Virtual Contact Alone Did Not Mitigate Loneliness for Seniors During COVID-19

Loneliness and Social Isolation — Tips for Staying Connected

Virtual Contact Alone Did Not Mitigate Loneliness for Seniors During COVID-19

Everyone needs social connections to survive and thrive. But as people age, they often find themselves spending more time alone.

Being alone may leave older adults more vulnerable to loneliness and social isolation, which can affect their health and well-being.

Studies show that loneliness and social isolation are associated with higher risks for health problems such as heart disease, depression, and cognitive decline.

If you are in poor health, you may be more ly to be socially isolated or lonely. If you are socially isolated or feeling lonely, it can put your physical and mental health at risk.

Adults who are lonely or socially isolated are less healthy, have longer hospital stays, are readmitted to the hospital more often, and are more ly to die earlier than those with meaningful and supportive social connections.

What is the Difference Between Loneliness and Social Isolation?

The number of older adults age 65 and older is growing, and many are socially isolated and regularly feel lonely. The coronavirus outbreak in 2020 brought even more challenges due to health considerations and the need to practice physicaldistancing.

Loneliness and social isolation are different, but related. Loneliness is the distressing feeling of being alone or separated. Social isolation is the lack of social contacts and having few people to interact with regularly. You can live alone and not feel lonely or socially isolated, and you can feel lonely while being with other people.

Older adults are at higher risk for social isolation and loneliness due to changes in health and social connections that can come with growing older, hearing, vision, and memory loss, disability, trouble getting around, and/or the loss of family and friends.

With the COVID-19 pandemic (global outbreak), maintaining safe distancing precautions has been challenging for everyone — even people who are otherwise well-connected with large supportive social networks.

Public health guidelines to keep physical distance from others have slowed the spread of COVID-19, but they have also made it harder for people to see family and friends.

Older adults are at greater risk of COVID-19, but it is also critically important for them to maintain active social connections.

Reach out by phone, video, text, email, social media, or letter to help everyone stay connected during this challenging time. Learn more at

How Can Feeling Lonely or Being Isolated Affect Older Adults’ Health?

People who are socially isolated or lonely are more ly to be admitted to the emergency room or to a nursing home. Social isolation and loneliness also are associated with higher risks for:

View the Social Isolation and Loneliness Outreach Toolkit for social media images and posts, animated graphics (GIFs), educational materials, and more.

People who are lonely or socially isolated may get too little exercise, drink too much alcohol, smoke, and often don’t sleep well, which can further increase the risk of serious health conditions.

People who are lonely experience emotional pain. Losing a sense of connection and community can change the way a person sees the world. Someone experiencing chronic loneliness may feel threatened and mistrustful of others.

Emotional pain can activate the same stress responses in the body as physical pain. When this goes on for a long time, it can lead to chronic inflammation (overactive or prolonged release of factors that can damage tissues) and reduced immunity (ability to fight off disease). This raises your risk of chronic diseases and can leave a person more vulnerable to some infectious diseases.

Social isolation and loneliness may also be bad for brain health.

Loneliness and social isolation have been linked to poorer cognitive function and higher risk for dementia, including and especially for Alzheimer's disease.

Also, little social activity and being alone most of the time may contribute to a decline in the ability to perform everyday tasks such as driving, paying bills, taking medicine, and cooking.

The Eldercare Locator connects the public to services for older adults and their families. This resource seeks to provide assistance for a wide range of issues affecting older Americans, including social isolation and loneliness.

Call the Eldercare Locator at 800-677-1116 or visit to get connected today.

For additional resources on older adults and social isolation and loneliness visit, Expand Your Circles: Prevent Isolation and Loneliness As You Age (PDF, 4.75M).

How Can You Know Your Risk for Loneliness and Social Isolation?

Those who find themselves unexpectedly isolated due to the illness of a loved one, separation from friends or family, loss of mobility, worsening vision or hearing problems, disability, or lack of mobility or access to transportation, are at particular risk of loneliness and social isolation.

Check out this resource to learn more about loneliness and social isolation and take a quiz to see if you might be at risk for loneliness or social isolation: Expand Your Circles: Prevent Isolation and Loneliness as you Age (PDF, 4.75M).

