Health needs and associated factors among community-dwelling socially isolated older adults: an evidence-mapping-informed cross-sectional survey

Background Community-dwelling socially isolated older adults are at increased risk of adverse health outcomes; however, the multidimensional structure of their health needs and the factors associated with these needs remain insufficiently understood. This study aimed to identify the major domains of health needs among socially isolated older adults and to examine the factors associated with these needs in an urban setting experiencing rapid population aging and community-service transformation. Methods This evidence-mapping-informed cross-sectional study was conducted in Hangzhou, China. Evidence mapping of studies published between 2011 and 2022 was first used to inform the conceptual framework and the development of the questionnaire. A structured questionnaire was then administered to 570 community-dwelling older adults randomly selected from the electronic health records of registered service users at four community health service centers in Hangzhou. Reliability and validity were assessed using Cronbach’s α and factor analysis. Univariate analyses and multiple linear regression analyses were used to examine factors associated with domain-specific health needs. Results Evidence mapping identified four core domains of health needs among socially isolated older adults: eldercare security needs, social participation and development needs, physical and mental health needs, and social-emotional needs. A total of 405 valid questionnaires were included in the analysis, yielding a response rate of 71.1%. In multivariable analyses, several sociodemographic and service-related factors were associated with domain-specific health needs, particularly age and educational attainment, and the patterns of association varied across domains. The adjusted R² values for eldercare security needs, social participation and development needs, physical and mental health needs, and social-emotional needs were 0.188, 0.134, 0.267, and 0.126, respectively. Conclusions Health needs among socially isolated older adults in urban communities were multidimensional and heterogeneous. These findings support more differentiated community-based service planning and may also inform service design in other urban communities undergoing similar population-aging and community-care transitions.