Living Well Principles

Social Isolation and Loneliness

Social isolation is defined as having “few social relationships or infrequent social contacts with others”(1) whereas loneliness is described as a “subjectively experienced, aversive emotional state resulting from the perception of unfulfilled personal and social needs.” (2) Both have been linked to increased risk of dementia (3, 4). For example, a recent study of over 5,000 Medicare beneficiaries found that 23% of older adults met criteria for social isolation and those individuals showed a 28% higher risk  of dementia than their counterparts who were not socially isolated (3). Similarly, loneliness was associated with higher risk of Alzheimer’s disease in another study of older adults, even after statistically controlling for social isolation (4).

Conditions Associated with Lonelines

In addition to cognitive decline and dementia, a number of health conditions are also associated with loneliness. As discussed in a 2020 article published in Brain and Life, loneliness is a risk factor for depression, anxiety, hypertension, and heart disease. Loneliness is also associated with worse prognosis following a stroke and with premature mortality. One potential mechanism between loneliness and worse health outcomes is chronic, low-level inflammation (5). 

Can We Identify Who is at Risk for Loneliness?

If we can identify factors that increase risk for loneliness, early intervention may reduce it and the associated negative health and cognitive outcomes. A recent review reported on factors associated with loneliness in older adults. Not being married, loss of a partner, living alone or in a residential care setting, friendship strain and verbal abuse from family increased the risk of loneliness (6). By contrast, higher number of social contacts, positive marital quality, engagement in social activities, and social and emotional support reduced the risk of loneliness (6). Among health factors, perceived health was associated with reduced loneliness, whereas depression, anxiety, and difficulty with daily activities was associated with increased loneliness (6).

Reducing Social Isolation and Loneliness

Fortunately, much can be done to reduce social isolation and loneliness. A recent study found that using technology can reduce social isolation. In the same cohort of Medicare beneficiaries discussed above, those who had access to cell phones and computers or who used email or text messaging had a 36 - 38% reduction in the risk of becoming socially isolated compared to those who lacked access (7).

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Sources: 

1. National Academies of Sciences Engineering and Medicine. The National Academies Press; 2020. doi:10.17226/25663
2. Peplau, L. A. and Perlman, D. (1982). Perspectives on Loneliness. New York: John Wiley & Sons.
3. Huang, A. R. et. al., (2022). Social isolation and 9-year dementia risk in community-dwelling Medicare beneficiaries in the United States. J of Am Geriatrics Society. DOI: 10.1111/jgs.18140
4. Wilson, R. S. et al., (2007). Arch Gen Psychiatry doi: 10.1001/archpsyc.64.2.234.
5. Colino S. (2020). How Loneliness Affects Health. Brain and Life https://www.brainandlife.org/articles/how-loneliness-affects-health
6. Dahlberg, L. et al., (2022). A systematic review of longitudinal risk factors for loneliness in older adults. Ageing and Mental Health https://doi.org/10.1080/13607863.2021.1876638
7. Umoh, M.E., et al., (2022).Impact of technology on social isolation: Longitudinal analysis from the National Health Aging Trends Study. DOI: 10.1111/jgs.18179
8. National institute on Aging. Loneliness and Social Isolation - Tips for Staying Connected. https://www.nia.nih.gov/health/loneliness-and-social-isolation/loneliness-and-social-isolation-tips-staying-connected