A Look at Loneliness—And Steps to Prevent It

Published In Mental Health & Well-Being

Everyone feels lonely sometimes. But when the feeling persists as a chronic or acute state of being, it can easily morph into clinical depression and suicidal ideation—especially among older people.

From poets to professors, many have tried to describe and define loneliness. Harry Stack Sullivan, a 20th century psychiatrist whose studies focused on interpersonal relationships, deemed it “the worst emotional experience imaginable.” Author and educator Irvin Yalom calls it “one of the great dreads of our time.” And sociologist professor Robert Weiss, in his book, Loneliness: The Experience of Emotional and Social Isolation, described it as “a gnawing chronic disease without redeeming features.”

Even those who are less alarmist agree that the feeling of longing and emptiness caused by the lack of emotional attachment or social ties, left untended, can have serious consequences.

How It Hurts

While the feeling of loneliness is subjective and somewhat hard to capture, its physical and psychological perils have recently been studied and found to be universal and profound.

A few examples:

  • A Dutch study following more than 2,000 healthy seniors found that those who suffered from loneliness had a 64% greater risk of developing dementia.
  • Assessing the outcomes of coronary disease, Swedish researchers discovered that coronary bypass patients who checked the box “I feel lonely” had a mortality rate 2.5 times higher than other patients 30 days after surgery—and even five years later, they were twice as likely to have died.
  • Research at the University of California, San Francisco found that within six years, nearly a quarter of the group of older adults who had reported feeling isolated or lonely had died; another 25% had suffered significant health declines. Among those who said they were satisfied with their social lives, only 12.5% had declining health, and only 14.2% had died.
  • A 2023 82-page advisory report from the US Surgeon General highlights the epidemic of loneliness, isolation, and disconnection on roughly half of U.S. adults. The Surgeon General wrote: “it [Loneliness] harms both individual and societal health. It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death.”
  •  A report from the National Academies of Sciences, Engineering, and Medicine (NASEM) found that more than one-third of adults aged 45 and older feel lonely, and nearly one quarter of adults aged 65 and older are considered to be socially isolated. Social isolation was associated with about a 50% increased risk of dementia.

Beyond dementia and death, there are other documented hazards of loneliness. Over the past couple decades, social neuroscientist John Cacioppo and his colleagues have focused on studying its effects on humans, young and old. In the book Loneliness: Human Nature and the Need for Social Connection, Cacioppo and co-author William Patrick summarize five ways and reasons loneliness can contribute to poor health and unhappiness. In brief, they found:

  1. Loneliness weakens willpower and perseverance over time, making it harder for people to regulate themselves, which leads to self-destructive habits, such as overeating and overuse of drugs and alcohol.
  2. People who are lonely exhibit higher activity in the region of the nervous system that is especially sensitive to social stress.
  3. Lonely people are more likely to withdraw from engaging with others and less likely to seek emotional support, which makes them more isolated.
  4. Several studies have shown that loneliness affects both the immune and cardiovascular system.
  5. Lonely people often experience difficulties sleeping, and sleep deprivation is known to have negative effects on metabolic, neural and hormonal regulation.

Alone v. Lonely

While many people confuse loneliness and being alone, the two are vastly different; some people simply prefer solitude. Patrick Arbore, Director and Founder of the Center for Elderly Suicide Prevention & Grief Related Services at San Francisco’s Institute on Aging uses himself as a prime example: “I’m 68 and I live alone and I choose that,” he says. “My body doesn’t get revived by going out to dinner with eight friends.”

In a recent workshop titled “Loneliness: The Hidden Risk in Older Adults,” Arbore clarified the difference to the capacity crowd: “During times when you are experiencing yourself as fragmented or incomplete or ‘invisible’ to those around you, and when that feeling is accompanied by self-doubt, then you are likely to experience being alone—not as solitude—but as loneliness.”

A 2012 study by University of California-San Francisco researchers bearing the doomsday title Loneliness in Older Persons: A Predictor of Functional Decline and Death documented the somewhat surprising disconnect between togetherness and loneliness. In a group of 1,600 people age 60 and older, 43% reported they feel lonely “on a regular basis.” And two-thirds of those who said they were lonely were married or living with at least one other person.

University of Arizona researchers in a 2023 report on its study of 426 adults, ranging from 24 to 90 years old, addressed the association between self-reported loneliness and objective social isolation. The researchers found: “Older single adults were the most likely to spend time alone. Regarding loneliness, as partnered people get older, they get less lonely. There is a robust but small association between time spent alone and loneliness. Finally, age moderates the association between time spent alone and loneliness. As people get older, spending time alone is more highly associated with feelings of loneliness.”

But even among those who, like Greta Garbo’s memorable downtrodden Russian dancer in the 1932 film “Grand Hotel,” profess that they want to be alone, the feeling of loneliness might act as a prod to honor the urge to connect to others that seems hardwired into humans.

Ways to Combat Loneliness

While it may feel counterintuitive to urge taking action when hampered by feelings of loneliness, it’s getting interesting and interested that restores hope. A number of tangible tips may help older people who are homebound or just need some extra inspiration to help break themselves out of isolation.

Seek out connections. While many lonely older people lament the deaths and distances of former friends and family members, there are a number of ways to replace and replenish human connections. Many churches, community centers, and nonprofit groups now run “friendly visitor” programs pairing seniors with volunteers who will visit them regularly. To find out whether such a program exists in your community, consult the local Eldercare Locator, a division of the Administration for Community Living.

Pick up the phone. All across the country, there are warmlines and hotlines staffed with individuals trained to connect callers to specific local resources, intervene in a crisis, or just offer some moments of engaged conversation. One in particular, The Friendship Line (888-670-1360), focuses on providing help and camaraderie, specifically for those who are age 60 and older.

Fill in the blanks. Take a hard look at whether underlying issues—such as practical challenges with transportation or physical problems with hearing and seeing—are at the heart of a senior’s isolation, and act on them.

Get up and move. Studies and empirical evidence abound about the benefits physical exercise has on the psyche. Learning something new, such as yoga, kayaking, or a particular style of dance, can even help improve brain functioning. And taking a class with other learners packs the additional obvious benefit of being in a room of people, some of whom might become friends.

Pursue a passion. Bibliophiles might discover new fodder and like-minded individuals at the book club offered by a local library or bookstore. Others might find that same comfort and camaraderie in a mini-medical school class at a nearby hospital, or a cooking class at a kitchen store, or a bible study group through a church.

Get a pet. Pets are proven therapy and good company for people of any age and stage, but may be especially helpful for older people. Grooming and caring for them can provide a sense of purpose to the days. And dogs on walks often catch the attention—and the conversation—of passersby.

Tune in to technology. While some experts warn that over-reliance on technology such as computers and cell phones can actually cause more isolation, for some people it provides a lifeline to friends and family members. They may reconnect with long lost acquaintances through Facebook, keep in touch with distant grandchildren by learning to text, video calling on Zoom, or keep tabs on far-flung friends through Skype, Whats App, or start writing a blog through Blogger.

Become a volunteer. Most older people have mastered skills through life or former work experiences they can teach to others, or they may be beckoned by the simple good services provided by shelters for homeless or abused individuals, food distribution centers, or peer counseling groups. Volunteering not only benefits others in need, but also provides some structured time to a day or week, relieves isolation, and adds to a sense of personal self-worth and satisfaction.

(This article was updated since it originally published on October, 2016.)

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