The reality of loneliness among Canada’s elderly. Why is it getting worse?

As Canada grapples with a rapidly aging demographic, experts are sounding the alarm on the increasing mental and physical health impacts of loneliness and social isolation, particularly among older people who make up a growing proportion of the population.

A report by the National Institute of Ageing (NIA) released Tuesday found that around 41 per cent of Canadians aged 50 years and older are at risk of social isolation and up to 58 per cent in that age group have experienced loneliness.

And this can have both mental and physical consequences.

“Social isolation and loneliness are as bad for your health as smoking 15 cigarettes a day,” Jacques Lee, a Toronto-based emergency physician, told Global News.

“This is nothing I ever learned in medical school. This is nothing we’ve been trained to ask about and we don’t know how to prescribe for it either. So it’s a hugely impactful health problem that we’re not monitoring and we’re not treating.”

The survey, which was conducted over the summer, comes on the heels of a recent warning from the World Health Organization (WHO), which said loneliness could soon become a global epidemic.

The NIA found that while most older Canadians report they have a network of family and friends they can count on, more than four in 10 are considered to be socially isolated.

And loneliness ranked even higher.

The majority (58 per cent) of older Canadians reported experiencing some level of loneliness. Nearly 20 per cent reported being “very lonely,” the report found.

The NIA report distinguishes between loneliness and social isolation. For example, NIA said social isolation is characterized as a “measurable deficiency in the number of social relations a person has.”

In contrast, loneliness is described as “an internal subjective experience,” that happens when a person’s social relationships fall short in either quality or quantity compared to what they desire.

“The thing about being lonely, it’s not the same necessarily, as just being isolated. So you can have a large group of connections with people but not feel deeply connected to any of them and be lonely. Or you can have one really close friend and not be lonely,” Lee explained.

While loneliness and social isolation can affect anyone, Lee noted that these experiences often intensify with age, compounded by health issues, retirement, widowhood, and the loss of family members or friends. These major life events can make it more difficult to maintain or establish social ties.

The report found the oldest Canadians, aged 80 years and older, appeared to fare better and reported less social isolation and loneliness compared to their younger counterparts aged 50 to 64 years and 65 to 79 years.

For example, among Canadians aged 80 years and older, nine per cent reported being very lonely, and among Canadians aged 50 to 64 years, almost one in four (23 per cent) reported being very lonely.

“That got us scratching our heads a little bit,” said Dr. Samir Sinha, the director of geriatrics at Sinai Health and the University Health Network in Toronto, in an interview with Global News.

“There’s some speculation that perhaps as we age, we’re able to better identify these issues and better cope with them. The other thought is that perhaps people who have loneliness and social isolation — because it can shorten people’s life expectancies by as much as 15 years — is that maybe only those who are less lonely and isolated are more likely to survive into older ages.”

And in terms of gender, the report found that there are no major differences between older Canadian men and women in their reported experiences of social isolation, but older women reported experiencing greater levels of loneliness than older men.

The risk of premature mortality from social isolation and loneliness is comparable to other risk factors such as smoking, lack of physical activity, obesity, substance abuse, injury and violence and lack of access to health care, NIA stated.

“The challenge is that we think about heart disease, we think about cancer as real significant health issues in our older population. But what we know is that social isolation and loneliness can be just as deadly for older people,” Sinha said.

“You can imagine that if you’re feeling isolated and you’re feeling lonely, it can increase mental health concerns like anxiety, and depression. This can also lead to physical health concerns that can affect people’s heart and other areas of health.”

Mood disorders, dementia, cardiovascular disease, malnutrition, falls and premature mortality are just a few of the adverse health outcomes that both social isolation and loneliness have been linked to among older adults, the report said.

And with older Canadians making up a rapidly growing proportion of the country’s population, the number of isolated or lonely older Canadians is expected to significantly increase, meaning that both the individual and societal consequences of this will likely also become more severe, the report stated.

The presence of family ties appears to be especially important in protecting against social isolation and loneliness among older Canadians, the report found.

Notably, the report said the company of both a life partner and children seems to bring notable advantages, contributing positively to the well-being of older individuals.

“Some of the populations we found that were more likely to experience social isolation and loneliness were folks who didn’t have children, for example,” Sinha said. “They may be single and either through widowhood or they just never married. And so these are things that would just mean they would have less social contact naturally with other people.”

Socioeconomic status was also found to be an important predictor of social isolation and loneliness among older Canadians. The report found that those who reported higher levels of education and income security consistently reported less social isolation and loneliness.

Health status also contributed to loneliness and social isolation.

For example, the report said the higher rated one’s health status was, the less likely they were to report being socially isolated or lonely. However, overall, the report said social isolation and loneliness levels “remained significant regardless of older Canadians’ reported health.”

“The folks who had significant health concerns or other reasons that would keep them more homebound, these were things that would make confined people less willing to socialize or even less able to socialize with others,” Sinha said.

The NIA survey also revealed that older Canadians living independently in their own homes were less likely to experience social isolation and have feelings of loneliness than those living in someone else’s home or other types of dwellings such as a care setting.

Lee stressed that because loneliness can be subjective, sometimes it is best just to ask someone “Are you feeling lonely” or “Are you feeling isolated” rather than assuming.

“We’ve got a problem with connection in our society, even walking down the street, everybody’s looking at their phones. So we’ve lost that sense of community,” he said.

“Talk to the person next to you on the bus. Think about your neighbour who maybe doesn’t have anybody in their life. Invite them over. Just take some chances and reach out.”

The NIA report recommended that the federal government tackle social isolation and loneliness through the implementation of a national strategy, something other countries are starting to do.

For example, in 2018 the United Kingdom created a minister of loneliness to tackle social isolation in the country. And in May 2023, Japan’s parliament enacted into law a bill to promote measures for supporting people experiencing social isolation and loneliness.

The NIA report suggested an additional approach to combat loneliness and isolation through the implementation of “social prescribing programs.” This involves getting a prescription from a doctor who then refers the patient to activities aligned with their interests, such as art classes, gardening, and fishing.

“We can think about the programs (and) how we can identify people who might be isolated and lonely and how we can better connect them,” Sinha said.

“So as we get older we have the opportunity to help build new connections and make sure that they can stay healthy and independent for as long as possible.”

The 2022 NIA Ageing in Canada Survey was conducted online with 5,885 Canadians aged 50 years and older from July 5 to Aug. 7, 2022. This report is based on the results from this inaugural benchmark survey that will serve as the initial point of reference against which Canadians’ evolving perspectives and experiences on issues such as social isolation and loneliness will be tracked over time.

The survey, comprised of 62 questions and lasting 20 to 25 minutes, was administered online with a representative sample of community-dwelling Canadians aged 50 and older living in Canada’s 10 provinces, using standard survey industry recruitment and confidentiality protocols. The survey sample was designed to provide meaningful categories, with robust representation by five-year increments for age cohorts across this population.

— with files from Global News’ Katherine Ward