Friends are Just What the Doctor Ordered

Social connections that create a sense of caring and community have a range of benefits for health and well-being across the lifespan. Loneliness is a measure of the quality of social connections and may be a particularly important indicator of elevated risk in later life for a wide range of negative outcomes, including worse mental and physical health.

Loneliness is associated with real health risks

• Elevated blood pressure
• Poor sleep
• Problems with the body’s stress response
• Reduced physical activity and problems completing the tasks of daily living (including toileting, bathing, eating)
• Deficits in memory and planning (including a greater risk for dementia)
• Depression, hopelessness, and lower subjective well-being
• Death from both “all-cause mortality” and suicide

In fact, studies have shown that the impact of loneliness on death is as least as large as — or larger than —the typical risk factors primary care physicians discuss with their patients, namely smoking, exercise, and weight. These data suggest that physicians might improve the health of their patients by asking about loneliness and helping older adults become more socially connected.

Is friendship necessary for health?

Before we encourage physicians to write prescriptions for social connectedness, scientists acknowledge that much is still unknown about loneliness and health. Specifically, we do not know what the mechanisms are that account for the health problems seen in lonely people. Some scientists believe being socially connected buffers the impact of life stressors while others believe there is a direct effect of loneliness on health problems. The latter hypothesis rests on the assumption that humans have a “need to belong” just as we have needs for food, air, and shelter.

Learn more and get involved        

We know that being lonely or disconnected is associated with poorer health, but another important unknown is whether reducing loneliness or creating social connectedness improves health. There are only a handful of studies examining this issue and none have been replicated, which is the gold standard for scientific evidence. (Those of you interested in learning more might enjoy reading Loneliness: Human Nature and the Need for Social Connection by John Cacioppo, or Lonely at the Top by Thomas Joiner.)

Older adults interested in getting more connected (or staying connected) might consider joining the Senior Corps and volunteering their time through the many programs that are offered nation-wide, including Foster Grandparents and Senior Companionship.

It is important to recognize that most older adults are not lonely. Loneliness is not an expected or “normal” response to aging – in fact, later life is characterized by greater well-being, more positive emotions, and better capacity to manage emotions. The size of social networks in later life does shrink, but older adults report greater satisfaction with the relationships that remain important to them. To reconcile these findings, loneliness is not a given fact of life for older adults, but when it is present, it increases risk for poor health, lower well-being, and premature death.

Scientists are now tackling the question of whether increasing connectedness improves health and well-being.  One study, conducted by University of Rochester Medical Center researchers, involves adults who are 60+, who report feeling lonely or like a burden, and who have a doctor in the URMC system. Half will be introduced to a volunteer peer companion and the other half will not. Both groups will be followed over time by the research group.  If you are in this age group, have feelings of loneliness or that you burden others, have a URMC primary care physician, and are interested in participating in the Senior Connection study, give one of our study coordinators a call: Judy at (585) 760-6657, or Nicole at (585)-760-6655.

Kimberly A. Van Orden, Ph.D., is an assistant professor in the University of Rochester Medical Center Department of Psychiatry. Her research focuses on the prevention of late life suicide. She has contributed to the formulation, refinement, and evaluation of the Interpersonal Theory of Suicide, including the development of a self-report measure to assess two of the theory’s constructs, The Interpersonal Needs Questionnaire. Her current focus is on using the Interpersonal Theory to inform the investigation of psychological mechanisms of action for suicide prevention interventions for older adults.