Abstract
This study characterizes loneliness and social isolation among population-based samples of community-dwelling US adults aged 50 to 80 years.
Loneliness and social isolation have been increasingly recognized as health risks, particularly during the COVID-19 pandemic.1,2,3,4,5,6 While loneliness is the subjective feeling of being alone, social isolation occurs when a person objectively lacks connections to family, friends, or a community.2,3,4 We characterized loneliness and social isolation using population-based samples of community-dwelling US older adults.
Methods
The University of Michigan National Poll on Healthy Aging is a recurring, nationally representative survey of US adults aged 50 to 80 years on health-related issues. Cross-sectional data were collected from 6 separate samples at 6 time points: October 2018, June 2020, January 2021, January 2022, January 2023, and March 2024. From 2018 to 2021, surveys were conducted online using Ipsos KnowledgePanel; from 2022 to 2024, surveys were conducted online and by phone using the NORC AmeriSpeak panel. Although response rates to the panel creation were low, completion rates for each fielding ranged between 61% and 78%, corresponding to a sample size between 2051 and 2576 respondents.
Respondents were asked how often in the past year they felt a lack of companionship and felt isolated from others, with response options of “hardly ever,” “some of the time,” or “often” (eAppendix in Supplement 1). Self-reported sociodemographic characteristics, physical health, and mental health were recorded (Table 1 and Table 2). Descriptive statistics were reported as population-level estimates using survey weights to reflect the US population of 50- to 80-year-olds. Results were described with marginal probabilities with 95% CIs. No formal testing was completed between different survey years. Statistical analyses were performed with Stata version 18.0. The University of Michigan Institutional Review Board reviewed this study and deemed it exempt from human subjects review and waived the informed consent requirement.
Table 1. US Adults Aged 50 to 80 Years Who Reported Feeling a Lack of Companionship Some of the Time or Often in the Past Year, 2018-2024.
| Respondents, % (95% CI), by year | ||||||
|---|---|---|---|---|---|---|
| 2018 (n = 2051) | 2020 (n = 2074)a | 2021 (n = 2023) | 2022 (n = 2277) | 2023 (n = 2563) | 2024 (n = 2576) | |
| Total | 33.9 (31.7-36.2) | 41.4 (39.1-43.7) | 37.1 (34.8-39.4) | 41.6 (38.8-44.5) | 37.2 (34.9-39.6) | 33.4 (31.7-35.1) |
| Sex | ||||||
| Female | 36.2 (33.1-39.5) | 46.8 (43.6-50.0) | 42.5 (39.3-45.7) | 45.3 (41.4-49.2) | 39.9 (37.0-42.8) | 36.2 (33.8-38.7) |
| Male | 31.4 (28.3-34.6) | 35.3 (32.1-38.7) | 31.1 (27.9-34.4) | 37.5 (33.4-41.6) | 34.3 (31.0-37.8) | 30.5 (27.6-33.6) |
| Age, y | ||||||
| 50-64 | 35.6 (32.6-38.7) | 41.8 (38.6-45.0) | 37.7 (34.6-41.0) | 44.4 (40.4-48.4) | 40.1 (36.5-43.7) | 38.5 (36.5-40.6) |
| 65-80 | 31.3 (28.2-34.6) | 40.7 (37.5-44.0) | 36.2 (33.0-39.5) | 38.1 (34.2-42.2) | 33.7 (31.1-36.4) | 27.6 (25.4-30.0) |
| Employment status | ||||||
| Employed | 33.0 (29.9-36.2) | 38.9 (35.3-42.5) | 33.8 (30.4-37.4) | 40.7 (36.7-44.9) | 36.0 (32.8-39.3) | 32.1 (29.8-34.5) |
| Retired | 34.2 (30.7-37.8) | 39.5 (36.2-42.8) | 35.4 (32.1-38.8) | 35.2 (31.2-39.5) | 30.6 (27.6-33.8) | 28.2 (25.1-31.4) |
| Not working/receiving disability | 37.5 (30.3-45.2) | 52.1 (45.6-58.4) | 49.5 (43.0-55.9) | 56.4 (48.5-63.9) | 55.0 (46.7-63.1) | 51.9 (46.1-57.6) |
| Education | ||||||
| Some college or less | 35.9 (33.2-38.8) | 40.4 (37.5-43.4) | 38.2 (35.4-41.1) | 42.8 (39.1-46.6) | 38.6 (35.5-41.9) | 34.3 (31.9-36.7) |
