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The impact of social isolation and loneliness on mortality in older people

Author: Andrew Steptoe
Institution: University College London
Type of case study: Research

About the research

Social isolation and loneliness have been found to be associated with mortality in older adults. However, because only a few studies examine both constructs at the same time, it is unclear whether the effects are independent or if the effects of isolation act through loneliness.

This research examines the effects of both isolation and loneliness on survival in a group of 6,500 adults aged 52 years and older.

Findings show that both isolation and loneliness are associated with shorter survival time, however following adjustments for demographic, socio-economic and health factors, only isolation continued to significantly predict survival.

The results suggest that interventions that aim to reduce isolation and increase levels of social contact and integration are likely to be particularly beneficial for older adults. Loneliness is important, but may be more closely associated with other health and demographic risk factors.


Data from Wave 2 were used as the baseline, with mortality follow-up until March 2012. Participants included those who had consented to the use of mortality follow-up data and had complete information on:

  • isolation (measured using an index based on marital status; contact with family, friends and children; and participation in organisations)
  • loneliness (measured using the short form of the UCLA loneliness scale)

Covariates used in the analysis: age, gender, wealth, limiting long-standing illness (diagnosis of chronic heart disease, cancer, stroke, diabetes, arthritis, or chronic lung disease), depression (measured using the Center for Epidemiologic Studies Depression scale) and mobility impairment.

A survival analysis was carried out using the Cox proportional hazards model.


Steptoe, A., Shankar, A., Demakakos, P. and Wardle, J. (2013) ‘Social isolation, loneliness and all-cause mortality in older men and women’, Proceedings of the National Academy of Sciences, 110 (15), pp. 5797-5801. doi: 10.1073/pnas.1219686110 Retrieved 30 May 2014 from

This study has also received wide media coverage, including:

BBC Health (26 March 2013) ‘Social isolation ‘increases death risk in older people’ BBC News. Retrieved 28 May 2014 from

Bingham, J. (26 March 2013) ‘Toll of loneliness: isolation increases risk of death, study finds’, The Telegraph. Retrieved 28 May 2014 from

Brynie, F. (29 March 2013) ‘Lonely? Socially isolated? Which is the greater threat to longevity?’, Psychology Today. Retrieved 28 May 2014 from

Mascarelli, A. (26 March 2013) ‘Social isolation shortens lifespan’, Nature. Retrieved 28 May 2014 from

McDermott, N. (25 March 2013) ‘The more the merrier! A higher number of friends in later life, rather than how well you know them, is key to reaching a ripe old age’, Mail Online. Retrieved 28 May 2014 from

Reinberg, S. (25 March 2013) ‘Isolation, Loneliness May Raise Death Risk for Elderly’, US News. Retrieved 28 May 2014 from

Stromberg, J. (25 March 2013) ‘Warning: Living Alone May Be Hazardous to Your Health’, Retrieved 28 May 2014 from

Tonoli, C. and Creagh, S. (26 March 2013) ‘Social isolation trumps loneliness as early death indicator in old age’, The Conversation. Retrieved 28 May 2014 from

This research was also covered in other outlets including Wired, the Los Angeles Times, Age UK and America’s National Public Radio.