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

Eur Geriatr Med. 2025 Oct 16. doi: 10.1007/s41999-025-01307-8. Online ahead of print.

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.

PMID:41099788 | DOI:10.1007/s41999-025-01307-8