You also may be at greater risk if you:

  • Live alone
  • Can’t leave your home
  • Had a major loss or life change, such as the death of a spouse or partner, or retirement
  • Struggle with money
  • Are a caregiver
  • Have psychological or cognitive challenges, or depression
  • Have limited social support
  • Have trouble hearing
  • Live in a rural, unsafe, and/or hard-to-reach neighborhood
  • Have language barriers where you live
  • Experience age, racial, ethnic, sexual orientation, and/or gender identity discrimination where you live
  • Are not meaningfully engaged in activities or are feeling a lack of purpose

People with hearing loss may find it hard to have conversations with friends and family, which can lead to less interaction with people, social isolation, and higher rates of loneliness.

If you are feeling isolated or lonely a lot of the time, you may want to tell your doctor or health professional. Talking about your health with your doctor means sharing information about how you feel physically, emotionally, and mentally. Describing your symptoms can help your doctor identify the problem.

Make sure to bring up your concerns. For example, let your doctor know about any major changes or stresses in your life, such as a divorce or the death of a loved one. A doctor who knows about your losses is better able to understand how you are feeling. They can make suggestions that may be helpful to you.

Be open and honest with your doctor about your health habits and what’s happening in your life. It will help them to understand your medical conditions and emotional health more fully and recommend the best treatment options for you. Learn more about talking with your doctor.

How Can You Stay Connected with Friends and Family?

Since Carla started having trouble with her vision, she had to give up driving and travels less often.

But she still enjoys spending time with her three grandchildren, even though she lives in Maryland and they live across the country in California. Carla reads stories to them on video chat and catches up on how they are doing on social media.

She also stays in touch with friends through email and weekly phone calls. Carla feels much happier knowing that she can stay connected with others.

There are things you can do to help protect yourself or a loved one from the negative effects of loneliness and social isolation. First, it’s important to take care of yourself. Try exercising, eating healthy, getting enough sleep (7 to 9 hours), and pursuing activities you enjoy to help manage stress and stay as mentally and physically healthy as possible.

Share this infographic and help spread the word about staying connected to combat loneliness and social isolation.

It’s also important to stay active and connect with others. People who engage in meaningful, productive activities they enjoy with others feel a sense of purpose and tend to live longer.

For example, helping others through volunteering helps you feel less lonely and allows you to have a sense of mission and purpose in life, which is linked to better health.

Studies show activities these may help boost your mood and improve your well-being and cognitive function.

Here are some other ideas to help you stay connected. Remember to take steps to help keep you safe and active during the COVID-19 pandemic

  • Find an activity that you enjoy, restart an old hobby, or take a class to learn something new. You might have fun and meet people with similar interests.
  • Schedule time each day to stay in touch with family, friends, and neighbors in person, by email, social media, voice call, or text. Talk with people you trust and share your feelings. Suggest an activity to help nurture and strengthen existing relationships. Sending letters or cards is another good way to keep up friendships.
  • Use communication technologies such as video chat, smart speakers, or even companion robots to help keep you engaged and connected.
  • If you’re not tech-savvy, sign up for an online or in-person class at your local public library or community center to help you learn how to use email or social media.Credit: Victoria Ruun
  • Consider adopting a pet if you are able to care for them. Animals can be a source of comfort and may also lower stress and blood pressure.
  • Stay physically active and include group exercise, such as joining a walking club or working out with a friend. Adults should aim for at least 150 minutes (2 1/2 hours) of activity a week that makes you breathe hard.
  • Introduce yourself to your neighbors.
  • Find a faith-based organization where you can deepen your spirituality and engage with others in activities and events.
  • Check out resources and programs at your local social service agencies, community and senior centers, and public libraries.
  • Join a cause and get involved in your community.

If you or a loved one has dementia and lives alone, family members, friends, or other caregivers may be able to help in different ways.

  • Identify a person you trust, such as a neighbor, who can visit regularly in-person or via a video call and be an emergency contact.
  • Learn about home- and community-based support and services from social service agencies, local nonprofits, and Area Agencies on Aging.
  • Stay connected with family and friends through video chats, email, and social media. If you’re not tech savvy, ask for help to learn.
  • Talk with others who share common interests. Try a support group online or in person. Maybe your community has a memory café you can visit — a safe place to enjoy activities and socialize for people living with memory loss and their families and caregivers.

Read more about staying safe and active during the COVID-19 pandemic

Read about this topic in Spanish. Lea sobre este tema en español.

For More Information About Loneliness and Social Isolation

NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center800-438-4380 (toll-free)
The NIA ADEAR Center offers information and free print publications about Alzheimer’s and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.


