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New research indicates that loneliness impacts multiple physical and mental health outcomes among older adults.

A recent study showed that loneliness significantly impacted mental QOL in older adults even after adjusting for demographic and clinical factors.

Monica M. Williams-Farrelly, PhD, lead author of the study, advocates for primary care physicians (PCPs) to screen for loneliness even if the patient has a social network. She emphasizes the importance of asking patients about their loneliness to improve their overall health outcomes.

Physician’s Weekly (PW) spoke with Dr. Williams-Farrelly about the clinical implications of her team’s findings, including how PCPs can address loneliness during routine visits with older adult patients.

PW: Please tell us about your background.

Dr. Williams-Farrelly: I am an assistant professor at Indiana University School of Medicine. By training, I am a sociologist and gerontologist and am involved with the IU Center for Agent Research. I research health and aging from a social background, considering how social interaction influences health and later life.

Can you elaborate on the implications of the correlation between loneliness and mental QOL?

QOL can be an overlooked outcome, but mental health-related QOL is highly correlated with physical health, cognition, and other health outcomes of interest among older adults. This study showed that over half of older adults experienced loneliness during COVID-19. If we can address loneliness, we can improve many health outcomes overall.

If you remove factors that you would expect to be correlated with loneliness—like gender or socioeconomic status—loneliness still correlates with QOL. This means that loneliness affects everyone, regardless of those factors. In particular, the relationship between loneliness and QOL remains after you control for things like anxiety and depression. Even if you look at individuals who don’t have those clinical diagnoses, loneliness persists.

How can PCPs screen for and identify loneliness among older adult patients during routine visits?

You don’t necessarily have to use a standardized, 25-question form to gauge if someone’s lonely. It is important just to recognize loneliness’s influence. I know there are a lot of questions to be asked during patient visits, and time is limited. But I think PCPs can start by asking patients how they’re doing. You can simply ask, “Are you lonely? How are you?”

Loneliness is a subjective feeling. It’s important to recognize that if you look at your patient’s chart and see they have a spouse and kids, that doesn’t necessarily mean they’re not lonely.

What resources or interventions would you recommend PCPs offer their older adult patients experiencing loneliness?

There’s still a lot of work to be done regarding interventions. A standard recommendation we can make is to encourage patients to get involved in activities and meet new people. That is easier for some people than others, so keep that in mind. One good thing COVID-19 did was expand how we communicate and stay in contact with people. If meeting someone in person is not an option for the patient, there are also digital and remote options. Digital interventions aren’t used widely yet, but even conversations with people online can help.

What steps should be taken at the research and policy levels to address loneliness?

We’re doing the research. We’re trying to understand how loneliness influences health issues—we know loneliness affects health outcomes, but why? Once we understand those mechanisms, we can start to shape and test interventions to reduce loneliness. Then, once we figure out what those interventions are, we can ask policymakers for funding to implement them. Maybe we need to make it easier for older adults who can’t drive to travel and interact with their peers.

Time will tell, but once we complete some more research and intervention work, we will know which way to steer policymakers.