Social isolation, loneliness common toward end of life

Older adults at the end of life frequently experience loneliness and social isolation, particularly those with low net-worth and who had experienced functional or sensory impairments, a recent study has found.

The researchers conducted a nationally representative, cross-sectional analysis of 3,613 older adults (mean age at death 78 years, 50 percent men) who were interviewed at least once during their last 4 years of life. Social isolation was defined using a 15-item tool that looked at household contacts, social network, and community engagement. The three-item UCLA Loneliness Scale was used to identify frequent loneliness.

Approximately 19 percent of the participants were socially isolated toward the end of life, while 18 percent had frequent loneliness; 5 percent reported both conditions at once. The adjusted population prevalence of loneliness did not significantly fluctuate over the 4 months leading to participant death.

In contrast, the prevalence of social isolation increased as participants approached death, rising from 18 percent at 4 years to 27 percent at 0–3 months before death (p=0.05). This effect was driven by increases in the frequency of low social network interaction (57 percent at 4 years to 68 percent at 0–3 months; p=0.003) and low community engagement (42 percent at 4 years to 53 percent at 0–3 months; p=0.01).

In terms of predictors, the researchers found that low net-worth (<$6,000 vs ≥$239,000) correlated with both social isolation (34 percent vs 14 percent, respectively) and loneliness (29 percent vs 13 percent; p<0.001 for both). Functional and impairments, such as difficulties in walking one block or in preparing hot meals, also correlated with both social isolation and loneliness. The same as true for hearing impairment.