By Dr Kathryn Mainstone, NCWQ Health Adviser
Social Isolation
That social isolation in old age significantly increases the risk of an early death has been accepted for some time e.g. a longitudinal study of ageing in the UK assessing the risk of death of 6,500 men and women aged 52 and older from 2004 to 2012, found that “socially isolated seniors have an increased risk of early death regardless of their health and demographic background, whereas the link between loneliness and early death exists only for participants with underlying mental or physical concerns Although both isolation and loneliness impair quality of life and well-being, efforts to reduce isolation are likely to be more relevant to mortality”.
Steptoe, A, Shankar, A, Demakakos,P and J Wardle (2013) Social isolation, loneliness, and mortality. Proceedings of the National Academy of Sciences Mar13, 201219686; DOI: 10.1073/pnas.1219686110; https://theconversation.com/social-isolation-trumps-loneliness-as-early-death-indicator-in-old-age-13069
Another study based on 6,123 women and 5,110 men aged 50+ from the English Longitudinal Study of Aging (ELSA) found that the association between social isolation and memory decline arises because social isolation is associated with increased memory decline rather than poor memory leading to increases in social isolation.
J Gerontol B Psychol Sci Soc Sci, 2020, Vol. 75, No. 2, 367–376 doi:10.1093/geronb/gbz152
A 2013 study, measuring cognitive function at two time points in a cohort of more than 6,000 older individuals taking part in the ELSA found people who reported having fewer social contacts and activities at the beginning of the study, showed greater decline in cognitive function, as measured by verbal fluency and memory recall tasks, after four years.
https://www.the-scientist.com/features/how-social-isolation-affects-the-brain-67701
However social isolation can have a detrimental effect not only on the elderly but all ages. The National Youth Mental Health Foundation surveyed 3,575 young people who received services at a headspace centre between 25th May and 5th June 2020 about the impact of COVID-19 on their current mental health and wellbeing. 74% reported that their mental health was worse since the outbreak of COVID-19 and gave several reasons including the loss of routine, social isolation, relationship issues, and anxiety over education / job or health concerns related to COVID-19. https://headspace.org.au/assets/Uploads/COVID-Client-Impact-Report-FINAL-11-8-20.pdf
For those who are experiencing social isolation, a doctor’s appointment may represent a unique opportunity to identify people who may be at risk and to start the process of intervention.
Recommendations
The following recommendations were made to a submission to the Inquiry into Social Isolation in Queensland, the Community Support and Services Committee of the Queensland Parliament:
That the Queensland Government:
- Promote education of GPs regarding the risks to the health of the elderly of loneliness and social isolation. Getting them to quickly screen for this using validated screens such as the Berkman-Syme Social Network Index and the UCLA Loneliness Scale would at least make them aware that this is a problem that needs addressing.
- Promote education of GPs regarding what resources in the community are available for them to refer the patients to. It appears that online resources are far more apparent in the US and the UK than they are in Australia. Perhaps this is one thing which the government could fund reasonably easily?
- Increase funding to mental health services across the state by approximately 50%.
Dr Kathryn Mainstone, NCWQ Health Advisor, MBBS(Qld), DRCOG,FRACGP
photo credit: https://theconversation.com/social-isolation-trumps-loneliness-as-early-death-indicator-in-old-age-13069
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