Who has higher rates of loneliness and isolation? Young adults or older adults, the answer may surprise you. Older adults actually have lower rates of loneliness and isolation than young adults, but the impact of loneliness and isolation on older adults. Is profound, which is why we pay so much attention to it if you're working with older adults.

A couple of years ago I was at a Gerontological Society of America conference and sat in on a session with researchers who study loneliness in Isolation. And what they shared was that even among folks living with dementia and their caregivers. Loneliness and isolation are different.

So caregivers, according to these researchers, tended to have higher rates of loneliness, whereas the person living with dementia had higher rates of isolation. And so what's the difference between loneliness and isolation and how harmful are they really?

So loneliness is the feeling of being alone regardless of how much social interaction you actually do have- it's a subjective feeling of feeling alone. I'm all alone with this, and this is why caregivers have higher rates of loneliness. Isolation, on the other hand, is an objective experience of having fewer social connections with people and fewer social contacts.

And so this makes sense why people with dementia who often lose friends when diagnosed with a dementia disorder have higher rates of social isolation

let's talk about the impact of loneliness and isolation on older adults.

According to a meta-analysis of more than 148 studies, totaling more than 300 participants, having social relationships increases a person's odds of living longer by 50% compared to those who have fewer or weaker social ties and the richer and more multifaceted, the relationships that you do have, the odds of living longer increased to 91%.

And so it's actually not about quantity of friendships, it's about quality of friendships and when people feel like they don't belong or have fewer social connections that are less meaningful, in that same meta-analysis, they found that isolation and loneliness in older adults is as risky as smoking and problem drinking, and even riskier than physical inactivity and obesity. And so with so much attention on physical exercise as it relates to aging well, which is important, physical exercise is key to aging well, we need to be paying attention to other important considerations like social connection.

And here's why it's so important that health providers and mental health providers are paying attention to this, is that we work with many older adults who maybe don't have access to physical activity. Maybe they have a chronic health condition that limits them from physical activity.

Maybe they have functional impairments that limit them from physical activity, or maybe they're in a food desert that limit them from adequate nutrition. Or food is more expensive now than we've experienced in recent years. Maybe they can't afford healthy nutrition - connection is free. It's affordable, it's available to us whether we can move our bodies with physical activity.

And so I love considering components like social connection and participation with others and deepening friendships as a way of promoting health and longevity. And so what happens when people don't experience connection and belonging?

Feeling like one doesn't belong is associated with a lack of meaning and purpose in life with increased physical health problems, increased mental health problems, and reduced longevity. In fact, loneliness and isolation has been correlated with increased rates of heart disease and stroke, and cognitive disorders, hypertension, depression, anxiety, obesity.

Even in a recent study that looked at more than 600,000 individuals with the meta-analysis, it was published in 2024, they found that loneliness increased the risk for dementia by 31%. So to break it down. It was vascular dementia by 17%, and Alzheimer's disease by 14%, totaling 31%, and cognitive impairment, like mild cognitive impairment by 12%. And so we need to be paying attention to how do we help connect older adults who are experiencing loneliness and isolation? Connect them so that. They get the best quality of life available to them because we know there are many benefits of belonging.

Like I'm gonna look at my screen and read this to you. For people who engage in frequent social activity with people that they care about in a place where they belong, the rate of cognitive decline with 70% less when measured over 12 years, seventy. 7-0% less. They were likely to live independently for longer, 43% less functional impairment.

And those with a greater sense of purpose, were less likely to be depressed, anxious, or have dementia.

And so what percentage of older adults actually experience loneliness and isolation? The National Academies of Sciences, engineering and Medicine, the division of Behavioral and Social Sciences and Education put out a report that found that 24% of American 65 and older who are living independently are considered to be socially isolated.

So about a quarter of older adults living independently and about 43% of adults, 60 and older, report being lonely.

I wanna also just say that the Lancet Commission that puts out a report every few years on what causes dementia. Things that cause dementia that can be modified, have identified social isolation as one of the 14 causes of dementia that we can modify. And it's not just these meta-analyses. Study after study, report after report are showing the negative impact of social isolation and loneliness.

So what can we do about it? The first thing we can do about it as healthcare and mental health professionals. Is of course to screen, are we even screening in the show notes, I'll put a link to two screening tools that can be helpful. Back to that national Academies of Sciences, engineering and Medicine.

They recommend that every adult in healthcare when they see their doctor. Over 50 get screened for loneliness and isolation. So then once we screen folks, if we identify loneliness and isolation, we can connect folks to resources where they might feel a sense of belonging.

There's a new buzzword that's on the scene called social prescribing. Maybe you've heard of it. It's simply like instead of a doctor giving a prescription for a medication, when they identify a physical health concern, I. When they identify loneliness or isolation, they essentially give a prescription for connection, and that's called social prescribing.

This means that we need to be screening and then connecting. We saw that what the benefits were earlier, that when people feel like they belong and are connected, the rates of illness, decrease the symptoms decrease mental health concerns, decrease longevity increases.

And so how do we do it? So we screen, and like I said, I have two screening tools for you. One that screens for loneliness, one that screens for isolation in the show notes, then we connect. And some places that you can connect are like

senior centers, walking groups, hiking groups, book clubs, your local library, all sorts of places you could call your area agency on aging and see what programs they're offering.

And one doctor in Madison, Minnesota when she screens for loneliness and isolation, she writes her patients a script, a prescription for a cup of coffee at a local coffee shop.

And the coffee shop is called Madison Mercantile because it's in Madison, Minnesota. And so what she does is she writes a script on a scrap piece of paper for a cup of coffee. The person takes the piece of paper to the coffee shop, they get a free cup of coffee or tea or whatever, and, and then there they can connect to a whole host of other programs. And in looking on their website at the Madison Mercantile, there's a list of programs. They have caregiver support groups, they have men's support groups, they have men's sheds, they have art groups, knitting groups, all sorts of activities that you could be a part of.

And so this is one of my favorite examples of social prescribing is that a doctor identifies loneliness and isolation and writes a script for it for connection. And so I love this quote that says, social prescribing is a way to connect a person to what matters to them instead of just treating what's the matter with them.

And so if you are working in healthcare or mental healthcare, please consider beyond exercise and nutrition. Of course, they're important. Encourage people to connect because that is equally important, if not more. And in the show notes also, I'll have a link to a list of recommended reading for addressing isolation and loneliness.

There are five books that I recommend that you can share with your older clients and consider social prescribing to your local senior center, to a local walking group. I live in a small town in Vermont and I get a weekly local newspaper for free in my mailbox that tells me the goings on around town.

And if I wanted to, if I had the time to, I could just easily pop into a meeting somewhere, like at the local library and connect with others easily. And it can be hard to get the momentum to do that, and there might be some barriers like transportation barriers for people that you're working with, but there are a myriad of other opportunities for them.

You have to get creative. Maybe it will be on Zoom or connecting with friends or joining a online book club or an online group, and that might be better than nothing. So check out the show notes for a lot of other resources. And share this episode with somebody who might need or benefit from it in their clinical work.

I'll see you next week. Bye for now.