Longitudinal associations between loneliness, social isolation, and healthcare utilisation trajectories: a latent growth curve analysis.

Publisher: Springer International Country of Publication: Germany NLM ID: 8804358 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-9285 (Electronic) Linking ISSN: 09337954 NLM ISO Abbreviation: Soc Psychiatry Psychiatr Epidemiol Subsets: MEDLINE

Original Publication: [Berlin] : Springer International, [c1988-

Loneliness*/psychology ; Social Isolation*/psychology ; Patient Acceptance of Health Care*/statistics & numerical data; Humans ; Male ; Female ; Aged ; Middle Aged ; Longitudinal Studies ; United States ; Nursing Homes/statistics & numerical data ; Aged, 80 and over

Purpose: To explore the longitudinal associations between eight-year trajectories of loneliness, social isolation and healthcare utilisation (i.e. inpatient, outpatient, and nursing home care) in US older adults.
Methods: The study used data from the Health and Retirement Study in 2006-2018, which included a nationally representative sample of American adults aged 50 and above (N = 6,832). We conducted latent growth curve models to assess the associations between trajectories of loneliness and isolation and healthcare utilisation over 8 years.
Results: Independent of sociodemographic and health-related confounders, social deficits were associated with a lower likelihood of baseline physician visits (loneliness β= -0.15, SE = 0.08; social isolation β= -0.19, SE = 0.08), but there was a positive association between loneliness and number of physician visits (β = 0.06, SE = 0.03), while social isolation was associated with extended hospital (β = 0.07, SE = 0.04) and nursing home stays (β = 0.05, SE = 0.02). Longer nursing home stays also predicted better trajectories of loneliness and isolation over time.
Conclusion: Loneliness and social isolation are cross-sectionally related to complex patterns of different types of healthcare. There was no clear evidence that social deficits led to specific trajectories of healthcare utilisation, but nursing home stays may over time help provide social contact, supporting trajectories of isolation and potentially loneliness. Non-clinical services such as social prescribing could have the potential to address unmet social needs and further promote patients' health-seeking profiles for improving healthcare equity.
(© 2024. The Author(s).)

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United Kingdom WT_ Wellcome Trust; 205407/Z/16/Z United Kingdom WT_ Wellcome Trust; 1862896-38-C-20 National Endowment for the Arts

Keywords: Health inequity; Health service; Healthy ageing; Loneliness; Social isolation

Date Created: 20240301 Date Completed: 20241009 Latest Revision: 20241012

20250114

PMC11464645

10.1007/s00127-024-02639-9

38429539