Social Isolation: The Effects of Chronic Loneliness on Health and Longevity in the Elderly
Social Isolation: The Effects of Chronic Loneliness on Health and Longevity in the Elderly
Introduction
According to a recent paper by the National Academies of Sciences, Engineering, and Medicine (NASEM) more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated. Among older adults, social isolation has been linked to various adverse physical and psychological effects, including increased risk of dementia and heart disease.
Loneliness
Loneliness is the subjective and distressing feeling of being alone, regardless of the amount of social contact. Social isolation is a lack of social connections. Social isolation can lead to loneliness in some people, while others can feel lonely without being socially isolated. For as many as 15–30% of the general population, loneliness is a chronic state.
Social isolation due to Covid or bullying has affected large numbers of youth. On the opposite end of the spectrum, older adults are at increased risk for loneliness and social isolation due to the loss of their partner, family or friends. Many have realistic financial concerns. Others, who were not the primary bread winner, are unfamiliar with banking, budgeting, investments, taxes and the like.
Lonely people, even when in the company of others, have difficulties relating because of hearing loss, and visual and mobility impairments. All these factors aggravated by chronic illness may force a person to relinquish their home and familiar neighborhood for unfamiliar quarters surrounded by strangers with similar, or even worse difficulties in communicating.
Current Research Findings
Social isolation was associated with about a 50% increased risk of dementia in older people.
Poor social relationships (characterized by social isolation or loneliness) were associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.
Social isolation, particularly among vulnerable populations such as low income, immigrant, LGBT people, substantially increased the risk for premature death, comparable to other risk factors such as high blood pressure, smoking, or obesity.
Loneliness was associated with higher rates of depression, anxiety, and suicide.
The high medical comorbidity and mortality associated with loneliness result in accelerated biological aging.
People living on their own tend to prepare meals that are quick and simple, low in nutrition and variety. This will be reflected in lack of diversity in their gut flora. Interestingly, research from the University of California, San Diego, found that loneliness was associated with lack of diversity in the gut microbiome.
It is also likely that loneliness may result in decreased stability of the gut microbiome and, consequently, reduced resistance and resilience to stress-related disruptions, increasing the risk of systemic inflammation. In the brains of lonely persons, all the channels serving the stress response are in overdrive.
A study from Kyushu University in Japan found that older people with few social contacts have loss of overall brain volume in areas of the brain affected by dementia..
Many lonely people not only feel sad; they also feel scared. Social situations are perceived as a threat, not an invitation. They worry about falling or getting lost. They worry about spending money even when they are financially secure.
Boosting Social Connections
If you are a friend or family member of a lonely person, you need to keep in mind that well-meaning advice like join a club, call a friend or make small talk with a stranger rarely works. If you feel lonely yourself, perhaps the realization that loneliness is highly detrimental to your health and markedly shortens your life-span, will move you to adopt some of the advice that follows. What is crucial – is to make a decision and then stick to it. Thinking about what measures to take can lead to delays and paralysis. Stop ruminating. Start acting.
Here are some tips to help you foster social connections and reduce feelings of loneliness. The more of these you adopt, the faster you will feel whole again.
• Step out of your comfort zone: Meeting new people and engaging in social activities may be intimidating at first, but it's essential to push yourself beyond your comfort zone. Start with small steps, like attending social events or gatherings related to your interests.
• Pursue your passions: Join clubs, groups, or organizations that focus on activities you enjoy. Engaging in hobbies and interests can help you connect with like-minded individuals and provide natural conversation starters.
• Exercising or eating in the company of other people.
• Social media can be a great tool to form connections as long as you use them prudently.
• Join skills workshops. Learning a new skill such as painting, pottery making or playing bridge.
• In-person shopping or trips to the library, museums and art galleries get you among people.
• Helping people is one of the most powerful antidotes to loneliness. A great way of accomplishing this is by volunteering. Volunteering has many benefits for the volunteer and the recipient. The satisfaction also multiplies if you volunteer in a field you love.
• Avail yourself of regular doctor’s appointments or visits from a home health nurse are opportunities for face-to-face encounters.
• It is important to also educate health care workers. They need to understand that addressing loneliness in their patients does not detract from patient care — it is patient care.
• Health care providers often neglect taking care of themselves. Unless we prioritize social connections, how can we do so for others?
• If, in spite of all your good intentions you find it challenging to socialize due to anxiety or shyness - seek professional therapy or counselling.
Final Thoughts
Remember that developing social connections is a gradual process, and it's okay to take small steps at your own pace. Be patient with yourself and celebrate the progress you make along the way.
Helpful Resources
AARP
Area Agencies on Aging
Eldercare Locator.
National Council on Aging
National Institute on Aging (NIA)
https://www.canadianseniorsdirectory.ca/senior-service-canada/older-womens-network/
Ontario Society of Senior Citizens Organizations (OCSCO)
Key Takeaways
Loneliness is synonymous with perceived social isolation, not with objective social isolation.
Loneliness increases morbidity and mortality.
Although loneliness is usually understood as an experience of mental anguish, in
reality it is a whole-body affliction. “It’s not just in your head.”
Aging is not an option. Healthy aging is.
Gay, lesbian, and bisexual populations tend to have more loneliness than their heterosexual peers because of stigma, discrimination, and barriers to care.
References
Holt-Lunstad, J., & Perissinotto, C. (2023). Social isolation and loneliness as medical issues. New England Journal of Medicine, 388(3), 193-195.
Blázquez-Fernández, C., & Cantarero-Prieto, D. (2023). The associations between suicides, economic conditions and social isolation: Insights from Spain. PLoS one, 18(7), e0288234.
Walter, Alexa E, Sandsmark, Danielle (2023). The Importance of Social Contact on Brain Atrophy among Older Individuals, DOI: https://doi.org/10.1212/WNL.0000000000207720
National Academies of Sciences, Engineering, and Medicine. (2020). Social isolation
and loneliness in older adults: Opportunities for the health care system. National Academies Press.
Blázquez-Fernández, C., & Cantarero-Prieto, D. (2023). The associations between suicides, economic conditions and social isolation: Insights from Spain. PLoS one, 18(7), e0288234.
Jeste, D. V., Lee, E. E., & Cacioppo, S. (2020). Battling the modern behavioral epidemic of loneliness: suggestions for research and interventions. JAMA psychiatry, 77(6), 553-554.
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of behavioral medicine, 40(2), 218-227.
