Social Isolation and Loneliness During COVID-19

There has been a big concern over the effects of social isolation on older adults. The shelter in place mandate has been longstanding now, and even though the outside world is starting to reopen, there is significant risk for those over age 60. Will seniors come through this pandemic cognitively intact?

The Research

Social isolation and loneliness are not new social problems discovered during the COVID-19 pandemic. Research into the association of social isolation and loneliness have been ongoing for years. The objective of this research was to determine if these two social determinants affect cognition. Data from a Spanish representative study sample (n=1691, age 50 years or older) identified that cognitive decline remained a significant finding even after the exclusion of participants with depression.

There was a longitudinal study including 6,123 women and 5,110 men aged 50+ from the English Longitudinal Study of Aging. These participants were tested every two years from 2002 to investigate associations between social isolation and memory. The results were definitive – Social isolation and memory decreased over time. An important finding in this study determined that the association between social isolation and memory decline comes about because social isolation is associated with increased memory decline rather than poor memory leading to social isolation. This distinction is important.

The Effects of Loneliness and Isolation.

Louise Hawkley, PhD, a research scientist at the research organization NORC, at the University of Chicago, reviewed the effects of perceived social isolation across the lifespan. She stated that “loneliness can wreak havoc on an individual’s physical, mental, and cognitive health.” Health consequences of social isolation include depression, poor sleep quality, impaired executive function, accelerated cognitive decline, poor cardiovascular function and impaired immunity at every stage of life.

A 2015 study led by Steven Cole, MD, a professor of medicine at the University of California, Los Angeles, provides additional cues as to why loneliness can harm overall health. He and his colleagues examined gene expressions in leukocytes (white blood cells that play key roles in the immune system’s response to infection). They found that the leukocytes of lonely participants showed an increased expression of genes involved in inflammation and decreased expression of genes involved in antiviral responses. Loneliness, it seems, can lead to long-term ‘fight-or-flight’ stress signaling, which negatively affects immune system functioning. Simply put, people who feel lonely have less immunity and more inflammation than people who don’t. (https://www.apa.org)

The Onslaught of COVID-19

Research studies have been going on for years that determined that social isolation and loneliness definitely contributed to cognitive decline. At least this isn’t something that has to be investigated with this pandemic. The effects are clear and they are grim. We already had a generation of older adults living independently who were experiencing loneliness. They were told to shelter in place because the risk of them getting coronavirus was high. But social isolation already accounts for elevated blood pressure, morning spikes in cortisol levels (stress hormone), and disrupted sleep. As a result, the long-term view indicates that social isolation may well impose increased mortality risks on society’s most-at-risk populations for mortality from cancer and cardiovascular disease, as well as, COVID-19.

This current period of self-isolation will overly impact the older population, whose prior social contacts occurred primarily at community centers or places of worship. My Mom loved going to the Senior Center. They had dinners, movies, group outings and trips all organized from the center. All of that is gone. She will finally get to attend her church next week and she is relieved that it will be open to worshippers. That has been the only thing she has mentioned that she misses a lot. It has been a difficult few months for her. But I have a number of siblings that are calling and visiting to make sure she doesn’t get lonely. She does miss her friends. They do talk on the phone everyday but they are all bored and have little to talk about. There isn’t much conversation about adults older than 80. I don’t think most people take into account that they had busy social lives. Now all of that is gone with no answers as to when it will be safe for them to get out and have some fun again.

What Happens Now?

Geriatric social workers have been some of the unsung heroes of this pandemic. They are working with frail seniors in nursing facilities – all confined to their rooms throughout this entire shelter-in-place order. They have taught these seniors how to use technology – FaceTime and Zoom call so that they can see their families. Modifying exercise so that it can be with social distancing in mind. This is such a vulnerable, high-risk group and they have suffered high mortality rates.

There has been an ugly expression of ageism throughout COVID-19. Ageism has been front and center as the pandemic started spreading. There was relief that older adults would be the most vulnerable and there was a collective sigh of relief from younger people. There was even the suggestion that older adults sacrifice themselves for economic relief for younger people. But now everyone has had the experience of social isolation. There is a better understanding of what it feels like to be lonely. Hopefully, that will result in better strategies and approaches to address social isolation and loneliness.

The research done years before the COVID-19 crisis greatly detailed the effects of social isolation and loneliness. COVID-19 gave everyone the experience of being isolated and alone. Will the post-COVID-19 world focus more attention on social isolation and loneliness for all ages?

References:

Berg-Weger,M. & Morley,J.E. (April 14, 2020). Loneliness and social isolation in older adults during the COVID-19 pandemic: implications for gerontological social work. J Nutr Health Aging. 2020 Apr 14: 1-3. Retrieved from https://www.ncbi.nim.nih.gov/pmc/articles/PMC7156792/

Douglas,Y. (April 29, 2020). The costs of social isolation: loneliness and COVID-19. Retrieved from https://www.psychiatryadvisor.com/home/topics/general-psychiatry/costs-of-social-isolation-loneliness-covid19/

Novotney, A. (May 2019). The risks of social isolation. American Psychological Association, Vol 50, No.5. Retrieved from https://www.apa.org

Read,S., Comas-Herrera,A., Grundy,E. (November 29, 2019). Social isolation and memory decline in later-life. The Journals of Gerontology: Series B, Volume 75, Issue 2. February 2020, pages 367-376. Retrieved from https://academic.oup.com/psychsocgerontology/article/75/2/367/5645554