Loneliness prevalence and risk factors in the last year of life: analysis of UK household panel data.

Abstract

Loneliness in the general and older population is associated with poorer health and reduced quality of life. At end of life, loneliness may increase the likelihood of care home admission and of experiencing pain and breathlessness. However, prevalence of loneliness in the critical last year of life has not yet been investigated. To investigate prevalence of loneliness among adults in the last year of life in the UK, assess change between 2017 and 2022, and identify risk factors for loneliness. Using five pooled waves of data from the UK Household Longitudinal Study, we estimated prevalence of loneliness among adults with a loneliness measure within 12 months of their death. Loneliness was measured with the UCLA-Loneliness scale and a cut-off of 6 (range 3-9). Potential socio-demographic, -economic, health and social support risk factors were assessed using multivariable logistic regression. Almost a third, 32.2% (CI 0.95: 27.2 - 37.6), of adults experienced loneliness in the last year of life in the UK, equating to feeling lack of companionship, left out and isolated at least some of the time. No significant changes in prevalence were found between 2017 and 2022, though survey changes limited this analysis. Risk factors included having a likely mental health condition, being unmarried and having 3 or more functional impairments in fully adjusted analyses. Findings highlight the importance of recognising loneliness as a common experience in the last year of life, identifying those at risk and enabling evidence-based support to reduce loneliness.