Evidence map›Paper›PMID 40262951›Full record

ArticleBMJ open2025

Association of loneliness with healthcare transitions and mortality in older adults in Ontario, Canada: a retrospective cohort study.

Rachel D Savage, Rinku Sutradhar, Jin Luo, Rachel Strauss, Jun Guan, Paula A Rochon, Andrea Gruneir, Claudia Sanmartin, Vivek Goel, Laura C Rosella and 5 more

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Rachel D SavageWomen's Age Lab, Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada Rachel.Savage@wchospital.ca.ORCID http://orcid.org/0000-0002-2746-373X
Rinku SutradharICES, Toronto, Ontario, Canada.
Jin LuoICES, Toronto, Ontario, Canada.
Rachel StraussICES, Toronto, Ontario, Canada.
Jun GuanICES, Toronto, Ontario, Canada.
Paula A RochonWomen's Age Lab, Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-5973-4151
Andrea GruneirICES, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-1972-6253
Claudia SanmartinAnalytical Studies and Modelling Branch, Statistics Canada, Ottawa, Ontario, Canada.
Vivek GoelICES, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-1389-2007
Laura C RosellaICES, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0003-4867-869X
Nathan M StallWomen's Age Lab, Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Stephanie A ChamberlainFaculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.ORCID http://orcid.org/0000-0001-9602-3060
Christina YuWomen's Age Lab, Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Azmina AltafICES, Toronto, Ontario, Canada.
Susan E BronskillICES, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-7341-0655

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate whether loneliness was associated with transition rates to and between healthcare settings and death in older adults and to examine whether associations were modified by sex.

designRetrospective cohort study.

settingOntario, Canada, from December 2008 to February 2020.

participantsCommunity-dwelling, Ontario respondents (≥65 years) to the 2008/2009 Canadian Community Health Survey-Healthy Aging (CCHS-HA). EXPOSURE: Baseline loneliness was measured with the Three-Item Loneliness Scale in the CCHS-HA. Respondents were classified as not lonely, moderately lonely or severely lonely. PRIMARY OUTCOME MEASURES: Healthcare transitions were assessed over a 12-year period through linkage to health administrative records. Relative rates of transition to and between community, inpatient hospitalisation, home care and long-term care (LTC) settings, as well as death, were estimated using a continuous-time multistate transition framework. Adjusted models were weighted and tested for sex interactions.

resultsOf 2671 respondents (weighted n=1 398 180), 20.9% were moderately lonely and 12.0% were severely lonely. Compared with those who were not lonely, moderately lonely respondents transitioned at a faster rate from the community to home care, and severely lonely respondents transitioned at a faster rate from the community to LTC; although, both associations were attenuated with adjustment (RR

conclusionsOur findings suggest that loneliness may hasten transitions from the community to home care and LTC settings in older adults, although these transitions are mostly driven by related health and social factors.

Indexed as

LonelinessMortalityAgedAged, 80 and overFemaleHome Care ServicesHospitalizationHumansIndependent LivingLong-Term CareMaleOntarioRetrospective StudiesSex FactorsAgingHealth ServicesRetrospective Studies

Identifiers

PMID40262951
PMCPMC12015718

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.