Socially isolated older adults who enter intensive care units are more likely to die after discharge compared with those who are more connected to family and friends, a Yale University study has found. They also are at increased risk of disability following their release from the hospital.
The study looked at data from nearly 1,000 patients aged 65 and older participating in the National Health and Aging Trends study who were admitted to intensive care units between 2011 and 2018. Participants were asked questions about their social interactions, such as whether they talk with family or friends about important matters, visit with family members or friends, and participate in social events or church. Participants scored 1 point for each negative response, with higher scores indicating greater social isolation.
Their results showed that any increase in social isolation scores corresponded to an increased risk of functional disability and death. The most socially isolated older adults had a 50% higher burden of functional disability and a 119% greater risk of death in the year after an ICU admission.
Concerns about social isolation among older adults have intensified during the recent COVID-19 pandemic. Infection control and risk-mitigation strategies, such as shelter-in-place orders, were well-meaning but inevitably increased social isolation, noted Lauren E. Ferrante, M.D., M.H.S., a pulmonary and critical care physician at Yale School of Medicine and senior author of the paper. She added that the findings point to an urgent need to develop in-hospital screening tools and intervention frameworks to support socially isolated older adults who are recovering from critical illness.
“Hospitalization may be our only chance of identifying people who are socially isolated,” Ferrante said. “In the hospital, we are all aware of the patient’s medical details, but we need to be more aware of the patient’s social situation as well.”
Findings were published Sept. 7 in JAMA Internal Medicine.