Understanding loneliness and quality of life in Singaporean older adults: A cross-sectional survey of CareLine users

Background: Population ageing is a major public health concern in Singapore, where one in four residents will be aged 65 years and above by 2030. Older adults living alone face heightened risks of loneliness, social isolation, and reduced quality of life. CareLine, a telephone-based befriending service, was established to provide regular check-ins, reassurance, and linkages to health and social resources. This study presents the first empirical evaluation of CareLine, focusing on the user profile, service utilisation, and participants’ perceptions of value.

 

Approach: A cross-sectional telephone survey was conducted with 708 CareLine users between November 2024 and March 2025, complemented by analysis of call log data from 2017 to 2023. The survey included validated measures of loneliness (UCLA 3-item scale) and quality of life (EQ-5D-3L), alongside questions on trust and service perceptions. Data were analysed descriptively and through multivariable regression to identify factors associated with loneliness, service perceptions, and health-related quality of life.

 

Results: Respondents were predominantly female (68.7%) and Chinese (74.4%), with a mean age of 70.9 years. Most reported low levels of loneliness, though 8.4% met the threshold for loneliness. Quality of life was moderate, with a mean EQ-5D index of 0.653 and EQ-VAS of 7.05. Almost half of respondents expressed trust in CareLine and willingness to use it for emotional or practical support.

Regression analyses revealed that non-Chinese respondents and those with more inbound calls reported higher loneliness, while lower EQ-5D index scores were associated with non-Chinese ethnicity, living with others, greater outbound call volume, and higher loneliness.

 

Implications: This study highlights both the promise and limitations of telephone-based befriending services for older adults. CareLine users reported generally low loneliness and moderate quality of life, though important disparities emerged by ethnicity, living arrangement, and service utilisation. Findings underscore the need to strengthen trust, address psychosocial risk factors, and tailor service delivery to diverse groups. Insights from this evaluation can inform the optimisation and scaling of telehealth-enabled befriending models in Singapore and internationally.