Title: Factors impacting the aging population: Loneliness (2/4)

By: Vrati M. Mehra

Canadians aged 65 years and older make up approximately 20% of the population as of 2023 (Older Adults and Population Aging Statistics, n.d.).Older adults are part of the fastest-growing age group in Canada (Older Adults and Population Aging Statistics, n.d.). The COVID-19 pandemic brought attention to the low quality of care and attention provided to older individuals in our society. Insufficient focus on addressing the unique challenges facing older individuals led to distressing conditions in nursing homes and assisted living facilities. Many found themselves isolated in cramped quarters, devoid of meaningful human interaction, and tragically, some passed away without the comfort of seeing their loved ones, owing to stringent visitor regulations. Moreover, the pandemic underscored the vulnerability of older adults to instances of abuse and neglect, particularly within institutional settings characterized by insufficient oversight and accountability.

As longevity becomes increasingly common, the inevitability of aging becomes more apparent. It affects not only those we cherish but also stands as a shared future experience for most of us. Consequently, there arises a pressing need to invest in comprehensive, long-term strategies that prioritize the integration of older individuals within their communities, safeguarding their dignity and well-being.

Central to implementing such solutions is fostering awareness and understanding of the multifaceted challenges faced by older adults. As such, in the coming weeks, this series will identify one factor impacting this group each week and propose potential solutions for these issues.

What is loneliness?

Often confused with social isolation, which is defined as a measurable deficiency in the number of social relations a person has, loneliness is different and is defined as an internal subjective experience when a person’s social relationships fall short in either quality or quantity compared to what they desire (Courtin & Knapp, 2017).

Prevalence and factors associated with loneliness

Loneliness has risen among all age groups, especially among younger individuals. However, nearly one in five Canadians reported feelings of loneliness in 2019 and 2020. Rates of loneliness were higher among older women when compared to older men (23% versus 15%) (Islam & Gilmour, 2023). Sadly, one in every four individuals aged 65 years or older wanted to participate more in social, recreational, or group activities but reported that they experienced barriers to social participation. In a national survey administered by the National Institute of Aging at the Toronto Metropolitan University, it was found that 41% of Canadians aged 50 years and older are at risk of social isolation and up to 58% have experienced loneliness (Bull et al., 2023).

The survey also highlighted that the presence of close family ties with children and partners is important in protecting against social isolation and loneliness among older Canadians. Those with higher education, better financial security, and those who were working were less likely to report social isolation and loneliness.

Loneliness experienced by women

Rates of loneliness have been reported to be higher among older women when compared to older men (23% versus 15%) (Islam & Gilmour, 2023).  Women have also been found to stay longer in abusive relationships due to fear of being lonely (Zink et al., 2003). In a study focusing on immigrant women who relocated from India to Canada, researchers delved into the influence of beliefs, values, and cultural factors in mitigating stress during the resettlement journey of older South Asian women (Choudhry, 2001). Among the key findings, a prominent theme emerged, highlighting experiences of social isolation and loneliness. Many participants expressed profound feelings of loneliness since their arrival in Canada.

Loneliness and its association with health 

The influence of loneliness on health is complex. However, the absence of standardized measurement scales has limited extensive research and our understanding of the relationship between loneliness, social isolation, and health.

Nevertheless, particularly following the COVID-19 pandemic, there has been growing acknowledgment of loneliness and social isolation as significant public health issues. The World Health Organization now recognizes loneliness as a crucial social determinant of health, emphasizing the importance of meaningful and high-quality social interactions for our mental, physical, and overall well-being (Social Isolation and Loneliness, n.d.). 

Research findings indicate that loneliness is linked with conditions like high blood pressure, regardless of age, gender, or other cardiac risk factors (Hawkley et al., 2010). It is also associated with an increased risk of depression (Domènech-Abella et al., 2017) and dementia including Alzheimer’s disease (Sundström et al., 2020). People reporting loneliness are also more likely to have reduced everyday physical activity (Schrempft et al., 2019) and worse quality and quantity of sleep (Shankar, 2020). 

Potential solutions

Community initiatives: Senior-friendly community programming that is affordable and accessible can help increase social connectivity among older individuals. For those residing in nursing homes and assisted living facilities, playful group activities aimed at increasing social connections and experience of joy with other residents and caregivers can not only help reduce levels of loneliness but also help improve cognition and physical activity levels. It can also reduce burnout among caregivers (Robison et al., 2007). These can all positively affect the health and wellness of all people involved. 

Creating spaces to bring people of diverse age groups together: Recent Canadian surveys show that younger individuals, especially young girls, have some of the highest rates of loneliness in the country (The Daily — Canadian Social Survey: Loneliness in Canada, 2021). Creating opportunities in schools, community centres, and other social places for younger individuals to interact with older individuals can help both groups learn from one another and support each other in feeling less isolated. Examples from around the world where similar programs exist show that older individuals enjoy their involvement with young students (Spiteri, 2016). 

