Lonely older adults are more likely to delay or avoid medical care during the coronavirus disease 2019 pandemic

Abstract

Objectives: To examine the relationship between loneliness and self-reported delay or avoidance of medical care among community-dwelling older adults during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Analyses of data from a nationally representative survey administered in June of 2020, in COVID-19 module of the Health and Retirement Study. Bivariate and multivariable analyses determined associations of loneliness with the likelihood of, reasons for, and types of care delay or avoidance. Results:The rate of care delay or avoidance since March of 2020 was 29.1% among all respondents (n = 1997), and 10.1% higher for lonely (n = 1,150%, 57.6%) versus non-lonely respondents (33.5% vs. 23.4%; odds ratio = 1.59, p = 0.003 after covariate adjustment). The differences were considerably larger among several subgroups such as those with emotional/psychiatric problems.Lonely older adults were more likely to cite "Decided it could wait," "Was afraid to go," and "Couldn't afford it" as reasons for delayed or avoided care. Both groups reported dental care and doctor's visit as the two most common care delayed or avoided.Conclusions: Loneliness is associated with a higher likelihood of delaying or avoiding medical care among older adults during the pandemic.

Retrospective Analysis of Risk Factors in Geriatric Hip Fracture Patients Predictive of Surgical Intensive Care Unit Admission

“…Furthermore, many previous studies have investigated differences in immediate versus delayed surgical intervention from the time of hospital admission, not necessarily time from injury-to-admission or injury-to-surgical intervention. The delays from injury to presentation in ED in a non-polytraumatized population where falls were the majority mechanism of injury (MOI) (98.4%) may reflect social determinants of health (SDoH) such as living alone without social support to find patients and get them to medical care, lower socioeconomic status and cannot afford a life-alert system or cell phone to call for help on their own, or living in an area with delayed ambulance response time for lower level triage calls due to lack of emergency medical services (EMS) responders or insufficient number of ambulances [36,37].…”

“…Some investigative studies and meta-analyses have demonstrated that postoperative mortality (30-day and one year) was lower in patients who underwent surgery within 24-48 hours after hospital admission [37][38][39]. Interestingly, there have also been multiple different studies that have concluded that there is no difference in mortality outcomes for geriatric hip fracture patients who underwent delayed surgical intervention [40][41][42][43][44].…”