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

Year: 2025
Type: article
Study design: Observational Study
Abstract: 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.
DOI: 10.1007/s41999-025-01307-8
Language: English
Subfield: Health
Open Access status: hybrid
Estimated APC paid: $2,390
OpenAlex ID: W4415233643
FWCI: 1.074
Cites: 20
Cited by: 1
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