[00:00:02] Speaker A: Hi Terence here. Before we start today's episode, I want to tell you about our friends at the Jerry Powell Podcast. Hosted by UCSF geriatricians and palliative care physicians Eric Wadera and Alex Smith, Gerripal brings you conversations with the brightest minds in geriatrics, hospice and aging research.
They dive into everything from groundbreaking clinical studies to the heavy, complex controversies that keep healthcare providers up at night.
What we love about Jerry Pal is that they manage to tackle serious topics like dementia care, healthcare policy and end of life decisions with an incredible mix of insight, heart and humor. You might just find yourself singing along.
Search for geripal that's G E R I P A L wherever you get your podcasts or Visit them at jerrypal.org thanks onto the show
[00:00:50] Speaker B: and what we found is that those people who were socially isolated had a 26% increased risk of dementia.
So it really being socially isolated really increased your chances of getting dementia.
[00:01:18] Speaker C: Welcome to the Age of Aging, a show about living well with an aging brain, produced by the Penn Memory center in the Michael Nadoff Communications Hub. I'm Terence Casey and I'm joined today by my co host Jake Johnson and executive producer Dr. Jason Karlewish. You've heard us say this on the show before, but there are 14 modifiable risk factors for dementia. These are things that can increase or decrease your likelihood of developing dementia later in life.
[00:01:44] Speaker D: Some of these are the things you
[00:01:45] Speaker C: would expect, like smoking and head trauma. And then there are the ones that you may have not considered, like vision loss, pollution and the subject of today's episode, loneliness and social isolation.
Jake spoke to two researchers about the cognitive cost of isolation and gives us a tour through a New York housing community designed to keep older residents connected.
After his reporting, Jake and I will dig into the response we got when we asked you, our listeners, to share your own stories about loneliness.
And then Jason will join us to discuss what he sees in his clinic and through his work with the Global Council on Brain Health.
But first, a word from our sponsors
[00:02:25] Speaker E: at the Salvation Army Ray and Joan Croc center in Philadelphia, our Golden Gems Senior program offers a welcoming space for older adults to stay active, connected and inspired.
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[00:03:31] Speaker F: Doris Kitt has a talent for making older adults feel better I'm a case
[00:03:37] Speaker G: aide, so my job literally is to call people and find out how they're doing.
Sometimes during the call you can hear in their voice and respond, respond that they're not doing good. So I will pick a topic that would draw them out and make them think differently, take them off whatever it is they're feeling bad about or just let them talk about it and see what the outcome is. And I gotta honestly say that a lot of times people tell me, I'm so glad you called because I feel so much better.
So I seem to have a gift for making people feel better about themselves and I'm kind of proud of that.
[00:04:26] Speaker F: Kit works for UUH Outreach in Northwest Philadelphia, a senior agency which provides social services and support to older adults in the area.
As a case aide, she makes wellness calls to see if people need additional support from a social worker.
Kit said that helping people deal with isolation and loneliness comes easy to her. At 81 years old herself, Kit said there have been many periods in her life when she was lonely.
[00:04:51] Speaker G: I used to live in England for a long time. I lived there for 27 years. So when I moved back I'm with my family more, but also lonely because I don't have my friends from those years with me.
So I would think of things to do. I'd get on the train and go to Atlantic City and walk around, sit somewhere and have lunch.
Things that in the past I would be afraid to do on my own. But I just found a way to get out of the doldrums by doing something.
[00:05:27] Speaker H: It's something that I ask about in every new patient visit and something that I often check in on at follow up visits.
[00:05:35] Speaker F: Dr. Holly Elser is an assistant professor of neurology at the University of Pennsylvania.
We also like to refer to her as the Age of Aging's resident epidemiologist.
You might remember her from our episode on Pollution Polluted Minds.
She explained that socialization as an older adult is more than just a way of boosting your mood. It's actually one of the main ways you can lower your dementia risk.
