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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 (β=−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.
- loneliness
- health service
- social care
- the oldest old
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Footnotes
Contributors HW proposed the research idea and conducted the analysis, as well as drafted the manuscript. CB critically reviewed the draft of this manuscript and provided input into analysis. EZ, JF, TD and K-TK provided feedback. JF and TD edited versions of the manuscript. All authors agreed to the submitted version of the paper.
Funding The first author researcher received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. We thank all the past CC75C sponsors for financial support spanning the decades since the Medical Research Council enabled the first follow-up survey (see study website for full list of project grants: http://www.cc75c.group.cam.ac.uk/background/grants/), most recently the Abbeyfield Research Foundation and the BMA Foundation for Medical Research Dawkins and Strutt Grant. CC75C was a member study of the National Institute for Health Research funded Collaboration for Leadership in Applied Health Research and Care for Cambridgeshire and Peterborough. No funder sponsor played any role in the study design; in the collection, analysis and interpretation of data; or in the writing of the report and the decision to submit the article for publication. All researchers were independent from funders.
Competing interests None declared.
Ethics approval The study is approved by the East of England—Cambridge Central Research Ethics Committee, approval number 05/ Q0108/308.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
Patient consent for publication Not required.