Social isolation is an ongoing concern within the aging services sector, and research has shown that both actual and perceived social isolation have been associated with a number of negative health outcomes including early mortality. A recent review of the literature on loneliness and social isolation aims to examine the magnitude of this problem, and to examine moderators that could affect the impact that loneliness and social isolation have on older adults.
From the available published studies on isolation and loneliness that control for other potential confounding factors, the authors of this meta-analysis calculated the increase in likelihood of mortality for individuals who were socially isolated, lonely, and living alone. They found that social isolation was associated with a 29 percent increased likelihood of mortality; loneliness was associated with a 26 percent increase in the likelihood of mortality; and living alone was associated with a 32 percent increased likelihood of mortality. The researchers found that these results remained consistent across gender and all areas of the globe studied.
Much attention has also been given to the distinction between loneliness and objective measurements of social isolation. Loneliness is a psychological state of perceived social isolation and has been described as a “dissatisfaction with the discrepancy between desired and actual social relationships.” On the other hand, research on the impact of objective social isolation focuses on the actual contacts between individuals and the size of individuals’ social networks. Past research has shown that loneliness and objective social isolation are often not significantly correlated, and that one can occur without the other. In this analysis of the impact of each on mortality, these researchers found no statistical differences between reports of loneliness and objective measurements of social isolation. An individual who feels lonely, but does not appear socially isolated from an analysis of their actual social contacts, faces the same mortality risk as someone who is objectively socially isolated. Additionally, the authors mention a study measuring both loneliness and objective social isolation that showed individuals high in both having the poorest immune response.
Two factors were found to influence these findings. First was the individual’s initial health status. Those individuals with a medical condition or recruited from a medical setting showed a greater risk than healthy individuals recruited from the general community. The other difference observed was the influence of age. The authors found that social isolation and loneliness were more predictive of death in populations younger than 65; however, the reasons for this remain unclear.
Based on impact seen in this data, the authors conclude that it would be prudent to add loneliness and social isolation to lists of public health concerns, and that they be treated in ways similar to how the obesity epidemic is treated—with public health campaigns. They note that the risk from social isolation and loneliness appears to be equivalent to the risk associated with Grade 2 and 3 obesity. In light of this, they suggest that loneliness and social isolation as matters of public health deserve greater coverage both from the media and in public health policy.
While social isolation has long been a concern in senior living and aging services, this review also suggests that aging services professionals need to be on the lookout for older adults who are lonely despite not being objectively socially isolated. The increased mortality risk for these individuals is just as high. In addition to getting people in greater contact with one another, efforts need to be made for this social contact to be satisfying, fulfilling, and able to reduce older adults’ feelings of loneliness.
Holt-Lunstad J, Smith TB, Baker M, et al. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on Psychological Science (2015) 10: 227-237.