[00:05:58] Speaker H: Social contact in any form has a potentially beneficial effect on dementia risk because it can build cognitive reserve, it can promote healthy behaviors and it can reduce stress.
[00:06:08] Speaker F: Dr. Elser explained that social isolation is among 14 modifiable risk factors identified by the Lansing Commission on Dementia Intervention, Prevention and Care.
The Lancet is one of the most prestigious peer reviewed medical journals in the world and its commissions are specialized articles that synthesize the latest research in specific fields related to public health and clinical medicine.
The Commission on Dementia Prevention, Intervention and Care was first released in 2017 and has been updated in 2022 and 2024. Each of the 14 modifiable risk factors for dementia is given a percentage, which Dr. Elser said represents how many fewer dementia cases we would see if that risk factor was eliminated from the population.
[00:06:52] Speaker H: So, for example, an estimated 7% of dementia cases would be avoided if high LDL cholesterol, which is the bad cholesterol in midlife, were eliminated.
[00:07:04] Speaker F: Modifiable risk factors are important in medicine, Dr. Elser explained, because unlike say, a genetic risk, modifiable risk factors can be changed in the course of someone's life. The Commission represents these dementia risk factors on a timeline from early life into midlife and then late life.
We'll link that infographic in the show notes if you're interested in taking a look at it. Social isolation sits in the late life section at 5%, along with air pollution at 3% and vision loss at 2%. Dr. Elser cautioned that these statistics don't necessarily mean that if you have one risk factor you will develop dementia, but that they can ultimately increase your risk.
[00:07:43] Speaker B: So we did a very large study.
[00:07:46] Speaker F: Dr. Barbara Sahakian is a professor of clinical neuropsychology at the University of Cambridge.
[00:07:52] Speaker B: We did a analysis of the UK Biobank data. So it's nearly half a million people, so it's a very large sample. And we measured social isolation and loneliness. We asked how often people were living alone, whether they were seeing other people and whether they were integrated in any social groups or going out to any these social activities.
And what we found is that those people who were socially isolated had a 26% increased risk of dementia.
So it really being socially isolated really increased your chances of getting dementia.
[00:08:30] Speaker F: Dr. Sahakin's team then looked at the brains of these socially isolated people and found that areas involved in learning and memory, like the hippocampus, had reduced volume.
[00:08:40] Speaker B: The hippocampus is one of the first areas to be affected in, for instance, Alzheimer's disease.
So normally the neuropathological changes, the changes in tau and beta amyloid that you see in the Brains of people with Alzheimer's disease start in areas like the entorhinal cortex and the hippocampus.
[00:09:01] Speaker F: Dr. Sahakian and her team also looked at loneliness, which they identified as distinct from social isolation.
[00:09:09] Speaker B: Social isolation is really. We measured it objectively, so it's really about, do you live alone, how often do you get sort of visitors from families and friends?
And also, do you participate in any group activities?
But loneliness really has to do with how you feel.
So you can be around people but still feel lonely. And that happens quite a lot. I mean, for instance, the who, the World Health Organization, has pointed out that about one in four older adults are socially isolated. So it's not uncommon to be socially isolated as an older adult, but actually, 5 to 15% of adolescents feel lonely. And if you think about it, those adolescents will be probably in school, so they'll be around a lot of other children and so forth, but they still have a sense of loneliness. So you can feel lonely even when there's other people around. It's the way you sense the world, the way you feel.
[00:10:06] Speaker F: When it came to Dr. Sahakian's study, her and her team looked at whether or not participants reported feeling lonely.
[00:10:13] Speaker B: Well, loneliness did have an association with dementia, but it seemed to be through depression.
So it seemed that the effects were really of depression on the risk of dementia rather than the loneliness itself.
And it seemed that it was direct between social isolation and dementia, more or less, but not direct through loneliness and dementia.
[00:10:39] Speaker F: Depression is another factor identified by the Commission as being associated with dementia.
So while loneliness itself wasn't directly correlated with dementia, there was still an association.
