Loneliness Prevalence and Correlates Among Community-Dwelling Older Adults in Taiwan: Clinical Utility of Brief Screening Measures.

Introduction: Loneliness is a growing public health concern among older adults. This study examined the prevalence and correlates of loneliness among community-dwelling older adults in Taiwan and compared the performance of three loneliness measurement tools. Methods: A cross-sectional survey was conducted among adults aged ≥65 years recruited from community centers in Southern Taiwan. Loneliness was assessed using the UCLA-LS-20, UCLA-LS-3, and a single-item direct measure. Psychological and health-related variables included LSNS-6, GDS-15, GAD-7, and EQ-5D-5L. Multivariable logistic regression was used to identify factors associated with loneliness, and ROC analysis was performed to compare the discriminatory performance of the three instruments. Results: Among 186 participants, the prevalence of loneliness ranged from 18% to 27% depending on the instrument used. Higher GDS-15 scores were consistently associated with loneliness across all models. Other associated factors included social network size, living arrangement, anxiety symptoms, and self-rated health. The models using the UCLA-LS-3 and single-item measure showed high AUC values (0.9005 and 0.8988, respectively), and the model using the UCLA-LS-20 also demonstrated good model-specific predictive performance (AUC=0.8123). Conclusion: Loneliness is common among older adults in Taiwan. Brief measures, such as the UCLA-LS-3 and single-item question, may be practical for community-based loneliness screening, and the UCLA-LS-20 remains useful for more comprehensive assessment.