MONTREAL (FRONTLINE MEDICAL NEWS) Loneliness is associated with poorer health, but isn’t necessarily more common among older adults; one in five adults in a primary care population reported being lonely, a number higher than previously reported, a study showed.

In a survey of 940 adults seeking care in primary care clinics, 193 (21%) reported loneliness, with women more likely than men to say they were lonely. “Respondents identifying as having poorer health classifications were more likely to report high loneliness scores,” said Rebecca Mullen, MD, and her colleagues in a poster presented at the annual meeting of the North American Primary Care Research Group.

Those who said they were lonely also had a higher level of health care utilization, and reported they had a lower number of healthy days than the respondents who didn’t report loneliness.

Loneliness is associated with more depressive symptoms and an increased risk for obesity, cardiovascular disease, and all-cause mortality. However, not much prospective work has been done to drill down further into these associations and to explore other patient characteristics that might be associated with loneliness, said Dr. Mullen of the University of Colorado at Denver, Aurora.

The study was conducted in outpatient practice-based research networks in both urban and rural settings in the states of Virginia and Colorado. Participants were adult, English-speaking primary care patients who were given the UCLA Three-Item Loneliness Scale . The scale asks how often respondents feel a lack of companionship, feel left out, and feel isolated from others; responses are “hardly ever,” “sometimes,” and “often.”

The investigators sought to determine whether high loneliness scores on this scale – the primary outcome – were correlated with health care utilization, the number of healthy days reported by patients, and demographic information. These associations were the study’s secondary outcomes.

After statistical analysis, several variables emerged as being significantly associated with high loneliness scores. These included the number of reported days with poor physical or mental health (odds ratio, 1.06), the number of primary care office visits (OR, 1.06), the number of hospitalizations (OR, 1.16), the number of emergency department or urgent care visits (OR ,1.27), and gender. When compared with male respondents, females had an OR of 1.56 for reporting loneliness.

Race and ethnicity were not associated with a greater risk of loneliness; neither were disability or employment status, or whether the respondent was in a relationship.

And despite other studies indicating an increased prevalence of loneliness among the elderly, “our findings suggest loneliness is not age related,” wrote Dr. Mullen and her colleagues.

The investigators said they plan to examine their data further, to see if factors such as living in a rural or urban environment are associated with differences in loneliness. Going into still more detail, they plan to use demographic data to plot out respondents’ residences, and then look for spatial associations and links to other comorbidities. Integrating the questionnaire with data from the electronic record will allow Dr. Mullen and her colleagues to search for further associations as well, they said.

Finally, the investigators plan to build partnerships with the community, public health agencies, and those involved in health policy to build interventions against loneliness targeted at both the individual and the community. Some of these interventions, they said, could begin in the clinic: “[T]he primary care health care setting may be an appropriate context to consider intervention delivery.”

Dr. Mullen reported no relevant financial conflicts of interest.

SOURCE: Mullen R et al. Abstract P196.


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