And as Dr. Sahake and his team found, loneliness was also associated with a variety of other diseases.
[00:10:57] Speaker B: We went on to look at proteins associated with loneliness, and loneliness actually increase the risk of a number of diseases, including cardiovascular disease, type 2 diabetes and stroke, and actually early death.
[00:11:13] Speaker F: Business owner Frank Saar is 86 years old and lives in Exton, Pennsylvania. He explained that his feelings of loneliness coincided with the death of his wife, who lived the last four years of her life with Alzheimer's disease.
[00:11:26] Speaker I: My purpose when she was, I was to keep her comfortable, to be with her and. And make her aware that I'm still here and she has me there, but when she's gone, then you have to create another purpose for why I am doing what I'm doing, what keeps me busy, other than worrying about the fact that my. I lost my wife.
[00:11:46] Speaker F: Saar explained that it wasn't necessarily the experience of being lonely that bothered him. Loneliness was different than solitude, he said, a feeling that something was missing.
[00:11:55] Speaker I: I grew up on a farm, so I spent three or four hours a day on a tractor plowing fields and I'm going, how more lonely can you be and still get off the tractor and feel you're happy, you know? So I, I've had many hours alone. I'm not afraid that I'm alone. I don't feel different because I'm alone. Loneliness simply says I'm missing something and I don't know what it is and, and I don't know how to find it.
[00:12:22] Speaker F: He said finding what it is day to day isn't easy. Gratitude helps, he said. Humor as well.
Socialization also helps, he said, but requires more effort.
[00:12:33] Speaker I: My wife was my icebreaker. And by the way, that's probably with most men sometimes his wife is the one that has all the connections, all the relationships and we're brought into them and then we get our relationship from that.
[00:12:44] Speaker F: Doris Kitt shared a similar story of grief turned to feelings of loneliness.
[00:12:49] Speaker G: In 2008, my daughter died. She died of uterine cancer and that was why I came back from England. So it was navigating around that, trying to find ways to grieve and still focus on moving forward.
[00:13:13] Speaker F: So while social isolation and loneliness impact many older adults and have a clear negative impact on our health, Dr. Holly Elser said that addressing these factors is not so straightforward.
[00:13:23] Speaker H: You think about these, you know, Lancet risk factors and some of them you can imagine, like a pretty uniform intervention at the population level, like for high blood pressure. We're just going to give people antihypertensives, probably. But the solution for social isolation is going to be really context dependent.
[00:13:42] Speaker F: As to why social isolation seems to be such a challenge for older adults, Dr. Elser has a few theories.
The first is a negative feedback loop in which patients with cognitive changes become more anxious about socializing.
[00:13:56] Speaker H: Many of my patients actually have relatively mild symptoms but are very aware of them. And I have some patients who feel really self conscious about subtle changes in their memory and cognition that leads them to withdraw from their friends and families because they're worried that they won't be able to keep up in the conversation or they'll say or do something embarrassing.
It's also the case that some of our patients experience apathy and indifference towards things they once enjoyed as part of their disease process. And an unfortunate byproduct of this can be withdrawal from previous social activities.
And then the last thing I would note is that I think that in the United States. In particular, many older adults prioritize aging in place or continuing to live in their own home in their community, rather than in, say, independent living or assisted living.
And while aging in place can provide an important sense of autonomy and independence, it can also be a source of social isolation. So based on recent data from the Current population survey, about 28% of people age 65 and older live alone. And those are the patients that I worry about. Because if your social isolation is sort of by design, you live alone, you live somewhere that's hard to get to without a car if you can't drive, it's harder to imagine how we can start to build back in those social connections that I think are so healthy and helpful.
[00:15:26] Speaker F: There are, of course, alternatives to the isolated aging in place that many Americans experience.
82 year old Dana Minaya lives in one of them.
[00:15:35] Speaker J: When I go to my primary care physician, they ask about whether I feel lonely. I said no, I'm over socialized.
