Isolation, loneliness may raise death risk for elderly
Elderly people who are socially isolated and lonely may be at greater risk of early death, British researchers report. Lack of social contact might be an even bigger risk factor than loneliness, the study adds. Why, isolation is such a powerful predictor of death isn't clear, though!
Social contact is a fundamental aspect of human existence. The scientific evidence is that being socially isolated is probably bad for our health. It may lead to the development of serious illness and a reduced life span, says Andrew Steptoe, director of the Institute of Epidemiology and Health Care at University College London.
There is also research suggesting that loneliness has similar associations with poor health. "In many ways, social isolation and loneliness are two sides of the same coin. Social isolation indicates a lack of contact with friends, relatives and organizations, while loneliness is a subjective experience of lack of companionship and social contact.
Social isolation is a more consistent predictor of not surviving than loneliness is. It is related to greater risk of dying even after age and background health were taken into account. The findings are indeed a little unexpected, though!
A thought that loneliness would compound the risk for mortality, as opposed to just isolation—it's a bit of a surprise, says Dr. Bryan Bruno, chair Psychiatry, Lenox Hill Hospital, New York City, who was not involved with the study. However, Steptoe feels, "Knowing about how lonely participants felt did not add to our ability to predict future mortality. This is not to say that loneliness is unimportant, or that we should not strive to reduce loneliness in older persons.
But, we need to keep an eye on the social connections of older people, since maintaining social contacts among seniors and reducing isolation may be particularly important for their future survival. Isolation is a significant factor in both reduced quality of life and mortality. It is a difficult, challenging problem.
For the elderly patients, we must do a lot of education about the risk associated with being isolated and encourage them to spend as much time with other people as possible, whether it be family, friends or joining groups, community organizations or doing volunteer work.
-- Proceedings of the National Academy of Sciences.
People who had limited contact with family or friends or community were classified as socially isolated. The researchers used a questionnaire to assess loneliness, which was described in background information in the study as a person's "dissatisfaction with the frequency and closeness of their social contacts, or the discrepancy between the relationships they have and the relationships they would like to have."
Social isolation, however, increases the risk of dying regardless of one's health and other factors, while loneliness increased the risk of dying only among those with underlying mental or physical problems, the researchers found.
How lonely you are may impact how well you sleep, research shows.
Introduction:
Study of adults in tight-knit South Dakota community shows lonely feelings associated with compromised sleep -- that is, the stronger the loneliness, the more disruptions during the night, with potentially negative consequences on wellness. Results agree with 2002 study of college students, indicating that individuals young and old, in big towns and small, need to feel secure in their social setting to get a healthy night's rest.
Social isolation puts elderly at health risk:
One in five elderly adults is socially isolated from family or friends, increasing their risks for poor mental and physical health, as well as higher rates of mortality, according to a University of Michigan study.
Men are more likely than women to be socially isolated. Women's lifelong investments in family and friend networks, often through their social roles as caregivers to others, suggest that they may be less likely to experience social isolation in older age. African-American, black Caribbean and white older adults reported similar levels of social isolation from family and friends.
Another key finding suggested that older adults who live with family members may still report social isolation from friends, suggesting that these family members and friends have distinctive and complementary roles in terms of social isolation.
In essence, living arrangements themselves—alone or with others—are not indicative of social contact or engagement, says lead author Linda Chatters, the Paula Allen-Meares Collegiate Professor of Social Work and professor of public health. Older adults with mobility impairments such as moving about in one's home, standing for 30 minutes or walking a long distance, are more likely to report being isolated from friends. In contrast, elderly who experienced impairments in self-care such as bathing and dressing are less likely to indicate being isolated from friends.
Mobility impairments lead to social isolation because they limit the ability to socialize with friends outside the home. In contrast, because self-care impairments reflect a higher level of physical frailty, friends may be more likely to make home visits to the elderly.
The findings appearing in the journal Healthcare:
Social isolation is a growing social problem in the United States that has been recognized by several health professions, including Public Health and Social Work. One of the reasons why social isolation is such a critical issue is due to the numerous negative impacts that it has on the health and well-being of older adults. Being socially isolated is associated with higher rates of all-cause mortality, chronic diseases, cognitive decline and dementia. For instance, the classic work of Berkman and Syme (1979) found that the risk of mortality among adults with the fewest social ties was more than double the risk for those with the most social ties. Additionally, both objective and subjective social isolation are linked to a broad variety of poor health conditions, including cardiovascular disease, recurrent myocardial infarction, atherosclerosis, high blood pressure, cancer and delayed cancer recovery
Linkages between Social Isolation and Health:
Social isolation is negatively associated with a range of indicators of physical health. One likely pathway linking social isolation and poorer health status involves the extent to which being isolated limits access to informal social support systems that provide assistance and resources to promote health. Studies in gerontology, family studies, and health services research indicate that adult children, spouses, other family members, and friends are important for providing health relevant information and informal support to social network members. These informal support systems provide general health maintenance activities, direct in-home care (e.g., meal preparation, personal care), chronic disease and medication management, rehabilitative efforts, health decision-making, and assistance in accessing and navigating formal health resources (e.g., transportation, medical appointment scheduling).
Family and Friend Social Networks:
As the most important primary groups in any society, family and friends are expected to fulfill the majority of our affiliative and social needs.
Living arrangements (alone or with others) are often interpreted as a straightforward indicator of social isolation.
As one might expect, both subjective isolation from family and subjective isolation from friends had particularly strong relationships with our measures of objective isolation. Subjective isolation from family was a risk factor for being objectively isolated from both family and friends and from family only. Similarly, subjective isolation from friends was a risk factor for being objectively isolated from both family and friends, as well as from friends only. These findings indicate that subjective isolation may be a precursor to objective isolation. That is, when individuals do not feel affectively close to their family and friends they are significantly less likely to interact with them.
Conclusions:
In recent years, social isolation has emerged as a significant public health and social welfare issue impacting older adults. The development of strategies, interventions, and social policies combatting social isolation must be built upon solid research that identifies the distribution and patterns of social isolation within racially and ethnically diverse groups of elders.
Acknowledgments:
* National Institute of Mental Health
* Office of Behavioral and Social Science Research at the National Institutes of Health (NIH) and the University of Michigan.
