
  • Paulo Santos

摘要

Background

Loneliness is an increasingly recognised determinant of health in older adults, associated with adverse outcomes and higher healthcare utilisation.

Purpose

This study aimed to evaluate the relationship between loneliness and healthcare use in an ageing rural population in southern Portugal.

Methods

A cross-sectional survey was conducted amongst community-dwelling individuals aged ≥ 65 years, randomly selected from primary care records in the Baixo Alentejo region. Data collection included the validated Portuguese version of the UCLA Loneliness Scale and self-reported use of healthcare services over the previous year (primary care and emergency visits, and the number of daily prescribed medicines).

Results

A total of 318 participants were included (58.8% female), with a mean age of 75.5 years, 28.9% over 80. Mild loneliness was reported by 52.2% and severe loneliness by 14.8%. Severe loneliness was significantly associated with increased primary care visits (OR = 6.8; 95%CI: 5.8–7.7; p < 0.001), emergency department use (OR = 5.8; 95%CI: 4.4–7.1; p < 0.001), and polypharmacy (OR = 2.0; 95%CI: 1.3–2.6; p < 0.001). Depression, poor perceived health, family dysfunction, and urinary tract disease were associated with severe loneliness, whilst strong neighbourhood relationships appeared protective.

Conclusion

Loneliness is a measurable and clinically relevant determinant of healthcare use in older adults. These findings support the integration of loneliness screening and intervention into routine clinical care, regardless of geographic setting.