Risk of Social Isolation - Ages 65+

Risk of Social Isolation - Ages 65+ in United States

United States

Approximately 43% of older people report feeling some degree of loneliness. Life events such as retirement, loss of loved ones and age-related mental and physical decline can make it difficult for older adults to maintain social connectedness. Socially isolated older adults are left further vulnerable as they go through stressful life events common to aging without the buffering effects of social support. Strong social networks have been shown to improve physical and cognitive health and self-management of chronic illness.

While there are many definitions of social isolation and a variety of ways to measure it, social isolation is generally described as the absence of meaningful social relationships. Social isolation differs from loneliness in that loneliness is the feeling of lacking meaningful social relationships, while social isolation addresses the objective lack of social relationships. An individual can be socially isolated and not lonely or feel lonely and not be socially isolated. In the United States, social isolation affects about a quarter of adults ages 65 and older.

The COVID-19 pandemic and the interventions it necessitated, such as quarantine and social distancing, have made it more difficult for older adults to maintain social and emotional support systems and exacerbated already-widespread feelings of isolation. In 2018, 27% of older adults reported feeling social isolation; in June 2020, at the height of the pandemic, that number jumped to 56%.

Social isolation can complicate health care and negatively impact physical health and mental well-being. It is associated with lower use of health care, increased risk of mortality and higher rates of several negative health outcomes, including dementia and coronary heart disease or stroke. The increased health care costs of social isolation are comparable to those of some chronic illnesses, accounting for an additional $6.7 billion in Medicare expenditures annually.

Factors that influence social isolation among older adults include race and ethnicity, immigration status, level of English proficiency, sexual orientation and gender identity, meaningful social participation and support of family and community. Older adults at greater risk of experiencing social isolation include:

• Those who live alone. Living alone is a well-documented risk factor for social isolation, although not all who live alone are isolated. Older adults who are divorced, widowed or separated, as well as those who never married, are therefore more vulnerable to isolation.
• Those with a disability and those who are homebound. A condition that limits daily activities can also restrict social functioning. Physical and mobility impairments may limit older adults’ ability to attend events or participate in activities, resulting in fewer social contacts and greater feelings of loneliness.
• Those living in poverty. The effects of economic hardship on one’s time, resources and safety may present a complex set of barriers to social engagement, leading to isolation. 

Interventions to decrease social isolation among older adults are most successful when they get older adults involved rather than simply providing services or training.

• Technology-based interventions, though not appropriate for all older adults, have been used internationally to enhance communication and connectedness, particularly among those with geographical or mobility barriers. 
• Service provision interventions where volunteers act as intermediaries between older adults may help sustain short- and long-term social connectedness. 
• Structural interventions that support the employment of older adults can promote inclusivity and help change societal attitudes toward older adults. 
• Medicare Advantage plans have begun to offer more flexible supplemental benefits that address social isolation directly or indirectly, such as home delivery meals, ride-sharing services and companionship initiatives.
• Expanded collaboration between public transportation and public health at the community level may address social isolation by increasing mobility among older adults.

AARP points to the importance of senior and community centers in facilitating group interactions. They also offer resources for older adults experiencing social isolation, including tools to find and maintain social connections.

Healthy People 2030 identified social cohesion as a key issue in the Social and Community Context domain of the social determinants of health.

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