From the National Institute on Aging at NIH

Understanding 

Loneliness and 

Social Isolation

How to Stay Connected 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

What are Loneliness and Social Isolation? . . . . . . . . 5

How Can Being Isolated or Feeling Lonely

Affect a Person’s Health? . . . . . . . . . . . . . . . . . . . . . . . . . 8

How Do I Know if I Am at Risk? . . . . . . . . . . . . . . . . . . 13

What Can I Do To Stay Connected? . . . . . . . . . . . . . . 19

For More Information . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Words To Know . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Use the Table of Contents to help you find things 

quickly. Page 24 has a list of resources for more 

information about loneliness and social isolation. 

We also put some medical terms in bold, such as 

inflammation. You can find how to say these words 

and what they mean in the “Words To Know” 

section on page 30.

Table of Contents

3

As people age, they often find themselves spending more 

time alone. This can affect your health and well-being. 

Everyone needs social connections to survive and thrive.

This booklet will help you learn about 

loneliness and social isolation: 

• What they are 

• Health effects 

• Risk factors 

• How to stay connected if you or someone you love 

is isolated or feeling lonely 

Introduction
4

Marvin’s Story

After working 35 years as a teacher, Marvin looked 

forward to an active retirement with his wife, Sandra. For 

many years, they enjoyed traveling, spending time with 

their grandchildren, and socializing with friends. Then 

Sandra developed breast cancer and passed away. Marvin 

had a difficult time coping with her death and didn’t feel 

like socializing with their friends or going out to do

things on his own.
5

The number of older adults age 65 and older is growing, 

and many are socially isolated and regularly feel lonely. The 

coronavirus outbreak in 2020 brought even more challenges 

due to health considerations and the need to practice 

physical distancing. 

Social isolation and loneliness are different, but related. 

Social isolation is the lack of social contacts and having 

few people to interact with regularly. Loneliness is the 

distressing feeling of being alone or separated. It’s possible to 

feel lonely while among other people, and you can live alone 

and not feel lonely or socially isolated. 

Older adults are at higher risk for social isolation and 

loneliness due to changes in health and social connections 

that can come with growing older, hearing, vision, and 

memory loss, disability, trouble getting around, and/or the 

loss of family and friends. 

What Are Loneliness and 

Social isolation? 
6

If you are in poor health, you may be more likely to be 

socially isolated or lonely. And, if you are socially isolated

or feeling lonely, it can also put your physical and mental 

health at risk.

Adults who are lonely or socially isolated are less healthy, 

have longer hospital stays, end up readmitted to the hospital 

more often, and are more likely to die earlier than those with 

meaningful and supportive social connections.
7

Staying Connected During COVID-19

With the COVID-19 pandemic (global outbreak), 

maintaining safe distancing precautions has been 

challenging for everyone — even people who are 

otherwise well-connected with large supportive 

social networks.

Public health guidelines to keep physical distance from 

others have slowed down the spread of COVID-19, 

but they have also made it harder for people to see 

family and friends. Older adults are at greater risk of 

COVID-19, but it is also critically important for them 

to maintain active social connections. Reach out by 

phone, video, text, social media, email, or letter to help 

everyone stay connected during this challenging time. 

Learn more at www.coronavirus.gov.
8

People who are socially isolated or lonely are more likely

to be admitted to nursing homes and the emergency room. 

Social isolation and loneliness also are associated with

higher risks for: 

• High blood pressure 

• Heart disease 

• Obesity 

• Weakened immune 

functioning 

• Anxiety 

People who are lonely or socially isolated may get too little 

exercise, drink too much alcohol, smoke, and often

don’t sleep well, which can increase the risk of heart

disease, diabetes, obesity, high blood pressure, and other 

serious conditions.

How Can Being Isolated or 

Feeling Lonely Affect

a Person’s Health? 

• Depression 

• Cognitive decline

• Dementia, including 

Alzheimer’s disease

• Death
9

People who are lonely experience emotional pain. Losing 

a sense of connection and community can change the way 

a person sees the world. Someone experiencing chronic

loneliness can feel threatened and mistrustful of others. 

Emotional pain can activate the same stress responses in the 

body as physical pain. When this goes on for a long time, it 

can lead to chronic inflammation and reduced immunity. 