[00:15:46] Speaker F: Minaya lives in Morningside Gardens, a cooperative housing complex in New York City.
It is considered a naturally occurring retirement community, or norc, meaning that although the buildings were not initially designed to house seniors, a large portion of the residents are older adults.
In 1966, the shareholders of Morningside Gardens voted to create Morningside Retirement Health Services.
Ron Bruno is the current executive director.
[00:16:13] Speaker K: Our mission statement from 1966 was twofold and the primary thing is to enable older adults to remain living at home.
Second one is to maintain a high quality of life for older adults living in the community. And that's done by putting services in place within the community that has a concentration of older adults. So those services are social workers.
A nurse, often a nort will serve as a kind of hub of services and activities. So we have relationships with nearby Mount Sinai Hospital.
They have a visiting docs program where they spend a whole day here.
And we're able to make referrals for people who need to visit from a doctor.
[00:17:02] Speaker F: Dan and Minya says that beyond the senior services that MRHS provides, it's their arts programs and clubs that make the community feel so special.
[00:17:11] Speaker J: We have a workshop where we have woodworking. I participated in ceramics, life drawing, and all sorts of arts and craftsy things that go on.
And as I have aged, I've been able to participate in the exercise classes that I've been going to.
A lot of them are sitting because I have really bad balance issues.
As I've gone through those transitions, then I've been able to benefit from that programming.
[00:17:46] Speaker F: She said that when she Moved to Morningside Gardens 42 years ago with her son. The plan wasn't to stay, but she just never wanted to leave.
[00:17:54] Speaker J: When I moved here, this was the first time that I met hundred year olds. And at one point I stopped counting. I reached two dozen. And I stopped counting because I guess because of the social atmosphere of this community, people have like. It's like a. Like a blue zone. It was. It was amazing.
[00:18:14] Speaker F: Although NORC programs are expanding across the country, obviously not everyone will be able to live in them.
The majority of people will have to build socialization into their everyday lives.
Of the older adults I interviewed for this episode, those that said they didn't feel socially isolated seem to have prioritized social activities and community earlier in their life and then just never stopped.
Gene Lindsay from Philadelphia is one of those people.
[00:18:41] Speaker L: I had a friend, we were working in a design company, and he says, hey, how about we take a drawing class at Fleischer? And then that was 1993, and I came and I just continued and never stopped.
[00:18:55] Speaker F: Fleischer Art Memorial is a community arts center located in South Philadelphia, offering a wide range of art classes to both kids and adults. At 78 years old, Lindsay has taken countless art classes at Fleischer, like basic drawing, pastels, watercolor, and stained glass. But for the last 20 years, photography has been his main interest.
He volunteers as a studio monitor for the photography Open Studio Time and meets monthly for the Fleischer Student Advisory Council.
[00:19:24] Speaker L: Well, I never have any loneliness because I'm always involved with different things, and I think that's very important.
I made a lot of different friends here over time, and like me, like, repeating things we would get into, like the, you know, the photography class. Everybody would come back and there would always be a few new people coming in and out, maybe one or two sessions, but then you would have several years off the same people coming.
[00:19:57] Speaker F: Lindsay said the friendships he's made have expanded beyond Fleischer to attending other arts clubs across Philadelphia, like the Philadelphia Sketch Club, the Plastic Club, and the Photo Society of Philadelphia.
He said he also loves going to different art exhibitions with his friends from class.
Do you feel like it's kept you sharp over the years being a part of Fleischer?
[00:20:20] Speaker L: Oh, sure, sure. Yeah. Like you have a purpose, you want to come here, you do things.
[00:20:27] Speaker F: If you want to be more like Gene Lindsay. And let's be honest, don't we all? Dr. Sahakian suggested to start by thinking about what you already enjoy doing.
