In April, the NIHR School for Social Care Research (SSCR) and the Campaign to End Loneliness hosted a joint event to showcase some of the latest research into loneliness, isolation and wellbeing in older age. Over 200 delegates came – representing universities, local government, older people’s forums and charities. We heard about new evidence, debated key issues for policy and practice and discussed the gaps in research and practice that need to be filled.

The prevalence of loneliness and isolation in England

Dr Aparna Shankar from UCL presented on her analysis of social connections and loneliness in the English Longitudinal Study of Ageing. Her research showed that 6% of the population aged 50+ in England could be described as highly isolated, and that the likelihood of isolation increased with age and decreased with greater wealth. The number of very lonely people was about 7%, and it also increased with age and low income. Interestingly, women were more likely to report feeling lonely than men were. The research also showed it was possible to be isolated but not lonely –of the people who are most isolated, about a third said they never felt lonely.

Loneliness and isolation are linked to a range of poor health outcomes

Emilie Courtin from the LSE, presented first – describing the evidence base on the links between loneliness, social isolation, and poor physical and mental health. She explained that the majority of research into loneliness and health is very new (published after 2010) and largely from the USA. She found that loneliness is key risk factor for depression in older age, even after you take away the influence of other known risk factors for depression like poor physical health. She also found that social isolation was a strong predictor for poor cardiovascular health.

Disability, poor health and environments can lead to loneliness in later life

Professor Vanessa Burholt from Swansea University shared her new research whether poor health and disability are triggers for loneliness in Wales. She found that the more disabled someone was, the greater their levels of loneliness were. However, this was because disability has an impact on our social resources (the quality and quantity of our relationships) and social participation (whether we’re involved in local groups and activities) which in turn can increase our chances of loneliness.

There were generally higher levels of loneliness in older people living in rural areas. But when she looked at the data in more depth, she discovered that people with a mild or severe disability living in urban areas were actually more lonely than people in rural areas.

The links between dementia and loneliness

Professor Christina Victor, from Brunel University, presented the findings of a recent review of research into dementia and loneliness. She found 4 studies that demonstrated that there were higher levels of loneliness amongst people with dementia than amongst people without dementia.

“What is so fascinating about loneliness? For me, it’s about the degree to which loneliness is part of the human experience, its part of what makes us human…but increasingly the research agenda around loneliness has been very much focused on health consequences” 

A further 4 studies found argued that loneliness was a cause of dementia but there were problems with the quality of the research. Two only looked at differences in recall and verbal fluency tests – therefore not a proper dementia diagnosis. A third study found that people were 30-50% more likely to have dementia if they were lonely but, crucially, the researchers didn’t use a proper loneliness measurement tool so this results are questionable. A fourth study showed that people who were lonely were at greater risk of having dementia, but couldn’t prove that one was causing the other. There is therefore no evidence showing that loneliness causes dementia.

Evidence for loneliness, independence and wellbeing ‘interventions’

Dr David McDaid, from LSE, shared the results of three reviews that aimed to identify the levels of, and evidence for, interventions that improve independence and mental wellbeing in older age. They also examined the cost-effectiveness of certain programmes and projects. They found a huge range of services were being organised. At the heart of most of these were communication and friendship. They ranged from mentoring programmes to arts and cultural activities, volunteering to sign-posting support, life-long learning to supporting carers. There was also some interest in digital inclusion and intergenerational activities.

However, David found that the evidence base for successful interventions is patchy still, and not always that robust. Many studies relatively small in size and needed to be larger to prove (statistically) that they make a difference. Most services were also reaching women but not men.

Principles for evaluating services that prevent loneliness and isolation

Dr Jose-Luis Fernandez, also from LSE, presented last. He discussed some of requirements and challenges that researchers, services and commissioners face when evaluating the cost and cost-effectiveness of loneliness prevention.