This raises your risk of chronic diseases and can leave a 

person more vulnerable to some infectious diseases. 

Social isolation and loneliness may also be bad for brain 

health. Loneliness and social isolation have been linked to 

poorer cognitive function and higher risk for dementia, 

including and especially for Alzheimer’s disease. Also, 

little social activity and being alone most of the time may 

contribute to a decline in the ability to perform everyday tasks 

such as driving, paying bills, taking medicine, and cooking.
10

Tips for Staying Connected if You Are 

Living Alone With Dementia

If you or a loved one has dementia and lives alone, family 

members, friends, or other caregivers may be able to help in 

different ways. 

• Identify a person you trust, such as a neighbor, who 

can visit you regularly in-person or via a video call, and be 

an emergency contact.

• Learn about home- and community-based support 

and services from social service agencies, local 

nonprofits, and Area Agencies on Aging. 

• Stay connected with family and friends through 

video chats, email, and social media. If you’re not tech 

savvy, ask for help to learn. 

• Talk with others who share common interests. 

Try a support group online or in person. Maybe your 

community has a memory café you can visit — a safe place 

to enjoy activities and socialize for people living with 

memory loss and their families and caregivers.
11

COVID-19 Precautions

During the COVID-19 pandemic, take precautions to

protect yourself and others. Wash your hands often with 

soap and water or use a hand sanitizer if soap and water 

are not available. Stay at least 6 feet from people who are 

not in your household. Cover your mouth and nose with 

a cloth face mask when around others. Always cover 

your mouth and nose with a tissue when you sneeze 

or cough, or use the inside of your elbow if you do not 

have a tissue. Frequently clean and disinfect surfaces 

that you frequently touch each day. Stay at home when 

you feel ill. Read more at www.coronavirus.gov.
12

Elena has been her father Oscar’s caregiver ever since 

he was first diagnosed with Alzheimer’s disease. As 

Oscar’s condition has worsened, Elena must do more to 

help, including helping him with bathing and dressing, 

taking him to the doctor, and preparing his meals. While 

she feels lucky to be caring for Oscar, Elena often feels 

overwhelmed and distant from her friends. She no longer 

has time to spend with them and is often too tired to do so 

even if she could.

Elena’s Story
13

Those who find themselves unexpectedly isolated due to 

the illness of a loved one, separation from friends or family, 

loss of mobility, worsening vision or hearing problems, 

disability, or lack of mobility or access to transportation, are 

at particular risk of loneliness and social isolation. 

You also may be at greater risk if you: 

• Live alone

• Can’t leave your home 

• Had a major loss or life change, such as the death 

of a spouse or partner or retirement 

• Struggle with money 

• Are a caregiver 

• Have psychological or cognitive challenges 

• Have limited social support 

• Live in a rural, unsafe, and/or hard-to-reach 

neighborhood 

• Have language barriers where you live 

• Experience age, racial, ethnic, sexual orientation, and/or 

gender identity discrimination where you live 

• Are not meaningfully engaged in activities or are feeling 

a lack of purpose

How Do I Know if I Am at Risk? 
14

Hearing Loss Can Make It Harder

To Stay Connected 

People with hearing loss may find it hard to have 

conversations with friends and family. 

Many older adults have difficulty hearing, but 

some may not want to admit it. Those who can’t 

hear well may withdraw from others because they 

feel frustrated, become depressed, or embarrassed. 

Sometimes, older adults are mistakenly thought to be 

confused, unresponsive, or uncooperative when the 

reality is that they don’t hear well.

Difficulties communicating with others can lead to less 

interaction with people, social isolation, and higher 

rates of loneliness.

Hearing problems that are ignored or untreated can get 

worse. If you have a hearing problem, see your doctor. 

Hearing aids, special training, certain medicines, and 

surgery are some of the treatments that can help. Read 

more at www.nidcd.nih.gov/health/hearing-lossolder-adults. 
15

Dealing with Grief, Mourning,

and Depression 

Although it is normal to mourn when you have a loss, 

later life does not have to be a time of ongoing sadness or 

disconnection. Depression is a common problem among 

older adults, but it is not a normal part of aging. It is 

treatable, so let your doctor know about your feelings and 

ask about treatment.

