Pollak Chava, Pham Yolanda, Ehrlich Amy, Verghese Joe, Blumen Helena M
Department of Neurology, Stony Brook Medicine, 101 Nicholls Rd HSC T12, Stony Brook, NY, 11794, USA.
Department of Rehabilitation Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
BMC Geriatr. 2025 Apr 28;25(1):290. doi: 10.1186/s12877-025-05947-0.
Social isolation and loneliness are highly prevalent in older adults. Older adults who are receiving home health services (HHS) post hospital discharge are at high risk for social isolation and loneliness related to multimorbidity and functional decline. Yet, the prevalence of social isolation and loneliness in this population is not commonly described.
We analyzed electronic health record (EHR) data from 2,026 community-dwelling older adults (mean age 77.5 ± 8.2, 61.7% female, 35% Black/African American, 42.2% Hispanic) who were discharged with HHS from three acute care facilities in Bronx County, NY. Marital and living alone status were assessed as proxy measures for social isolation. Loneliness was assessed with a one-item loneliness question. The prevalence and overlap between loneliness and social isolation risk factors were examined with descriptive and inferential statistics. Logistic regression models were used to examine correlates of loneliness, living alone, and marital status.
Of 2,026 individuals, 29.5% lived alone, 33.5% were married, and 11.6% reported feeling lonely at least some of the time. Those who lived alone had better cognitive and physical function, were more likely to be female, White/Caucasian, and lonely- and less likely to need assistance with activities of daily living (ADLs). Individuals who were unmarried or living alone were more likely to be lonely. After adjusting for covariates, Black/African Americans and those who had better cognitive function had lower odds of loneliness. Living alone, depressive symptoms, multimorbidity, functional impairment were associated with increased odds of being lonely, after adjusting for covariates.
Risk for social isolation is highly prevalent among diverse, homebound older adults. Home health care is ideally situated for loneliness assessment and intervention for an otherwise hard to reach, vulnerable population. EHR data can be leveraged to identify individuals at risk and additional brief indicators integrated into the EHR (e.g., validated loneliness assessment, social isolation metrics) may be valuable to facilitate identification and stratification of individuals at risk.
社会隔离和孤独感在老年人中极为普遍。出院后接受家庭健康服务（HHS）的老年人因多种疾病和功能衰退而面临社会隔离和孤独感的高风险。然而，这一人群中社会隔离和孤独感的患病率并不常见。
我们分析了来自纽约布朗克斯县三家急性护理机构出院后接受HHS的2026名社区居住老年人（平均年龄77.5±8.2岁，61.7%为女性，35%为黑人/非裔美国人，42.2%为西班牙裔）的电子健康记录（EHR）数据。婚姻状况和独居状况被评估为社会隔离的替代指标。孤独感通过一个单项孤独问题进行评估。使用描述性和推断性统计方法检查孤独感与社会隔离风险因素之间的患病率和重叠情况。使用逻辑回归模型检查孤独感、独居和婚姻状况的相关因素。
在2026名个体中，29.5%独居，33.5%已婚，11.6%报告至少有时感到孤独。独居者具有更好的认知和身体功能，更可能为女性、白人/高加索人且感到孤独，并且在日常生活活动（ADL）方面需要帮助的可能性较小。未婚或独居的个体更可能感到孤独。在调整协变量后，黑人/非裔美国人和认知功能较好的人孤独感的几率较低。在调整协变量后，独居、抑郁症状、多种疾病、功能障碍与孤独感增加的几率相关。
社会隔离风险在多样化的居家老年人中极为普遍。家庭医疗保健非常适合对这一原本难以接触到的弱势群体进行孤独感评估和干预。可以利用EHR数据识别有风险的个体，并且将其他简短指标整合到EHR中（例如，经过验证的孤独感评估、社会隔离指标）可能有助于识别和分层有风险的个体。
