How Social Isolation and Connection Affect Older Adults With Diabetes

Older adults with diabetes are at higher risk of feeling socially isolated, which can affect physical and mental health. Learn these strategies to help keep you connected with your community.

Worldwide, people are living longer; the proportion of elderly people in the world population continues to increase. According to the World Health Organization, one in six people will be over age 60 by the year 2030. 

Additionally, a major health concern, particularly for older adults, is diabetes. According to the Centers for Disease Control and Prevention (CDC), nearly 30% of Americans over age 65 have diabetes. With so many elderly adults living with diabetes, researchers are investigating how social isolation and social participation affect their overall health.

Because of the growing needs of the aging population, this data suggests that the physical, emotional, and social needs of elderly people are pressing issues. Scientists are investigating just what those needs are and how we can address them. 

What is social isolation?

Social isolation is a broad term that means reduced interactions with other people. People who are socially isolated may live alone, have infrequent contact with friends and relatives, or have few or no friends at all. Social isolation goes beyond simply feeling lonely. It can affect people’s health and cut them off from resources, services, and information.

Elderly people are at a higher risk of becoming socially isolated, often because of changes associated with aging. Connect2Affect, a program run by the AARP, lists some risk factors that lead to social isolation:

• Frailty

• Mobility

• Hearing loss

• Poor mental health 

• Lack of accessible or affordable transportation

• Leaving the workforce

• Loss of a partner or friends 

Research has shown that social isolation is related to decreased activities of daily living such as bathing, dressing, and feeding, increased inflammation, increased blood pressure, decreased physical activity, falling, motor decline, anxiety and depression, cognitive decline, and death from all causes. 

How is social isolation related to diabetes?

Elderly people with diabetes often have one or more risk factors for social isolation. Frailty, mobility, hearing loss, and poor mental health are all more common among elderly people with diabetes. Not surprisingly, social isolation is more common among people with diabetes than their healthy peers. 

When researchers conducted a meta-analysis of studies focused on people with diabetes age 60 and above, they found that 28% to 49% engaged with others less than once per week. These numbers suggest that a large percentage of elderly people with diabetes are socially isolated and at risk of its many negative health consequences. 

Considering the health risks that come with diabetes compounded by the health risks of social isolation, these statistics are troubling and suggest a need for interventions to reduce social isolation and improve social participation of elderly people with diabetes. 

What is social participation?

Social participation is a measure of an individual's activity within a community, particularly in terms of interacting with other people. It includes exercising, engaging in hobbies, volunteering, or becoming involved with neighborhood associations. 

Social participation is a challenge for some elderly people. Kate Keelty, a speech pathologist and licensed mental health counselor with Island Counseling Services, works with elderly individuals in assisted living and rehabilitation settings. 

She observes that many of these people may “be coping with failing health, reduced mobility, reduced ability to engage with their community, loss of hearing function, or changes to cognitive function that make it harder for them to engage in the same activities they once did.” 

Social participation provides many health benefits

Several studies show that social participation provides a variety of health benefits. Participating in sports, hobbies, and volunteer activities helps people maintain their activities of daily living. Social participation of any type reduces the rate of decline in cognitive function, prevents the need for long-term care, and decreases the risk of death. 

Keelty said that her elderly patients who “participate in community-based activities or have regular social interaction with others tend to be more resilient in the face of a health challenge.” 

These benefits highlight the need to help elderly people maintain their social networks.

Social participation helps people with diabetes by creating a support network of family, friends, and neighbors. These networks provide information, emotional support, and practical help. In terms of information, engaging with others allows people to share ideas and access new information that may improve their health. In terms of emotions, managing diabetes can be taxing, and the support and encouragement of friends and family can relieve some of the stress.

In practical terms, social contacts can help people with diabetes by picking up their medication, taking them to medical appointments, and simply checking in on their well-being. 

How can elderly people with diabetes increase their social participation?

Because there are so many benefits to social participation, researchers are interested in the factors that contribute to increased social participation. 

One study found that people with diabetes who engaged in physical activity and did not smoke had increased social participation, as did those with greater physical mobility. If you have diabetes, there are many steps you can take to maintain or improve your social participation. 

Keelty recommends that elderly people with diabetes participate in regular activity-based groups (as might be led at an assisted-living facility or senior center), enroll in an adult day health program (which often focus on cognitive stimulation activities), or become involved with their local volunteer organizations to whatever extent they are able.  

“For those who may not wish to engage with a larger group,” she said, “I advise my patients that even a regular coffee date or card game with a friend or family member can be beneficial to their emotional and cognitive health.” 

Here are some other ideas:

• Exercise: Walking is a great place to start for many people. But even people with limited mobility can participate in chair yoga, tai chi, strength training, water aerobics, and more. Your local senior center or YMCA may offer accessible, affordable exercise classes.

• Play a sport: There is a sport out there for you, regardless of your level of mobility. Pickleball is increasingly popular with seniors. Badminton, tennis, and golf are good options when the weather is nice, and table tennis or table shuffleboard work well in the wet or cold.

• Quit smoking: It’s never too late to kick the cigarette habit. Talk to your doctor if you need extra support to quit.

• Take up a hobby: Many libraries and senior centers offer hobby groups devoted to musical instruments, card playing, painting, and needle arts such as knitting, crocheting, and quilting.