The Double Pandemic Of Social Isolation And COVID-19: Cross-Sector Policy Must Address Both

Virtual Contact Alone Did Not Mitigate Loneliness for Seniors During COVID-19

The struggle to balance literal survival with all the things that make surviving worthwhile has never been so clear, with the COVID-19 pandemic forcing many to sacrifice social connections – and therefore quality of life – for life itself. And yet, as I wrote in a recent Health Affairs policy brief, Social Isolation and Health (released June 22, 2020), being socially connected in meaningful ways is actually key to human health and survival.

The COVID-19 pandemic and the need to slow the virus’ spread have highlighted the pervasiveness of social contact within, and social relevance of, nearly every sector of our lives, including employment, education, entertainment, travel, transportation, and recreation.

The pandemic has also highlighted the underlying weaknesses of our current social “support systems” for older adults, students, families, workers, and at-risk populations.

  As such, COVID-19 has underscored the necessity of strengthening local and federal systems to rebuild and sustain the social and emotional needs of the population – a task that will be critical to the nation’s public health recovery from the pandemic.

In this post, I explain why concerns about social isolation are heightened during the pandemic; discuss why policy responses must consider the impact of reduced or changed social connection across all sectors; highlight possible unintended consequences of improved digital connection; and, emphasize the importance of prioritizing social needs in recovery efforts.

Population-Wide Social Isolation Due To COVID-19

While social isolation and loneliness were prevalent in the population prior to COVID-19, efforts to reduce the virus’ spread via stay-at-home orders, quarantine, and social distancing recommendations have exacerbated an already serious problem.

With the exception of “essential workers,” the pandemic has meant limiting physical proximity to those with whom one lives. For the 28 percent of Americans who live alone, this has meant little to no human contact for months.

Regardless of living situation, interactions with anyone outside the home have been severely limited for everyone. Preliminary surveys suggest that within the first month of COVID-19, loneliness increased by 20 to 30 percent, and emotional distress tripled.

While several surveys are still ongoing to capture the full extent of the problem, current evidence suggests the pre-existing public health crisis of social isolation and loneliness may be far more widespread than previously estimated.

In addition, older adults, people of color, those with low income, and those in congregate living centers (e.g., nursing homes and prisons) have been disproportionately victims of COVID-19.

These populations were already at high risk for poor health outcomes, social isolation, and loneliness. Pandemic-related inequities in access to resources compound this risk.

  For example, the prevalence of loneliness is higher among low-income individuals, who may be less able to work remotely and subsequently more ly to lose employment.

Social Isolation Carries Long-Term And Immediate Risks To Survival

With a highly infectious and deadly novel virus, why should we care about social isolation and loneliness? As described in my brief, robust evidence links social isolation to increased risk of death from all causes and increased morbidity across a variety of physical health outcomes.

These well-established risks are a result of chronic effects over time. Thus, understandably, restrictions associated with the immediate risks of the coronavirus were prioritized for public health.

Nonetheless social isolation and loneliness do have immediate effects that are health-relevant that should not be ignored.

The increase in distress due to social distancing that many Americans are experiencing is a normal response. Given that humans are a social species, this is our biology signaling a need to reconnect socially, just hunger signals us to eat, and thirst signals us to drink water.

  Proximity to others, particularly trusted others, signals safety. When we lack proximity to trusted others our brain and body may respond with a state of heightened alert.

This can result in increases in blood pressure, stress hormones, and inflammatory responses—which if experienced on an ongoing basis can put us at increased risk for a variety of chronic illnesses.

  Among those with pre-existing health conditions, these changes in physiology could potentially exacerbate the condition, precipitate the onset of an acute event, or hasten disease progression.

Immediate effects of social isolation related to the pandemic have already been observed, with surges in mental health concerns, substance abuse, and domestic violence. Early observation suggests problematic health behaviors, including substance use, poorer sleep, and emotional or overeating, may increase.

Further, more than two million Americans purchased guns during the month of March (the second highest monthly total in the decades since such records have been kept), raising concerns for increased risk for suicide.

Both short-term and long-term public health concerns will emerge if steps are not taken to mitigate these effects.

Social Contact Is A Key Component Of Every Sector

The pandemic has shown the world how fundamental social contact is in our lives, as almost every aspect of life has changed to create social distance.

These social distancing efforts have led to remote working; remote or online education; cancellation of sporting, entertainment, and professional events; and, closures of museums, parks, churches and much more.

 Going forward, we are ly to see sustained changes to the way we live, work, and play, and even in the way we age.  In fact, we have already seen calls for permanent changes in social norms, policies and physical environments– all of which are social determinants of health.

