Issue link: https://tmcpulse.uberflip.com/i/1182394
t m c » p u l s e | n o v e m b e r 2 0 1 9 32 How Loneliness Compounds Age-Related Diseases Isolation can create stress and depression in seniors B y S h a n l e y P i e r c e B y nature, humans are a social species. Evolution has hard- wired us to depend on our connec- tions and interactions with others to survive and thrive. As people live longer, though, they tend to have smaller social net- works, due to retirement, declining health, mobility limitations and other challenges. What happens to seniors, physically and mentally, when their social relationships start to diminish? A confluence of factors— physical, social, psychological and neurological—could create a depres- sive phenomenon known by the umbrella term "late-life depression," according to Vineeth John, M.D., director of the Geriatric Psychiatry Section at The University of Texas Health Science Center at Houston (UTHealth). "It is different than the early life depression in the sense that people don't even come out and say they're depressed," John explained. "In fact, they'll say, 'I don't know. Life is kind of blah. I'm very much tired of all these pains, all these aches and so,' but this can get missed in a primary care setting or geriatric physician office visit because they don't really think they're depressed. But actu- ally, these are all manifestations of late-life depression." About 10,000 baby boomers turn 65 in the United States every day; by 2030, 20 percent of the American population will be 65 or older. Loneliness is a stealth epidemic growing among this group. Approximately one in four seniors reported feeling isolated or disconnected and one in three reported feeling lonely in the National Poll on Healthy Aging. "Our cells change by virtue of being in an environment [of] social isolation," said Robert Roush, Ed.D., M.P.H., professor of geriatrics at Baylor College of Medicine and director of the Texas Consortium Geriatrics Education Center at the Huffington Center on Aging. "Loneliness could be part of the pre- cursor of an epigenetic change." Health risks The immune system is the first of the body's systems to be affected by normal aging, but when com- pounded with chronic loneliness, the psychological stress can initiate physiological changes in the body. Researchers have linked social isolation and loneliness to an increased risk of health issues including high blood pressure, cardiovascular disease, cancer, obesity, weak immune system, anx- iety, depression, cognitive decline, Alzheimer's disease, even death. Understanding the physiological effects of loneliness is integral to developing solutions and inter- ventions that can help seniors lead healthier lives. "Aging itself is not a disease, but there are diseases that are age-related, like cancer, demen- tia and other things," Roush said. "There is a higher prevalence rate among older people who think of themselves as being lonely or feel socially isolated." With significant depression, the immune system becomes compro- mised and the body is more prone to infections, John said. "When we go through stress, when we go through sadness, the inflammation load is very high," he added. Individuals who spend a lot of time alone become hypervigilant of their surroundings. The resulting stress can activate the hypothalamic- pituitary-adrenal (HPA) axis and the sympathetic nervous system, which modulates the body's fight-or-flight response. The brain sends signals that trigger the body to divert blood