Understanding
Loneliness and
Social Isolation
How to Stay Connected
From the National Institute on Aging at NIH
Table of Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
What are Loneliness and Social Isolation? . . . . . . . . 5
How Can Being Isolated or Feeling Lonely
Affect a Person’s Health? . . . . . . . . . . . . . . . . . . . . . . . . . 8
How Do I Know if I Am at Risk? . . . . . . . . . . . . . . . . . . 13
What Can I Do To Stay Connected? . . . . . . . . . . . . . . 19
For More Information . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Words To Know . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Use the Table of Contents to help you find things
quickly. Page 24 has a list of resources for more
information about loneliness and social isolation.
We also put some medical terms in bold, such as
inflammation. You can find how to say these words
and what they mean in the “Words To Know”
section on page 30.
Introduction
As people age, they often find themselves spending more
time alone. This can affect your health and well-being.
Everyone needs social connections to survive and thrive.
This booklet will help you learn about
loneliness and social isolation:
• What they are
• Health effects
• Risk factors
• How to stay connected if you or someone you love
is isolated or feeling lonely
3
Marvin’s Story
After working 35 years as a teacher, Marvin looked
forward to an active retirement with his wife, Sandra. For
many years, they enjoyed traveling, spending time with
their grandchildren, and socializing with friends. Then
Sandra developed breast cancer and passed away. Marvin
had a difficult time coping with her death and didn’t feel
like socializing with their friends or going out to do
things on his own.
4
What Are Loneliness and
Social isolation?
The number of older adults age 65 and older is growing,
and many are socially isolated and regularly feel lonely. The
coronavirus outbreak in 2020 brought even more challenges
due to health considerations and the need to practice
physical distancing.
Social isolation and loneliness are different, but related.
Social isolation is the lack of social contacts and having
few people to interact with regularly. Loneliness is the
distressing feeling of being alone or separated. It’s possible to
feel lonely while among other people, and you can live alone
and not feel lonely or socially isolated.
Older adults are at higher risk for social isolation and
loneliness due to changes in health and social connections
that can come with growing older, hearing, vision, and
memory loss, disability, trouble getting around, and/or the
loss of family and friends.
5
If you are in poor health, you may be more likely to be
socially isolated or lonely. And, if you are socially isolated
or feeling lonely, it can also put your physical and mental
health at risk.
Adults who are lonely or socially isolated are less healthy,
have longer hospital stays, end up readmitted to the hospital
more often, and are more likely to die earlier than those with
meaningful and supportive social connections.
6
Staying Connected During COVID-19
With the COVID-19 pandemic (global outbreak),
maintaining safe distancing precautions has been
challenging for everyone — even people who are
otherwise well-connected with large supportive
social networks.
Public health guidelines to keep physical distance from
others have slowed down the spread of COVID-19,
but they have also made it harder for people to see
family and friends. Older adults are at greater risk of
COVID-19, but it is also critically important for them
to maintain active social connections. Reach out by
phone, video, text, social media, email, or letter to help
everyone stay connected during this challenging time.
Learn more at www.coronavirus.gov.
7
How Can Being Isolated or
Feeling Lonely Affect
a Person’s Health?
People who are socially isolated or lonely are more likely
to be admitted to nursing homes and the emergency room.
Social isolation and loneliness also are associated with
higher risks for:
• High blood pressure • Depression
• Heart disease • Cognitive decline
• Obesity • Dementia, including
Alzheimer’s disease
• Weakened immune
functioning • Death
• Anxiety
People who are lonely or socially isolated may get too little
exercise, drink too much alcohol, smoke, and often
don’t sleep well, which can increase the risk of heart
disease, diabetes, obesity, high blood pressure, and other
serious conditions.
8
People who are lonely experience emotional pain. Losing
a sense of connection and community can change the way
a person sees the world. Someone experiencing chronic
loneliness can feel threatened and mistrustful of others.
Emotional pain can activate the same stress responses in the
body as physical pain. When this goes on for a long time, it
can lead to chronic inflammation and reduced immunity.
