Zhu Change, Walsh Christine A, Zhou Lulin, Zhang Xinjie
School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing, Jiangsu, China.
Faculty of Social Work, University of Calgary, 2500 University Drive NW Calgary, Calgary, AB, T2N 1N4, Canada.
Soc Psychiatry Psychiatr Epidemiol. 2024 Sep 4. doi: 10.1007/s00127-024-02760-9.
To explore the impact of unmet community service demands on loneliness among older adults.
Based on the longitudinal tracking data of CLHLS (2008-2018), latent growth curve model (LGCM) was used to describe the trajectory of loneliness among older adults. Panel regression was used to analyze the impact of unmet community service demands on loneliness, and latent classification analysis (LCA) was used to classify the older adults and analyze the differences in loneliness among different types of older adults.
A total of 1445 older people participated in all four surveys, and 22.4% of them reported feeling lonely. From 2008 to 2018, there was a significant non-linear increase in loneliness, with average values of 1.77, 1.81, 1.83, and 1.96, respectively. The level of community service supply (1.31) was far from meeting the demand level (5.11). Unmet community service demands were associated with a higher prevalence of loneliness (β = 0.012, P = 0.003, 95% CI = [0.004, 0.020]). In addition, according to the demand difference for community services, older adults were classified into the comprehensive demand type (Type I) and the medical demand type (Type II). The loneliness of Type I older adults was significantly higher than that of Type II (P < 0.05).
With the passage of time, loneliness of older adults is showing an accelerating upward trend. Unmet community services can lead to enhanced loneliness among older adults, and the higher the demand for community services, the stronger the loneliness. The government should increase the supply of community services to meet the basic and socio-emotional needs of the older adults to reduce loneliness.
探讨未满足的社区服务需求对老年人孤独感的影响。
基于中国老年健康影响因素跟踪调查（CLHLS，2008 - 2018年）的纵向跟踪数据，采用潜在增长曲线模型（LGCM）描述老年人孤独感的轨迹。运用面板回归分析未满足的社区服务需求对孤独感的影响，并采用潜在类别分析（LCA）对老年人进行分类，分析不同类型老年人孤独感的差异。
共有1445名老年人参与了全部四次调查，其中22.4%的人表示感到孤独。2008年至2018年，孤独感呈显著的非线性上升，平均值分别为1.77、1.81、1.83和1.96。社区服务供给水平（1.31）远未达到需求水平（5.11）。未满足的社区服务需求与更高的孤独感患病率相关（β = 0.012，P = 0.003，95%置信区间 = [0.004, 0.020]）。此外，根据对社区服务的需求差异，将老年人分为综合需求型（I型）和医疗需求型（II型）。I型老年人的孤独感显著高于II型（P < 0.05）。
随着时间的推移，老年人的孤独感呈加速上升趋势。未满足的社区服务会导致老年人孤独感增强，且对社区服务的需求越高，孤独感越强。政府应增加社区服务供给，以满足老年人的基本和社会情感需求，从而减少孤独感。