| Bachelor’s degree or higher | 29.7 (26.2-33.5) | 43.2 (39.5-47.1) | 34.6 (30.9-38.5) | 39.3 (35.2-43.5) | 34.5 (31.8-37.3) | 31.6 (29.0-34.3) |
| Annual household income, US$ | ||||||
| <60 000 | 43.7 (40.0-47.5) | 46.1 (42.2-50.0) | 47.3 (43.2-51.4) | 48.0 (43.7-52.4) | 43.3 (40.1-46.5) | 38.1 (35.6-40.7) |
| ≥60 000 | 26.3 (23.8-29.1) | 38.1 (35.3-40.9) | 30.6 (28.0-33.3) | 35.2 (31.7-38.8) | 31.4 (28.8-34.1) | 28.9 (26.8-31.1) |
| Lives alone | ||||||
| Yes | 58.6 (52.9-64.0) | 50.3 (45.3-55.3) | 49.1 (43.9-54.3) | 49.1 (43.6-54.7) | 46.5 (42.2-50.8) | 26.5 (24.6-28.5) |
| No | 28.5 (26.2-31.0) | 38.7 (36.1-41.3) | 33.9 (31.4-36.5) | 38.6 (35.4-42.0) | 33.4 (31.0-35.8) | 52.1 (47.8-56.3) |
| Self-reported physical health | ||||||
| Excellent/very good/good | 30.4 (28.1-32.9) | 39.1 (36.6-41.6) | 33.4 (31.0-35.9) | 36.8 (33.9-39.8) | 33.1 (31.2-35.1) | 28.8 (27.2-30.4) |
| Fair/poor | 49.9 (44.0-55.8) | 51.7 (45.8-57.6) | 56.9 (50.6-63.0) | 59.6 (52.4-66.4) | 54.9 (46.2-63.2) | 52.9 (48.4-57.3) |
| Self-reported mental health | ||||||
| Excellent/very good/good | 31.5 (29.2-33.8) | 39.1 (36.8-41.5) | 34.2 (31.8-36.6) | 36.7 (33.8-39.7) | 33.2 (30.7-35.7) | 28.9 (27.1-30.7) |
| Fair/poor | 74.3 (64.2-82.4) | 67.7 (58.7-75.6) | 69.9 (61.2-77.3) | 80.5 (72.2-86.8) | 72.9 (63.9-80.4) | 75.1 (69.2-80.2) |
In 2020, the question read, “Since March 2020, how often have you felt a lack of companionship?” See the eAppendix in Supplement 1 for full survey items.
Table 2. US Adults Aged 50 to 80 Years Who Reported Feeling Isolated From Others Some of the Time or Often in the Past Year, 2018-2024.
| Respondents, % (95% CI), by year | ||||||
|---|---|---|---|---|---|---|
| 2018 (n = 2051) | 2020 (n = 2074)a | 2021 (n = 2033) | 2022 (n = 2277) | 2023 (n = 2563) | 2024 (n = 2576) | |
| Total | 26.6 (24.5-28.8) | 55.7 (53.4-58.1) | 45.9 (43.6-48.3) | 44.4 (41.5-47.3) | 33.7 (30.9-36.6) | 29.2 (27.5-30.9) |
| Sex | ||||||
| Female | 29.1 (26.1-32.3) | 60.9 (57.7-64.0) | 52.5 (49.2-55.7) | 47.7 (43.8-51.7) | 36.5 (33.6-39.6) | 30.7 (28.5-33.0) |
| Male | 23.9 (21.1-26.9) | 50.0 (46.6-53.5) | 38.6 (35.3-42.0) | 40.6 (36.5-44.9) | 30.7 (26.4-35.3) | 27.5 (24.7-30.4) |
| Age, y | ||||||
| 50-64 | 29.6 (26.8-32.7) | 56.6 (53.3-59.8) | 47.9 (44.7-51.2) | 46.4 (42.4-50.5) | 37.3 (33.0-41.8) | 34.5 (32.0-37.0) |
| 65-80 | 21.7 (19.0-24.8) | 54.4 (51.2-57.7) | 43.0 (39.7-46.3) | 41.8 (37.8-45.9) | 29.3 (26.8-32.0) | 23.1 (20.9-25.5) |
| Employment status | ||||||
| Employed | 25.0 (22.2-28.0) | 55.5 (51.8-59.2) | 42.2 (38.6-45.9) | 41.2 (37.2-45.4) | 29.8 (26.6-33.2) | 26.9 (23.6-30.4) |
| Retired | 26.0 (22.8-29.4) | 55.2 (51.8-58.5) | 44.7 (41.3-48.1) | 41.4 (37.2-45.9) | 28.8 (24.5-33.5) | 24.1 (20.5-28.2) |
| Not working/receiving disability | 35.8 (28.7-43.6) | 57.6 (51.1-63.8) | 58.1 (51.5-64.3) | 56.9 (48.9-64.5) | 55.0 (47.9-61.9) | 50.1 (43.1-57.1) |
| Education | ||||||
| Some college or less | 28.0 (25.4-30.8) | 54.0 (51.1-57.0) | 44.7 (41.8-47.7) | 44.4 (40.7-48.3) | 33.5 (29.8-37.4) | 28.4 (26.4-30.5) |
| Bachelor’s degree or higher | 23.6 (20.4-27.2) | 59.1 (55.3-62.9) | 48.6 (44.6-52.5) | 44.2 (40.1-48.4) | 34.1 (31.5-36.9) | 30.8 (28.1-33.5) |
| Annual household income, US$ | ||||||
| <60 000 | 33.1 (29.6-36.9) | 55.4 (51.4-59.3) | 49.9 (45.9-54.0) | 48.1 (43.8-52.5) | 38.9 (34.5-43.4) | 33.3 (30.4-36.4) |
| ≥60 000 | 21.5 (19.1-24.1) | 56.0 (53.1-58.8) | 43.3 (40.5-46.2) | 40.6 (37.0-44.3) | 28.8 (26.2-31.6) | 25.1 (23.3-27.1) |
| Lives alone | ||||||
| Yes | 40.7 (35.2-46.4) | 57.3 (52.3-62.1) | 51.2 (46.0-56.3) | 43.0 (37.6-48.6) | 37.7 (34.0-41.5) | 25.8 (23.8-27.8) |
| No | 23.5 (21.3-25.8) | 55.3 (52.6-57.9) | 44.5 (41.9-47.2) | 44.8 (41.4-48.2) | 31.9 (28.7-35.3) | 38.4 (35.0-42.0) |