This raises your risk of chronic diseases and can leave a
person more vulnerable to some infectious diseases.
Social isolation and loneliness may also be bad for brain
health. Loneliness and social isolation have been linked to
poorer cognitive function and higher risk for dementia,
including and especially for Alzheimer’s disease. Also,
little social activity and being alone most of the time may
contribute to a decline in the ability to perform everyday tasks
such as driving, paying bills, taking medicine, and cooking.
9
Tips for Staying Connected if You Are
Living Alone With Dementia
If you or a loved one has dementia and lives alone, family
members, friends, or other caregivers may be able to help in
different ways.
• Identify a person you trust, such as a neighbor, who
can visit you regularly in-person or via a video call, and be
an emergency contact.
• Learn about home- and community-based support
and services from social service agencies, local
nonprofits, and Area Agencies on Aging.
• Stay connected with family and friends through
video chats, email, and social media. If you’re not tech
savvy, ask for help to learn.
• Talk with others who share common interests.
Try a support group online or in person. Maybe your
community has a memory café you can visit — a safe place
to enjoy activities and socialize for people living with
memory loss and their families and caregivers.
10
COVID-19 Precautions
During the COVID-19 pandemic, take precautions to
protect yourself and others. Wash your hands often with
soap and water or use a hand sanitizer if soap and water
are not available. Stay at least 6 feet from people who are
not in your household. Cover your mouth and nose with
a cloth face mask when around others. Always cover
your mouth and nose with a tissue when you sneeze
or cough, or use the inside of your elbow if you do not
have a tissue. Frequently clean and disinfect surfaces
that you frequently touch each day. Stay at home when
you feel ill. Read more at www.coronavirus.gov.
11
Elena’s Story
Elena has been her father Oscar’s caregiver ever since
he was first diagnosed with Alzheimer’s disease. As
Oscar’s condition has worsened, Elena must do more to
help, including helping him with bathing and dressing,
taking him to the doctor, and preparing his meals. While
she feels lucky to be caring for Oscar, Elena often feels
overwhelmed and distant from her friends. She no longer
has time to spend with them and is often too tired to do so
even if she could.
12
How Do I Know if I Am at Risk?
Those who find themselves unexpectedly isolated due to
the illness of a loved one, separation from friends or family,
loss of mobility, worsening vision or hearing problems,
disability, or lack of mobility or access to transportation, are
at particular risk of loneliness and social isolation.
You also may be at greater risk if you:
• Live alone
• Can’t leave your home
• Had a major loss or life change, such as the death
of a spouse or partner or retirement
• Struggle with money
• Are a caregiver
• Have psychological or cognitive challenges
• Have limited social support
• Live in a rural, unsafe, and/or hard-to-reach
neighborhood
• Have language barriers where you live
• Experience age, racial, ethnic, sexual orientation, and/or
gender identity discrimination where you live
• Are not meaningfully engaged in activities or are feeling
a lack of purpose
13
Hearing Loss Can Make It Harder
To Stay Connected
People with hearing loss may find it hard to have
conversations with friends and family.
Many older adults have difficulty hearing, but
some may not want to admit it. Those who can’t
hear well may withdraw from others because they
feel frustrated, become depressed, or embarrassed.
Sometimes, older adults are mistakenly thought to be
confused, unresponsive, or uncooperative when the
reality is that they don’t hear well.
Difficulties communicating with others can lead to less
interaction with people, social isolation, and higher
rates of loneliness.
Hearing problems that are ignored or untreated can get
worse. If you have a hearing problem, see your doctor.
Hearing aids, special training, certain medicines, and
surgery are some of the treatments that can help. Read
more at www.nidcd.nih.gov/health/hearing-loss-
older-adults.
14
Dealing with Grief, Mourning,
and Depression
Although it is normal to mourn when you have a loss,
later life does not have to be a time of ongoing sadness or
disconnection. Depression is a common problem among
older adults, but it is not a normal part of aging. It is
treatable, so let your doctor know about your feelings and
ask about treatment.
