Loneliness and social isolation – focus is there, solutions are emerging

Heightened focus on social isolation has resulted in more research, greater concern.  Since the initial correlation between loneliness, social isolation and poor health outcomes, new reports have emerged to try and understand why people are lonely and what can be done to mitigate it. AARP, which has been researching the subject since 2010, released new survey results in 2018 confirming the same percentage – 35 percent of adults age 45+ are lonely – but with a growing number of older adults in the population, this represents an additional five million adults based on census data and asks them to assess their health. Today, Aging in Place Technology Watch and GreatCall have published a new white paper about initiatives to fight social isolation -- a few of the points are excerpted here:

 What has changed in the past two years?  First, the research.  Once the correlation between social isolation and poorer health outcomes was made, the volume of research spiked. From its pre-correlation measurement in the 1996 UCLA Loneliness Scale, a number of other surveys have been released that include correlation with health care costs, economic status, and lifestyle preferences. In late 2017, research from AARP’s Public Policy Institute concluded that socially isolated older adults cost the U.S. health system an additional $6.7 billion in health-related spending. Newer research from the National Institute on Aging is focusing on the connections between loneliness, long viewed as a predictor of cognitive decline, and other health risks, including:  high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death.

Social isolation – is this a worsening 21^st century phenomenon? Is social isolation more of a problem today than in the past. And, what is the prognosis for the future? The recent AARP report zeroed in on the key predictors of loneliness, sometimes referred to as “perceived social isolation.” Living situations and marital status may provide a clue to societal changes that result in social isolation and loneliness. In 2018, the Administration for Community Living (ACL) released its survey profile of older Americans (age 65+). It showed that while only 14 percent of the 65+ population lives alone, almost half (45 percent) of women aged 75+ live by themselves. According to Pew Research, among those 65 and older, the divorce rate has tripled since 1990.

A top predictor of loneliness is size and quality of one’s social network.  To assess these elements and their connection to loneliness, the AARP respondents were asked for both the number of people in their lives who have been supportive in the past year and the number with whom they can discuss matters of personal importance. From the study: “As expected, as one’s social network increases, loneliness decreases. Also as expected, as physical isolation decreases (the factor which included items such as disability status, number of hours spent alone and household size), so does loneliness.”

Health limitations can exacerbate social isolation. While loneliness and social isolation are emerging as public health issues, less has been published about the health issues that may lead to social isolation: mobility limitations, depression, cognitive impairment and hearing loss.  In another study, older adults with mobility impairments were more likely to report being isolated from friends. These surveys underscore the fact that elderly people are the most likely to experience social isolation and its related health effects. According to a UK study, those who provide care -- including family caregivers such as children or spouses -- are also known to experience loneliness in their roles and would benefit from greater societal appreciation and possible interventions such as respite care.  

Untreated hearing loss contributes to social isolation.  According to government statistics, among adults aged 70 and older with hearing loss who could benefit from hearing aids, fewer than 30% have ever used them. Denial and unreimbursed cost ($2400/ear) are factors, and delay in acquiring them can worsen the isolation.  Hearing aids today also offer features that include fall detection, smartphone integration, and AI capabilities.  Moving forward, Medicare Advantage plans are beginning to contribute to a portion of the cost. Audiologists play a role in managing user expectations and training an individual to adjust to the change from little or no sound to the noisy environment of stores, restaurants, office buildings and streets.

Click here to read the full white paper.