[00:20:36] Speaker B: Do you like to read books? Do you want to join a book club. Do you want to get a bit more exercise? Because exercise is what I call an all rounder. It's good for your mood, it's good for your cognition, it's good for your mental health and it's good for your physical health. So maybe, you know, join an exercise group, either cycling or yoga or something. Or if you're interested in musical instruments or singing, join a choir. We've been doing some studies on reading and book clubs seem to be very valuable for older adults to keep them connected with other people and you find like minded people that you may develop friendships with. And so that's a great way to make sure you don't get socially isolated as well.
[00:21:19] Speaker F: Frank Saar said he tries to plan at least one thing to do every day of the week in order to combat social isolation.
Some of these things include groups and classes he's joined based on his own interests.
[00:21:31] Speaker I: I joined writers groups I go to it's called olli, which is the Lifelong Learning Program, and I go to Macalata College's Symphony.
[00:21:41] Speaker G: Make a list of things that you'd like to try that are new or that you'd like to accomplish, like a bucket list.
[00:21:51] Speaker F: Doris Kitt said that while she has her own strategies for social isolation and loneliness, it's ultimately something you have to figure out for yourself.
The important thing is just getting out of your house, she said.
[00:22:03] Speaker G: Go to the movies on your own, go out to lunch by yourself. Just positive reinforcement. I think being lonely is an individual thing and people have to learn to navigate it on their own.
I will drive and sit in the park and read a book or I love being around kids and their antics.
Sometimes I'll sit in an area and just watch kids, just thinking in my mind that I'm going to keep them safe if I see anything go wrong.
[00:22:40] Speaker F: However, she said that if you're a socially isolated adult and your feelings of loneliness aren't getting better, please ask for help.
[00:22:47] Speaker G: Talking to seniors. I know how they are. Oh, you know I can handle it. If it's not getting better, that means you can't and it's okay.
And that's what people need to know, that it's okay to ask for help.
[00:23:05] Speaker F: Kit actually shared with us a poem that she wrote about her experience dealing with loneliness. If you'd like to read that, it's down in the show notes.
And if you're feeling lonely or just need someone to talk to, there will be some resources in the show notes as well.
[00:23:28] Speaker C: Hi Terence here again and I'm joined Today by producer Jake Johnson and executive
[00:23:32] Speaker D: producer Dr. Jason Karlewich. Thanks both for being here and Jake especially for your reporting.
[00:23:37] Speaker M: Yeah, thank you.
[00:23:38] Speaker G: Yeah.
[00:23:38] Speaker N: Awesome work, Jake.
[00:23:39] Speaker D: Jake, I just wanted to jump right in to talk about a distinction you made in this episode about loneliness and social isolation. When we had started working about this in one of our editorial meetings, I had asked, aren't these interchangeable? But they're not. Could you tell me a little bit more about the distinction?
[00:23:54] Speaker M: Yeah, I had the same. I also thought of them as interchangeable, and that was definitely clarified for me when I talked to Dr. Sahakian, because
[00:24:03] Speaker F: she and her team, when they did
[00:24:04] Speaker M: their research, really identified the loneliness and social isolation as two distinct things that are associated but not necessarily the same. So social isolation was really whether you've had contact with people for an extended period of time, and that is a lot easier to measure objectively in research. And rather than loneliness, which is more of a subjective feeling, you can be lonely in a crowd, in a group of people, and that's more linked to depression, more prolonged feelings of sadness than social isolation.
[00:24:40] Speaker C: So, Jason, how does social isolation impact someone living with cognitive impairment?
[00:24:45] Speaker N: Early and often, unfortunately, because of the distancing that often occurs between them and other people for a number of reasons. One, people don't want to be around them. They detect the uncanniness. And one way to avoid the feeling of peculiar horror that Freud described is to avoid the uncanny.
