The Effect of Imposed Social Isolation on Older Adults During the Pandemic

The consumer news media has published stories of older adults feeling isolated during the COVID-19 pandemic. A study conducted by Lee Anne Siegmund, PhD, RN, ACSM-CEP, Nurse Scientist II at Cleveland Clinic, and published as a journal pre-proof Aug. 20, 2021 in Geriatric Nursing, reveals emotional suffering that older adults may have during times of imposed social distancing.

Study methods

Dr. Siegmund performed a path analysis to evaluate the relationship between physical activity, social isolation and depression among older adults during COVID-19. “We know there is an inverse relationship between physical activity and depression. There is quite a bit of literature in which authors found that the more you exercise, the less likely it is that you will be depressed,” says Dr. Siegmund. “I wondered if social isolation plays a role in this. Are people who are socially isolated due to COVID-19 depressed and less physically active?”

Dr. Siegmund collaborated with Karen Distelhorst, PhD, APRN, GCNS-BC, Nurse Scientist I at Cleveland Clinic, on the cross sectional, descriptive, correlational design utilizing survey methodology. The final sample included 477 surveys from adults aged 65 and older. They measured the following variables using the tools listed:

• Depression – 15-item Geriatric Depression Scale (GDS-15)
• Social Isolation – PROMIS Short Form v2.0 – Social Isolation 8a
• Physical Activity – Physical Activity Scale for the Elders (PASE)

Participants also completed a demographic questionnaire.

Research results

“We hypothesized several specific pathways that included higher social isolation (imposed social distancing), lower physical activity and personal factors, such as older age, lower income and lower education, would lead to higher depression during COVID-19,” says Dr. Siegmund. “And the results panned out fairly close to what we thought. Both physical activity and social isolation predicted depression among older adults.”

Of the variables that predicted depression among older adults during COVID-19, social isolation and decreased physical activity accounted for 44% of it. “Since social isolation is modifiable, learning its importance in depression can lead to interventions that address it,” says Dr. Siegmund.

Clinical implications

Dr. Siegmund hopes the results of the study will encourage clinicians to not only screen for depression in older adults, but also ask important questions about what’s going on in their lives to cause the depression.

“So many things can result in social isolation that can lead to depression,” she says. “Older adults may lose all of their friends to death, move to assisted living or skilled nursing home facilities, or have adult children who no longer visit or rarely contact them.” She says nurses can play a key role in ensuring older adults stay active and connected to others.

“Nurses can educate older adults who are socially isolated, as well as advocate for programs and policies that promote ways for them to connect to others,” says Dr. Siegmund.