Loneliness, along with depressive symptoms, are related to worsening cognition over time. A systematic review of suicide risk also found that loneliness is associated with both suicide attempts and completed suicide among older adults (Fässberg et al., 2012). Increased depressive symptomatology may also be caused by loneliness, along with poor self-rated health, impaired functional status, vision deficits, and a perceived negative change in the quality of one’s life (Lee et al., 2019). Reduced time in bed spent asleep (7% reduced sleep efficiency) and increased wake time after sleep onset have been related to loneliness (Cacioppo et al., 2002 Fässberg et al., 2012). Furthermore, research has shown that both loneliness and social isolation are independent risk factors for higher all-cause mortality (Yu et al., 2020).īeing lonely has several adverse impacts on mental health.
Both loneliness and social isolation have been associated with an increased risk for coronary artery disease-associated death, even in middle-aged adults without a prior history of myocardial infarction (Heffner et al., 2011 Steptoe et al., 2013). Loneliness is associated with various physical and mental repercussions, including elevated systolic blood pressure and increased risk for heart disease. The present position paper aims to describe the nature of loneliness and social isolation among older persons, its effect on their health, and ways to cope with loneliness and social isolation during the COVID-19 pandemic. While robust social restrictions are necessary to prevent spread of COVID-19, it is of critical importance to bear in mind that social distancing should not equate to social disconnection. Older adults are also more vulnerable to social isolation and loneliness as they are functionally very dependent on family members or supports by community services. The impact may be disproportionately amplified in those with pre-existing mental illness, who are often suffering from loneliness and social isolation prior to the enhanced distancing from others imposed by the COVID-19 pandemic public health measures. However, there is a high cost associated with the essential quarantine and social distancing interventions for COVID-19, especially in older adults, who have experienced an acute, severe sense of social isolation and loneliness with potentially serious mental and physical health consequences. This compares with CFR of 0.0026%–0.3% in those under age 45.
According to the Centre for Evidence-Based Medicine, the case fatality rate (CFR) is about 4% for patients over 60 years old, 8% for patients over age 70 years, and approximately 15% for patients over the age of 80 (Oxford COVID-19 Evidence Service, 2020). The risk of COVID-19 infection is greater for older adults over the age of 60 years who are at a heightened risk of severe illness, hospitalization, intensive care unit admission, and death (US CDC, 2020). In addition to quarantine and isolation procedures for those who have been exposed to or infected with COVID-19, social distancing has been enforced amongst the general population to reduce the transmission of COVID-19.
The COVID-19 pandemic has led to implementation of unprecedented “social distancing” strategies crucial to limiting the spread of the virus.
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