The Department of Health and Human Services sounded the alarm on the devastations of loneliness and isolation in the United States. This societal concern, however, has even greater implications for veterans and older adults. Already, somewhat specific challenges present themselves in these respective populations.
A new advocacy brief out today ahead of the International Day of Friendship highlights that millions of older people around the world suffer from social isolation and loneliness. These were exacerbated by the pandemic and ensuing physical distancing measures. The UN Decade of Healthy Ageing 2021 – 2030 is an unprecedented opportunity for WHO and other United Nations agencies to take bolder action.
According to Dr. Etienne Krug, Director of the WHO Department of Social Determinants of Health, meaningful human relationships play a big role in overall health and well-being. WHO has an appeal to all governments to give the issues of social isolation and loneliness precedence in society so that every person can be free to benefit from a sense of friendship and solidarity commonly shared.
According to studies, 20-34% of older persons in China, India, the United States, Europe, and Latin America suffer from loneliness. In institutional settings, rates are even higher. Other than shortening lives, social isolation and loneliness have severe mental and physical impacts on health, such as cardiovascular disease, stroke, cognitive decline, dementia, depression, anxiety, suicidal ideation, and suicide. These issues also put a great weight on societies’ financial burdens.
Evidence supports several types of possible successful strategies for reducing social isolation and loneliness. At the level of the individual, these range from interventions such as social-skills training and peer-support and social-activity groups to “befriending” services and cognitive behavioral therapy. At the community level, they include improving transportation and the built environment, and digital inclusion; at the societal level, improving social cohesion and reducing marginalization.
This WHO advocacy brief, jointly developed with the International Telecommunication Union, UN Women, and the UN Department of Economic and Social Affairs, proposes a three-point strategy to address social isolation and loneliness during the UN Decade of Healthy Ageing 2021–2030. These should make it possible to create a global coalition to raise political priority for these issues and provide better research and strengthened evidence for effective interventions, as well as implement and scale them up.
The world population is reportedly aging at a highly alarming rate. By 2030, one in every six people in the globe will be 60 years or older. Loneliness and social isolation are the major risk factors for good mental health conditions in old age. Around 14% of adults aged 60 years and above always live with a mental disorder, while mental disorders in older adults account for 10.6% of the total years lived with disability for this particular age group.
Older adults—all veterans, family members, community contributors, volunteers, and workers—are active in society. Yet many are at risk for developing a mental health condition such as depression or an anxiety disorder. They may also be experiencing reduced mobility, chronic pain, frailty, dementia, or other health problems that require long-term care.
These conditions of mental health are often underrecognized and undertreated in older people. The stigma surrounding such mental health conditions instills a reluctance to seek help. Social isolation and loneliness, affecting about one in four older people, are key risk factors for developing mental health conditions in later life. Abuse of older adults, often by their carers, has serious consequences, leading to depression and anxiety.
Promotion and prevention strategies for older adults focus on healthy aging. It creates physical and social environments that assist in well-being and give people the chance to do things important to them despite losses in capacity. There are measures to reduce financial insecurity and income inequality and also ensure that there is safe and accessible housing, public buildings, and transport. The strategies also include social support for older adults and their carers and also provide support for healthy behaviors.
In particular, social connection is especially important to be provided to older adults to decrease the risk factors of social isolation and loneliness. Meaningful social activities are likely to improve positive mental health and life satisfaction significantly, and they also enhance the quality of life. At the same time, they reduce depressive symptoms. Ageism and abuse protection are critical. These include anti-discrimination policies and legislation that address ageism, discrimination based on other characteristics, and abuse. Educational interventions and intergenerational activities are the main interventions.
Identification and management of mental health conditions in older people should be timely. This needs to be according to the guidelines for integrated care of older people, community-based, and long-term care for older adults living with mental health conditions and intrinsic capacity declines, and their carers being educated, trained, and supported.
WHO works with various partners to develop strategies, programs, and tools that will help governments respond to the mental health needs of older adults. The Decade of Healthy Ageing is a new global collaboration, under the leadership of WHO, for improving the lives of older people, their families, and the communities in which they live.