Older Adults Face Lower Social Isolation, But Mental Health Woes Linger

March 17, 2023 - Social isolation, a key social determinant of health (SDOH) affecting health outcomes, has begun to decline among older adults after three years of pandemic living. However, a survey revealed that one in three individuals aged 50 to 80 still experience these feelings, emphasizing the ongoing need for more support

Before the pandemic, numerous older adults faced challenges with loneliness and infrequent social interactions, which intensified during the early stages of the COVID-19 outbreak. As the pandemic unfolded, social isolation significantly affected mental health and well-being, becoming a prominent SDOH. The enforcement of social distancing rules furthered emphasized social isolation concerns, particularly for the elderly population.

The National Poll on Healthy Aging surveyed adults aged 50 to 80 to evaluate the changes in social isolation levels among older adults compared to pre-pandemic times and several years after the pandemic began. During the early stages of the pandemic, 56 percent of older adults experienced isolation; this figure dropped to 34 percent in 2023.

Although these figures demonstrate a decrease in social isolation, the rates have not yet returned to the pre-pandemic level of 27 percent seen in 2018.

Additionally, those with health problems or disabilities that limit daily activities were more likely to experience social isolation, 51 percent against 26 percent without such limitations.

“Three years into the COVID-19 pandemic, we see reason for hope, but also a real cause for concern,” Preeti Malani, MD, the poll’s senior advisor and former director, said in the press release.

“If anything, the pandemic has shown us just how important social interaction is for overall mental and physical health, and how much more attention we need to pay to this from a clinical, policy, and personal perspective,” said Malani, who is also a U-M Medical School infectious disease professor trained in geriatrics.

Moreover, about two in five older adults reported feeling a lack of companionship in the past year, compared to 41 percent in June 2020 and 34 percent in 2018.

Around 33 percent of older adults report infrequent social contact (once a week or less) with non-household family members, friends, or neighbors. This figure has dropped from 46 percent in 2020 but remains higher than the 28 percent observed in 2018.

The survey highlighted the significant mental health implications of social isolation, lack of companionship, and infrequent contact.

Feelings of isolation, occurring sometimes or often in the past year, were more common among individuals reporting fair or poor mental health, with 77 percent of this group experiencing isolation compared to 29 percent with better mental health. Likewise, 56 percent of individuals in the fair/poor mental health group reported limited social contact, as opposed to 30 percent in the better mental health group. Individuals who reported their mental health as fair or poor were twice as likely to also experience a lack of companionship.

While differences were less stark, there were still significant challenges among those who reported fair or poor physical health. Over half of older adults with poor physical health reported social isolation compared to 29 with better physical health. Fifty-five percent of those in the fair or poor health group experienced a lack of companionship, compared to 33 percent in the better health group. Similarly, 55 percent in the fair/poor group reported feelings of isolation versus 29 percent in the better group. Limited social contact was experienced by 56 percent in the fair/poor group compared to 29 percent in the better group.

“Loneliness and isolation were too high before the pandemic, and it will take a concerted effort to bring these rates down further,” said poll director Jeffrey Kullgren, MD, MPH, MS, an associate professor of internal medicine at Michigan Medicine and physician and researcher at the VA Ann Arbor Healthcare System.

“While we must always balance risk of infection with risk of isolation in older adults, we now know that a combination of vaccination, medication, testing, ventilation, and masking can protect even the most vulnerable and allow them to engage socially,” he added.

One effective strategy for combating social isolation is layperson phone calls. According to a JAMA Psychiatry study, empathetic calls from laypeople to high-risk individuals have successfully reduced feelings of loneliness.