It is especially important to get help with your loss to help
prevent you from feeling overwhelmed. If you feel sad all
the time, are unable to imagine life moving forward without
your loved one, experience a general loss of interest in things
you used to like to do, or if your sense of loss keeps you from
doing your daily activities, let your doctor know. Also, tell
your doctor about symptoms such as lack of energy, poor
appetite, trouble sleeping, or little interest in life. These
could be signs of complicated grief or depression, both of
which can be treated.
Family and caring friends often can provide great support.
There are also support groups where grieving people help
each other. Also, remember to take good care of yourself:
Try to eat well, exercise, get enough sleep, and do activities
you enjoy.
15
Talking With Your Doctor
If you are feeling isolated or lonely a lot of the time, you may
want to tell your doctor or health professional. Talking about
your health with your doctor means sharing information
about how you feel physically, emotionally, and mentally.
Describing your symptoms can help your doctor identify the
problem. Make sure to bring up your concerns. For example,
let your doctor know about any major changes or stresses in
your life, such as a divorce or the death of a loved one.
As we grow older, we may lose people in our lives, including
spouses and cherished friends. Or, we may have to move
away from home or give up favorite activities. A doctor who
knows about your losses is better able to understand how
you are feeling. They can make suggestions that may be
helpful to you.
16
Be open and honest with your doctor about your health
habits and what’s happening in your life. It will help them
to understand your medical conditions and emotional
health more fully and recommend the best treatment
options for you. Learn more about doctor-patient
communication at www.nia.nih.gov/twyd.
Think You Might Be at Risk?
Check out this resource to learn more about loneliness
and social isolation and take a quiz to see if you might
be at risk for loneliness or social isolation: Expanding
Your Circles: Prevent Isolation and Loneliness as you
Age, https://eldercare.acl.gov/Public/Resources/
Brochures/docs/Expanding-Circles.pdf
17
Carla’s Story
Since Carla started having trouble with her vision, she’s
had to give up driving and travels less often. But she
still enjoys spending time with her three grandchildren,
even though she lives in Maryland and they live across
the country in California. Carla reads stories to them on
video chat and catches up on how they are doing on social
media. She also stays in touch with friends through email
and weekly phone calls. Carla feels much happier knowing
that she can stay connected with others.
18
What Can I Do To Stay
Connected?
There are things you can do to protect yourself or a loved one
from the effects of loneliness and social isolation. First, it’s
important to take care of yourself. Exercise, eat healthy, get
enough sleep, and pursue activities you enjoy to help manage
stress and stay as mentally and physically healthy as possible.
It’s also important to stay active and connect with others.
People who engage in meaningful, productive activities they
enjoy with others feel a sense of purpose and tend to live
longer. Studies show these activities may help boost your
mood and improve your well-being and cognitive function.
People who live an active lifestyle:
• Are less likely to develop certain diseases
• Have a longer lifespan
• Are happier and feel less depressed
• Are better prepared to cope with loss
• May be able to improve their thinking abilities
For example, helping others through volunteering helps you
feel less lonely and allows you to have a sense of mission and
purpose in life, which is linked to better health.
19
Here are some other ideas to help you stay connected:*
• Find an activity that you enjoy, restart an old hobby, or
take a class to learn something new. You might have fun
and meet people with similar interests.
• Schedule time each day to stay in touch with family,
friends, and neighbors in person, by email, social media,
voice call, or text. Talk with people you trust and share
your feelings. Suggest an activity to help nurture and
strengthen existing relationships. Sending letters or cards
is another good way to keep up friendships.
• Use communication technologies such as video chat,
smart speakers, or even companion robots to help keep
you engaged and connected.
• If you’re not tech-savvy, sign up for an online or in-person
class at your local public library or community center to
help you learn how to use email or social media.
• Consider adopting a pet if you are able to care for them.
Animals can be a source of comfort and may also lower
stress and blood pressure.
