Duke NUS Medical School, Republic of Singapore, Singapore.
Geriatr Gerontol Int. 2017 Nov;17(11):1789-1798. doi: 10.1111/ggi.12962. Epub 2017 Jan 6.
To assess the association between loneliness and physician visits among community-dwelling older adults in Singapore.
We obtained data from two consecutive waves (2009 and 2011) of a nationally representative longitudinal survey of community-dwelling Singaporeans aged 60 years and older. Out of 3103 responses, we excluded proxy interviews (n = 365; 11.8 %), resulting in a final analysis cohort of 2738 respondents. Using the frequency of physician visits in the past 30 days as the dependent variable, we carried out negative binomial hurdle regression controlling for predisposing characteristics, enabling factors, needs, social capital and change in loneliness status between the two waves of the survey.
Approximately 23% of respondents suffered from chronic loneliness; a further 19% developed loneliness, whereas 33% recovered from loneliness by wave 2. Chronic (OR 0.76 ± 0.11) and recently-developed loneliness (OR 0.70 ± 0.10) were significantly associated with lower odds of physician visits, compared with being never lonely. Meanwhile, those who recovered from loneliness had the same odds of physician visits, but were associated with lower number of visits (-0.71 ± 0.27) if they did utilize their physicians.
The present study found a significant association between loneliness and lower odds of physician visits regardless of whether the loneliness was recently developed or chronic. In addition, respondents who had loneliness in the past also had a significantly lower number of visits to physicians compared with those who were never lonely. Further studies on the underlying behavior and the health consequences are warranted. Geriatr Gerontol Int 2017; 17: 1789-1798.
评估新加坡社区老年人孤独感与就医行为之间的关系。
我们从一项针对 60 岁及以上新加坡社区居民的全国代表性纵向调查的两个连续波次（2009 年和 2011 年）中获取数据。在 3103 个回复中，我们排除了代理访谈（n=365；11.8%），最终分析队列包括 2738 名受访者。以过去 30 天内的就医频率为因变量，我们通过负二项式障碍回归进行分析，控制了倾向特征、促成因素、需求、社会资本以及调查两波之间孤独感状态的变化。
约 23%的受访者患有慢性孤独感；另有 19%的受访者出现了孤独感，而 33%的受访者在第 2 波调查时已从孤独感中恢复。与从不孤独相比，慢性孤独（OR 0.76±0.11）和近期孤独（OR 0.70±0.10）与就医次数较少显著相关。然而，那些从孤独中恢复的人就医次数相同，但如果他们利用了医生，就医次数则较少（-0.71±0.27）。
本研究发现孤独感与就医次数较少显著相关，无论孤独感是近期出现还是慢性的。此外，过去有孤独感的受访者与从不孤独的受访者相比，就医次数也明显较少。需要进一步研究其潜在行为和健康后果。
