We wear masks and keep a safe distance to protect people. Unfortunately, no good deed goes unpunished. We are starting to see second and third-order consequences of keeping a distance during the pandemic.
The current pandemic has exacerbated the prevalence and severity of loneliness and social isolation.
Social isolation is defined as having few or infrequent social contacts. This is now commonplace in the elderly and individuals with health complications due to COVID. Loneliness is related but differs.
Loneliness is the "subjective dissatisfaction with the discrepancy between the actual and preferred level and quality of social contact."
Frequent Zoom calls may limit social isolation but can leave a person still feeling lonely. Conversely, someone can be socially isolated but not lonely if the few contacts made are meaningful and fulfill someone's preferred level and quality of social contact. Unfortunately, loneliness and social isolation are associated with an increased risk of developing frailty.
The relationship between loneliness and frailty
Frailty is a concern with any patient population but especially in elderly adults.
Fried's phenotype model defines frailty on the basis of the presence of at least three of five criteria: slow gait speed, low physical activity, self-reported exhaustion, unintentional weight loss, and weak grip strength. Frailty is often associated with non-modifiable factors, such as age, and modifiable factors, such as diet.
According to recent research and trends, social support and loneliness warrant more attention.
One way to minimize the influence of frailty is exercise. Exercise is an important component to building resilience, but social interaction can be equally powerful.
It is vital to build resilience and tackle loneliness. It is highly prevalent and is associated with depression and anxiety, cardiovascular disease, stress, disrupted sleeping, and premature mortality.
While loneliness has been studied in the elderly population extensively, would it surprise you if I said it is highly prevalent in the 18–34-year-old age group?
The elderly are not the only people who are lonely
“All the focus has been on older people and perhaps we have been neglecting the impact of loneliness and isolation on our younger people,” Prof Brian Lawlor, consultant psychiatrist at St James’s hospital
The Institute of Public health recently released troubling data concerning loneliness.
In 2018, 3% of 18 to 34-year-olds reported they were lonely “all or most of the time”. The figure jumped to 26% by November 2020. Throw in people who felt lonely “some of the time” and the numbers jump to a staggering 80%. The combined number was only 33% in 2018.
Regardless of the age group, loneliness and social isolation is a concern. As a health care provider, I see its effects in the clinic.
I am not saying distancing precautions should be abandoned, but we do need to find methods to address these mental health concerns.
Exercise is one method of addressing a consequence of isolation and loneliness - frailty - but we need other strategies, as well.