Addressing the loneliness epidemic and cognitive decline in seniors

Mounting research proves that loneliness can be devastating to our health and that older adults are particularly vulnerable to its consequences.^1,7

In fact, the detrimental effects of social isolation — including increased risk of heart disease, stroke, dementia and premature death² — are so severe that the U.S. Surgeon General declared loneliness an epidemic in 2023, noting that it’s as deadly as smoking 15 cigarettes a day.³

Older adults face increased risk of loneliness because they're more likely to live alone, experience the loss of family or friends and have a chronic illness as well as sight or hearing loss.⁴

As the U.S. population ages, this crisis has emerged as a significant and worsening public health issue with profound implications for individual well-being and societal health.

Data from the University of Michigan’s National Poll on Healthy Aging shows that more than a third of older adults reported being lonely in 2023 — a level still notably higher than pre-COVID figures.⁵

This disconnection creates significant economic costs, including an estimated $6.7 billion in excess Medicare spending annually, largely due to higher hospital and nursing home spending.⁶

Payers can play an important role in mitigating this epidemic by embracing innovative interventions and holistic care strategies. Here are several strategies payers can adopt to tackle loneliness among older Americans.

While no panacea for aging exists, exercise is the closest thing we have to a wonder drug and combining it with social connection offers even more benefits. A study by Cedars-Sinai Medical Center that started with in-person classes before the COVID-19 pandemic found:

• Older adults who joined group exercise classes experience decreased loneliness and social isolation.⁸ 
• Those who continued with virtual workouts after lockdowns began enjoyed similar benefits.

By offering opportunities for classes that combine activity and social connection, payers can give members a proven mental and physical boost. An easy way to do this is to look for a Medicare fitness benefit that partners with many gyms and fitness centers of all sizes.

The best solution will offer multilocation access as well as a comprehensive library of on-demand fitness videos and live-stream offerings. This will allow seniors to pick and choose classes from multiple gyms in any given month.

But it’s not enough to stop at group exercise. Seniors are also interested in broader health and wellness resources that encourage socialization, whether that’s:

• Healthy cooking club 
• Guest lecture on sleep hygiene 
• Seminars about emerging health research

To meet these needs, payers can incorporate senior benefits that build robust member communities through a variety of free events, both in-person and virtual.

Physical fitness itself offers plenty of proven brain benefits. For example, a study published in the journal Comprehensive Physiology found that exercise can help people retain more memories and enhance their cognitive skills.⁹

But among older adults, the fear of dementia is so pervasive¹⁰ that they often want to add cognitive training to maintain optimal brain function. Evidence supports this, with some research suggesting that taking part in mentally stimulating games can delay the onset of dementia for up to 5 years.¹¹

It’s no surprise, then, that although Medicare only recently approved the inclusion of memory fitness, brain health is the fastest-growing category of Medicare Advantage fitness benefits.¹²

And when seniors were asked in a 2021 survey what motivated them to switch Medicare Advantage plans, 34% cited a lack of mental training benefit with their current plan.¹³

Additionally, brain health and social ties are deeply connected because the relationship between isolation and cognitive decline is bidirectional. Not only does loneliness increase the risk of dementia, but the early stages of cognitive decline can also increase social isolation.

In fact, a study of older adults with mild cognitive impairment demonstrated significantly higher levels of perceived loneliness and depression than in a control group.¹⁴

Accordingly, payers should consider offering personalized brain-training programs designed with evidence-based criteria to assist in:

• Improving focus 
• Lengthening attention span 
• Boosting cognitive processing

Research confirms that technology can enhance seniors’ social connectivity. A National Health and Aging Trends study found that more than 70% of people ages 65 and up who were not socially isolated at their initial appointment regularly used email or texting.

Over a 4-year research period, older adults with access to a cell phone and/or computer consistently showed a 31% lower risk for social isolation than the rest of the cohort.¹⁵

Initiatives such as virtual support groups, online social activities and telehealth check-ins — along with access to technology and training — are a critical way for payers to ensure that older adults stay connected with family, friends and health care providers.

User-friendliness is particularly key. A study by AARP shows that while seniors are rapidly embracing mobile apps, ease of navigation and intuitive functionality are crucial to engagement.¹⁶

Seniors are less likely to participate in digital experiences that require logging in to various sites with different member IDs, apps and customer experiences. Payers should seek out a vendor that can curate various products, tools and features into a single experience.

To mitigate the growing social and economic consequences of senior citizen disconnection, payers must advance their Medicare fitness and wellness offerings to meet individuals’ changing physical, social and cognitive needs.

Creating a vibrant hub of special connection begins with offering an easy-to-use benefit that delivers access to a broad array of fitness locations, on-demand and live-streamed workouts, complimentary personalized brain training programs, social activities and more.

By taking a holistic approach, payers can help seniors live their best lives — and fight an alarming public health crisis at the same time.