She is a 62-year-old white woman. Let’s call her Maria. She lives in the United States and has a night job, which makes socializing a little difficult. Yesterday she went to bed at 4:00 a.m. and today she woke up at 9:00 a.m. She could sleep more, but she doesn’t want to, or perhaps she is having trouble falling back asleep. She turns on the television; a religious show is on. That is fine with her. Maria watches a lot of TV. There is always something going on in it. In her daily life, not so much. She has no children or close friends. She is not particularly sociable, so she fills her days with shows, reality programs, newscasts and movies — other people’s lives. When the religious broadcast ends, Maria flips through the channels until she becomes engrossed in another show. Then another. A movie. Suddenly it is 5:45 p.m., so she makes some dinner. After that she cleans the house, rests a little and zones out. Oh, it’s late. She showers quickly and gets ready. It’s 10:45 p.m. and she has to leave for work.
This could have been yesterday, last week or any day, really. That is simply her routine. Maria’s self-perceived health is reasonably good, but she is not happy. If you asked her, she would tell you that her level of happiness is two out of ten. This is what was she told the American Time Use Survey that the U.S. government has been carrying out since 2003. In these 20 years, they have confirmed that Maria is not an exception. In fact, loneliness has become a much more common experience in recent decades, and it was increased by the Covid-19 pandemic. And this is more than a social problem; it is also a health problem. Even though Maria thinks that her health is good, she is 39% more likely to die than a person of the same age, sex and condition, but with more social connections.
This is what a scientific study recently published in the journal BMC Medicine states. The idea is not new; different studies have alluded to this evidence in recent years, although few have done so as categorically and concretely as this one. Instead of referring to loneliness in general, the authors make a distinction between objective and subjective loneliness; the one that comes from an isolation from superficial relationships, and from those that are more intense, which we maintain with close friends and family. It takes into account the qualitative, but also the quantitative, and its conclusion is that in this life, the most important thing is to see family and close friends. At least once a month.
“The truth is that this was not what we expected to find,” confessed cardiologist Jason Gill, one of the authors of the study, during its presentation, held a few days ago via videoconference. “But it seems clear that there is a threshold effect. Once you start seeing your friends and family every month, the risk remains fairly stable. It doesn’t matter if it’s one visit a month, a week, several times a week or every day,” he explained. One has to be sociable, yes, but it is not necessary to be too sociable — at least not from a health point of view. “Seeing them more frequently doesn’t provide any additional benefit.”
The study used data from 458,146 adults from the U.K. Biobank, a large-scale biomedical database available for scientific trials. The participants had been recruited between 2006 and 2010 and had a mean age of 56.5 years; 13 years later, 33,135 of them had died. The authors compared the deaths with their answers regarding a series of questions about loneliness, matching factors like age, sex, socioeconomic situation and previous illnesses. They then came to a devastating conclusion: loneliness kills.
“There are different types of loneliness and different types of isolation,” explains Glasgow University professor Harmish Foster, who also participated in the study. The researchers analyzed several types and observed that subjective loneliness is less lethal than objective social isolation, but that, combined, they are fatal. Among the factors that determine how isolated a person may feel are whether or not they participate in group activities, whether they live alone or with someone, and whether they receive visits from friends and family. “Each of these three factors was associated with a higher risk of death, but in particular, people who reported never receiving visitors stood out.”
As for the reasons that may explain the protective effect of loved ones, researchers can only speculate. “Our study doesn’t answer this directly, but it may be that friends and family offer a particular degree of support to people and help them access health services.” There is also a link with behavior: socially isolated people have more unhealthy habits, such as smoking or heavy alcohol consumption. They also cease or curb healthy habits like exercising, keeping a regular schedule and sleeping more than seven hours a day. Maria’s case, with inconsistent schedules and a sedentary routine, would be a perfect example of this.
“I find it interesting that a distinction is made between different types of loneliness, differentiating between the structural and the functional,” explains Bryan Strange, director of the Laboratory for Clinical Neuroscience at the Technical University of Madrid. This structural solitude is where the benefits of sporadic visits are noticed. “Seeing the results of the study, I think it is highly advisable, if you know someone who lives alone, to pay them a visit.” Strange has devoted a lot of time to the study of superagers, people whose memory at 80 years old is similar to that of people decades younger. “In this case, it also stood out that these people had many social relationships, so it seems that there is a general benefit at a cognitive level.”
Social gerontologist Andrés Rueda agrees with this idea, and states: “They go hand in hand. Loneliness is a bad companion of physiology. Mood influences the course of diseases. Consequently, the worse the mood, the worse the state of the diseases.” Rueda has been working in nursing homes for 40 years and believes that visits from friends and family do help, but that important connections can also be created with other residents. In any case, he says, once a person reaches a certain age, it is much better to live in a nursing home than in solitude.
Cintia Gracia, social worker and director of the Albertia el Moreral nursing home, in Spain, also highlights the role of stronger ties among the residents. “The family makes it much easier to leave the nursing home or the house, your family comes, takes you out, tells you about their life. In some way they are encouraging you to stay active, to have a reason to be alert, excited.”
The BMC Medicine study focused on older adults, who at the beginning were between 40 and 70 years old. “We don’t have data on younger people,” laments Foster. “But one of the ideas of this type of research, especially if it is about mortality, is that it tends to happen to everyone.” Visiting grandma once a month can be a good protective measure, a nice way to extend her life expectancy. But it is not an altruistic act: the protective effect could be bidirectional. “We are social animals,” he adds. “And that is regardless of our age.”
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