| Self-reported physical health | ||||||
| Excellent/very good/good | 23.0 (20.8-25.3) | 54.8 (52.2-57.3) | 42.5 (40.0-45.0) | 40.1 (37.2-43.2) | 28.9 (26.0-32.0) | 23.9 (22.4-25.5) |
| Fair/poor | 43.3 (37.5-49.4) | 60.3 (54.4-65.9) | 64.2 (57.9-70.0) | 60.3 (53.1-67.1) | 54.7 (49.8-59.4) | 52.0 (47.9-56.1) |
| Self-reported mental health | ||||||
| Excellent/very good/good | 23.4 (21.4-25.5) | 54.5 (52.0-56.9) | 42.9 (40.4-45.3) | 39.3 (36.3-42.3) | 28.7 (25.8-31.8) | 24.1 (22.5-25.7) |
| Fair/poor | 79.1 (69.8-86.1) | 71.5 (62.7-78.9) | 78.3 (69.7-85.0) | 82.4 (74.4-88.2) | 76.7 (72.1-80.8) | 77.3 (72.4-81.6) |
In 2020, the question read, “Since March 2020, how often have you felt isolated from others?” See the eAppendix in Supplement 1 for full survey items.
Results
In 2018, the proportion of adults aged 50 to 80 years reporting that they felt a lack of companionship “some of the time” or “often” was 33.9% (95% CI, 31.7%-36.2%), increasing to 41.4% (96% CI, 39.1%-43.7%) during the early pandemic in 2020. In 2021, this proportion was 37.1% (95% CI, 34.8%-39.4%); in 2022, 41.6% (95% CI, 38.8%-44.5%); in 2023, 37.2% (95% CI, 34.9%-39.6%); and in 2024, 33.4% (95% CI, 31.7%-35.1%) (Table 1).
Loneliness was most commonly reported among those not working, those living alone, and those with lower household incomes. Rates of loneliness were higher among those with self-reported fair and poor physical health and mental health than among those with excellent, very good, or good physical health and mental health (Table 1).
Reports of social isolation followed a similar pattern (Table 2). In 2018, 26.6% (95% CI 24.5%-28.8%) of those aged 50 to 80 years reported feeling isolated from others “some of the time” or “often” in the past year. This proportion increased to 55.7% (95% CI, 53.4%-58.1%) in 2020. In 2021, the proportion was 45.9% (95% CI, 43.6%-48.3%); in 2022, 44.4% (95% CI, 41.5%-47.3%); in 2023, 33.7% (95% CI, 30.9%-36.6%); and in 2024, 29.2% (95% CI, 27.5%-30.9%). The same groups who reported high rates of loneliness were also more likely to experience social isolation (Table 2).
Discussion
This study found that adults aged 50 to 80 years commonly reported loneliness and social isolation. While the pandemic disrupted social connections, rates of loneliness and isolation were substantial both before and after the early pandemic. High rates of loneliness and social isolation occurred in several sociodemographic groups, especially those with self-reported fair or poor physical or mental health.
Limitations include possible recall bias and use of self-reported data. Respondents to a survey may differ from the general population. The results are not longitudinal. Questions on social isolation and loneliness in the 2020 survey asked about these feelings during the past 3 months (vs 12 months in the other years). Results may not generalize to groups excluded from the poll sample, such as adults in nursing homes, those older than 80 years, or those unable to complete surveys online. Surveys were conducted at different times of the year and the panels were changed between 2021 and 2022.
Overall, these findings highlight opportunities to better support older adults who are experiencing loneliness and social isolation. Much like routinely asking about diet and exercise, clinicians should consider screening older adults for loneliness and social isolation and connect them with appropriate resources.
Section Editors: Kristin Walter, MD, and Jody W. Zylke, MD, Deputy Editors; Karen Lasser, MD, MPH, Senior Editor.
eAppendix. Survey Items
Data Sharing Statement
References
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
eAppendix. Survey Items
Data Sharing Statement