Loneliness is as Deadly as Obesity and Drug Abuse, Surgeon General Says

by Katie Brown
April 20, 2023 at 11:05 AM UTC

Loneliness is connected to dementia.

Clinical relevance: Patients who don’t get a lot of social interaction are at greater risk for cognitive decline

  • A lack of social connectedness can speed up memory deficits and dementia.
  • When a person does not have regular contact with others, they can become confused and forget to do basic tasks like eating and taking medicine.
  • While technology can help people connect, lack of mastery can prevent some people with memory problems from using it.

Surgeon General Vivek Murthy warned about the epidemic of loneliness that affects more than 50 percent of Americans. He said he is one of them.

“I had neglected my family and my friends during that time, thinking that it was too hard to focus on work, and focus on family and friends,” he told BBC News, referring to the period during the pandemic lockdown. “I was really suffering from the consequences of that, which were a profound sense of loneliness that followed me for weeks, which stretched into months.”

Murthy called loneliness a “profound public health challenge” that “we should talk about” and address. Social isolation should be treated as seriously as obesity or drug abuse, he warned. He also pointed to studies showing loneliness decreases life expectancy by as much as 30 percent. His words are backed up by evidence showing that loneliness hastens the slide into dementia and other neurodegenerative conditions.

Isolating Lockdowns

The COVID-19 pandemic left a lot of people of all ages feeling cut off from the world. This seems to be especially true for older adults who entered the COVID era with memory loss disorders like Alzheimer’s disease and other forms of dementia.

A lack of in-person socialization can heighten dementia symptoms in seniors, according to neuropsychologist Neil H. Pliskin, a professor of clinical psychiatry and neurology at the University of Illinois School of Medicine. 

“When we talk about dementia, we talk about a decrease in the ability of an individual to manage affairs of daily life on their own,” he said. “If someone has mild forgetfulness associated with dementia and there’s a lack of stimulation, that forgetfulness can worsen.”

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Routine and Stimulation

A common hallmark of dementia is the abnormally rapid forgetting of information, according to Pliskin. Patients typically recall information from the distant past much more easily than recent events. Consistent social interaction helps keep them focused on the present.

Regular visitors, phone calls, and other social activities woven into their daily routines can act as indicators in the brain that stimulate memory. When their routines are disrupted, such as when the pandemic curtailed visitation, “their markers of everyday life get disrupted,” Pliskin said. 

Interrupted routines can leave someone with dementia feeling discombobulated. That’s why they often miss meals or forget to take their medication, Pliskin explained. In turn, they risk malnourishment and worsening health which further exacerbates their symptoms. 

“Nutritional difficulties will certainly contribute to cognitive confusion and declining health status,” he said. “It’s all linked together.”

The question Dr. Pliskin is most often asked by patients with memory loss diagnosis is, “How can I keep what I have?”. 

His answer is simple: “The studies consistently show, over and over again, that regular cardiovascular exercise—as tolerated by your health condition and as approved by your physician—causes better cardiac circulation which leads to better brain circulation and actually helps in terms of pushing back against cognitive decline.” 

But here again, lack of social interaction is a problem. It’s unsafe for many dementia patients to take walks or perform other forms of exercise alone. So isolated patients are less likely to get the exercise they need to keep their brains thriving. 

Technology Troubles

Social connections via the virtual world are not also less accessible for many elderly patients.

“Even though the statistics show that there are more older adults using electronics than ever before, the fact of the matter is that a lot of older adults—especially those with dementia—lack the facility and knowledge to use a computer or smartphone, and that further cuts them off from the outside world,” Dr. Pliskin said. 

The potential isolating effects of being technologically challenged go beyond a misunderstanding of social media platforms. It makes getting help for mental health less accessible too. For example, psychotherapy largely transitioned to virtual during COVID. While having instant access to mental health resources is generally a good thing, aging dementia patients who suffer from paranoia, depression, and memory loss often struggle to understand how to find and connect to virtual therapy. 

Additionally, Pliskin said it’s not uncommon for isolated patients to spend their days sitting in front of a TV set. The sedentary nature and lack of interaction associated with tube time can be detrimental. 

“People with moderate dementia sometimes have a hard time distinguishing between what’s real and what isn’t,” he said, meaning that the media they’re consuming may have a particularly profound influence on their mood. Watching TV alone on a regular basis, Pliskin said, hastens the decline in memory.

Keeping a Wide Social Circle

Regular face-to-face socialization is key to preventing and slowing the effects of dementia. One 2008 study demonstrated that elderly women with large social networks were less likely to develop memory loss disorders than women with smaller social networks. 

Pliskin attributes this, in part, to caretaker burnout—the exhaustion of the typically small number of people responsible for the food, housing, and transportation of a dementia patient. “It takes a village,” he said. 

In the Netherlands, a village inhabited solely by dementia patients and their caretakers seems to prove this theory. The tiny town called Hogewey is equipped with cameras. It was built with safety features that allow people with dementia to socialize and live somewhat independently. In 2013, CNN reported: “Residents at Hogewey require fewer medications; they eat better, and yes, they live longer. On a mental level, they also seem to have more joy.”

While such forward-thinking nursing home alternatives are not yet an option for patients in the U.S, Pliskin stressed that all forms of socialization are better for brain health than utter isolation. 

“Virtual contact is better than no contact; interpersonal contact is better than virtual contact,” he said.

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