Prevalence and clinical significance of loneliness in older patients admitted to acute hospital wards

Objective

Loneliness represents a risk factor for morbidity and mortality. We aimed to evaluate the prevalence of loneliness among hospitalized older patients, and its association with baseline characteristics and clinical post-discharge outcomes.

Design

Multicenter observational study, including a cross-sectional and a longitudinal phase.

Setting

Acute medical hospital wards of three Italian hospitals.

Partecipants

Three hundred patients ≥65 years old.

Measurements

A questionnaire was administered to participants, including socio-demographic data, and information on loneliness (assessed with 3-item UCLA scale and 6-item De Jong Gierveld and Van Tilburg Loneliness scale-DJGT), cognitive, emotional and functional level. Rehospitalizations and mortality were evaluated 1 and 6 months after discharge.

Results

A high prevalence of loneliness emerged with both scales (63% with UCLA, 60% with DJGT). At multiple linear regression analyses, Geriatric Depression Scale (GDS) was independently associated with UCLA (B coeff. 0.46, p < 0.001) and DJGT (B coeff. 0.51, p < 0.001) scales, and Basic Activities of Daily Living with UCLA scale (B coeff. −0.21, p = 0.02). In longitudinal analysis, global loneliness scores were not associated with mortality and rehospitalization risk, while the item n.6 of DJGT scale (“There are enough people I feel close to”) was independently associated with higher mortality risk within 1 and 6 months from discharge (OR 4.6, 95%C.I. 1.64–12.92; OR 4.38, 95%C.I. 1.83–10.48, respectively).

Conclusion

Loneliness was reported by more than half of older adults hospitalized in acute medical wards, and was associated with depressive symptoms and disability. The perception of scarce social ties was associated with higher mortality risk. Awareness of the "loneliness" phenomenon should be increased also in clinical settings.