It is especially important to get help with your loss to help 

prevent you from feeling overwhelmed. If you feel sad all 

the time, are unable to imagine life moving forward without 

your loved one, experience a general loss of interest in things 

you used to like to do, or if your sense of loss keeps you from 

doing your daily activities, let your doctor know. Also, tell 

your doctor about symptoms such as lack of energy, poor 

appetite, trouble sleeping, or little interest in life. These 

could be signs of complicated grief or depression, both of 

which can be treated. 

Family and caring friends often can provide great support. 

There are also support groups where grieving people help 

each other. Also, remember to take good care of yourself:

Try to eat well, exercise, get enough sleep, and do activities 

you enjoy.
16

Talking With Your Doctor 

If you are feeling isolated or lonely a lot of the time, you may 

want to tell your doctor or health professional. Talking about 

your health with your doctor means sharing information 

about how you feel physically, emotionally, and mentally. 

Describing your symptoms can help your doctor identify the 

problem. Make sure to bring up your concerns. For example, 

let your doctor know about any major changes or stresses in 

your life, such as a divorce or the death of a loved one.

As we grow older, we may lose people in our lives, including 

spouses and cherished friends. Or, we may have to move 

away from home or give up favorite activities. A doctor who 

knows about your losses is better able to understand how

you are feeling. They can make suggestions that may be 

helpful to you. 
17

Think You Might Be at Risk?

Check out this resource to learn more about loneliness 

and social isolation and take a quiz to see if you might 

be at risk for loneliness or social isolation: Expanding 

Your Circles: Prevent Isolation and Loneliness as you 

Age, https://eldercare.acl.gov/Public/Resources/

Brochures/docs/Expanding-Circles.pdf

Be open and honest with your doctor about your health 

habits and what’s happening in your life. It will help them 

to understand your medical conditions and emotional 

health more fully and recommend the best treatment 

options for you. Learn more about doctor-patient 

communication at www.nia.nih.gov/twyd.
18

Since Carla started having trouble with her vision, she’s 

had to give up driving and travels less often. But she 

still enjoys spending time with her three grandchildren, 

even though she lives in Maryland and they live across 

the country in California. Carla reads stories to them on 

video chat and catches up on how they are doing on social 

media. She also stays in touch with friends through email 

and weekly phone calls. Carla feels much happier knowing 

that she can stay connected with others.

Carla’s Story
19

What Can I Do To Stay 

Connected? 

There are things you can do to protect yourself or a loved one 

from the effects of loneliness and social isolation. First, it’s 

important to take care of yourself. Exercise, eat healthy, get 

enough sleep, and pursue activities you enjoy to help manage 

stress and stay as mentally and physically healthy as possible. 

It’s also important to stay active and connect with others. 

People who engage in meaningful, productive activities they 

enjoy with others feel a sense of purpose and tend to live 

longer. Studies show these activities may help boost your 

mood and improve your well-being and cognitive function. 

People who live an active lifestyle: 

• Are less likely to develop certain diseases 

• Have a longer lifespan 

• Are happier and feel less depressed 

• Are better prepared to cope with loss 

• May be able to improve their thinking abilities 

For example, helping others through volunteering helps you 

feel less lonely and allows you to have a sense of mission and 

purpose in life, which is linked to better health. 
20

Here are some other ideas to help you stay connected:*

• Find an activity that you enjoy, restart an old hobby, or 

take a class to learn something new. You might have fun 

and meet people with similar interests.

• Schedule time each day to stay in touch with family, 

friends, and neighbors in person, by email, social media, 

voice call, or text. Talk with people you trust and share 

your feelings. Suggest an activity to help nurture and 

strengthen existing relationships. Sending letters or cards 

is another good way to keep up friendships.

• Use communication technologies such as video chat, 

smart speakers, or even companion robots to help keep 

you engaged and connected.

• If you’re not tech-savvy, sign up for an online or in-person 

class at your local public library or community center to 

help you learn how to use email or social media. 

• Consider adopting a pet if you are able to care for them.

Animals can be a source of comfort and may also lower 

stress and blood pressure.
21

• Stay physically active and include group exercise, such 

as joining a walking club or working out with a friend. 

