Cumulative effect of loneliness and social isolation on health outcomes among older adults

Abstract

Objectives: Loneliness and social isolation are described similarly yet are distinct constructs. Numerous studies have examined each construct separately; however, less effort has been dedicated to exploring the impacts in combination. This study sought to describe the cumulative effects on late-life health outcomes. Method: Survey data collected in 2018-2019 of a randomly sampled population of US older adults, age 65+, were utilized (N = 6,994). Survey measures included loneliness and social isolation using the UCLA-3 Loneliness Scale and Social Network Index. Participants were grouped into four categories based on overlap. Groups were lonely only, socially isolated only, both lonely and socially isolated, or neither. Bivariate and adjusted associations were examined. Results: Among participants (mean age = 76.5 years), 9.8% (n = 684) were considered lonely only, 20.6% (n = 1,439) socially isolated only, 9.1% (n = 639) both lonely and socially isolated, and 60.5% (n = 4,232) neither. Those considered both lonely and socially isolated were more likely to be older, female, less healthy, depressed, with lower quality of life and greater medical costs in bivariate analyses. In adjusted results, participants who were both lonely and socially isolated had significantly higher rates of ER visits and marginally higher medical costs. Conclusion:Results demonstrate cumulative effects of these constructs among older adults. Findings not only fill a gap in research exploring the impacts of loneliness and social isolation later in life, but also confirm the need for approaches targeting older adults who are both lonely and socially isolated. As the COVID-19 pandemic continues, this priority will continue to be urgent for older adults.

Physical activity as a determinant of successful aging: a narrative review article

“…Tan et al [37] Case-control study (pilot randomized controlled evaluation) 113 Older adults who were engaging in volunteering showed an increase in their physical activity level Sofi et al [30] Systematic meta-analysis of prospective studies 33,816 Physical activity of all levels showed a protective effect on the occurrence of cognitive decline ATTICA study; Kollia et al [27] Observational population study 853 Higher Healthy Aging Index (which included physical activity) was associated with lower 10-year CVD risk Lindsay-Smith et al [35] Observational population study 28 Group-based social and physical activities programs for older people may improve their well-being and prevent loneliness Xu et al [29] Observational population study 613 Physical activity was associated with a reduced risk of developing metabolic syndrome in the participants with the highest levels of physical activity de Oliveira et al [32] Observational population study 200 There was a correlation between low levels of physical activity and symptoms of anxiety and depression in older people Steltenpohl et al [34] Observational population study 39 Older adults were more likely to prefer to exercise with others, rather than alone Liu et al [31] Meta-analysis of randomized controlled trials 1039 In the elderly with cognitive decline, exercise and nutrition interventions showed a positive effect on global cognitive function Barnes et al [33] Observational population study 6994 Loneliness and social isolation in older people was associated with lower quality of life and higher medical costs picking up physical activity later in life has similar, but smaller benefits for health. Almeida et al conducted a study with 10-13 year follow-up, involving 12,201 older men living in Perth, Australia.…”

“…Loneliness and social isolation in older age have a negative effect on the quality of life. Increased likelihood of depression and greater medical costs are also connected to these constructs [33]. Therefore, social engagement is often included in definitions of successful and healthy aging.…”

Social Determinants and Self-Care for Making Good Treatment Decisions and Treatment Participation in Older Adults: A Cross-Sectional Survey Study

“…The U.S. Centers for Disease Control and Prevention reported that adults 65 years and older are more likely than those of other age groups to die or develop a severe illness leading to hospitalization if they contract the coronavirus [ 9 ], which resulted in recommendations for older adults to stay at home and avoid close contact with others. Already, several studies have reported on the compounding health conditions among older adults—anxiety, depression, loneliness, increasing comorbidities, and the worsening of existing chronic diseases—brought about as they were considered the most vulnerable to COVID-19 [ 10 , 11 , 12 , 13 , 14 ]. These studies also implied that older adults desired a sense of control and preparedness to make medical decisions involving their care [ 10 , 11 , 15 , 16 ].…”

“…Already, several studies have reported on the compounding health conditions among older adults—anxiety, depression, loneliness, increasing comorbidities, and the worsening of existing chronic diseases—brought about as they were considered the most vulnerable to COVID-19 [ 10 , 11 , 12 , 13 , 14 ]. These studies also implied that older adults desired a sense of control and preparedness to make medical decisions involving their care [ 10 , 11 , 15 , 16 ].…”

“…The notion that older adults are frail and vulnerable tends to challenge their active involvement in self-care and often relegates their care to nursing homes designed to provide more attention and care support. Contrarily, a few studies have shown that most older adults above the age of 65 consider themselves active and in better physical and psychological health than labels often suggest [ 8 , 10 , 18 ]. A recent survey of more than 1000 older adults in Western Canada exploring the question “What suggestions can you make to engage someone in their health and healthcare?” indicated that older adults wanted to be engaged as partners in their care in ways that enhance feasible healthcare access and autonomy in making decisions [ 8 ].…”