Doctors ask about smoking, alcohol and exercise at almost every visit. Fewer ask who you talked to this week. The research of the past decade suggests they should, because social connection turns out to be closely tied to physical health, especially as people get older.

Loneliness and isolation are not the same thing

The National Institute on Aging draws a useful distinction. Loneliness is the distressing feeling of being alone or separated. Social isolation is having few people to interact with regularly. You can live alone and feel connected, and you can feel lonely in a full house or a busy community.

Both become more likely with age. The NIA points to hearing and vision loss, memory problems, trouble getting around, and the loss of family and friends. Retirement, the death of a spouse, caring for someone who is ill, and moving away from familiar people all play a part. Moving to Florida in retirement, or splitting the year between two homes, can mean starting over socially in one place or both.

What the research shows

In 2023 the U.S. Surgeon General issued an advisory on loneliness and isolation. Among its findings:

  • About one in two U.S. adults reported experiencing loneliness in recent years, even before the pandemic.
  • Loneliness and social isolation were linked to a 26 percent and 29 percent higher risk of premature death.
  • Poor social connection was associated with a 29 percent higher risk of heart disease and a 32 percent higher risk of stroke.
  • The advisory compared the mortality effect of social disconnection to smoking up to 15 cigarettes a day.

The NIA adds high blood pressure, weakened immune function, anxiety, depression, cognitive decline and dementia to the list of associated risks. People who are lonely or isolated also tend to have longer hospital stays and more readmissions.

These studies show associations, and the arrows run both ways: poor health can make people more isolated, and isolation can make health worse. Part of the link is behavior. The NIA notes that lonely people are more likely to exercise less, drink more, smoke and sleep poorly. Part may be biological, with long-term stress responses that promote inflammation.

Practical ways to rebuild connection

Connection is something you can work on, much like fitness. The NIA suggests starting small and choosing what suits you:

  • Schedule contact. A standing phone call, a weekly lunch, a regular video chat with grandchildren.
  • Join something with a rhythm. A walking group, a class, a faith community, a book club or a volunteer shift brings the same faces back each week.
  • Volunteer. The NIA links helping others with a sense of purpose and better health.
  • Combine movement and company. Exercising with a friend counts twice.
  • Learn the technology. Libraries and community centers often teach video calling and email.
  • Consider a pet, if you are able to care for one.
  • Introduce yourself to neighbors. Small, regular contact adds up.

For local programs, the federal Eldercare Locator, at 800-677-1116, connects older adults and families with Area Agencies on Aging and community services.

Fix what gets in the way

Sometimes the barrier is medical. Hearing loss is a common one: the NIA notes that people who cannot follow conversations may withdraw, and can even be mistaken for confused. Treating it can reopen a social life. Our article on hearing loss and memory explains why it matters. Poor vision, fear of falling, incontinence, chronic pain and depression can all keep people at home, and all can be addressed.

Other barriers are practical. The NIA lists lack of transportation, being unable to leave home without help, financial strain and language barriers among the risk factors for isolation. If giving up driving is on the horizon, it helps to plan rides, deliveries and regular visits before the keys are handed over.

If you feel lonely much of the time, tell your doctor. That is part of your health, and it often connects to sleep, mood, blood pressure and memory. If loneliness comes with persistent sadness or thoughts of self-harm, see our article on depression in older adults, and call or text 988 in a crisis.

At Legacy Medical, Dr. Shtern asks about the parts of life that affect health beyond lab numbers, and has the time to listen. For adult children watching a parent become more isolated, our page on care for families explains how she can help. The first visit is a complimentary meet and greet.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.