Social isolation causes mortality in the elderly

Social isolation in old age significantly increases the risk of an early death and outstrips loneliness as a factor associated with mortality, according to British research.

The investigation involved 6,500 men and women aged 52 and older who were enrolled in an English longitudinal study of ageing in 2004, and their risk of death was assessed through to March 2012.

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

The study assessed social isolation based on marital status, frequency of contact with family and friends, and participation in community organisations. Those taking part filled in questionnaires to gauge loneliness and factors such as demographics, pre-existing long-term illness, age and sex.

“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 researchers wrote in a paper published in the journal PNAS.

“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 University College London, noted that the people taking part in the study did not end their own lives but died of the usual causes such as cardiovascular disease, cancer and respiratory illness.

“We found that mortality was higher among more socially isolated and more lonely participants. However, after adjusting statistically for demographic factors and baseline health, social isolation remained significantly associated with mortality,” the researchers said.

Other researchers 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 one.

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

Previous research has found that when people become socially isolated and communication with others becomes very limited or ceases, they can lose their health and well-being, possibly leading to an earlier death. Suicide among the socially isolated is also high.

Researchers said it was essential that anyone at risk of becoming socially isolated through ostracism, and-or lack of transport, income, infrastructure and social outlets, had a support programme put in place by family, friends, neighbours or formal and volunteer support services.

Community nurses and other health staff, such as general practitioners, 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.