Adults should aim for at least 150 minutes (2 1/2 hours) 

of activity a week that makes you breathe hard.

• Introduce yourself to your neighbors.

• Find a faith-based organization where you can deepen 

your spirituality and engage with others in activities 

and events.

• Check out resources and programs at your local social 

service agencies, community and senior centers, and 

public libraries.

• Join a cause and get involved in your community.

*See page 11 for information to help you stay safe during the 

COVID-19 pandemic.
22

The Benefits of Exercise 

If you’re feeling down, anxious, or stressed because you 

are lonely or isolated, one way to boost your mood is to get 

moving through exercise. Research has shown that exercise 

is not only good for your physical health; it also supports 

emotional and mental health. You can exercise with a friend 

and get the added benefit of emotional support. 

Physical activity can help: 

• Reduce feelings of depression and stress, while improving 

your mood and overall emotional well-being 

• Increase your energy level 

• Improve sleep 

• Empower you to feel 

more in control 
23

In addition, exercise and physical activity may possibly 

improve or maintain some aspects of cognitive function. 

Whether it’s gardening, playing tennis, taking a walk in the 

park, kicking around a soccer ball with your grandchildren, or 

something else, choose an activity you enjoy.* 

*See page 11 for information to help you stay safe during the 

COVID-19 pandemic.

There are many things you can do to stay connected as 

you age. By staying active, participating in meaningful 

activities you enjoy, and maintaining relationships 

with others, you can help keep your brain active, 

avoid health problems, and feel less isolated and more 

engaged with the world around you.
24

Federal Government Resources 

NIA Alzheimer’s and related Dementias Education

and Referral (ADEAR) Center 

800-438-4380 (toll-free) 

adear@nia.nih.gov

www.nia.nih.gov/alzheimers

The National Institute on Aging’s ADEAR Center offers 

information and publications for families, caregivers, and 

health professionals on Alzheimer’s disease and related 

dementias, including information on caregiving, clinical 

trials, and research. Staff members answer inquiries by 

phone, email, and in writing and make referrals to local and 

national resources. Visit the ADEAR website to learn more 

about Alzheimer’s and related dementias, find clinical trials,

and sign up for email updates.

AmeriCorps Seniors 

800-942-2677 

https://americorps.gov

Senior Corps is a network of national service programs 

for Americans age 55 and older, made of three primary 

programs: Senior Companions, Foster Grandparents, and 

RSVP. Senior Corps volunteers commit their time to address 

critical community needs including academic tutoring and 

mentoring, elderly care, disaster relief support, and more. 

For More Information
25

Eldercare Locator 

800-677-1116 (toll-free) 

eldercarelocator@n4a.org

https://eldercare.acl.gov

This service of the Administration on Aging, of the 

Administration for Community Living, can help you find 

housing, support services, transportation, health and 

insurance, and benefits information in your local community.

Other Resources 

AARP 

888-687-2277 (toll-free) 

877-434-7598 (TTY/toll-free) 

member@aarp.org

www.aarp.org/caregiving

AARP provides resources and guidance for family caregivers 

on social isolation, in-home care, medical, financial, and legal 

considerations, and caregiver well-being.

Alzheimer’s Association 

800-272-3900 (toll-free) 

866-403-3073 (TTY/toll-free) 

info@alz.org

www.alz.org

The Alzheimer’s Association provides information and 

support for people with Alzheimer’s disease and their 

caregivers including a 24-hour helpline for confidential 

support and information for those living with Alzheimer’s 

disease, caregivers, families, and the public. 
26

Connect2Affect 

https://connect2affect.org

Connect2Affect is an online resource to address social 

isolation and loneliness and increase awareness. It features 

tools, training resources, and information to help evaluate 

isolation risk and create networks. 

Isolation Assessment

https://connect2affect.org/assessment/self

This assessment can be done by an individual or a 

caregiver to help gauge how connected the person is. It 

also provides suggestions for resources that may help. 

Family Caregiver Alliance 

800-445-8106 (toll-free) 

info@caregiver.org

www.caregiver.org

The Family Caregiver Alliance provides services to family 

caregivers of adults with physical and cognitive impairments, 

such as Parkinson’s, stroke, Alzheimer’s and other types of 

dementia, including assessment, care planning, direct care 

skills, wellness programs, respite services, and legal/financial 

consultation vouchers. 

