Potential Risk Factors for Lonely Death: A Nationwide Case-Control Study in Korea

Lonely death, referred to the death of an individual at home alone and found after some time has elapsed, has emerged as a significant social issue in many countries. This study aimed to distinguish high-risk groups by comparing the characteristics of individuals who died of loneliness with those of the control group.

This case-control study was conducted using data from the Korea Crime Scene Investigation and National Health Insurance Service (NHIS) databases. We identified all lonely deaths that occurred in 2021 in Korea and sex- and age-matched controls were randomly selected from the NHIS database in a 1:3 ratio. Data on demographics, health conditions, and healthcare utilisation were analysed. Associations between lonely deaths and various factors were assessed using logistic regression.

This study included 3,122 lonely death cases and 9,493 controls. Individuals who experienced lonely death were more likely to be covered by medical aid, in the lowest income group, and have high (≥ 3) Charlson comorbidity index scores than the controls (30.8% vs. 4.0%, 54.5% vs. 19.2%, 14.5% vs. 8.6%, respectively). Furthermore, they exhibited a higher prevalence of chronic diseases (including diabetes and heart failure), mental health disorders (including schizophrenia and bipolar disorder), and alcohol-related diseases, along with more frequent healthcare utilisation. Most of these factors exhibited statistical or borderline significance in adjusted logistic regression analyses.

Lonely death is associated with low income, multi-morbidity, underlying diseases, and frequent healthcare utilisation. Targeted intervention strategies that focus on these potentially high-risk populations may help prevent lonely deaths.