Human beings are social creatures. Our connection to others enables us to survive and thrive. Yet, as we age, many of us are alone more often than when we were younger. Therefore, we are vulnerable to social isolation and loneliness and related health problems such as cognitive decline, depression, and heart disease. Fortunately, there are ways to counteract these negative effects.
“A key scientific question is whether social isolation and loneliness are two independent processes affecting health differently, or whether loneliness provides a pathway for social isolation to affect health,” Dr. Nielsen noted.
Health Effects of Social Isolation, Loneliness in Older Adults
Research has linked social isolation and loneliness to higher risks for a variety of physical and mental conditions:
- high blood pressure
- heart disease
- obesity
- a weakened immune system
- anxiety
- depression
- cognitive decline
- Alzheimer’s disease
- even death
People who find themselves unexpectedly alone due to the death of a spouse or partner, separation from friends or family, retirement, loss of mobility, or lack of transportation are at particular risk.
Conversely, people who engage in meaningful, productive activities with others tend to live longer, boost their mood, and have a sense of purpose. Studies show these activities seem to help maintain their well-being and may improve their cognitive function.
Dr. Cacioppo’s research found that being alone and loneliness are different but related. Social isolation is the objective physical separation from other people (living alone). On the other hand, loneliness is the subjective distressed feeling of being alone or separated. It’s possible to feel lonely while among other people, and you can be alone yet not feel lonely.
“The misery and suffering caused by chronic loneliness are very real and warrant attention,” she said. “As a social species, we are accountable to help our lonely children, parents, neighbors, and even strangers in the same way we would treat ourselves. Treating loneliness is our collective responsibility.”
Understanding the Biology of Loneliness
Losing a sense of connection and community changes a person’s perception of the world. Someone experiencing chronic loneliness feels threatened and mistrustful of others, which activates a biological defense mechanism, according to Steve Cole, Ph.D., director of the Social Genomics Core Laboratory at the University of California, Los Angeles.
Loneliness acts as a fertilizer for other diseases,” Dr. Cole said. “The biology of loneliness can accelerate the buildup of plaque in arteries, help cancer cells grow and spread, and promote inflammation in the brain leading to Alzheimer’s disease. Loneliness promotes several different types of wear and tear on the body.
People who feel lonely may also have weakened immune cells that have trouble fighting off viruses, which makes them more vulnerable to some infectious diseases, he added.
NIA-supported research by Dr. Cole and others shows that having a sense of mission and purpose in life is linked to healthier immune cells. Helping others through caregiving or volunteering also helps people feel less lonely. “Working for a social cause or purpose with others who share your values and are trusted partners puts you in contact with others and helps develop a greater sense of community,” he noted.
Living Alone with Cognitive Impairment
Older adults living alone with cognitive impairment – a growing and vulnerable population – face unique challenges. Elena Portacolone, Ph.D., assistant professor of sociology at the University of California, San Francisco, leads an NIA-funded study to understand their daily experiences, social networks, and decision-making ability.
These structural obstacles included fear of being robbed, distrust of neighbors, limited availability of appropriate services, dilapidated surroundings, and limited meaningful and positive relationships. Having few friends or family members attuned to their concerns was another factor exacerbating social isolation. Study participants expressed a desire to be socially integrated, an idea that runs against the prevailing assumption that isolated older adults are alone by choice.
As a result, older adults with cognitive impairment living alone spend much of their time managing their household and their health, Dr. Portacolone said. They are often reluctant to show they need help because they fear being forced to move from their homes.
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References
- Administration on Aging. A Profile of Older Americans: 2017 (PDF, 712K). April 2018.
- Cacioppo JT and Cacioppo S. The growing problem of loneliness. Lancet2018;391(10119):426.
- Portacolone E, Covinsky KE, Rubinstein RL, et al. The precarity of older adults living alone with cognitive impairment. The Gerontologist 2019;59(2):271-280.
