Social isolation, loneliness in older people pose health risks (2022)

Human beings are social creatures. Our connection to others enables us to survive and thrive. Yet, as we age, many of us are alone more often than when we were younger, leaving us vulnerable to social isolation and loneliness—and related health problems such as cognitive decline, depression, and heart disease. Fortunately, there are ways to counteract these negative effects.

Social isolation, loneliness in older people pose health risks (1)

NIA-supported researchers are studying the differences between social isolation and loneliness, their mechanisms and risk factors, and how to help people affected by these conditions. “NIA is interested in exploring potential interventions to address social isolation and loneliness, which are both risk factors for poor aging outcomes,” said Lisbeth Nielsen, Ph.D., of NIA’s Division of Behavioral and Social Research.

Social isolation and loneliness do not always go together. About 28 percent of older adults in the United States, or 13.8 million people, live alone, according to a report by the Administration for Community Living’s Administration on Aging of the U.S. Department of Health and Human Services, but many of them are not lonely or socially isolated. At the same time, some people feel lonely despite being surrounded by family and friends.

“A key scientific question is whether social isolation and loneliness are two independent processes affecting health differently, or whether loneliness provides a pathway for social isolation to affect health,” Dr. Nielsen noted.

Health effects of social isolation, loneliness

Research has linked social isolation and loneliness to higher risks for a variety of physical and mental conditions: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death.

People who find themselves unexpectedly alone due to the death of a spouse or partner, separation from friends or family, retirement, loss of mobility, and lack of transportation are at particular risk.

Conversely, people who engage in meaningful, productive activities with others tend to live longer, boost their mood, and have a sense of purpose. These activities seem to help maintain their well-being and may improve their cognitive function, studies show.

(Video) Social Isolation and Loneliness in Older Adults / Focus on Aging: Federal Partners’ Webinar Series

Breaking ground in loneliness research

Much of what we know about the causes and effects of social isolation and loneliness comes from the groundbreaking research of the late John T. Cacioppo, Ph.D., former director of the Center for Cognitive and Social Neuroscience at the University of Chicago and an NIA grantee.

Dr. Cacioppo’s research found that being alone and loneliness are different but related. Social isolation is the objective physical separation from other people (living alone), while loneliness is the subjective distressed feeling of being alone or separated. It’s possible to feel lonely while among other people, and you can be alone yet not feel lonely.

A pioneer in the field of social neuroscience, Dr. Cacioppo passed away in March 2018. His wife and collaborator, Stephanie Cacioppo, Ph.D., continues this work as assistant professor of psychiatry and behavioral neuroscience at the University of Chicago and director of the university’s NIA-supported Brain Dynamics Laboratory.

“The misery and suffering caused by chronic loneliness are very real and warrant attention,” she said. “As a social species, we are accountable to help our lonely children, parents, neighbors, and even strangers in the same way we would treat ourselves. Treating loneliness is our collective responsibility.”

Although there is more to learn, the understanding of the mechanisms of action of loneliness and its treatment has increased dramatically since scientific investigation began more than two decades ago, according to Dr. Stephanie Cacioppo. Among the novel predictions from the Cacioppo Evolutionary Theory of Loneliness is that loneliness automatically triggers a set of related behavioral and biological processes that contribute to the association between loneliness and premature death in people of all ages. Research is headed toward the systematic study of these processes across generations, Dr. Cacioppo explained.

Understanding the biology of loneliness

Losing a sense of connection and community changes a person’s perception of the world. Someone experiencing chronic loneliness feels threatened and mistrustful of others, which activates a biological defense mechanism, according to Steve Cole, Ph.D., director of the Social Genomics Core Laboratory at the University of California, Los Angeles. His NIA-funded research focuses on understanding the physiological pathways of loneliness (the different ways that loneliness affects how your mind and body function) and developing social and psychological interventions to combat it.

For example, loneliness may alter the tendency of cells in the immune system to promote inflammation, which is necessary to help our bodies heal from injury, Dr. Cole said. But inflammation that lasts too long increases the risk of chronic diseases.

Loneliness acts as a fertilizer for other diseases,” Dr. Cole said. “The biology of loneliness can accelerate the buildup of plaque in arteries, help cancer cells grow and spread, and promote inflammation in the brain leading to Alzheimer’s disease. Loneliness promotes several different types of wear and tear on the body.

(Video) Loneliness & isolation among seniors is a public health crisis.

People who feel lonely may also have weakened immune cells that have trouble fighting off viruses, which makes them more vulnerable to some infectious diseases, he added.