The other is the person, because of their cognitive impairments, has what we call a shrinkage in their life space. It's a quirky term, but essentially they don't go out much. Why? Well, you know, it's hard to organize a trip out. You know, you gotta plan it. You gotta organize the transportation, whatever it might be. And those are the kinds of factors that conspire together to cause someone who has dementia, even in its earliest stages. Because actually, shrinkage of life space is one of the earliest signs of emergent cognitive impairment. To become socially isolated, which then can lead to feelings of loneliness, which then leads to this cascade of problems that cause a brain to begin to fail or to accelerate its failure.
[00:25:37] Speaker C: We talked about the relationship between loneliness and depression, and it seems like it could be cyclical.
[00:25:44] Speaker N: Yeah, it could be. I think in my own practice. Here's how I think about this.
I am keen to find out whether someone's experiencing these phenomena. Okay. And it's not the kind of thing you just ask someone, are you lonely? Because it's a little. It's the flip side of asking someone do you understand something no one ever has ever told me? I don't understand what you've just said. Occasionally I've gotten it from my husband, perhaps.
So people aren't going to necessarily endorse loneliness, but what they will endorse is a host of things that add up to loneliness. And it begins with when I ask them a very simple question.
What's a typical day? What's keeping you busy? And oftentimes, as I hear that narrative, it's not so much what's in it as what's not in it and what's not happening. And my entry question, after I got them into that space of thinking about their day is a question I often then ask is, are you bored?
And boredom, I find to be then an entry into identifying what amounts to one of the sort of epiphenomena, if you will, of being lonely. You're sort of bored. I'm not doing anything, et cetera. And then you begin to think, for this particular individual, what can we do to intervene and correct that boredom.
[00:26:51] Speaker D: Yeah.
[00:26:51] Speaker C: And years ago, our neuropsychologist, Dr. Don McCanna Hamilton, had some research talking about how one of the first warning signs of cognitive impairment will come from changes noticed by your spouse.
Somebody's in your home constantly seeing your
[00:27:06] Speaker D: behavior changes over time.
[00:27:07] Speaker C: If there aren't other people in that home, it seems like it could be a real burden to people even thinking that they should come in for a while.
[00:27:14] Speaker D: Yeah.
[00:27:15] Speaker N: I think what you're getting at is that being socially isolated is, in some sense, could be conceived of as a risk factor for delayed detection of cognitive impairment. Absolutely. Yeah. Because people often feel their symptoms, but it's often others who notice them, who then also say, we need to do something about it. It's tough to feel something and want to act on it. It's a little bit different, at least to notice it in someone you care about, to then push them to get something done about it.
[00:27:41] Speaker D: Okay.
[00:27:41] Speaker E: Yeah.
[00:27:41] Speaker C: You mentioned that patients have to come in with an informant, knowledgeable informant, caregiver, spouse. People use a lot of different terms for that.
[00:27:50] Speaker N: They do, yes. Yes. We haven't really like much of our field, the nomenclature is in flux.
[00:27:54] Speaker C: So how do we address that issue of people? It's important data that we get from that. But if it is creating this burden of people coming in for an evaluation, how do we address that?
[00:28:03] Speaker N: Yeah. So the issue you raise is the practice of dementia, historically up and now has been the need for someone else to be there.
And actually, my colleague, Emily Largent, And I are writing on this. Hope to have a piece out soon in a prominent journal. Listeners will be informed where we make the case for the need for someone to take part in your care. I fully respect that people can come to a memory center alone. I get that now. I used to be, like, upset when they came alone because I need to have someone else here. As people present earlier and earlier, coming alone and doing a workup actually is doable. But presenting alone to the clinic, to the memory center, is a problem that needs to be addressed. Because if I do make a diagnosis of Alzheimer's disease and related diseases that cause dementia, I know that we need another human mind involved in that. And so that's something to address. Those individuals who come in alone, some of them are isolated, others are fiercely independent, and they're driving this on their own, and I respect that. But I know that that independence is. Is going to become a source of enhanced, ironically, dependence if it's not addressed.
[00:29:11] Speaker D: Sure, I appreciate that.
[00:29:11] Speaker N: It was a great irony, wasn't it? Yeah.
Clever.
