Nobody relishes the thought of getting older with no one at their side to provide support, love, and laughter through good times and bad. Unfortunately, about 40% of older adults experience loneliness, while 7-17% report being socially isolated. Although these terms are often used in place of one another, social isolation and loneliness are not quite the same thing (1). Social isolation refers to an actual lack of social support and meaningful contact, whereas loneliness refers to a person’s belief that they are lacking or have lost companionship, and the negative feelings that stem from this (1;2).
Whether actual or perceived, social isolation and loneliness can have real impacts on the overall health and well-being of older adults (1;3). In fact, social isolation is linked with increased death (1;4), dementia (1;5), depression, and risk of elder abuse (6); while loneliness is associated with increased blood pressure (3;7), cognitive decline (3;8), and reducing the body’s ability to protect itself from infections (3;9).
There are many reasons why older adults may spend more time on their own—living alone, the death of loved ones, certain health conditions, and a lack of access to transportation are just a few examples (6). Fortunately, efforts are underway to identify strategies to combat social isolation and loneliness, and the worrisome health effects that come along with them (1;3;10).
What the research tells us
One systematic review explored the effectiveness of a variety of programs aimed at reducing social isolation and/or loneliness in older adults. This review found that some of these programs may help improve physical, mental (e.g. depression and mental wellbeing), and social (e.g. social support and loneliness) health in older adults who are or are thought to be lonely or socially isolated. Overall, programs that were group-based, grounded in theory, and incorporated active input from participants and social support/activity appeared to provide the most benefit.
Some of the specific programs that were found to be effective include: a psychosocial activity group involving art, discussions, therapeutic writing, group therapy, and exercise that led to new friendships; a coping group that led to improved functional health in people with chronic rheumatic disorders; a psychosocial group focusing on health education, coping skills, and stress management that helped women with breast cancer gain more confidants and reduce loneliness; and a bereavement support group for widows that led to enhanced socialization and reduced depression (1).
Another systematic review assessing health promotion strategies –such as bereavement support, peer support, and education– further supports the idea that the characteristics of programs or strategies that aim to address loneliness and social isolation in older adults play an important role in effectiveness. Here it was found that the small number of strategies that were effective in reducing or preventing loneliness and social isolation were once again group-based, included support activities or this time education as well, were geared towards specific groups of older adults (e.g. women, widowers, caregivers), and provided older adults with the opportunity to assist in developing and carrying out the activities involved in the strategy or program (10).
A more recent meta analysis targeted solely on loneliness also introduced the idea that strategies that focus on changing a person’s negative perceptions and thoughts –for example through cognitive behavioral therapy– may be even more beneficial for reducing loneliness than those that focus on enhancing social support (3).
Overall, the current evidence-base around approaches to tackling social isolation and loneliness in older adults shows some promising strategies, while highlighting that the characteristics of the program or strategy being used are important in determining success. A need for more recent high quality studies, which are well-designed and properly report on outcomes is also apparent, so more definitive conclusions can be made (1;3;10).