20
• Stay physically active and include group exercise, such
as joining a walking club or working out with a friend.
Adults should aim for at least 150 minutes (2 1/2 hours)
of activity a week that makes you breathe hard.
• Introduce yourself to your neighbors.
• Find a faith-based organization where you can deepen
your spirituality and engage with others in activities
and events.
• Check out resources and programs at your local social
service agencies, community and senior centers, and
public libraries.
• Join a cause and get involved in your community.
*See page 11 for information to help you stay safe during the
COVID-19 pandemic.
21
The Benefits of Exercise
If you’re feeling down, anxious, or stressed because you
are lonely or isolated, one way to boost your mood is to get
moving through exercise. Research has shown that exercise
is not only good for your physical health; it also supports
emotional and mental health. You can exercise with a friend
and get the added benefit of emotional support.
Physical activity can help:
• Reduce feelings of depression and stress, while improving
your mood and overall emotional well-being
• Increase your energy level
• Improve sleep
• Empower you to feel
more in control
22
In addition, exercise and physical activity may possibly
improve or maintain some aspects of cognitive function.
Whether it’s gardening, playing tennis, taking a walk in the
park, kicking around a soccer ball with your grandchildren, or
something else, choose an activity you enjoy.*
*See page 11 for information to help you stay safe during the
COVID-19 pandemic.
There are many things you can do to stay connected as
you age. By staying active, participating in meaningful
activities you enjoy, and maintaining relationships
with others, you can help keep your brain active,
avoid health problems, and feel less isolated and more
engaged with the world around you.
23
For More Information
Federal Government Resources
NIA Alzheimer’s and related Dementias Education
and Referral (ADEAR) Center
800-438-4380 (toll-free)
[email protected]www.nia.nih.gov/alzheimers
The National Institute on Aging’s ADEAR Center offers
information and publications for families, caregivers, and
health professionals on Alzheimer’s disease and related
dementias, including information on caregiving, clinical
trials, and research. Staff members answer inquiries by
phone, email, and in writing and make referrals to local and
national resources. Visit the ADEAR website to learn more
about Alzheimer’s and related dementias, find clinical trials,
and sign up for email updates.
AmeriCorps Seniors
800-942-2677
https://americorps.gov
Senior Corps is a network of national service programs
for Americans age 55 and older, made of three primary
programs: Senior Companions, Foster Grandparents, and
RSVP. Senior Corps volunteers commit their time to address
critical community needs including academic tutoring and
mentoring, elderly care, disaster relief support, and more.
24
Eldercare Locator
800-677-1116 (toll-free)
[email protected]
https://eldercare.acl.gov
This service of the Administration on Aging, of the
Administration for Community Living, can help you find
housing, support services, transportation, health and
insurance, and benefits information in your local community.
Other Resources
AARP
888-687-2277 (toll-free)
877-434-7598 (TTY/toll-free)
[email protected]
www.aarp.org/caregiving
AARP provides resources and guidance for family caregivers
on social isolation, in-home care, medical, financial, and legal
considerations, and caregiver well-being.
Alzheimer’s Association
800-272-3900 (toll-free)
866-403-3073 (TTY/toll-free)
[email protected]
www.alz.org
The Alzheimer’s Association provides information and
support for people with Alzheimer’s disease and their
caregivers including a 24-hour helpline for confidential
support and information for those living with Alzheimer’s
disease, caregivers, families, and the public.
25
Connect2Affect
https://connect2affect.org
Connect2Affect is an online resource to address social
isolation and loneliness and increase awareness. It features
tools, training resources, and information to help evaluate
isolation risk and create networks.
Isolation Assessment
https://connect2affect.org/assessment/self
This assessment can be done by an individual or a
caregiver to help gauge how connected the person is. It
also provides suggestions for resources that may help.
Family Caregiver Alliance
800-445-8106 (toll-free)
[email protected]www.caregiver.org
The Family Caregiver Alliance provides services to family
caregivers of adults with physical and cognitive impairments,
such as Parkinson’s, stroke, Alzheimer’s and other types of
dementia, including assessment, care planning, direct care
skills, wellness programs, respite services, and legal/financial
consultation vouchers.
