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4 Risk and Protective Factors for Social Isolation and Loneliness
Pages 63-90

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From page 63...
... Mechanisms and moderators will be discussed in Chapter 5. This chapter reviews the risk and protective factors for social isolation and loneliness, including predisposing physical health factors (e.g., chronic diseases, functional impairments)
From page 64...
... PHYSICAL HEALTH FACTORS Various physical health factors are related to social isolation and loneliness, including many common chronic diseases, impairments, and geriatric syndromes. As mentioned earlier, these relationships are often bi-directional.
From page 65...
... There is robust evidence, for example, that cardiovascular disease and stroke can increase the risk of social isolation and loneliness and also of low social support; conversely, there is also research indicating that people who have cerebrovascular or cardiovascular disease may have worse outcomes if they are socially isolated or lonely (Air et al., 2016)
From page 66...
... , and older adults living with HIV may face greater social isolation and loneliness as a result of decreased social participation and engagement due to a loss of friends and social networks and to HIV-related stigma (Greene et al., 2018; Greysen et al., 2013; Nachega et al., 2012; Rueda et al., 2014)
From page 67...
... . A recent study also found an association between frailty and social isolation and a fear of falling in older adults; however, physically frail study participants who were also socially isolated reported having fewer falls than participants who were either physically frail or isolated, but not the two combined (Hayashi et al., 2020)
From page 68...
... . PSYCHOLOGICAL, PSYCHIATRIC, AND COGNITIVE FACTORS Psychological symptoms, syndromes, and stressors can all influence whether an individual experiences loneliness or becomes socially isolated.
From page 69...
... Loneliness is not a core diagnostic feature of depression but may be an associated symptom. In some older adults, depression is accompanied by broad deficits in social function and well-being, including high levels of loneliness, low social support, and fewer social connections (Barger et al., 2014; Domènech-Abella et al., 2017)
From page 70...
... . In a separate study, 70 percent of nursing home residents with dementia reported feelings of loneliness (Cohen-Mansfield et al., 2015)
From page 71...
... Such factors include social support characteristics (including marital status and the quality of relationships with family and friends or pets) and the occurrence of disruptive life events (including bereavement, illness, and retirement)
From page 72...
... . Family and Marriage Family can be an important source of social support for older adults, providing social and emotional connection as well as contributing to an individual's financial and physical well-being (Verdery and Margolis, 2017)
From page 73...
... . Among older African Americans, family relationships often take precedence over relationships with friends, and social networks tend to be primarily made up of family members (Chatters et al., 2018; Cornwell et al., 2008; Griffin et al., 2006; Taylor et al., 2013)
From page 74...
... . For lesbian, gay, or bisexual individuals, living alone may be a symptom of larger discriminatory practices or societal stigma (Fredriksen-Goldsen et al., 2013; Kim and Fredriksen-Goldsen, 2016)
From page 75...
... (See discussions on rural versus urban living later in this chapter.) Caregivers With the rapid aging of the population, the number of older adults who need care continues to grow rapidly (NASEM, 2016b)
From page 76...
... Other aspects of human–animal relationships may be related to subsequent social isolation or loneliness in older adults. Interactions with animals can promote social interactions and participation; can add structure, routine, meaning, or purpose to an individual's day; can increase exercise and physical activity opportunities; and can provide emotional support (Brooks et al., 2018; Friedmann and Krause-Parello, 2018; Gee and Mueller, 2019; Hui Gan et al., 2019; Mueller et al., 2018)
From page 77...
... . The loss may be particularly acute when caregivers' responsibilities have compromised their regular social network while they were providing care, thus leaving them with diminished social support or feelings of isolation after the loved one's death (Holtslander et al., 2017)
From page 78...
... . In some cases, chronic illness may increase individuals' social support networks and decrease their likelihood of being socially isolated because addressing health issues may increase social interactions in the form of medical or therapy appointments and other health-related activities (Finlay and Kobayashi, 2018)
From page 79...
... . Women with functional limitations have been found to experience greater loneliness if they have strained marital relationships while men may experience increased loneliness if they have overly supportive relationships, and people who lacked contact with friends all experienced greater loneliness (von Soest et al., 2020; Warner et al., 2019)
From page 80...
... . The disruption of these daily social interactions and structured routines upon retirement can lead to subsequent socialization difficulties (Morris, 2019)
From page 81...
... . Additionally, several studies have found that women are more likely to be active members and experience greater overall benefits from participation in religious organizations, to have stronger social support and social networks, and to generally be less lonely than men (Gray, 2009; Idler et al., 2017; Kirkpatrick et al., 1999; Lauder et al., 2006; Strawbridge et al., 2001)
From page 82...
... Regardless of where or in what type of housing a person lives, the degree of social isolation or loneliness an individual experiences can be affected by whether he or she feels safe in his or her community. Prior direct or indirect exposure to community violence can lead to increased loneliness or a reduction in perceived social support from friends, thus increasing socially isolation (Tung et al., 2019)
From page 83...
... . In addition, the desire to remain independent and enmeshed in established social networks close to home can be a compelling reason to stay (Benefield and Holtzclaw, 2014; Herbert and Molinsky, 2019)
From page 84...
... . Although subsidized housing communities, senior housing, and retirement communities all offer similar socialization opportunities (e.g., interactions with peers, planned activities, and meeting spaces)
From page 85...
... Long-Term Care Service Options: Residential Care and Nursing Homes Locations that offer long-term care services such as adult day care, nursing homes, and residential care provide older adults with a range of health care, personal care, and supportive services. In 2016 long-term care service providers served more than 8.3 million people in the United States, including 1,347,600 in nursing homes and 811,500 in residential care facilities (Harris-Kojetin et al., 2019)
From page 86...
... Generally, study participants in the outer suburbs reported greater loneliness than those closer to the city center, with loneliness decreasing with moves into the inner suburbs and closer to the city center. Many of the inner suburbs lacked communal places in which to gather, and people who lived in the outer suburbs reported that isolation from neighbors and the long distances to opportunities for socialization increased their social isolation and loneliness, although these results were not consistent among study participants.
From page 87...
... . A study of older, highly acculturated Korean immigrants found lower levels of depression in people who had stronger social support networks (Kim et al., 2012)
From page 88...
... . FINDINGS AND CONCLUSIONS Physical Health Factors • Physical health risk factors for social isolation and loneliness include many common chronic diseases and conditions, including heart disease, stroke, and cancer.
From page 89...
... • Social environmental factors such as driving status, housing status, or location can affect the levels of social isolation and loneliness. • At younger ages men and women experience similar rates of social isola tion and loneliness, but women may be at higher risk as they get older.


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