[00:29:14] Speaker J: Yeah.
[00:29:15] Speaker N: The more independent you are, you're the more dependent you become.
[00:29:17] Speaker D: Jake, I want to talk with you a little bit about some of the narrative gathering that we had for this episode. One of the things that we sort of accepted from the outset is that this is a deeply human, deeply personal topic and that we can report on
[00:29:32] Speaker C: the science all we want, but we
[00:29:33] Speaker D: needed to hear from the people who expressed loneliness, and we were intentionally vague about what that meant when we put out a call to our listeners and their family members to tell us their stories about anytime they were experiencing loneliness. Could you tell me a little bit? What kind of response did we get to that call?
[00:29:52] Speaker M: Yeah, we got a lot of responses. A wide range of people reached out, came back to us.
[00:29:59] Speaker F: A lot of the responses of people
[00:30:01] Speaker M: talking about loneliness was around some kind of loss, usually dealing with some kind of grief. There was a lot of caregivers or former caregivers who were taking care of somebody, and then that person passed and were trying to figure out what their purpose was.
[00:30:20] Speaker N: That reminds me of our summer special episode.
[00:30:22] Speaker M: Yes. Yeah, yeah, exactly. Margo Woodacre, who spoke about her experience
[00:30:27] Speaker N: of feeling lonely as her husband's dementia worsened.
And after his death, she had a new experience, a different kind of loneliness as well.
[00:30:35] Speaker M: Yeah, yeah. And one person that I spoke, Frank Saar, he identified loneliness as the feeling that something was missing, that there was just something.
[00:30:45] Speaker A: A hole.
[00:30:45] Speaker M: A hole that wasn't, you know, something.
The purpose of his life was just unclear. So I think that that was another way that, you know, social isolation and loneliness can be thought of as somewhat distinct. You know, I think that there is a feeling of More tied to one's own personal sense of meaning in the world that loneliness is more connected to.
[00:31:10] Speaker D: Okay, Jason, I don't think we can
[00:31:12] Speaker C: talk about social isolation without going back six years here.
[00:31:16] Speaker N: Yeah, back to Covid. Exactly. Yeah.
[00:31:19] Speaker C: We could have a whole episode just focused on the impact of the COVID pandemic.
[00:31:26] Speaker N: What a great idea. Season 7.
[00:31:29] Speaker C: The truth is, I don't think we'll ever fully know the impact on a global scale, but there are signs.
[00:31:34] Speaker N: Yes. Well, anyway, so we studied this.
Ask a. Go to a barber, you get a haircut. Ask an academic, you get a study. So we studied this. Emily Largent and myself and colleagues, we interviewed caregivers during the pandemic, during the time of isolation, about what was happening to their relative as a result of the social isolation. And it's a great paper. I will put it in the show notes. Bottom line findings were there was a crowd that said there's no difference. And debt tended to be spousal crowds. We were always here together and had our system and it worked, and that's what we're still doing.
And they were to be distinguished from.
I'll never forget a daughter working whose mother would go to adult day programs, who just narrated how bad things really were. Because of course, now she's working at home, but she's working she's not. And her mother can't go to adult daycare. And she said, I'm convinced my mother decline accelerated during this period where she lacked the ability to leave the house and go to her adult day program, which she greatly enjoyed. And I was there, but not there. In some sense, she was isolated and lonely. The mother in this house while the daughter's upstairs on zoom calls doing her work. And there were variations therein. And the general theme we took away was resonate, recapitulates, amplifies what this episode is about, which is to quote a bit from Genesis, you know, it's not good that humans are alone. Bad things ensue.
And that's what the COVID pandemic brought out. Having said that, of course, you know, it was pandemic and we had to take public health measures to prevent spread of a virus that, for example, we could have also heard a tragic story from that daughter of my mother went to adult daycare and got Covid, and now she's either in the hospital on the ventilator or dead.
[00:33:16] Speaker C: And that doesn't even get into adults who maybe live in isolated care.