Meals on Wheels America 

888-998-6325 (toll-free) 

info@mealsonwheelsamerica.org 

www.mealsonwheelsamerica.org

Meals on Wheels America provides home meal delivery 

services to people who have trouble getting out of their homes. 
27

National Association of Area Agencies on Aging 

202-872-0888 

info@n4a.org

www.n4a.org

This national network of Area Agencies on Aging provides 

resources and information for older adults and people with 

disabilities on health, safety, and staying connected. 

National Council on Aging 

571-527-3900 

www.ncoa.org

The National Council on Aging partners with nonprofit 

organizations, government, and businesses to provide 

innovative community programs and services, online help, 

and advocacy. 

Center for Healthy Aging

www.ncoa.org/center-for-healthy-aging

Geri-Fit

www.gerifit.com

Healthy Moves

www.eblcprograms.org/evidence-based/

recommended-programs/healthy-moves

Fit & Strong!

www.fitandstrong.org
28

SilverSneakers 

866-584-7389 (toll free) 

support@silversneakers.com

www.silversneakers.com

SilverSneakers is a community fitness program for older 

adults that offers offers exercise classes, workouts,

how-to videos, and workshops. 

YMCA

800-872-9622

fulfillment@ymca.net 

www.ymca.net/healthy-living/programs-for-older-adults

The YMCA offers evidence-based group exercise programs 

for older adults to improve fitness and prevent falls.
29

To Learn More About

Health and Aging

National Institute on Aging Information Center

800-222-2225 (toll-free)

800-222-4225 (TTY/toll-free)

niaic@nia.nih.gov

www.nia.nih.gov

Visit www.nia.nih.gov/health to find more health and aging 

information from the National Institute on Aging at NIH and 

subscribe to email alerts. Visit https://order.nia.nih.gov

to order free print publications.
30

Alzheimer’s Disease 

(pronounced allz-high-merz duh-zeez) 

A disease that causes large numbers of nerve cells in the brain 

to die. People with this disease lose the ability to remember, 

think, and make good judgments. The symptoms begin 

slowly and get worse over time. 

Chronic 

(pronounced kron-ik) 

A condition that continues for a long time or recurs

over time. 

Cognitive Decline 

(pronounced kog-ni-tiv dih-klahyn) 

A medical condition that causes people to have more 

memory problems than other people their age. The signs are 

not as severe as those of Alzheimer’s disease. They include 

forgetting to go to events and appointments, and having 

more trouble coming up with the right words than other 

people the same age. 

Complicated Grief 

(pronounced kom-pli-key-tid greef) 

A condition in which people who have lost a close loved one 

may be unable to comprehend the loss, experience intense, 

prolonged grief, and have trouble resuming their own life. 

Words To Know
31

Dementia

(pronounced duh-men-shuh) 

A loss of cognitive functioning. This means changes to a 

person’s thinking, remembering, reasoning, and behavior 

that make daily life and activities difficult to manage.

Immunity 

(pronounced ih-myoo-ni-tee) 

The ability to resist or fight off a disease.

Inflammation 

(pronounced in-fluh-mey-shuhn) 

Inflammation includes heat, swelling, and redness caused 

by the body’s protective response to injury or infection. 

Inflammation that occurs in healthy tissues or lasts too long 

can be harmful. 

Loneliness 

(pronounced lohn-lee-nes) 

The distressing feeling of being alone or separated.

Physical Distancing 

(pronounced fiz-i-kuhl dis-tuhns-ing) 

The act of keeping a safe space between yourself and other 

people who are not from your household. To practice physical 

distancing, stay at least 6 feet (about 2 arms’ length) from 

other people in both indoor and outdoor spaces who are not 

from your household. 

Social Isolation 

(pronounced soh-shuhl ahy-suh-ley-shuhn) 

The lack of social contacts and having few people to interact

with regularly.
32
33

Share this booklet with friends and family so they can 

understand more about loneliness and social isolation 

and staying connected.
34

 

NIH Publication No. 20-AG-8150 

November 2020