Joseph Moyenda, Lockie Kate, Mbazira Agnes, Stewart Robert
South London and Maudsley NHS Foundation Trust, London, UK.
King's College London (Institute of Psychiatry, Psychology and Neuroscience), London, UK.
Int J Geriatr Psychiatry. 2025 Feb;40(2):e70052. doi: 10.1002/gps.70052.
We investigated the prevalence of loneliness recorded during assessment of general hospital inpatients by older adult liaison psychiatry services and its associations with level of subsequent hospitalisation, emergency presentation and mortality.
Data were drawn from a large south London mental healthcare provider of older adult liaison psychiatry services to four acute general hospitals. The sample comprised all patients receiving assessments from these services from 2007-2017. Recorded loneliness was ascertained from text fields via a bespoke natural language processing algorithm and, via a linkage with national hospitalisation data, was investigated as a risk factor for repeat emergency department (ED) attendance, inpatient days in the subsequent 12 months, and mortality.
In 11,631 patients assessed, loneliness was recorded in 11.2%. After adjustment for a range of demographic and health covariates, recorded loneliness was associated with an increased risk of ED attendance, but with lower mortality and, in survivors, with fewer hospitalisation days over a 12-month follow-up.
Loneliness is recorded in over 10% of inpatients assessed by older adult liaison services and is likely to be present in substantially more. Lack of recording in more severe illness and/or cognitive disorders may explain associations with lower mortality and hospitalisation days. Its association with higher likelihood of repeat ED attendance suggests that loneliness should be considered more routinely in clinical assessments, possibly with formal screening.
我们调查了老年联络精神科服务在综合医院住院患者评估期间记录的孤独感患病率，及其与随后的住院水平、急诊就诊和死亡率的关联。
数据来自伦敦南部一家大型老年联络精神科服务机构，该机构为四家急性综合医院提供服务。样本包括2007年至2017年期间接受这些服务评估的所有患者。通过定制的自然语言处理算法从文本字段中确定记录的孤独感，并通过与国家住院数据的关联，将其作为再次急诊就诊、随后12个月内的住院天数和死亡率的风险因素进行调查。
在11631名接受评估的患者中，有11.2%记录了孤独感。在对一系列人口统计学和健康协变量进行调整后，记录的孤独感与急诊就诊风险增加相关，但与较低的死亡率相关，并且在幸存者中，在12个月的随访期间住院天数较少。
在老年联络服务评估的住院患者中，超过10%记录了孤独感，实际存在的可能更多。在更严重的疾病和/或认知障碍中缺乏记录可能解释了与较低死亡率和住院天数的关联。其与再次急诊就诊可能性较高的关联表明，在临床评估中应更常规地考虑孤独感，可能需要进行正式筛查。