The Centers for Disease Control define the social determinants of health as “the conditions in which people are born, grow, live, work and age, as well as the complex, interrelated social structures and economic systems that shape these conditions.

”  The substantial changes in our social behavior as a result of this pandemic are clearly far-reaching, but we do not yet know what lingering longer-term public health effects the pandemic may foreshadow. If the prevalence rates of social isolation and loneliness remain elevated or increase, such changes are ly to lead to a greater public health burden in the longer term.

I proposed in my brief that we use a “social in all policy” framework to address social isolation and loneliness. This approach remains just as, if not more, important in light of COVID-19.  Indeed, the social relevance of every sector is now more readily apparent.  Changes to each of these sectors can either promote or deter social connection.

 Therefore, caution and ongoing evaluation are needed.  Reactionary policy could potentially ignore the long-term public health costs of social isolation and loneliness, creating changes that lead to permanent increases in distance and isolation.

  Policies that create greater isolation to curb the virus’ spread should be considered temporary, and novel social approaches should be explored for more permanent or long-term policy.

Addressing The Digital And Social Divides

Maintaining connections to others outside the home during the quarantine has increased our reliance upon phones and digital technologies.

Of course, reliance on technology was rapidly increasing prior to the pandemic, but with increasing demand for telehealth, telework, and online education, issues of connectivity and the digital divide have been catapulted to the forefront of many policy discussions.

Access to the internet is more crucial than ever, but we must pause to ask the bigger question: what is the full scope of consequences that may result from scaling digital capabilities and solutions?

While digital tools have clear benefits, including the capability to provide access to information and resources and bridge distances, there are potential tradeoffs.  It is unclear to what extent digital tools approximate the human experience of in-person contact, or whether our biological needs for human connection can be satisfied through such tools.

There is some evidence of a “loneliness paradox” wherein tech and social media that should make us more socially connected actually increase loneliness. In addition, the pandemic has highlighted limitations of video conferencing tools that go beyond Zoom Fatigue.

 For example, anyone who has attended a virtual funeral or wedding, or even just a virtual happy hour, realizes that it may be better than nothing but feels drastically inadequate.  According to one survey, these virtual social gatherings failed to reduce loneliness among 48 percent, and actually increased loneliness among 10 percent of respondents.

  Permanent scaling of digital solutions may create a different kind of digital divide, such that human contact becomes a luxury exacerbating economic disparities.

Whether a digital solution is specifically aimed at social isolation and loneliness or is employed to address other issues (e.g., remote secondary education), there may be social consequences to such solutions.

 Any sector transitioning to digital or remote modes of operation, and any policy that promotes or funds such transitions, should simultaneously require (and fund) evaluation of its effectiveness across social outcomes, not just access and productivity.

 This moment provides us an opportunity to address digital market failures and longstanding inequities in access and to evaluate the safety and effectiveness of digital based solutions.

Social Needs Must Be Prioritized In Pandemic And Recovery Policy

Concerns about the secondary ramifications of the pandemic have focused nearly exclusively on a global economic recession. There should be similar concerns of a social recession.

Similar to an economic recession that can have lasting effects even after the economy begins to grow, the social restrictions put in place during the pandemic may have profound long-term consequences, even after restrictions are lifted.

Social isolation and loneliness can also influence our economic recovery. A recent AARP study found social isolation among older adults is associated with 6.7 billion in annual Medicare spending.

The true economic burden of loneliness is ly much larger, given that it has also been linked to greater workplace absenteeism, lower productivity, and lower quality of work.

Thus, if social needs are not met, the economic burden post-COVID-19 may be greater.

Recently the Coalition to End Social Isolation and Loneliness made the following policy recommendations: (1) Maintain and improve access to mental and behavioral health services that mediate the mental health implications of social isolation and loneliness for vulnerable populations; (2) Improve the public health response to COVID-19 and widespread social isolation and loneliness; (3) Provide for additional targeted funding for programs and services under the Older Americans Act; and (4) Enhance supports for our nation’s education system to combat the effects of social isolation and loneliness for our now displaced students. These are a good start, but as described in my brief and here, social isolation has broader implications for policy.  Drawing on the “Social in All Policy” framework proposed in my brief, we must consider social ramifications across sectors of health, transportation, housing, employment, nutrition, water, and sanitation. This global pandemic may yet provide an important opportunity to redraft policy so as to alleviate further social isolation.

As we move forward in our “new normal,” individual and stakeholder decision-making should be scientific evidence of benefits and drawbacks to our well-being, not solely on economic costs and convenience.

