Adults aged 50 – 80 years Often Experience Loneliness, Social isolation

Preeti N. Malani, MD

Credit: University of Michigan

Adults aged 50 – 80 years commonly report loneliness and social isolation, a study revealed.¹

During the COVID-19 pandemic, loneliness, the subjective feeling of being alone, and social isolation, the objective lack of companionship, started being recognized more as health risks. Back in 2015, loneliness and social isolation were recognized as being as unhealthy as smoking 15 cigarettes a day or having an alcohol use disorder, and in 2020, a study was published on how loneliness and social isolation were associated with an increased risk of coronary artery disease and all-cause mortality.^2,3

“While the pandemic disrupted social connections, rates of loneliness and isolation were substantial both before and after the early pandemic,” wrote investigators, led by Preeti N. Malani, MD, from the University of Michigan Medical School, Ann Arbor.¹

Investigators sought to examine the presence of loneliness and social isolation in adults aged 50 – 80 years. Using the University of Michigan National Poll on Healthy Aging, a recurring, nationally representative survey of US adults aged 50 – 80 years, the team collected data from 6 separate samples at 6 time points: October 2018, June 2020, January 2021, January 2022, January 2023, and March 2024.

Surveys from 2018 to 2021 were conducted online using Ipsos KnowledgePanel and surveys from 2022 to 2024 were conducted online and by phone using the NORC AmeriSpeak panel. The surveys had low response rates, but completion rates ranged between 61% and 78%, with 2051 respondents in 2018, 2074 in 2020, 2023 in 2021, 2277 in 2022, 2563 in 2023, and 2576 in 2024.

In the surveys, respondents answered how often in the past year they felt a lack of companionship and felt isolated, with response options of “hardly ever,” “some of the time,” or “often.” The surveys also collected data on demographic characteristics, physical health, and mental health.

In 2018, 33.9% of respondents reported feeling like they lack companionship “some of the time” or “often” (95% confidence interval [CI], 31.7% - 36.2%), which increased to 41.4% during the early pandemic in 2020 (95% CI, 39.1% - 43.7%). The proportion of respondents that reported feeling like they lack companionship some or most of the time continued to rise in 2021 (37.1%; 95% CI, 34.8% - 29.4) and 2022 (41.6%; 95% CI, 38.8% - 44.5%

By 2023, the reports of adults feeling like they lack companionship dropped to 37.2% (95% CI, 34.9% - 39.6%). This dropped even further in 2024 to 33.4% (95% CI, 31.7% - 35.1%), just under the rate it had been in 2018 with a 0.5% difference.

The study discovered that loneliness was most reported among those not working, living alone, with lower household incomes, and self-reported fair and poor physical and mental health.

The trends of social isolation among adults aged 50 – 80 years followed a similar pattern to loneliness. 26.6% (95% CI, 24.5% - 28.8%) of adults reported isolation either “some of the time” or “often” in 2018, which increased to 55.7% (95% CI, 53.4% - 58.1%) in 2020 and dropped to 45.9% (95% CI, 43.6% - 48.2%) in 2021, 33.7% (95% CI, 30.9 – 36.6%) in 2023, and 29.2% (95% CI, 27.5% - 30.9%) in 2024. As seen here, the rates of social isolation in 2024 were still slightly greater than in 2018. Like with loneliness, those who were more likely to experience social isolation were unemployed, living alone, had a lower household income, and reported their physical and mental health as fair or poor.

The research was potentially limited by recall bias and examining self-reported data. In the 2020 survey, questions on social isolation were asked about the past 3 months, versus 12 months like the surveys in the other years. Furthermore, the results may not generalize to adults in nursing homes, individuals older than 80 years, and those who cannot complete an online survey. Survey results could also be impacted by the surveys being conducted at different times of the year and the switch of panels between 2021 and 2022.

“Overall, these findings highlight opportunities to better support older adults who are experiencing loneliness and social isolation,” investigators wrote. “Much like routinely asking about diet and exercise, clinicians should consider screening older adults for loneliness and social isolation and connect them with appropriate resources.”

References

1. ^{Malani, P, Solway, E, Kirch, M, et al. Loneliness and Social Isolation Among US Older Adults. JAMA Network. 2024.doi:10.1001/jama.2024.23213}
2. ^{Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015 Mar;10(2):227-37. doi: 10.1177/1745691614568352. PMID: 25910392.}
3. ^{Hwang TJ, Rabheru K, Peisah C, Reichman W, Ikeda M. Loneliness and social isolation during the COVID-19 pandemic. Int Psychogeriatr. 2020 Oct;32(10):1217-1220. doi: 10.1017/S1041610220000988. Epub 2020 May 26. PMID: 32450943; PMCID: PMC7306546.}