The Effects of Social Isolation and Loneliness on Physical and Mental Health

We all aspire to live longer, healthier lives. But no matter our age, it can be difficult to commit to a healthy diet, daily exercise routine and eight hours of sleep every night. Fortunately, there’s another, often overlooked factor that influences our well-being and how we age: social interaction. Social interaction is critical for mental and physical health, especially as we grow older.

More than just a fleeting emotion, loneliness is a public health crisis. As a physician at Aviv Clinics, I’ve witnessed firsthand how social isolation and loneliness can impact wellness, leading to chronic illness and even premature death. Fortunately, changes to our lifestyle, some as simple as introducing yourself to your neighbors, can enhance our social connectivity and mitigate some of these risks.

Social Isolation in Seniors

Although social isolation and loneliness are two different conditions, they are closely intertwined. Social isolation is an objective term used to describe people with infrequent social contact with others. Loneliness is a subjective feeling of isolation.

Sadly, both are prevalent among older adults. Consider these statistics:

•   Nearly one in four American seniors are considered socially isolated.
•   Previous studies have found that as many as 43% of older adults feel lonely, a number that has likely escalated since the pandemic.
•   Approximately 28% of older adults, or 13.8 million people, in the United States live alone.

And while living alone can contribute to loneliness and isolation, many older adults live in single-person households but still live vibrant, active lives. In contrast, some people may feel lonely even when surrounded by others.

Americans 65 and older will reach 20% of the population by 2040. Because social interaction is necessary to both our mental and physical well-being, the need is paramount to address senior isolation and loneliness today.

Are Loneliness and Isolation Bad for Your Health?

Chronic loneliness can trigger cortisol release, potentially leading to obesity and chronic inflammation. This inflammatory state can leave us vulnerable to disease at a stage in life when we’re already predisposed to infections.

The effects of social isolation on elderly individuals can be devastating. Studies show social isolation is linked to a 29% higher risk of heart disease and 32% higher risk of stroke. It can accelerate cognitive decline, leading to a 50% increased risk of dementia. Furthermore, isolation and loneliness are linked to a 14% increase in premature death.

In addition, social isolation has been linked to:

•   Recurrent myocardial infarction (heart attacks)
•   Atherosclerosis (hardened arteries)
•   Autonomic nervous system dysregulation
•   Hypertension (high blood pressure)
•   Cancer and delayed cancer recovery
•   Slower wound healing
•   Weakened immune function
•   Anxiety and depression.

Social isolation has further been associated with a 57% increase in the risk of emergency department visits and nursing home placements.

Isolation and Cognitive Decline

Research links social isolation among older adults to dementia. Indeed, loneliness can stimulate disease including the advancement of inflammation in the brain leading to Alzheimer’s disease. Sadly, studies also show a link to propagating the problem: friends are less willing to see friends who have been diagnosed with Alzheimer’s disease.

How Does Isolation Affect Mental Health?

Social isolation has also been linked to mental health concerns, including high stress, poor sleep, cognitive challenges and even suicidal thoughts. The effects of isolation on older people can also include poor personal or self-care—including not bothering to get dressed—decreased mobility, a diminished memory, apathy and a poor diet. Social isolation can lead to smoking, too little exercise and alcohol abuse, all causing a spiral effect toward serious illnesses.

Social Isolation and Elder Abuse

Finally, isolation is also a risk factor for elder abuse, including neglect, physical, financial and psychological abuse. A 2021 Australian government report explains that limited contact with family and friends could be tied to a higher likelihood of elder abuse. Depression, cognitive decline and physical dependence on others can make isolated seniors easy targets for abuse and neglect. Isolation also reduces access to resources that may help address and prevent elder abuse.

Why Are Older Adults Susceptible to Isolation and Loneliness?

As we age, our social circles can shrink. Friends may relocate, spouses or family may pass on, and loss of mobility or transportation can limit our social activities.