NIA-supported research by Dr. Cole and others shows that having a sense of mission and purpose in life is linked to healthier immune cells. Helping others through caregiving or volunteering also helps people feel less lonely.

“Working for a social cause or purpose with others who share your values and are trusted partners puts you in contact with others and helps develop a greater sense of community,” he noted.

Researching genetic and social determinants of loneliness

In another NIA-funded study, researchers are trying to understand the differences between social isolation and loneliness and how they may influence health. They are also trying to identify potential interactions between genes and the environment of older adults affected by social isolation and loneliness.

Previous studies have estimated the heritability of loneliness between 37 percent and 55 percent using twins and family-based approaches. “Individuals who are not prone genetically to feeling lonely may, for example, suffer much less from social isolation, while others feel lonely even though they are surrounded and part of a rich social life,” according to Nancy Pedersen, Ph.D., a professor of genetic epidemiology at the Karolinska Institutet in Stockholm, Sweden. “We are also interested in understanding what role socioeconomic status plays in such associations.”

Using data from twin studies, Dr. Pedersen and researchers found that both social isolation and loneliness are independent risk factors, and that genetic risk for loneliness significantly predicted the presentation of cardiovascular, psychiatric (major depressive disorder), and metabolic traits. Family history does not strongly influence this effect.

“We need to identify people who are most prone to suffer from social isolation and loneliness and those who would benefit most from interventions,” said Dr. Pedersen. “Interventions for social isolation may look very different from interventions for those who feel lonely.”

Beyond genetics, understanding social determinants of health, and the role of social and interpersonal processes in healthy aging and longevity, is another research direction at NIH. Scientists are beginning to apply this framework to research on social isolation and loneliness.

(Video) Isolation and Seniors

“Future research will need to clarify the extent to which loneliness and social isolation are malleable, and if so, what are the most effective approaches? Demonstrating that we can move the needle on these risk factors is a critical first step toward developing effective interventions,” said Dr. Nielsen. Research is also needed to clarify how great a change in loneliness or social isolation is required to achieve a meaningful change in health, she added.

References

Administration on Aging. A Profile of Older Americans: 2017 (PDF, 712K). April 2018.

Cacioppo JT and Cacioppo S. The growing problem of loneliness. Lancet 2018;391(10119):426.

Cacioppo JT and Cacioppo S. Loneliness in the modern age: an evolutionary theory of loneliness (ETL). Advances in Experimental Social Psychology 2018; 58:127-197.

Cacioppo JT and Cacioppo S. Older adults reporting social isolation or loneliness show poorer cognitive function 4 years later. Evidence-Based Nursing 2014;17(2):59-60.

Cacioppo S, Capitanio JP, Cacioppo JT. Toward a neurology of loneliness.Psychological Bulletin 2014;140(6):1464-1504.

Cacioppo S,Grippo AJ, London S, et al. Loneliness: Clinical import and interventions. Perspectives on Psychological Science 2015;10(2):238-249.

(Video) Loneliness: The Hidden Health Cost of Social Isolation

Cacioppo JT and Hawkley LC. Perceived social isolation and cognition. Trends in Cognitive Sciences. 2009;13(10):447-454.

Cole SW, Capitanio JP, Chun K, et al. Myeloid differentiation architecture of leukocyte transcriptome dynamics in perceived social isolation.Proceedings of the National Academy of Sciences USA. 2015;112(49):15142-15147.

Cole SW, Hawkley LC, Arevalo JM, et al. Transcript origin analysis identifies antigen-presenting cells as primary targets of socially regulated gene expression in leukocytes. Proceedings of the National Academy of Sciences USA 2011;108(7):3080-3085.

Portacolone E. Structural factors of elders’ isolation in a high-crime neighborhood: An in-depth perspective. Public Policy And Aging Report 2018;27(4):152–155.

Portacolone E. On living alone with Alzheimer’s disease. Care Weekly 2018;1-4.

Portacolone E, Covinsky KE, Rubinstein RL, et al. The precarity of older adults living alone with cognitive impairment. The Gerontologist 2019;59(2):271-280.

Portacolone E, Johnson JK, Covinsky KE, et al. The effects and meanings of receiving a diagnosis of mild cognitive impairment or Alzheimer's disease when one lives alone. Journal of Alzheimer's Disease 2018;61(4):1517-1529.

Portacolone E, Perissinotto CM, Yeh J, et al. “I feel trapped”: The tension between personal and structural factors of social isolation and the desire for social integration among older residents of a high-crime neighborhood. The Gerontologist 2018;58(1):79–88.

