Loneliness and social isolation can have serious consequences for frail seniors. Clinicians should be on the lookout for these risk factors and consider the use of personalized interventions when treating patients, investigators say.

In a 22-year study of frail older adults in the Netherlands, researchers found a gradual increase in mortality risk tied to social vulnerability. Although frailty put participants at a higher overall risk of mortality when compared with their peers who were not frail, the highest risk was observed in those with combined frailty and loneliness — or frailty and social isolation.

Lack of social connections may lead to unfulfilled care needs and poor health outcomes, wrote Emiel O. Hoogendijk, Ph.D., from the Amsterdam Public Health Research Institute.

Frail older adults with loneliness or social isolation may have less favorable personality characteristics such as low self-esteem. This can affect their ability to cope with stress, for example. Social problems also may be expressed physically in immune responses and various medical conditions, the researchers added. Social isolation, for example, is linked to depression and cardiovascular disease.

To forestall adverse outcomes, targeted interventions should be tailored to match the cause of social isolation or loneliness, Hoogendijk wrote.

Evidence exists that group‐based social activities alleviate social isolation, for example. But the evidence is less clear for loneliness, he said. “Some approaches have the potential to diminish feelings of loneliness, such as psychological therapies,” he added.

The findings are particularly relevant during the COVID-19 pandemic, the researchers said. “Social distancing may prevent transmission of a virus, but it increases social isolation and feelings of loneliness that in turn may increase the long‐term risk of mortality in this group,” they concluded.

Full findings were published in the Journal of the American Geriatrics Society.