Identifying & Addressing Social Isolation

Social isolation is a significant and widespread problem, with a variety of health consequences. A recent paper in the Journal of Primary Prevention reviews the last 15 years of research on social isolation among older adults, presenting an overview of the topic for health and geriatric professionals.

Several health consequences of social isolation have been identified in the literature, including poor mood and cognitive decline. Social isolation also leads to higher risks for heart disease and stroke, though the exact causality is unclear. One likely pathway for this relationship is poor health behavior, as socially isolated older adults are less likely to engage in healthy behaviors, and more likely to engage in high risk health behaviors such as cigarette smoking and poor nutrition.

There are health and other personal factors associated with increased risk for social isolation, such as untreated impaired vision or hearing. Urinary incontinence and insomnia can also lead to social isolation. Social factors, like changes in family and work roles (due to, for example, retirement or unemployment), and living in an unsafe neighborhood have also been shown to predict higher risk of social isolation.

For individuals at high risk for social isolation, there a few specific assessments that may be useful to many clinicians, such as the Lubben Social Network Scale (LSNS). The LSNS exists in an 18-item and a six-item version, which can be used as a brief measure to screen for social isolation. It asks about available emotional support, practical support, and the number of social ties.

Aside from formal clinical scales, the author suggests that, for health professionals who work with community-dwelling older adults, inquiring about family members and friends during routine clinical visits may be a way to enhance the therapeutic relationship as well as create the opportunity to discuss social isolation. In long-term care and other residential settings, identifying and addressing social isolation may be a way to enhance quality of life and health for residents.

The review notes that while there are no well-established interventions against social isolation, anecdotal evidence suggests a few possible strategies, such as organizing groups of up to eight members for weekly meetings. Referrals to senior centers or organized overall community activities also may be helpful, so it is useful for clinicians to be aware of such local resources. The author advocates for, when possible, a preventive approach to social isolation, such as (in assisted living settings) prioritizing the prevention of future social isolation in plans of care.



Nicholson NR. A review of social isolation: an important but underassessed condition in older adults. Journal of Primary Prevention; (2012). DOI: 10.1007/s10935-012-0271-2.

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