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Social isolation, the lack of a social life, is growing continually every year in older people. Social isolation is the cause of many health problems.

Definition

Social isolation is generally defined as the absence of contact with other people. It is a key factor when looking at the influence of the social environment on people’s quality of life. Social isolation affects a significant proportion of older people and is associated with poor health outcomes.

History

The amount of older people in the society has increased in recent decades. It is estimated that approximately 25% of the population will be age 60 or older within the next 20 to 40 years. As the percentage of older people in the population increases, more are at risk of social isolation. Research in the United Kingdom shows that between 11% and 17% of people over the age of 65 suffer from social isolation. Research indicates that approximately one-third of older people over the age of 65 years report loneliness, with even higher rates among those aged over 85; however, findings indicate that some of the people experience loneliness that they feel they are able to manage. They experience a fluctuating loneliness that was linked to feeling valuable and having power and energy. Loneliness has also been described as being agonizing. People who feel this type of loneliness experience a present and extensive loneliness, together with feeling less valuable and lacking in power and initiative. They seemed trapped in their loneliness, and unable to overcome their situation themselves. Loneliness for some older people can become so severe that they urgently need help to manage their situation.

Causes

There are many causes that may contribute to social isolation in the elderly. For example, older people may lack access to private transportation. This in turn would cause minimal or no contact with friends and family. The lack of a partner also may be a cause for social isolation. Death or separation from a loved one causes loneliness and the lack of ability to associate with other people. There are thought to be specific events in life that may cause social isolation in older lives; For example, retirement is one event that is thought to play a role. Another specific event may be moving into an elderly home. Many older people claim that they have no say when brought to the home. If moved to an elderly home it is important that the elderly have visitors come to visit them and remain a social life with others around them. Removing themselves from society and from their normal lives can greatly affect someone. Certain factors such as age, gender, marital and socio-economic status also seem to play an important role in social isolation. The higher vulnerability to negative social circumstances may affect the social status of elderly people, as well as is a health risk factor for malnutrition, hospitalization and cognitive decline. Indeed, being widowed, living alone in later stage of life, and grieving for a loved one have also been identified as potential risk factors and are in turn significantly associated with serious adverse effects, including depression, anxiety, cognitive decline, functional limitations, and poorer quality of life.

Causes	Prevention	Effects
Age, Gender, Widowhood, Living alone, Poor economic status	Social engagement, Social support, Good quality of life	Worse health, Mortality, Increase in comorbidities, Disability, Functional limitations and frailty, Poor self-perceived health status, Malnutrition, Cognitive Decline, Hospitalization, Depression, Anxiety, Poorer quality of life

Effects

Elderly people are particularly vulnerable to the effects of social reduction, so there is an urgent need to identify the risks associated with social isolation. A social life is vital in a person's life. There are many negative consequences of social isolation on the health and well-being of older people. For example, social isolation is associated with increased mortality, poor self-rated physical health, and increased susceptibility to dementia. There is some evidence that social isolation leads to a greater risk of coronary heart disease. In a study done by Roger Patulney, it was found that isolation in older people is associated with heart disease leading to death, and higher levels of C-reactive protein.

Controls

There have been many steps taken to control social isolation in older people. Two examples of where we have attempted to control the effects of isolation in the elderly are educational and social activity groups for older people and telephone befriending. Social activity groups allow individuals to be able to interact with one another. Through the activity groups, the elderly are able to gain a group of friends and be able to talk with other individuals. Telephone befriending, is a way for the elderly to also associate with other people. Telephone befriending is great in that it is low cost, helps isolated older people gain confidence, develop self-respect, gain a sense of security, and re-engage with the community. Sharing a household with a partner (or other relative/person) in old age also reduces the risk of social isolation, as partners and family living in the household are great sources of support; however, relationships with family and friends who live outside the household are also important. Contact with family and friends outside the household provides additional support beyond that available in the household. These relationships also provide support for times when relationships inside the household are under strain. Examples of this would be the separation or death of a spouse.

Differences among countries

It has been proven that there are some differences among countries in how many elderly people are vulnerable to social isolation. In a study done by Fokkema T, De Jong Gierveld J, and Dykstra PA, surveys from Austria, Belgium, the Czech Republic, Denmark, France, Germany, Greece, Ireland, Italy, the Netherlands, Poland, Spain, Sweden, and Switzerland, were taken. Loneliness was measured by a single item derived from the CES-D (depression) scale. Their findings were that older adults in the southern and central European countries were generally lonelier than their peers in the northern and western European countries. In the southern and central European countries, loneliness was attributed to not being married, economic deprivation, and poor health. Preventions, however, were the same in all countries. Frequent contacts with parents and adult or children, social participation, and providing support to family members, were shown to all be important in preventing loneliness. Thus, it is important to remember two things while combatting loneliness among the elderly: 1) generic approaches aimed at improving social embededness; and 2) country-tailored approaches aimed at improving health and wealth.