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Lonely Is Not the Same as Alone
~ by Carol Vartuli
It's no secret that older people can become isolated, especially if they suffer chronic illness or have physical limitations brought on from aging. But recently, the Journal of the American Geriatrics Society has noted that, "There is growing attention to loneliness and social isolation in later life. Both have been linked to adverse outcomes such as depression, cardiovascular disease, and mortality."
Those who are studying that connection distinguish between social isolation and loneliness. Isolation is the objective measure of the social contacts one has. Loneliness is subjective -- it is the feeling, or the perception, of being isolated.
Thus, not all socially isolated people experience loneliness. While about a quarter of adults over 65 are considered to be socially isolated, more than a third of adults 45 and over feel lonely (National Academies of Sciences, Engineering and Medicine, NASEM).
"We found that whether people considered themselves to be lonely was a bigger risk factor for depression than how many social contacts and support they had,” said Dr. Gemma Lewis of University College London (UCL), Psychiatry. The 2020 UCL study found loneliness responsible for 18% of depression among people over age 50 in England.
The Centers for Disease Control and Prevention (CDC) concur that Americans ages 50 and older are at increased health risk from social isolation and loneliness. Citing recent studies, the CDC states that being socially isolated significantly increases the risk of premature death from all causes. The risk equates to those from smoking, obesity, and physical inactivity. In addition, social isolation is linked to a 50% increased risk of dementia.
Loneliness, when combined with actual social isolation, can result in poor social relationships, which are associated with a 29% increase in the risk of heart disease and a 32% increase in strokes. As noted by the UCL study, loneliness is linked to increased rates of depression and anxiety.
What Can Be Done to Reduce Social Isolation or Loneliness?
Obviously, lonely or isolated individuals cannot magically change their own circumstances-- or their feelings. They're not likely to seek help for non-medical issues. So, while numerous agencies and organizations, like AARP and The National Council on Aging, can provide information, solutions, and services, an intermediary is needed to connect individuals to them.
A 2019 study by the NASEM, "Integrating Social Care into the Delivery of Health Care," outlined the role of health care systems in linking patients with social care resources.
A health care provider may be one of the few connections a socially isolated individual has, so that professional is in a unique position to determine a patient's social health, and to 'prescribe' solutions -- like a physical exercise program to increase mobility, and help expand patients' social participation.
Integrated care consortiums, like Kaiser Permanente, are piloting programs (like Thrive Local) to create connections between health care providers and social service agencies. Thrive is also integrated into Kaiser's electronic health record to track social needs and referrals to local providers.
Health insurance companies, too, are focusing on social isolation and loneliness as problems to address in their broader health campaigns.
The growing recognition of social isolation and loneliness as significant health risks for older people has spurred action among a diversity of players.
Like the adage, "It takes a village to raise a child," it seems equally clear that 'It takes a community to sustain an elder.'