Social Isolation and Loneliness
By Ross Peters
January 2004

This article addresses one of the widespread issues of aging in contemporary society -- social isolation and loneliness. It defines the issue and looks at its prevalence among seniors, examines the underlying factors related to loneliness, and relates isolation and loneliness to general health. It also cites a Manitoba study's suggested strategies to address the isolation and loneliness issue.

Social isolation and loneliness tend to increase as people age and as family and friend networks become smaller. Social contacts usually decrease after retirement and may continue to decline with the deaths of family members and friends and changes in residence following widowhood, mobility difficulties and ill health. Social isolation is defined as being separated from one's environment to the point of having few satisfying and rewarding relationships. Loneliness, on the other hand, is one's feeling of dissatisfaction with social contacts in terms of quantity of contacts, quality of relationships or both.

Social isolation can occur without the presence of loneliness, while loneliness can occur even with many social contacts. Many researchers agree that reduced social contact can precipitate a feeling of loneliness and a 2001 study on aging in Manitoba found people having the fewest contacts expressing the highest levels of loneliness.

Most studies involving loneliness in a number of countries have shown a significant percent of elderly people experiencing loneliness. The Aging in Manitoba study showed that 45% of participants aged 72 and over showed high levels of loneliness. Eighty-five percent of the group was also defined as socially isolated, due to a low number of regular social contacts.

Factors Related to Loneliness
Loneliness appears to be more prevalent among people who are widowed, regardless of gender or the presence of adult children. Loneliness following widowhood also appears greater, the longer the person was married. Those widowed for less than five years were more likely to be lonely than those widowed for a longer period.

Another factor affecting loneliness for older people is whether the individual lives alone or with someone. But one study showed the highest levels of loneliness among widowed older persons who lived with their children, followed by those living with a brother or sister.

One researcher felt that living in a nursing home increased social isolation and loneliness among the elderly. In this study, the lack of intimate relationships, increased dependency and loss (i.e. friends, home, previous lifestyle, independence and self-identity) were all found to increase loneliness.

At the same time, other studies have shown that elderly people feeling socially isolated and lonely and also declining in health, were more likely to move to nursing homes or seniors' residences. Such moves may increase their social participation and delay further health decline. Overall, however, it remains unclear whether moves to nursing homes are beneficial or detrimental regarding isolation and loneliness.

Most researchers have found that elderly women are more likely than elderly men to feel lonely. A study by the authors of this article found gender to be a significant predictor of social isolation, but not loneliness. Women's increased longevity compared to men's means many live alone, and many also experience chronic health problems that can limit social interaction. However men appear to have a harder time coping with the loss of their spouse as they often have a smaller social support system than women and fewer intimate contacts including contacts with family.

Social isolation and loneliness have consistently been found to be associated with health. Declining physical health may lead to social isolation and associated feelings of loneliness. Perceived loneliness has been found to be one of the strongest predictors of health and the use of health care services among institutionalised seniors. Loneliness has also been found to be associated with diabetes, heart disease, ulcers, respiratory conditions, headache, low back pain and abdominal pain.

Perceptions of personal relationships are also found to affect feelings of physical health. People who are not lonely may have a more positive view of their relationships, accept aging and its changes and therefore feel healthier. Research has shown that people in poor health coupled with high anxiety tend to feel more isolated and lonely.

Strategies to Address Isolation and Loneliness for Older People
The Manitoba study developed recommendations to address the isolation and loneliness issue among older people and
focused on three groups: individuals, community groups and agencies, and program planners and policy makers.

It was suggested that individuals keep in regular contact with older family members, friends and neighbours and ensure that older people feel needed and valued. Local communities and agencies were advised to increase the availability of programs and services for seniors, establish or enhance transportation programs and low-cost leisure and education activities, and involve seniors at all levels of planning. For their part, policy makers were advised to increase barrier-free access and housing options that foster socialization. Finally, resources should be provided for continuing research on isolation and loneliness. Enhanced communication between all levels of government to improve links among social services, housing, health and education to reduce isolation and loneliness was also suggested.

Reference: Madelyn Hall, Betty Havens. "Social Isolation and Loneliness." NACA Writings in Gerontology on Mental Health and Aging. Spring/Summer (2002).