The role of loneliness and social isolation among older adults in the use of health care services - A systematic review

Abstract

Background: Loneliness and social isolation have been linked to poor health outcomes and higher morbidity and mortality due to all causes, with an effect comparable with risk factors such as obesity and substance abuse. Older adults are more vulnerable to loneliness and social isolation due to the current lifestyle and morbidities associated with age. This systematic review aims to evaluate the influence of loneliness and social isolation of older adults in the health care utilization. Methods: Two databases, MEDLINE (PubMed) and Scopus, were searched for this investigation, alongside an individual search through relevant journals to the matter. A total of 672 studies on loneliness or social isolation and health care ou primary care use published after 2002 were found in the initial search, from which 34 studies were eligible for full-text assessment and 18 studies were included in the final review. Results: Almost all of the studies included had found an association between loneliness, social isolation or weak social relationships and poor health outcomes or increased frequency in health care use (16/18). The most common health care use outcome found was higher frequency of utilization associated with higher loneliness and poorer social relationships. An association between loneliness or social isolation and hospital admissions and longer hospital stays was also found. Higher mortality rates and multimorbidity were also associated with higher social isolation and loneliness, as well as a negative association between social isolation and health promoting behaviors. Conclusions: This systematic review shows that loneliness, social isolation and poor social networks are associated with increased GP, emergency department and specialist visits, as well as with prolonged hospital stays.