• Prevalence
• Risk Factors
• Health Impacts
• Interventions
• Social prescribing
• Barriers to addressing the problem
• Related links

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Loneliness is defined as the feeling of distress that arises when one perceives a gap between one's desires for social connection and actual experiences of it.

Social isolation refers to a lack of social contacts, having few people to interact with regularly, and the absence of mutually rewarding relationships.

Social isolation is typically recognized by others observing a person's relationships, whereas loneliness is a personal experience.

Prevalence in Canada

Here are some statistics from the 2023 Statistics Canada report titled "A Look at Loneliness Among Seniors":

• Research shows that an estimated 30% of Canadian seniors are at risk of becoming socially isolated.
• Nearly 25% of seniors reported barriers to social participation and loneliness.
• Senior women were more likely to report being lonely than senior men (23% versus 15%)
• Seniors who never married (29%) or were widowed (31%), separated, or divorced (32%) were over twice as likely to report being lonely as seniors who were married or in a common-law relationship (13%).
• Seniors in the lowest income group (25%) were likelier to report loneliness than those in the highest income group (15%).
• Seniors living in cities with 1 million or more people (21%) were likelier to report loneliness than those living in small towns with 1,000 people (17%).

Risk Factors

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Older adults are at higher risk for social isolation and loneliness due to:

• Advanced age
• Living alone
• Widowhood/divorce
• Small/shrinking social networks
• Low income/poverty
• Health issues (hearing, vision, memory loss)
• Inadequate transportation
• Having no children or contact with family

Health Impacts

A substantial amount of research indicates that social isolation and loneliness significantly affect older adults' longevity, physical health, mental health, and overall quality of life.

Isolation and loneliness can undermine an individual's sense of purpose, decrease self-esteem, and diminish their ability to engage in healthy lifestyle behaviors.

Social isolation and loneliness  are associated with higher risks for:

• High blood pressure & heart disease
• Obesity
• Anxiety & depression
• Cognitive decline, dementia, Alzheimer's

The impact of social isolation and loneliness on mortality is comparable to other well-known risk factors for mortality, such as smoking, obesity, and physical inactivity.

The increased risk of death from social isolation and loneliness is comparable to smoking 15 cigarettes a day or having an alcohol use disorder, according to a recent medical study.

Interventions

Principles to help older adults who are socially isolated and/or lonely (as per the CCSMA Clinical Guidelines)

1. Ensure that underlying medical conditions are treated.
2. Take an individualized approach with shared decision-making
3. Identify individuals' interests to determine interventions that may be the best fit
4. Take into account the cultural diversity within older adult populations

Specific interventions for social isolation and loneliness include:

• Befriending interventions (examples include older adult peer volunteering, peer groups, and neighborhood helping initiatives)
• Physical activity interventions (examples include group-based physical activity, physical and social interaction activity)
• Psychological therapies
• Animal-assisted therapies
• Leisure-skill development and leisure activities

Social prescribing

Social prescribing is a rapidly growing field in Canada. Healthcare professionals and social service providers collaborate to connect older adults with services that meet basic needs, support social and emotional well-being, and promote community belonging.

Social prescribing connects older adults with non-clinical supports and community resources to address their needs based on social determinants of health.

Social prescribing helps bridge the gap between what is needed and what is available, proactively promoting individual and community health and reducing the burden on the health care system.

Learn more about Social prescribing in Canada. (https://www.socialprescribing.ca)

Barriers to addressing the problem

Health Care Providers identified several barriers that impact their ability to address social isolation & loneliness:

• a lack of community resources
• insufficient funding to put appropriate interventions in place
• inadequate organizational and administrative support

Social isolation and loneliness among older adults are an increasing public health and policy concern that has become more prominent due to the COVID-19 pandemic. However, they can be reduced through interventions such as befriending, physical activity, cognitive and behavior therapy and promoting age-friendly communities.

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Sources:

Loneliness and Social Isolation — Tips for Staying Connected
https://www.nia.nih.gov/health/loneliness-and-social-isolation/loneliness-and-social-isolation-tips-staying-connected

Social isolation of seniors - Volume 1: Understanding the issue and finding solutions
https://www.canada.ca/en/employment-social-development/corporate/seniors-forum-federal-provincial-territorial/social-isolation-toolkit-vol1.html

Social Isolation and Loneliness
https://ccsmh.ca/areas-of-focus/social-isolation-and-loneliness/older-adults-and-care-partners/

Reducing social isolation and loneliness among older people
https://www.who.int/activities/reducing-social-isolation-and-loneliness-among-older-people

Social Isolation and Loneliness – Clinical Guidelines
https://ccsmh.ca/areas-of-focus/social-isolation-and-loneliness/clinical-guidelines/

From Patient Care to Human Connection: How Healthcare Practitioners Can Bridge the Loneliness Gap
https://ccsmh.ca/article-social-isolation-loneliness/

A look at loneliness among seniors
https://www.statcan.gc.ca/o1/en/plus/4881-look-loneliness-among-seniors

Editorial – Social prescribing in Canada: health promotion in action, 50 years after the Lalonde report
https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-44-no-6-2024/social-prescribing-canada-health-promotion-action-50-years-after-lalonde-report.html