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Strategies to help battle loneliness and social isolation in our golden years

The Bottom Line

  • Loneliness and social isolation among older adults are growing public health concerns across the globe.
  • Several strategies appear to have the potential to improve loneliness, social isolation, and social support in older adults living in the community or a long-term care setting.
  • More high-quality research is needed to improve the current evidence base.  
  • Feeling lonely or socially isolated? Discuss the available strategies that can be used safely to combat these issues with your health care team.   

Loneliness and social isolation do not discriminate. They can impact anyone at any age and for a variety of reasons. That said, older adults tend to be especially susceptible targets (1-5). Disability and poor health, decreased mobility and access to transportation, losing loved ones, retirement, changes to housing, reduced income, and pandemics are just a few factors that put older adults at an increased risk of experiencing loneliness and social isolation (5-8).


Although loneliness and social isolation can be described as ‘silent beasts,’ their physical and mental health impacts are loud—including a greater risk of everything from stroke to suicide (5-7). Moreover, like heart disease, tobacco use, and lack of physical activity, the issue of loneliness and social isolation in older adults is increasingly being seen and treated as a public health issue of global concern (5;8).


Now that we have identified the problem, we can focus on whether there are effective strategies to help tackle loneliness and social isolation in older adults. A recent systematic review points us to potential options for people living in the community and long-term care settings (3). 


What the research tells us

Overall, the review found eight strategies that can be effective in improving one or more of the following: loneliness, social isolation, and social support. These strategies are animal therapy, cognitive–behavioural therapy (CBT) or psychotherapy, social therapy, exercise, music therapy, reminiscence therapy, or some combination of strategies. Folks engaging in these strategies were compared to those not participating in any strategy or partaking in a different kind of strategy.


What did these strategies entail? Animal therapy had older adults interact with either live or robotic animals—generally, dogs or birds. CBT centred on the learning of coping skills. Social therapy included participation in a friendly visitor program. Exercise involved engaging in different exercises like Tai Chi or group yoga. Music therapy consisted of choir programs and rhythm wellness programs. Reminiscence therapy provoked memories by leveraging senses like sight, touch, and smell. Strategies using technology integrated items like smartphones, computers, and pedometers. Lastly, some interventions combined two or more strategies.


The evidence shows that these strategies are effective, but their effect varies by approach and setting. Let’s take a closer look at the findings.


First, we have older adults living in the community. In this population, the review found that exercise and music therapy can reduce loneliness by a small amount, while reminiscence therapy and combined or multi-component strategies can do so by a moderate amount. Additionally, CBT or psychotherapy and combined or multi-component strategies can increase social support by a small amount, while social therapy can do so by a large amount.


Second, we have older adults living in long-term care settings. In this population, the review found that exercise and combined or multi-component strategies can reduce loneliness by a moderate amount, whereas animal therapy and reminiscence therapy can do so by a large amount. Furthermore, strategies that use technology were shown to reduce social isolation by a large amount.


While this review is comprehensive and potentially the largest one on the topic to date, it is essential to note that the individual results discussed above are based on a small number of studies—specifically, one to six studies each. The quality of the evidence also needs to be improved with future studies, as it is currently very low, and there is a lot of variability in the data. This means we need to interpret the findings carefully (1).   


Ultimately, humans are social beings, we need one another to age optimally. If you feel lonely or socially isolated, supports are available that may reduce your loneliness and/or isolation. Connecting with your health care team is a good first step to discuss potential strategies that may work best for you.     


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Author Details

References

  1. Hoang P, King JA, Moore S, et al. Interventions associated with reduced loneliness and social isolation in older adults: A systematic review and meta-analysis. JAMA Netw Open. 2022; 5(10):e2236676.
  2. Social Care Institute for Excellence. At a glance 60: Preventing loneliness and social isolation among older people. [Internet] 2012. [cited January 2023]. Available from https://www.scie.org.uk/publications/ataglance/ataglance60.asp
  3. Centers for Disease Control and Prevention. Loneliness and social isolation linked to serious health conditions. [Internet] 2021. [cited January 2023]. Available from https://www.cdc.gov/aging/publications/features/lonely-older-adults.html
  4. Dahlberg L, McKee KJ, Frank A, et al. A systematic review of longitudinal risk factors for loneliness in older adults. Aging Ment Health. 2022;26(2):225-249. doi: 10.1080/13607863.2021.1876638.
  5. Social isolation and loneliness among older people: Advocacy brief. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.
  6. Cotterell N, Buffel T, Phillipson C. Preventing social isolation in older people. Maturitas. 2018; 113:80–84.
  7. Social isolation and loneliness in older adults: Opportunities for the health care system. Washington DC: The National Academies Press; 2020.
  8. Gilmour H, Ramage-Morin PL. Health reports: Social isolation and mortality among Canadian seniors. [Internet] 2020. [cited January 2023]. Available from https://www150.statcan.gc.ca/n1/pub/82-003-x/2020003/article/00003-eng.htm

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.

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