In older adults, loneliness is associated with a 45 per cent increase in risk of death, making its effects comparable to risk factors such as obesity and smoking.
The litany of poor health outcomes and disconcerting statistics about loneliness is something the world is finally coming to understand: The World Health Organization has declared loneliness to be a pressing global health threat. The U.S. surgeon general has said the mortality effects of loneliness are equivalent to smoking 15 cigarettes a day. Loneliness contributes to dementia and depression and, according to a paper titled, “Loneliness in Older Adults” and published by the Canadian Medical Association Journal (CMAJ), nearly 40 per cent of older adults, particularly women, feel lonely.
Those who are frequently lonely report poorer mental health and lower levels of overall life satisfaction than those who aren’t. Further, loneliness is associated with elevated blood pressure, increased risk of coronary heart disease, stroke and cardiovascular mortality and functional impairment. In older adults, it’s associated with a 45 per cent increase in risk of death, making its effects comparable to risk factors such as obesity and the aforementioned smoking.
“Recent research has found that the biggest predictors for dementia are actually social isolation and loneliness,” says Namrata Bagaria, a medical doctor who has a master’s of public health from Harvard University and is a PhD candidate at the University of Ottawa. Her thesis examines social isolation in older adults.
Clearly loneliness — and its related problem of social isolation — are monstrous health concerns globally, and the pandemic may have exacerbated them, as many seniors continue to be cautious in their social interactions. The pandemic may also simply have given more voice to an existing issue because it drew attention to the problem to a wider demographic.
Mitigating loneliness
Bagaria says a significant cause of social isolation, which can accompany loneliness, is hearing loss so one solution to that problem is to develop policies that make hearing aids affordable and accessible.
Next, she says, make a plan for all seasons because loneliness can be cyclical. People can be lonelier in the winter when it’s harder to get out, for example.
“It's almost like fitness,” Bagaria says. “You have to make a plan for every season, find ways to connect [in winter], whether through phone calls, texting, videos. And be aware that having friends doesn't solve this problem, unless you know how to connect with them. You have to develop your social muscle.”
When lonely, some people turn to pets — which rarely bring the emotional baggage associated with human relationships — for companionship.
“If we can connect with a pet, at least we are connecting with someone,” she says.
Bagaria also recommends joining local community recreation clubs and finding like-minded people with whom one can spend time. Walking groups are one good example, she says. Volunteering is another way older adults can break the loneliness cycle while also doing rewarding work and finding interesting, like-minded people with whom to do it.
“Volunteering is a big one, one of the best solutions,” Bagaria says.
Further, she suggests digging back into the past to rediscover some things you used to enjoy doing and gave up maybe because you were working a full-time job, raising children and spending time with a spouse. If you played tennis when you were younger, try that again, or consider pickleball. If learning an instrument or a language were sources of joy — try to find groups that will facilitate that kind of learning.
Gail Low, a professor of human and social development at the University of Alberta, just completed a study with a number of colleagues. They interviewed 13,127 older adults across 10 provinces in an effort to “acknowledge, gather and celebrate” their wisdom. The study, titled “Mitigating Social Isolation Following the COVID-19 Pandemic,” is published in a journal called COVID.
“Ninety per cent of [respondents shared] messages of hope about how to mitigate social isolation at varying levels,” Low says. “One might be where you’re pursuing new avenues for learning, or a new hobby that you hadn’t been doing prior to COVID, as well as getting out in communities in which you’re known and also reaching out to new ones, maybe through volunteering. Other [respondents] felt very strongly about reaching out to others. What can you do to put your skillset to work by helping others?”
In the aforementioned CMAJ study, the authors say that social prescribing is an emerging intervention for loneliness, noting that loneliness can’t be effectively treated with medication or acute care. Volunteering, group learning and activities that can lead to new friendships are all on the list of social prescriptions community organizations would suggest and may even facilitate.
Innovative approaches
In the Netherlands, one grocery store chain decided to address loneliness in one of the ways it knew it could — by introducing slow lanes in its grocery stores. The Dutch grocery chain, Jumbo, responded to the Dutch government’s campaign to tackle the problem of loneliness. Bagaria understands this idea because she has a friend who emigrated to Canada 40 years ago for his studies and the only person he spent meaningful time with in the first little while was the cashier at his local grocery store. It’s worth noting that Jumbo’s pilot project began before the global pandemic hit and was so successful it implemented 200 slow lanes across the country.
Meanwhile, in the U.K. in 2018, then-prime minister Theresa May called loneliness “one of the greatest challenges of our time” and established a ministerial lead to tackle the issue. Then- Japanese prime minister Yoshihide Suga went one further by naming a minister of loneliness to his cabinet in 2021.
Britain’s Royal Mail implemented a strategy to tackle loneliness, whereby postal workers delivered the mail with “a side of compassion,” as one business publication put it. The “safe and connected initiative” saw Royal Mail employees check on people when they delivered the mail. The posties asked a few questions, logged the answers and a local volunteer organization followed up with those who sounded as though they could use some company. Postal services in Finland and Iceland have implemented similar programs.
Quality of relationships
It’s important to note that it’s not just people who live alone or spend a lot of time alone who are lonely, according to Frederick Grouzet, an associate professor of psychology at the University of Victoria.
“Being surrounded by people might not have an effect on loneliness,” Grouzet said. “It’s more about feeling connected and feeling that the person cares for you and you care for them. We all have some basic psychological needs and one of them is to feel connected in a meaningful way. If this need isn’t satisfied, we will experience depression, anxiety and even physical symptoms.
Grouzet said that when we experience social rejection, we feel it in the same area of the brain that we feel physical pain. “It’s like a punch in your stomach,” he says.
For those who have friends they suspect are lonely, Grouzet suggests easing them back into positive social interactions.
“You could suggest meeting once a week, then twice a week, and so on,” he says. “Remember, it’s not the quantity of time, but the quality.”
Like the other experts, he also encourages volunteering, because it has positive effects for the person who’s receiving the social support, but also the volunteer.
And he suggests reconnecting with old friends from whom you’ve drifted. “That can be very positive,” he says, adding that it might be worthwhile looking up old friends or colleagues on social media to try to reconnect.
What is loneliness?
Loneliness is a subjective experience and is characterized by the distress involved when one’s social relationships are perceived as being less satisfying than what is desired, according to a Government of Canada report titled, Social Isolation of Seniors. Even active and married or co-habitating older adults can experience loneliness.
What is social isolation?
Social isolation is defined as a low quantity and quality of contact with others, meaning a person has few social contacts, few social roles and the absence of mutually rewarding relationships, according to the same report.