Loneliness hurts. How to recognize loneliness as a health concern.

The Bottom Line

  • Many older adults are lonely and this could affect their overall health.
  • A solution to loneliness may be changing negative or wrong perceptions about oneself and others.

Why is loneliness a health concern?

Most people feel lonely once in a while, but the feeling usually doesn’t last long. There are, however, some older people who feel lonely quite often – one in five Canadians aged 65 or older indicated that they felt lonely some of the time or often in a recent study (1). The proportion is even higher among those 85 years or older – 25% of individuals in that age bracket felt lonely some of the time or often (1).

Loneliness is a distressing feeling that one does not have enough social relationships or not enough contact with people. Researchers have made the strong point that loneliness is not the same as social isolation; social isolation really does mean that you do not have enough people to interact with. Consider two people who have a very small social network. Both these people have no family and only a neighbor stops by for a visit once in a while. Researchers note that one of these people may feel lonely, but the other person does not. On the other hand, a person can have a large family that lives close by, but still feel lonely; this is an example of why sometimes we say that one can feel lonely in a crowd. Loneliness is really about how you think about or perceive your situation. Also, loneliness is not depression; although some lonely people are depressed, many are not depressed. However, loneliness can sometimes lead to depression. We don’t exactly understand this but it is like the chicken and the egg parable; we are not certain which came first.

What does the research (scientific evidence) show us about loneliness?

Research shows that loneliness has a number of implications for people’s health. For example, older people who are lonely are more likely to experience a decline in their mobility, compared to those who are not lonely (2). Older people who are lonely also have an increased risk of dying sooner (3). Cacioppo (4), a prominent expert in this field, likens loneliness to social pain; like physical pain it hurts. But loneliness can also serve as a motivational force for change in connection with one’s social relationships.

If loneliness is not about having enough people to interact with, then what causes it? One theory (5) is that loneliness comes about because of negative or wrong (called maladaptive) thoughts about oneself and others. People who believe that they are lonely are more likely to believe that other people will reject them. They are also more likely to have low self-worth. If loneliness comes about because of such negative or wrong thinking (maladaptive perceptions), then different ways to make this better (called interventions) should presumably focus on changing those perceptions. That is exactly what has been tried in some research studies. For example, participants in one intervention study took part in a workshop. This workshop focused, among other things, on identifying positive relationships from the past, how to apply positive aspects of past relationships to present relationships, and gaining awareness of personal accomplishments.

In a review study(5), researchers looked at 50 studies that used a wide range of things that might help with loneliness (called interventions). Some of these studies were designed to change negative or wrong thinking (maladaptive perceptions). Some studies looked at other interventions focusing on enhancing social supports (for example, linking to community groups). This review showed that interventions that focused on changing people’s negative or wrong thinking (maladaptive perceptions) indeed were more effective than all other types of interventions.

What is the bottom line about loneliness and well-being?

Many older adults are lonely. Reducing loneliness first requires an understanding of a person’s circumstances. Is the person lonely because she is socially isolated and doesn’t have anybody to interact with? If so, the solution may be to connect them to other people; there are many programs available that serve this goal, such as those easily found in community and senior centres. But maybe the problem is not so much the lack of social connections, but rather the way a person thinks about himself or other people. In that case, research suggests that the focus needs to be on changing negative perceptions.

Author Details


  1. Canadian Institute for Health Information. Canadian Institute for Health Information (CIHI). Seniors using five or more types of prescription drugs. 2010. http://www.cihi.ca/CIHI-ext-portal/internet/en/document/types+of+care/pharmaceutical/release_18mar2010.
  2. American Psychiatric Association. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association; 2013.
  3. Canadian Institute for Health Information (CIHI. Canadian Institute for Health Information (CIHI). Seniors and the healthcare system: what is the impact of multiple chronic conditions. Toronto, Canada: CIHI; 2011.
  4. Cacioppo JT, Hawkley LC, Norman GJ, Berntson GG. Social isolation. Ann N Y Acad Sci 2011 Aug;1231:17-22.
  5. Masi CM, Chen HY, Hawkley LC, Cacioppo JT. A meta-analysis of interventions to reduce loneliness. Pers Soc Psychol Rev 2011 Aug;15(3):219-66.