(Video) Seniors and Isolation (Depression and Loneliness Tips)

Portacolone E, Segal SP, Mezzina R, et al. A tale of two cities: The exploration of the Trieste public psychiatry model in San Francisco. Culture, Medicine, and Psychiatry 2015;39(4):680-697.

FAQs

Why is social isolation a risk for older adults aging in place? ›

Health effects of social isolation, loneliness

Research has linked social isolation and loneliness to higher risks for a variety of physical and mental conditions: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer's disease, and even death.

How the loneliness of social isolation can affect older adults brains? ›

A new study reports that social isolation can increase a person's risk of heart attack and stroke. Another new study concludes that loneliness can lead to cognitive decline. Experts say older adults can lower their risks by being socially active, eating a healthy diet, and exercising regularly.

How loneliness is damaging our health? ›

Being lonely, like other forms of stress, increases the risk of emotional disorders like depression, anxiety and substance abuse. Less obviously, it also puts people at greater risk of physical ailments that seem unrelated, like heart disease, cancer, stroke, hypertension, dementia and premature death.

What are the three major health consequences of loneliness? ›

1669, 2015). Hawkley points to evidence linking perceived social isolation with adverse health consequences including depression, poor sleep quality, impaired executive function, accelerated cognitive decline, poor cardiovascular function and impaired immunity at every stage of life.

What is the most common cause of social isolation among the elderly? ›

The loneliness and social isolation that seniors experience is usually caused by low-quality social relationships, or a lack of these relationships entirely. However, there are many other things that could cause these issues, such as being age 80 or older, having chronic health problems, and changing family structures.

What happens if you are old and alone? ›

The consequences are profound, older adults who consider themselves lonely are more likely to have trouble completing daily tasks, experience cognitive decline, develop coronary heart disease and even die.

What happens to a human when they spend too much time alone? ›

Loneliness raises levels of stress hormones and blood pressure. It undermines regulation of the circulatory system so that the heart muscle works harder and the blood vessels are subject to damage by blood flow turbulence.

Is social isolation a social determinant of health? ›

High-quality social connections are essential to our mental and physical health and our well-being. Social isolation and loneliness are important, yet neglected, social determinants of the health of older people.

How does social isolation affect the brain? ›

Socially isolated people have an increased risk of cognitive decline such as impaired concentration, memory loss, dementia, and loss of social capacities. They also suffer adverse emotional consequences such as depression, stress, and anxiety. They also feel sick more often and have a shorter lifespan.

Does isolation lower life expectancy? ›

Studies have repeatedly shown that those with fewer social connections have the highest mortality rates, highlighting that social isolation can threaten health through lack of access to clinical care, social services or needed support.

How does loneliness affect life expectancy? ›

Specifically, Smith's team calculated that social isolation -- having few or no social contacts or activities -- upped the risk for dying sooner by 29 percent. The feeling of being lonely -- whether or not a person did have social contacts -- was also linked to a 26 percent higher risk for an earlier death.

How can loneliness affect your mental health? ›

Feeling lonely can also have a negative impact on your mental health, especially if these feelings have lasted a long time. Some research suggests that loneliness is associated with an increased risk of certain mental health problems, including depression, anxiety, low self-esteem, sleep problems and increased stress.

What happens when you don't socialize? ›

It can lead to a toxic combination of low self-esteem, hostility, stress, pessimism and social anxiety – ultimately culminating in the isolated person distancing themselves from others even further.

What are two common causes of loneliness in older clients? ›

Causes of loneliness in seniors
  • Bereavement.
  • Retirement.
  • Loss of network of friends and companions.
  • A change in living environment.
  • Poor physical health (have difficulty listening, talking)
  • Lack of transport.
  • Fear of becoming a burden.
  • Financial difficulties.
9 Oct 2019

What are the symptoms of social isolation? ›

Experiencing anxiety or panic when thinking about social interactions. Feeling distress during periods of solitude. Feeling dread associated with social activities. Spending large amounts of time alone or with extremely limited contact with others.

What are the consequences of depression in the elderly? ›

A risk to daily living

Depression can lead to eating habits that result in obesity or, conversely, can cause a significant loss of appetite and diminished energy levels, sometimes resulting in a condition known as geriatric anorexia. Depressed older adults also experience higher rates of insomnia and memory loss.

