Research links isolation in old age to negative health outcomes

For many, keeping up with a brimming email inbox has become a chore. But for older adults, access to tools such as email and texting may help them stay socially engaged and reduce their chances of developing dementia. Or so suggests a pair of recent studies examining social isolation in older adults.

Such research is timely given our graying population. Today, more than 1 in 6 Americans is age 65 or older, and as that segment of the population continues to grow, that number is on track to increase to 1 in 5 by 2040. Meanwhile, the National Institute on Aging estimates that a quarter of older adults are experiencing social isolation, defined as having a lack of social contacts and few people with whom to interact regularly.

Research has linked social isolation among older adults with numerous negative health outcomes, including heart disease, obesity, and depression. Dementia is also on this list, and a recent study in the Journal of the American Geriatrics Society makes perhaps the strongest case yet for a connection.

The study utilized data from the more than 5,000 Medicare beneficiaries enrolled in the National Health and Aging Trends Study, a longitudinal project launched in 2011. Participants, all of whom were living independently and not in nursing homes, were interviewed each year to gather information about their daily lives, health, and well-being.

Several of the questions could be used to determine whether a participant was socially isolated, such as if they lived with anyone, how often they reported having discussions about "important matters" with others, and whether they attended religious services or engaged in social activities such as clubs, meetings, or volunteering.

Researchers' analysis determined that in 2011, 23% of participants were socially isolated but lacked signs of dementia. By 2020, over 20% of this subset had developed dementia. "Social isolation was associated with a 28% higher risk of dementia" over the nine-year study period, says lead author Alison Huang, a senior researcher at the Johns Hopkins Bloomberg School of Public Health. Notably, she adds, the study's sample was more nationally representative than many of those done in the past, which have been limited to older adults from specific geographic areas or age groups.

Why social isolation increases the risk of dementia is less understood, though people who are socially isolated are more likely to engage in unhealthy behaviors, such as being sedentary, having poor diets, or smoking—all of which have been shown to increase the risk for dementia. It also might come down to the simple mental stimulation that comes from interacting with others.

"If you're more socially isolated, you're not getting as much cognitive engagement through talking to people or being involved in activities," Huang says. "This reduced engagement can also lead to the cognitive decline we see in dementia."

As for possible interventions? That's where email might come in. Another study recently published in the Journal of the American Geriatrics Society also utilized the National Health and Aging Trends Study. Only this time, after determining which participants were socially isolated, researchers homed in on data relating to access to technology: whether they had a cellphone or computer, and whether they used email or texting.

Focusing on data from 2015, the researchers found that most participants who were not socially isolated reported having access to technology: 88% had a cellphone, 71% a computer, and 56% used email or text messaging. From 2015 to 2019, the older adults who had access to such technology consistently showed a 31% lower risk for social isolation than those in the study who were not as plugged in.

The simple technologies studied are a stark contrast to the sophisticated artificial intelligence–powered robots some tech companies are developing to offer companionship to isolated older adults. Take, for example, Israel-based Intuition Robotics' AI companion ElliQ—billed as "the sidekick for healthier, happier aging"—or Buddy from France's Blue Frog Robotics, an "emotional companion" robot designed to combat feelings of isolation and loneliness in its users.

"The reason people are designing these sophisticated AI robots is because we really know how impactful social isolation can be in terms of adverse health effects," says Mfon Umoh, a postdoctoral fellow in geriatric medicine at the School of Medicine and the lead author of the second study. But "our findings indicate that maybe our interventions don't have to be these grand-scale or costly initiatives. Just ensuring that older adults have access to very basic technology may be a protective factor against social isolation."