Few friends combined with loneliness linked to poor mental and physical health for elderly

Although not having many close friends contributes to poorer health for many older adults, those who also feel lonely face even greater health risks, research at the University of Chicago suggests. Older people who are able to adjust to being alone don't have the same health problems.

The study is the first to examine the relationships between health and two different types of isolation. Researchers measured the degree to which older adults are socially connected and socially active. They also assessed whether older adults feel lonely and whether they expect that friends and family would help them in times of need.

'Social disconnectedness is associated with worse physical health, regardless of whether it prompts feelings of loneliness or a perceived lack of social support,' said study co-author Linda Waite, the Lucy Flower Professor in Sociology at the University of Chicago and a leading expert on ageing.

However, the researchers found a different relationship between social isolation and mental health. 'The relationship between social disconnectedness and mental health appears to operate through feelings of loneliness and a perceived lack of social support,' Waite explained.

Older adults who feel most isolated report 65 percent more depressive symptoms than those who feel least isolated, regardless of their actual levels of connectedness. The consequences of poor mental health can be substantial, as deteriorating mental health also reduces people's willingness to exercise and may increase health-risk behaviours such as cigarette smoking and alcohol use, Waite explained.

Among the study's findings:

- The most socially connected older adults are three times as likely to report very good or excellent health compared to those who are least connected, regardless of whether they feel isolated.

- Older adults who feel least isolated are five times as likely to report very good or excellent health as those who feel most isolated, regardless of their actual level of social connectedness.

- Social disconnectedness is not related to mental health unless it brings feelings of loneliness and isolation.

Older adults who are able to withstand socially isolating circumstances or adjust their expectations so they do not develop strong feelings of loneliness may fare better, the study suggests. 'We need to better understand how older adults adapt to changes in their social relationships,' Waite added.

The work is reported in the article, 'Social Disconnectedness, Perceived Isolation and Health Among Older Adults,' published in the March issue of the Journal of Health and Social Behaviour, a quarterly journal of the American Sociological Association. Waite conducted the study with lead author Erin York Cornwell, a Postdoctoral Associate in Sociology at Cornell University who completed her Ph.D. in Sociology at Chicago in 2008.

For their research, the scholars examined the results of the National Social Life, Health and Ageing Project, a nationally representative study of older adults supported by the National Institute on Ageing. The study, a comprehensive look at ageing and health, included interviews with about 3,000 people aged 57 to 85 between 2005 and 2006.

Because of the size of the survey, the scholars were able to consider in detail older adults' social networks, their participation in social activities, their feelings of loneliness and their perceptions of the availability of help or advice from friends and family members. They also asked questions about physical health, mental health and feelings of sadness or depression.

The work should help policymakers develop programs to compensate for the problems brought on by social disconnectedness and loneliness among older people.

Ageing often brings changes in social relationships as individuals retire, take up new activities, endure losses and experience health changes, the authors said.

'For some older adults, a shrinking circle of friends and family can lead to feelings of loneliness or isolation. Our findings suggest that those who adapt to losses so that they don't feel isolated fare better with respect to both physical and mental health,' Cornwell explained.