What is the difference between loneliness and social isolation? ›

People may find themselves socially isolated regularly as a side effect of an isolating mental health issue such as social anxiety or agoraphobia. For example, someone with agoraphobia may feel too anxious to leave their house on some days. Loneliness, on the other hand, is an emotional state.

What causes social isolation and loneliness? ›

Factors that prevent people from engaging with others, such as long-term illness, disabilities, transportation issues, unemployment, or exposure to domestic or community violence, may increase social isolation and loneliness. Those younger than fifty are more likely to report loneliness than those age fifty and older.

What happens to elderly people with no family? ›

If you have no family, no money, you become a ward of the state or county. The state assigns a guardian to you, and that person makes the decisions about your living situation, your health care, your finances.

What loneliness does to the brain? ›

"Loneliness can change the neurochemistry of the brain, turning off the dopamine neurons, which trigger the reward response, and causing some degeneration in the brain when the reward response is not activated," says Katherine Peters, MD, PhD, FAAN, associate professor of neurology and neurosurgery at Duke University.

What happens to old people with no family and no money? ›

If an elderly person has no money and no family to assist them, and they encounter a health emergency that prevents them from living alone, they may become a ward of the state. A guardian will be assigned to help make decisions about their living situation.

Is it unhealthy to live alone? ›

Being Alone Can Be Bad for Our Health

Too much time alone is bad for our physical health. Studies have found that social isolation and loneliness can increase the likelihood of mortality by up to 30%.

Is it OK to not have friends? ›

People need at least a little human contact in order to thrive, and true isolation can take a toll on your overall well-being. If you're not totally isolated, though, and your lack of friends doesn't trouble you, it can be perfectly fine to be satisfied with your own company.

How do you help an elderly person who is lonely? ›

Loneliness in the elderly: how to help
  1. Start a conversation. It's not always easy to know who or how to help. ...
  2. Offer practical help. ...
  3. Share your time. ...
  4. Help with household tasks. ...
  5. Share a meal. ...
  6. Watch out for signs of winter illness. ...
  7. Useful resources.

What is an example of social isolation? ›

All types of social isolation can include staying home for lengthy periods of time, having no communication with family, acquaintances or friends, and/or willfully avoiding any contact with other humans when those opportunities do arise.

Can social isolation cause dementia? ›

Health Risks of Loneliness

Social isolation significantly increased a person's risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity. Social isolation was associated with about a 50% percent increased risk of dementia.

What are the long term effects of the lack of socialization? ›

Studies in rodents have shown that major long-lasting consequences caused by the lack of social interaction have been associated with behavioural abnormalities such as cognitive deficits, including attention disruption, impaired recognition memory, reversal learning, and inability for decision-making4,5,6,7.

Can loneliness cause Alzheimer's? ›

In a cohort of about 800 elderly persons followed up annually for up to 4 years, lonely individuals were more than twice as likely to develop an AD-like dementia syndrome than were those who were not lonely, even after controlling for level of social isolation.

Does social isolation cause cognitive decline? ›

The effect of loneliness and social isolation on cognition remained significant after the exclusion of individuals with depression. Conclusions: Both loneliness and social isolation are associated with decreased cognitive function over a 3-year follow-up period.

How does isolation cause death? ›

Research has shown that social isolation has links with an increased risk of disease and premature death. A recent study identifies an association between social isolation and two inflammatory markers, suggesting that inflammation may be a contributing factor.

Do people living alone live longer? ›

Lonely older adults are more likely to live shorter lives than their peers and spend less of their remaining life in good health or being active, according to a new study in Singapore and Japan. The study categorically quantifies for the first time the affects of loneliness in old age on life and health expectancy.

Why is loneliness as harmful as smoking? ›

Studies show loneliness can present the same risk of heart disease that smoking does. Loneliness can increase the risk of cardiovascular disease and stroke by 30%, according to Dr. Ramesh Mazhari, Director of Interventional Cardiology at the George Washington University School of Medicine and Health Sciences.

Is loneliness a disease? ›

Loneliness, which leads to distress and dysfunction in the elderly, may be assessed in many ways and is, thus, can be diagnosed as a disease entity. A lonely person often feels low, helpless, separated, or discriminated; finds difficulty during interactions; feels abandoned and alone.

How many old people live alone? ›

In the US, about 28% (14.7 million) of community-dwelling older adults live alone, which is 21% of older men and 34% of older women. The percentage of people living alone increases with age (ie, among women ≥ 75 years, about 44% live alone).