Meals on Wheels America
888-998-6325 (toll-free)
[email protected]www.mealsonwheelsamerica.org
Meals on Wheels America provides home meal delivery
services to people who have trouble getting out of their homes.
26
National Association of Area Agencies on Aging
202-872-0888
[email protected]
www.n4a.org
This national network of Area Agencies on Aging provides
resources and information for older adults and people with
disabilities on health, safety, and staying connected.
National Council on Aging
571-527-3900
www.ncoa.org
The National Council on Aging partners with nonprofit
organizations, government, and businesses to provide
innovative community programs and services, online help,
and advocacy.
Center for Healthy Aging
www.ncoa.org/center-for-healthy-aging
Geri-Fit
www.gerifit.com
Healthy Moves
www.eblcprograms.org/evidence-based/
recommended-programs/healthy-moves
Fit & Strong!
www.fitandstrong.org
27
SilverSneakers
866-584-7389 (toll free)
[email protected]
www.silversneakers.com
SilverSneakers is a community fitness program for older
adults that offers offers exercise classes, workouts,
how-to videos, and workshops.
YMCA
800-872-9622
[email protected]
www.ymca.net/healthy-living/programs-for-older-adults
The YMCA offers evidence-based group exercise programs
for older adults to improve fitness and prevent falls.
28
To Learn More About
Health and Aging
National Institute on Aging Information Center
800-222-2225 (toll-free)
800-222-4225 (TTY/toll-free)
[email protected]www.nia.nih.gov
Visit www.nia.nih.gov/health to find more health and aging
information from the National Institute on Aging at NIH and
subscribe to email alerts. Visit https://order.nia.nih.gov
to order free print publications.
29
Words To Know
Alzheimer’s Disease
(pronounced allz-high-merz duh-zeez)
A disease that causes large numbers of nerve cells in the brain
to die. People with this disease lose the ability to remember,
think, and make good judgments. The symptoms begin
slowly and get worse over time.
Chronic
(pronounced kron-ik)
A condition that continues for a long time or recurs
over time.
Cognitive Decline
(pronounced kog-ni-tiv dih-klahyn)
A medical condition that causes people to have more
memory problems than other people their age. The signs are
not as severe as those of Alzheimer’s disease. They include
forgetting to go to events and appointments, and having
more trouble coming up with the right words than other
people the same age.
Complicated Grief
(pronounced kom-pli-key-tid greef)
A condition in which people who have lost a close loved one
may be unable to comprehend the loss, experience intense,
prolonged grief, and have trouble resuming their own life.
30
Dementia
(pronounced duh-men-shuh)
A loss of cognitive functioning. This means changes to a
person’s thinking, remembering, reasoning, and behavior
that make daily life and activities difficult to manage.
Immunity
(pronounced ih-myoo-ni-tee)
The ability to resist or fight off a disease.
Inflammation
(pronounced in-fluh-mey-shuhn)
Inflammation includes heat, swelling, and redness caused
by the body’s protective response to injury or infection.
Inflammation that occurs in healthy tissues or lasts too long
can be harmful.
Loneliness
(pronounced lohn-lee-nes)
The distressing feeling of being alone or separated.
Physical Distancing
(pronounced fiz-i-kuhl dis-tuhns-ing)
The act of keeping a safe space between yourself and other
people who are not from your household. To practice physical
distancing, stay at least 6 feet (about 2 arms’ length) from
other people in both indoor and outdoor spaces who are not
from your household.
Social Isolation
(pronounced soh-shuhl ahy-suh-ley-shuhn)
The lack of social contacts and having few people to interact
with regularly.
31
32
Share this booklet with friends and family so they can
understand more about loneliness and social isolation
and staying connected.
33
National Institute
on Aging
NIH Publication No. 20-AG-8150
November 2020
34
