The consequences of unwanted loneliness in older people

The main consequences of unwanted loneliness in those who suffer from it primarily affect their mental and psychological health, leading to an increased incidence of depression, anxiety, and sleep disorders.

As a subjective feeling of suffering, it causes a prolonged state of stress in the person who suffers from it, which can manifest clinically as anxiety .

It is more frequent at night, so it is often accompanied by sleep disorders. And it leads to a feeling of hopelessness, negativity, pessimism, insecurity and lack of confidence, which causes a greater tendency towards isolation, sadness and depression (Santini, 2015) (Domènech-Abella, 2017).

Suicide among older adults increased by 8.8% in the last five years, according to the latest definitive data from 2017 to 2021 published by the National Institute of Statistics (INE). In Spain, a total of 1,235 people over the age of 65 died by suicide in 2021. 75% were men and 25% were women. Older adults more frequently experience the pain of losing a loved one or a decline in socioeconomic status as a result of retirement or disability—factors that can lead to loss of independence, loneliness, and distress.

Ageing and suicide

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It has also been observed that older adults who live alone experience greater cognitive decline and higher rates of dementia than those who live with others. This is because loneliness generates persistent and prolonged feelings of insecurity and mistrust, which, in addition to anxiety and depression, lead to a decrease in attention span and concentration. This, combined with a lack of social interaction and mental activity, affects memory, especially recent memory, and ultimately results in progressive cognitive decline (Kuiper et al., 2015).

In the Amsterdam study on aging, Holwerda's group followed more than 2,000 older people for 3 years, finding that unwanted loneliness is an independent risk factor for dementia, and that there is a higher incidence of dementia in older people who live alone and suffer from unwanted loneliness (Holwerda et al., 2014).

Social isolation and loneliness among older people: advocacy brief. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.

However, unwanted loneliness not only has consequences for mental health but also affects physical health , as it has been observed that people who live alone experience higher rates of cardiovascular events, such as heart attacks or strokes. In fact, many doctors consider unwanted loneliness to be another modifiable vascular risk factor, just like smoking, sedentary lifestyle, or obesity, and mortality is higher among those who live alone (Valtorta et al., 2018).

Another widely observed issue among older adults living alone is nutritional deficiencies . They don't worry about preparing meals; isolation leads them to eat less and eat less healthily, resulting in an increase in easy and pre-cooked meals—as well as carbohydrates and fats—and a reduction in protein. This leads to an increase in nutritional imbalances among older adults living alone: both weight loss with a risk of malnutrition or undernutrition, and overweight and obesity. Sarcopenic obesity is particularly concerning, in which the individual gains weight and body mass index, but at the expense of an increase in fat tissue. This leads to a decrease in muscle mass, which triggers a greater loss of strength and functional decline (Besora-Moreno et al., 2020).

People who experience loneliness have higher rates of healthcare resource consumption : the number of medical consultations and hospitalizations increases, as do the rates of institutionalization in care homes. Furthermore, mortality rates are higher among those who suffer from loneliness.

This article was originally published in the Guide for Supporting Older Adults Experiencing Unwanted Loneliness. San Juan de Dios Solidarity.