[00:33:19] Speaker N: Residential, residential, long term care.
[00:33:20] Speaker C: Yeah. And you had talked a lot about that.
[00:33:23] Speaker E: Yeah.
[00:33:23] Speaker N: Residential long term care was of course, ground zero. And there, I think there's an initiative to pass legislation to allow family caregivers to be present in residential long term care during times of.
And I think there's a logic to that legislation, but what it's going to require is a real collaboration between the long term care and the family. You know, you just can't come in because you, quote, have a right to come in. We understand your role in the care of your relative, but here's the precautions that need to be in place, et cetera. I think one of the takeaways from the pandemic was it sadly showed how important it is that we have each other around. I'm of the policy view that that doesn't mean don't have isolation because then you have the problem of a widespread pandemic knocking people off. But it does amplify for us during our non pandemic life to address the public health problem of loneliness, because that's what it is. It's a public health problem.
[00:34:14] Speaker D: We often like to bring in a sort of practical tip near the end of our episodes. Jake, you heard a lot from your interviews from both the research side and from the long term care side. What do you recommend? What can people do to combat social isolation as they age?
[00:34:30] Speaker M: Yeah, I mean, I was struck by speaking to people just that socialization is not something that's really built into the fabric of American society very well. I think that it's easy to get lonely. It's easy to get socially isolated, especially as you age.
[00:34:47] Speaker F: And a lot of the people that
[00:34:48] Speaker M: I spoke to that were very socialized in their older years had started that a lot earlier and had made a distinct effort to seek out socialization.
[00:35:00] Speaker N: And listeners should be prompted to go back and listen to our episode on Deconstructing Home. Because I think one of the themes that was in that episode was the nostalgia for the place of 50 years, particularly the suburban home, you know, with no sidewalk.
[00:35:16] Speaker B: Right.
[00:35:17] Speaker N: Is a ticket to social isolation and loneliness. And I encourage listeners, having finished this, to go back and listen to Deconstructing Home.
[00:35:24] Speaker M: Yeah, I think it's about finding places within your community that you enjoy where you have social connections regularly and people that you feel like you can rely on. I think building that in early and
[00:35:38] Speaker F: making it a regular part of your
[00:35:40] Speaker M: life is key, I think.
[00:35:42] Speaker D: All right, so find your community in your community before there is cognitive impairment.
[00:35:47] Speaker H: Before.
[00:35:47] Speaker M: Yeah, yeah, exactly.
[00:35:48] Speaker D: I hear that. All right. Well, thank you, Jake.
[00:35:50] Speaker C: Thanks, Jason.
[00:35:51] Speaker D: I appreciate your time today.
[00:35:52] Speaker B: Yeah, that was good.
[00:35:53] Speaker J: Bye.
[00:35:53] Speaker L: Bye.
[00:35:57] Speaker D: Thanks for listening to this episode of
[00:35:59] Speaker C: the Age of Aging.
[00:36:00] Speaker D: A special thanks to today's guests, Doris Kitt, Dr. Holly Elser, Dr. Barbara Sahakian, Danaminaya, Frank Sar, and today's co hosts,
[00:36:09] Speaker C: Jake Johnson and Jason Karlewish.
[00:36:12] Speaker D: If this episode resonated with you, please
[00:36:14] Speaker C: subscribe, leave us a review or share it with somebody who would appreciate it. This makes a real difference in helping others find the show.
[00:36:21] Speaker D: And if you have a topic you'd
[00:36:22] Speaker C: like to hear, email
[email protected] the Age
[00:36:27] Speaker D: of Aging is a pen Memory center
[00:36:29] Speaker C: production made possible by generous support of the Michael Nadoff Communications Hub Fund, Lena Chow, and the TIAA Institute. Our team includes Morgan Adams, Dahlia El Said, Jake Johnson, Jason Karlewish, Emily Largent, and Allison Lynn. I'm your host, Terrence Case.