Technology and digital literacy: Teaching seniors how to use technology such as smartphones, tablets, and social media to stay connected with family and friends can help them stay connected to their loved ones, especially when it is not possible to meet them in person. 

Creating volunteer and paid opportunities for seniors: Involving seniors in meaningful engagements, whether volunteer or paid, promotes dignity, combats loneliness, and contributes to societal well-being (Moore et al., 2021).

Home visits and outreach: Building programs that provide regular visits or check-ins from family members, friends, or even volunteers to provide companionship and prevent feelings of isolation (Gough, 1996; Keller et al., 1988).

References

Bull, A., Iciaszczyk, N., & Sinha, S. K. (2023). Understanding the Factors Driving the Epidemic of Social Isolation and Loneliness among Older Canadians.

Choudhry, U. K. (2001). Uprooting and Resettlement Experiences of South Asian Immigrant Women. Http://Dx.Doi.Org/10.1177/019394590102300405, 23(4), 376–393. https://doi.org/10.1177/019394590102300405

Courtin, E., & Knapp, M. (2017). Social isolation, loneliness and health in old age: a scoping review. Health & Social Care in the Community, 25(3), 799–812. https://doi.org/10.1111/HSC.12311

Domènech-Abella, J., Lara, E., Rubio-Valera, M., Olaya, B., Moneta, M. V., Rico-Uribe, L. A., Ayuso-Mateos, J. L., Mundó, J., & Haro, J. M. (2017). Loneliness and depression in the elderly: the role of social network. Social Psychiatry and Psychiatric Epidemiology, 52(4), 381–390. https://doi.org/10.1007/S00127-017-1339-3/FIGURES/2

Gough, K. (1996). Outreach for Seniors: Understanding How Museum Outreach Can Impact the Social Well-Being of Seniors Living in Care Facilities in British Columbia. The University of Lethbridge.

Hawkley, L. C., Thisted, R. A., Masi, C. M., & Cacioppo, J. T. (2010). Loneliness Predicts Increased Blood Pressure: 5-Year Cross-Lagged Analyses in Middle-Aged and Older Adults. Psychology and Aging, 25(1), 132–142. https://doi.org/10.1037/A0017805

Islam, M. K., & Gilmour, H. (2023). Immigrant status and loneliness among older Canadians. Health Reports, 34(7), 3–18. https://doi.org/10.25318/82-003-X202300700001-ENG

Keller, K. L., Flatten, E. K., & Wilhite, B. C. (1988). Friendly visiting as a means of informing homebound senior citizens of health-related community services. Journal of Community Health, 13(4), 231–240. https://doi.org/10.1007/BF01324235/METRICS

Moore, A., Motagh, S., Sadeghirad, B., Begum, H., Riva, J. J., Gaber, J., & Dolovich, L. (2021). Volunteer Impact on Health-Related Outcomes for Seniors: a Systematic Review And Meta-Analysis. Canadian Geriatrics Journal, 24(1), 44. https://doi.org/10.5770/CGJ.24.434

Robison, J., Curry, L., Gruman, C., Porter, M., Henderson, C. R., & Pillemer, K. (2007). Partners in Caregiving in a Special Care Environment: Cooperative Communication Between Staff and Families on Dementia Units. The Gerontologist, 47(4), 504–515. https://doi.org/10.1093/GERONT/47.4.504

Schrempft, S., Jackowska, M., Hamer, M., & Steptoe, A. (2019). Associations between social isolation, loneliness, and objective physical activity in older men and women. BMC Public Health, 19(1), 1–10. https://doi.org/10.1186/S12889-019-6424-Y/TABLES/3

Shankar, A. (2020). Loneliness and sleep in older adults. Social Psychiatry and Psychiatric Epidemiology, 55(2), 269–272. https://doi.org/10.1007/S00127-019-01805-8/TABLES/1

Social Isolation and Loneliness. (n.d.). WHO Commission on Social Connection. Retrieved May 15, 2024, from https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-ageing/social-isolation-and-loneliness

Spiteri, D. (2016). What do older people learn from young people? Intergenerational learning in ‘day centre’ community settings in Malta. International Journal of Lifelong Education, 35(3), 235–253. https://doi.org/10.1080/02601370.2015.1132278

Sundström, A., Adolfsson, A. N., Nordin, M., & Adolfsson, R. (2020). Loneliness Increases the Risk of All-Cause Dementia and Alzheimer’s Disease. The Journals of Gerontology: Series B, 75(5), 919–926. https://doi.org/10.1093/GERONB/GBZ139

The Daily — Canadian Social Survey: Loneliness in Canada. (2021, November 24). Statistics Canada. https://www150.statcan.gc.ca/n1/daily-quotidien/211124/dq211124e-eng.htm

Zink, T., Regan, S., Jacobson, C. J., & Pabst, S. (2003). Cohort, Period, and Aging Effects. Http://Dx.Doi.Org/10.1177/1077801203259231, 9(12), 1429–1441. https://doi.org/10.1177/1077801203259231