When we are younger, we never imagine not having enough friends or at least acquaintances to create a wide social circle. The bigger the circle, the more confident we became in ourselves. But as time marches on and we grow apart from some friends, our circles are reduced. When we are left to live alone and lose friends and family members — coupled with illnesses — loneliness creeps in.

A Higher Risk of Loneliness and Isolation

Who has a higher risk of being socially isolated or stricken with loneliness as older adults? Research, while limited, shows that the risk is higher with immigrants and members of the LGBTQ community, followed by racial and ethnic minorities.

•   Latino immigrants have fewer social ties and lower levels of social integration than those born in the United States. Factors include language barriers, as well as community and family dynamics, all of which can contribute to a lack of new relationships.
•   LGBTQ people report more loneliness than their heterosexual peers, presumably because of stigma, discrimination, and because sexual minorities are more likely to be single or childless than their heterosexual counterparts.
•   Ethnic and racial minorities are at risk for loneliness as well. In a study performed by the British Red Cross, 38% of people who were Black, Asian or other ethnic minority said they often felt alone.
•   In the same study, almost half of those who had previously experienced discrimination reported feeling lonely, compared to 28% of those who had not experienced such prejudices.

What Are the Benefits of Social Interaction for Older Adults?

Studies show social engagement, including social leisure activities, can reduce the risk of cognitive decline and are key to maintaining cognitive functions as we age. Another study reported that men and women with an average age of 65 who are socially interactive or have large circles of friends have shown better cognitive function than those who do not. Moreover, a higher level of social interactivity has been shown to reduce the risk of one day developing dementia.

There is evidence that social relationships benefit our health in many ways and can keep us alive. The risk of death in older adults with a low level of social interactivity are twice as high as those with the most social ties, including those with medical issues. For those with chronic conditions, the risk can be even higher. Socially isolated adults with coronary artery disease had a 2.4 times greater risk of cardiac death than those who were socially active.

How Can We Reduce Loneliness and Isolation in Older Adults?

There are several opportunities to reduce loneliness in seniors and people who are isolated:

• Prioritize social connections:  Schedule weekly visits, lunch dates or phone calls with friends, family members and neighbors. Make a schedule denoting the time and day for each visit.

• Join a group: Beyond simply staying in touch, engaging in an activity with others will strengthen your relationships. Look for local clubs, groups, or classes focused on your interests or hobbies. Often, these are hosted by community recreation departments, senior centers, social service agencies or public libraries.

• Volunteer: Helping others boosts well-being and provides a feeling of purpose, as well as allowing you to become involved in your community by helping others. Local nonprofits and faith-based organizations offer opportunities to lift your spirits and the spirits of others.

• Adopt a pet: Our furry, feathered and finned friends provide companionship and comfort, give us purpose, and reduce feelings of loneliness, stress and anxiety. Pets can even help reduce blood pressure. If you are healthy and able, adopting a pet from a local shelter can be a win-win for both parties.

• Exercise: Seniors who are physically active can exercise with others. There are walking clubs, senior yoga classes and team sports that provide opportunities to be social and stay fit. 

• Leverage technology: For those with mobility concerns, online courses and video chats can allow older adults to connect (and even work or volunteer) virtually. For seniors who may lack technical prowess, many libraries and community centers offer computer and technology classes.

Connectivity in a Clinical Setting

At Aviv Clinics, social connectivity is an essential part of our medical program, which is designed to help people age better and facilitate recovery from isolating conditions like stroke, traumatic brain injury and fibromyalgia. Whether clients complete the Aviv Medical Program individually or with a partner or friend, our clients frequently express that the sense of community was their favorite part of their Aviv experience.

Because the hyperbaric portion of the Aviv Medical Program is performed in spacious 14-person HBOT suites, hyperbaric dive-mates often form lasting bonds with one another. Even after completing the program, many clients meet regularly for book clubs, happy hours, bible studies, double dates, workouts and even international travel. Others look forward to our monthly client socials to reconnect.

Although social interaction isn’t a substitute for a healthy diet or regular exercise, our relationships with others are still vital to our health.