Dataset Information

Is loneliness associated with increased health and social care utilisation in the oldest old? Findings from a population-based longitudinal study.

ABSTRACT:

Objectives

The present study aimed to examine the impact of loneliness on health and social care service use in the oldest old over a 7-year follow-up.

Design

Prospective study.

Setting

UK population-based cohort.

Participants

713 people aged 80 years or older were interviewed at wave 3 of the Cambridge City over-75s Cohort Study. Of these, 665 provided data on loneliness. During 7 years' follow-up, 480 participants left the study, of which 389 due to death. 162 still in the study answered the loneliness question.

Main outcome measure

Use of health and social care services, assessed at each wave from wave 3 to wave 5.

Results

At wave 3, of 665 participants who had data on loneliness, about 60% did not feel lonely, 16% felt slightly lonely and 25% felt lonely. Being slightly lonely at wave 3 was associated with a shorter time since last seeing a general practitioner (?=-0.5, 95%?CI: -0.8 to -0.2); when examining the association between time-varying loneliness and health and social care usage, being lonely was associated with three times greater likelihood of having contact with community nurses and using meals on wheels services (community nurse contact: incidence rate ratio (IRR)=3.4, 95%?CI: 1.4 to 8.7; meals on wheels service use: IRR=2.5, 95%?CI: 1.1 to 5.6). No associations between loneliness and other health and social care services use were found.

Conclusion

Loneliness was a significant risk factor for certain types of health and social care utilisations, independently of participants' health conditions, in the oldest old. Study findings have several implications, including the need for awareness-raising and prevention of loneliness to be priorities for public health policy and practice.

SUBMITTER: Wang H

PROVIDER: S-EPMC6549652 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Is loneliness associated with increased health and social care utilisation in the oldest old? Findings from a population-based longitudinal study.

Wang Hanyuying H Zhao Emily E Fleming Jane J Dening Tom T Khaw Kay-Tee KT Brayne Carol C

BMJ open 20190601 5

<h4>Objectives</h4>The present study aimed to examine the impact of loneliness on health and social care service use in the oldest old over a 7-year follow-up.<h4>Design</h4>Prospective study.<h4>Setting</h4>UK population-based cohort.<h4>Participants</h4>713 people aged 80 years or older were interviewed at wave 3 of the Cambridge City over-75s Cohort Study. Of these, 665 provided data on loneliness. During 7 years' follow-up, 480 participants left the study, of which 389 due to death. 162 stil ...[more]

PMID: 31154294

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Project description:BACKGROUND:Potentially inappropriate prescribing (PIP) is associated with negative health outcomes, including hospitalisation and mortality. Life and Living in Advanced Age: a Cohort Study in New Zealand (LiLACS NZ) is a longitudinal study of M?ori (the indigenous population of New Zealand) and non-M?ori octogenarians. Health disparities between indigenous and non-indigenous populations are prevalent internationally and engagement of indigenous populations in health research is necessary to understand and address these disparities. Using LiLACS NZ data, this study reports the association of PIP with hospitalisations and mortality prospectively over 36-months follow-up. METHODS:PIP, from pharmacist applied criteria, was reported as potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs). The association between PIP and hospitalisations (all-cause, cardiovascular disease-specific and ambulatory-sensitive) and mortality was determined throughout a series of 12-month follow-ups using binary logistic (hospitalisations) and Cox (mortality) regression analysis, reported as odds ratios (ORs) and hazard ratios (HRs), respectively, and the corresponding confidence intervals (CIs). RESULTS:Full demographic data were obtained for 267 M?ori and 404 non-M?ori at baseline, 178 M?ori and 332 non-M?ori at 12-months, and 122 M?ori and 281 non-M?ori at 24-months. The prevalence of any PIP (i.e. ?1 PIM and/or PPO) was 66, 75 and 72% for M?ori at baseline, 12-months and 24-months, respectively. In non-M?ori, the prevalence of any PIP was 62, 71 and 73% at baseline, 12-months and 24-months, respectively. At each time-point, there were more PPOs than PIMs; at baseline M?ori were exposed to a significantly greater proportion of PPOs compared to non-M?ori (p =?0.02). In M?ori: PPOs were associated with a 1.5-fold increase in hospitalisations and mortality. In non-M?ori, PIMs were associated with a double risk of mortality. CONCLUSIONS:PIP was associated with an increased risk of hospitalisation and mortality in this cohort. Omissions appear more important for M?ori in predicting hospitalisations, and PIMs were more important in non-M?ori in predicting mortality. These results suggest understanding prescribing outcomes across and between population groups is needed and emphasises prescribing quality assessment is useful.

Dataset Information

Is loneliness associated with increased health and social care utilisation in the oldest old? Findings from a population-based longitudinal study.

Objectives

Design

Setting

Participants

Main outcome measure

Results

Conclusion

Publications

Is loneliness associated with increased health and social care utilisation in the oldest old? Findings from a population-based longitudinal study.

Similar Datasets

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