Loneliness and isolation in long-term care and the COVID-19 pandemic

Social isolation (the objective state of having few social relationships or infrequent social contact with others) and loneliness (a subjective feeling of being isolated) are serious yet underappreciated public health risks that affect a significant portion of the adult population. Social isolation is a risk factor for development of loneliness, but some persons enjoy it (eg, hermits). Conversely, having social relationships does not ensure that loneliness will not develop, because the social relationship has to be meaningful. Many people feel lonely under the best of circumstances. Approximately one-quarter (24%) of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely (35% of adults aged 45 and older and 43% of adults aged 60 and older).