Elderly Social Isolation Loneliness in COVID-19 May Lead to Cognitive Decline
Expert tells HD Live! that socialization of seniors in COVID-19 needs to be tailored to individual needs
THURSDAY, Sept. 17, 2020 (HealthDay News) -- Social isolation and loneliness can increase the risk for cognitive decline in seniors, according to Carla Perissinotto, M.D., geriatrician and associate chief for geriatrics clinical programs at the University of California in San Francisco, who recently spoke with HD Live! about the current challenges facing seniors in assisted living or nursing homes during the COVID-19 pandemic.
While people are having to socially and physically distance to protect their health now, the long-term health effects of this isolation remain unknown, Perissinotto said. Being able to socialize and be physically active are both health-protective measures, and similar to the model of "use it or lose it" in regard to muscle development, a lack of social interaction can be detrimental to a person's cognitive health and even increase the risk for developing dementia over time by 50 percent, she explained.
"One of the challenges right now, though, is that because we are seeing these changes in real time, we haven't actually had time to study this in detail," Perissinotto said. "Anecdotally, [I hear] from family members and friends and people living and working in assisted living and nursing homes that [because] older adults [are] less socially engaged and less active, they are absolutely seeing changes in physical function and in cognitive sharpness, just by not being around other people and then by the subjective feeling of being alone."
When identifying loneliness in someone who is in isolation, all assumed age-related biases must be removed. "One of the main things to think about is ageism, and don't assume what all people need and want," Perissinotto said. "You can't assume that because someone is alone, that they are lonely. And the reverse is true, that because they are with other people, they are not lonely."
Perissinotto recommends using validated tools to evaluate a person's loneliness while in isolation. She pointed readers to a Consensus Study Report titled, "Social Isolation and Loneliness in Older Adults," released in February by the National Academy of Sciences, which highlights some of the tools that can be used to identify signs of loneliness in older adults.
While there is no one-size-fits-all solution to loneliness in isolation, there are ways to see family members and friends safely by following public health guidelines that have been found to be effective (such as masking and maintaining distance), according to Perissinotto.
Technology is also a helpful tool, but it is critical to evaluate suitability on an individual basis. For example, technology may not be the ideal solution for those with severe cognitive, hearing, or visual impairments. Additionally, for some, socialization via technology might accentuate the loss of not being able to see others in person, explained Perissinotto.
It is also important to share the decision making when determining how and when older adults will connect with others, said Perissinotto. For instance, if a grandparent wishes to see their grandchildren, she recommends reviewing the risks together (i.e., how widespread COVID-19 is within that person's community, whether there are any medical problems to consider) and then evaluating the benefits of visiting with those family members. The best thing to do at this time, she said, is to be cognizant of mitigating the risks for spread and infection, while maintaining social interactions in whatever way is valuable to both the individual and their community.