Social isolation trumps loneliness as early death indicator in old age

Social isolation in old age is linked to an increased risk of early death, the study found. EPA/DENNIS SABANGAN

Social isolation in old age significantly increases the risk of an early death and outstrips loneliness as a factor associated with mortality, a UK study has found.

The new findings, published in the journal PNAS, are based on a study of 6,500 men and women aged 52 and older enrolled in the English Longitudinal Study of Ageing in 2004, and assessed the participants’ risk of death through to March 2012.

The study assessed social isolation based on marital status, frequency of contact with family and friends, and participation in community organisations.

Participants filled in questionnaires to gauge loneliness and factors such as demographics, preexisting long term illness, age and sex were also taken into account.

The study found that socially isolated seniors have an increased risk of early death regardless of their health and demographic background, whereas the link between loneliness and early death exists only for participants with underlying mental or physical concerns.

“Both social isolation and loneliness were associated with increased mortality. However, the effect of loneliness was not independent of demographic characteristics or health problems and did not contribute to the risk associated with social isolation,” the paper said.

“Although both isolation and loneliness impair quality of life and well-being, efforts to reduce isolation are likely to be more relevant to mortality.”

Lead author of the study, Professor Andrew Steptoe, Director of the Institute of Epidemiology and Health Care at the University College London, said that the people in the study did not end their own lives.

“The people in this study died of the usual causes -– cardiovascular disease, cancer, respiratory illness – not suicide,” he said.

Loneliness versus social isolation

Professor Richard Hugman, convener of the Social Work discipline at University of NSW and Fellow of the Australian Association of Gerontology, said the findings shed new light on the connections and differences between isolation and loneliness.

“This is important because in the work of health and human service professions, as in the wider society, there is often a tendency to conflate the two – leading either to assumptions that all isolated older people must be lonely or that, if they are distinct, then it must be loneliness that is the cause of negative health outcomes,” said Professor Hugman, who was not involved in the study.

“The strong evidence that it is social isolation that has the negative impact on health outcomes is challenging because for many people it is counter-intuitive,” he said.

Dr Lynette Chenoweth, Professor of Aged and Extended Care Nursing at the University of Technology Sydney, said the findings were consistent with what had been reported elsewhere.

“When people become socially isolated and communication with others is very limited or ceases, the person can lose their health and well-being and this can lead to an earlier death. Suicide in the socially isolated person is high,” said Professor Chenoweth, who was not involved in the study.

“It’s essential that anyone at risk of becoming socially isolated through ostracism, lack of transport, income, infrastructure, function and social outlets, has a support program put in place by family, friends, neighbours, formal and volunteer support services,” she said.

“Community nurses and other health staff, such as GPs, have an obligation to help the person and their family to institute support processes and strategies and/or refer them to community support service agencies,” she said.

Professor Victor Minichiello, a gerontologist at the University of New England, said the research was significant because it includes a large sample size and a longitudinal study.

“It is consistent with what we have known for a long time,” he said, adding that the new finding “further highlights the need to look at what causes social isolation in seniors.”

“It is interesting to look at the implications of the way people are interacting, not only in the physical, but also in virtual worlds. This highlights the ways in which social networking technologies could be helpful,” said Professor Minichiello, who was not involved in the study.

“We need to be looking at what sort of services can we bring into the homes of seniors that allow greater virtual social interaction and enhance their connectivity with the world, including family and friends.”

Ageism could also be a factor, he said.

“Our society is ageist, our services are frequently based on a youth culture and from the point of view of financial institutions, once a person is no longer employed, they lose their relevance and social identity, and reduce their social networks.”