Accordingly, we will need evidence-based guidance, and that means a focus on science in both our public discourse and in institutional funding.

 A full understanding of the effects of COVID-19-related social isolation and loneliness on both short- and long-term public health will require rigorous study.

 Further, as adaptations to the pandemic across sectors are shifting and may become permanent, the need for action and evaluation of such practices and policies becomes more urgent.  It is clear that no single organization or sector can solve this issue alone.  Thus it is critical to establish and fund a National Resource Center to centralize evidence, resources, training, and best practices.

Now is the time to study the costs of human loneliness.  Our future health depends on encouraging and maintaining greater social connection.


Social Isolation and Loneliness of Older Adults in Times of the COVID-19 Pandemic: Can Use of Online Social Media Sites and Video Chats Assist in Mitigating Social Isolation and Loneliness?

Virtual Contact Alone Did Not Mitigate Loneliness for Seniors During COVID-19

The COVID-19 pandemic is a serious global burden. Epidemiological data suggest that the severity of COVID-19, in particular its case fatality rate, rises strongly with age. It is possible that neither a vaccine nor an effective treatment will be available for >1 year.

Thus, it may be necessary for older adults to protect themselves by avoiding direct social contact and practicing social distancing for a rather long period of time. This may result in loneliness and social isolation because, for example, grandchildren cannot visit their grandparents.

In turn, both loneliness and social isolation can have serious deleterious consequences (e.g., in terms of morbidity and mortality).

Thus, the question arises: are there ways to mitigate loneliness and social isolation? One way to stay in contact is to use online social media such as or using video calling software such as Skype.

However, there are very few studies examining whether the use of online social media or video chats are associated with loneliness and social isolation in older adults. We sum up some preliminary findings and make a call for further research on the link between online social media use/video chat and loneliness, as well as social isolation, in older adults.

© 2020 S. Karger AG, Basel


The COVID-19 pandemic has already changed the world and will continue to do so. While the economic and social consequences are not completely predictable, there is little doubt that it will have an effect on many areas of life – at least in the midterm.

It is widely acknowledged that the severity of COVID-19, in particular its case fatality rate, increases considerably with age. One possible scenario is that older adults will be forced to stay home for extended periods of time to avoid physical contact with other people (e.g., when buying food) in order to avoid infection with the coronavirus.

This can affect mental health and well-being among individuals in old age [1, 2]. Ultimately, this can also lead to feelings of social isolation (feeling that one does not belong to the society) and loneliness (perceived discrepancy between actual and desired social relationships).

This has been found to be the case, for example, when grandchildren cannot have direct contact with their grandparents. Loneliness and social isolation are correlated, but they are distinct constructs and differ in their predictors. While individuals can perceive themselves as socially isolated, they may not feel lonely at the same time and vice versa.

Nevertheless, both social isolation and loneliness should be avoided because they can have important negative consequences for morbidity and mortality.

Main Text

One possible solution to cope with this situation and stay in contact with others is to use video chats (e.g., Skype) or online social media (e.g., ). These solutions may at least temporarily substitute physical contact (e.g.

, with friends, acquaintances, children, or grandchildren) in times of the COVID-19 pandemic. It appears plausible that these possibilities can reduce feelings of social isolation or loneliness (e.g., when seeing their grandchildren on their monitor or smartphone).

Moreover, older individuals using video chats or online social media sites to stay in contact with family and friends may think that they are better off than when they did not use such technical possibilities during self-isolation (intraindividual comparison).

Thus, they may highly appreciate such technical solutions to overcome feelings of isolation and loneliness. Furthermore, they may compare themselves with other individuals who are not able to participate (e.g.

, for health reasons) in video chats or online social media sites (interindividual comparisons) and may realize that they are better off than these individuals. Both intraindividual and interindividual comparisons could lead to decreased feelings of social isolation or feelings of loneliness.

To date, very few studies have investigated the association between the use of video chats or online social media and social isolation or loneliness among older adults.

We first summarize these preliminary findings before making a call for further research on the association between online social media use/video chat and social isolation among older adults.