What happens if you are isolated for a year? ›

Loneliness can be damaging to both our mental and physical health. Socially isolated people are less able to deal with stressful situations. They're also more likely to feel depressed and may have problems processing information. This in turn can lead to difficulties with decision-making and memory storage and recall.

Does isolation cause psychosis? ›

Although social isolation is an effective method for preventing the COVID-19 from spreading, for some individuals it is associated with an increased risk of developing psychotic symptoms.

Can loneliness cause anxiety attacks? ›

They found that those who reported greater feelings of loneliness were more likely to experience symptoms of depression, generalized anxiety, and thoughts of suicide. In other words, loneliness has a much greater impact on your life than you might have thought.

What happens to a human when they spend too much time alone? ›

Loneliness raises levels of stress hormones and blood pressure. It undermines regulation of the circulatory system so that the heart muscle works harder and the blood vessels are subject to damage by blood flow turbulence.

What are two common causes of loneliness in older clients? ›

Causes of loneliness in seniors
  • Bereavement.
  • Retirement.
  • Loss of network of friends and companions.
  • A change in living environment.
  • Poor physical health (have difficulty listening, talking)
  • Lack of transport.
  • Fear of becoming a burden.
  • Financial difficulties.
9 Oct 2019

Is social isolation a social determinant of health? ›

High-quality social connections are essential to our mental and physical health and our well-being. Social isolation and loneliness are important, yet neglected, social determinants of the health of older people.

What is an example of social isolation? ›

All types of social isolation can include staying home for lengthy periods of time, having no communication with family, acquaintances or friends, and/or willfully avoiding any contact with other humans when those opportunities do arise.

Is it unhealthy to live alone? ›

Being Alone Can Be Bad for Our Health

Too much time alone is bad for our physical health. Studies have found that social isolation and loneliness can increase the likelihood of mortality by up to 30%.

What are the symptoms of social isolation? ›

Experiencing anxiety or panic when thinking about social interactions. Feeling distress during periods of solitude. Feeling dread associated with social activities. Spending large amounts of time alone or with extremely limited contact with others.

Is it OK to not have friends? ›

People need at least a little human contact in order to thrive, and true isolation can take a toll on your overall well-being. If you're not totally isolated, though, and your lack of friends doesn't trouble you, it can be perfectly fine to be satisfied with your own company.

How does loneliness affect mental health? ›

Feeling lonely can also have a negative impact on your mental health, especially if these feelings have lasted a long time. Some research suggests that loneliness is associated with an increased risk of certain mental health problems, including depression, anxiety, low self-esteem, sleep problems and increased stress.

What are the consequences of depression in the elderly? ›

A risk to daily living

Depression can lead to eating habits that result in obesity or, conversely, can cause a significant loss of appetite and diminished energy levels, sometimes resulting in a condition known as geriatric anorexia. Depressed older adults also experience higher rates of insomnia and memory loss.

What loneliness does to the brain? ›

"Loneliness can change the neurochemistry of the brain, turning off the dopamine neurons, which trigger the reward response, and causing some degeneration in the brain when the reward response is not activated," says Katherine Peters, MD, PhD, FAAN, associate professor of neurology and neurosurgery at Duke University.

How do you help an elderly person who is lonely? ›

Loneliness in the elderly: how to help
  1. Start a conversation. It's not always easy to know who or how to help. ...
  2. Offer practical help. ...
  3. Share your time. ...
  4. Help with household tasks. ...
  5. Share a meal. ...
  6. Watch out for signs of winter illness. ...
  7. Useful resources.

What is the difference between loneliness and social isolation? ›

People may find themselves socially isolated regularly as a side effect of an isolating mental health issue such as social anxiety or agoraphobia. For example, someone with agoraphobia may feel too anxious to leave their house on some days. Loneliness, on the other hand, is an emotional state.

What happens when you don't socialize? ›

It can lead to a toxic combination of low self-esteem, hostility, stress, pessimism and social anxiety – ultimately culminating in the isolated person distancing themselves from others even further.

Videos

1. Geriatric loneliness with Dr. Steven Wengel
(MDedge: news and insights for busy physicians)
2. Isolation and Loneliness among Seniors during the Pandemic
(NYU Rory Meyers College of Nursing)
3. Relieving Social Isolation Among Seniors
(Commonwealth Club of California)
4. Tackling Loneliness and Social Isolation in our Ageing Population
(Intellect)
5. Only the lonely - Is loneliness a growing 'health epidemic'?
(Roundtable)
6. Reducing Social Isolation in Older Adults and Staying Resilient during the Pandemic
(AGE-WELL NCE)

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