Prevalence and patterns of unmet healthcare needs in older adults: a systematic review

Background and Objectives

Population ageing increases demand for healthcare and social services, yet unmet healthcare needs remain an important concern. This study aimed to systematically review the prevalence and patterns of unmet healthcare needs in older adults.

Methods

A systematic review of the literature was performed. PubMed was used to search for studies reporting unmet healthcare, social and rehabilitation needs in older adults. A total of 1550 records were screened, and 24 peer-reviewed full-text studies were included and used for descriptive analysis.

Results

Unmet social needs – including companionship, daytime activities and community support – were highly prevalent across studies, ranging from 1.6% to 44.4%, with intimate relationships among the most frequently reported unmet needs. Psychological unmet needs, predominantly psychological distress, ranged from 0.2% to 24.7%, with patient reported rates consistently exceeding staff assessments. Functional and healthcare-related unmet needs were substantial: unmet needs for assistance with activities of daily living ranged from 10.2% to 20.7% among those with identified need, rising to 58.7% for self-care in institutional settings. Dental care, medication management and home health services were frequently unmet, with rates ranging from 0.3% to 45.3%. Cognitive impairment, depressive symptoms, functional dependency and a solitary life were the most reported associated factors of unmet needs.

Conclusions

The prevalence of unmet healthcare, social and psychological needs varies considerably across care settings and populations of older adults. Significant unmet needs are observed in social support, activities of daily living, and healthcare services such as dental care and medication management. Cognitive impairment, depressive symptoms, functional dependency and social isolation are the most reported associated factors of unmet need burden, suggesting these groups may require more focused assessment.

Key messages

• Unmet social and psychological needs – particularly companionship and psychological distress – are highly prevalent among older adults and systematically underestimated by formal care staff.

• Functional dependency, cognitive impairment and a solitary life are the strongest predictors of unmet needs, underscoring the urgency of patient-centered needs assessment into geriatric care.