Loneliness in the time of COVID‐19: Impact on older adults

Social isolation is defined as the objective state of having few social relationships or infrequent social contact with others, (National Academies of Sciences et al., 2020) while loneliness is a subjective feeling of being isolated (National Academies of Sciences et al., 2020). Loneliness has gained the recognition as a global phenomenon and its impact has worsened with the COVID-19 pandemic. Recently this recognition influenced Japan's appointment of a “Minister of Loneliness” following increasing rates of suicide. Loneliness was also recognized as a national issue in the United Kingdom, where they appointed a “Minister for Loneliness” in 2018. Social isolation and loneliness are serious yet underestimated public health risks that affect a significant portion of the older adult population. In the United States (U.S.), approximately one-quarter of community-dwelling older adults are considered to be socially isolated, and 43% of them report feeling lonely (Committee on the Assessment of Ongoing Efforts in the Treatment of Posttraumatic Stress et al., 2014). Social isolation and loneliness are major risk factors linked to poor physical and mental health status (Wu, 2020). Prior to the COVID-19 pandemic, loneliness and social isolation were acknowledged as public health issues linked to increased risk of morbidity and mortality. The effects of the COVID-19 pandemic have had an increasing negative effect on the number of older adults who are socially isolated and are a high-risk group for both COVID-19 and loneliness. The COVID-19 virus has shown worse outcomes and a higher mortality rate in older adults and those with comorbidities such as hypertension, cardiovascular disease, diabetes, chronic respiratory disease and chronic kidney disease (CKD) (Shahid et al., 2020). A significant percentage of older American adults have these chronic conditions, putting them at a higher risk of infection (Shahid et al., 2020). COVID-19 has also disproportionately affected older adults, including residents in nursing homes or long-term care facilities. Primary prevention especially for older persons with comorbidities is to practice social distancing, which can often translate to social isolation. For older persons, one of the negative outcomes of social isolation is loneliness. Loneliness can lead to depression, cognitive dysfunction, disability, cardiovascular disease and increased mortality rates (Morley however, treating the whole body, fully addressing their physical and mental health should be the way we approach care. What remains missing is a collaborative mental health approach to preserve their emotional well-being during this process. In considering these guidelines, there should be a multifaceted approach to preserve dignity, and reduce the negative health outcomes of loneliness and social isolation that will continue long after the COVID-19 pandemic. Editorials are opinion pieces. This piece has not been subject to peer review and the opinions expressed are those of the authors. None.