It is worth noting that we focused on nationally representative samples to present findings which are generalizable to the entire (community-dwelling) population of older adults in the specific countries. We included studies focusing on individuals in their second half of life (i.e., 40 years and over [3]).

nationally representative samples, only 3 studies have investigated the link between online social network sites and loneliness or social isolation among older adults. While a first study focused on various outcomes (i.e., social connectedness and social isolation) [4], a second study focused on loneliness [5], and a third study focused on social isolation as the outcome measure [6].

data from the nationally representative Health and Retirement Study (n = 1,620 individuals aged 50 years and over in the United States), the first study [4] showed a link between use of social network sites and increased feelings of connectedness (an aspect of loneliness), whereas the use of these sites was not associated with feelings of social isolation. a sample of community-dwelling individuals aged 60 years and over (n = 626) in the Netherlands, the second study revealed that the use of these sites was neither associated with general loneliness nor with social or emotional loneliness [5]. The third study [6] examined the link between social network sites and social isolation. a nationally representative sample of individuals in the second half of life (n = 7,837 individuals aged 40 years and over) in Germany, this recent cross-sectional study [6] showed that daily online social network users (e.g., users of ) reported lower social isolation scores compared with those with less frequent or no social media use. In a sensitivity analysis, this study [6] also examined the association between the use of the internet “for contact with friends and relatives (e.g., e-mail, , chat, video calls)” and social isolation. Compared to daily users, less frequent users and nonusers had significantly higher social isolation scores. These associations did not differ by sex or educational level. This is in line with a review performed by Leist [7]. She thought that online communities are “places where people can get together and engage in social contact, for example, overcome loneliness at nighttime” [7]. Therefore, she concluded that these sites can help to overcome feelings of loneliness and isolation. In a similar vein, a very recent qualitative study concluded that sites such as or video chats, via Skype, for example, can help to overcome social isolation among Muslim immigrant older adults in Canada [8]. In sum, the findings are mixed. Moreover, these results come from a time prior to COVID-19. Therefore, they may not directly be transferable to our present time. Thus, future research is urgently required.


We would to conclude with some recommendations for future research. There is a need for further research examining the link between online social network sites/video chat and loneliness as well as social isolation, particularly among the older adults nationally representative samples.

While one longitudinal study exists which investigated the link between video chat and depressive symptoms a nationally representative sample of older adults [9], there is a complete lack of nationally representative longitudinal studies regarding the link between online social network sites/video chat and loneliness as well as social isolation. Therefore, future studies are urgently required.

Future research is required to elucidate the underlying mechanisms. For example, a recent study [10] among students aged 18–30 years showed that while having positive experiences on social network sites is not associated with social isolation, negative experiences on social network sites is associated with increased levels of social isolation.

This suggests that humans weigh negative entities more than positive ones (negativity bias) [10]. Moreover, the intensity of using online social network sites should be investigated among older adults.

Even personality factors such as extraversion may play a role in the link between online social network sites/video chat and loneliness or social isolation among older adults.

We truly hope that this commentary will inspire new research in this emerging area. Ultimately, we hope that this knowledge may help to avoid feelings of social isolation and loneliness among older adults dealing with the conditions of the COVID-19 pandemic.

Conflict of Interest Statement

The authors declare that they have no conflicts of interest.

Author Contributions

A.H.: conceptualization, roles/writing – original draft, and writing – review & editing. H.H.K.: conceptualization, resources, writing – review & editing, and supervision.


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  5. Aarts S, Peek ST, Wouters EJ. The relation between social network site usage and loneliness and mental health in community-dwelling older adults. Int J Geriatr Psychiatry. 2015;30(9):942–9.
  6. Hajek A, König HH.

    The association between use of online social networks sites and perceived social isolation among individuals in the second half of life: results a nationally representative sample in Germany. BMC Public Health. 2019;19(1):40.

  7. Leist AK. Social media use of older adults: a mini-review. Gerontology. 2013;59(4):378–84.
  8. Salma J, Salami B.

    “Growing Old is not for the Weak of Heart”: social isolation and loneliness in Muslim immigrant older adults in Canada. Health Soc Care Community. 2020;28(2):615–23.

  9. Teo AR, Markwardt S, Hinton L. Using Skype to beat the blues: longitudinal data from a national representative sample. Am J Geriatr Psychiatry. 2019;27(3):254–62.

  10. Primack BA, Karim SA, Shensa A, Bowman N, Knight J, Sidani JE. Positive and negative experiences on social media and perceived social isolation. Am J Health Promot. 2019;33(6):859–68.

André Hajek

Department of Health Economics and Health Services Research

Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, DE–20246 Hamburg (Germany)

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Received: May 13, 2020Accepted: September 29, 2020Published online: December 02, 2020

Issue release date: January 2021

Number of Print Pages: 3 Number of Figures: 0

Number of Tables: 0

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

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