Among the Canadian population, living alone becomes increasingly more common as people age, especially for older women. According to the 2011 census, 31.5% of women aged 65 and over lived alone compared to 16% of senior men. Among those aged 85 and over, 36.6% of women lived alone compared to 21.7% of men (Statistics Canada, 2012). This is due to the higher life expectancy of women, men marrying younger women, lower rates of remarriage among women, and increasing preferences for independent living over time (Wister and McPherson, 2014). Older women are also more likely to live in institutions: among those aged 85 and over, 35.2% of women compared to 22.6% of men lived in institutions (Statistics Canada, 2012).
The association between living alone, social isolation and loneliness is complex. Living or not living with others does not necessarily result in a lack of social contact (Victor et al., 2000), yet it may be a sufficient cause. Living alone has been associated with fewer social contacts and lower social support, partly because people who live alone are not married or partnered, thereby lowering the amount of proximal support available (Sinha, 2014). Widowed, divorced and never married seniors have been shown to experience higher rates of loneliness and social isolation than married seniors (de Jong Gierveld et al., 2015a; Keefe et al., 2006; National Seniors Council, 2014a and 2014b). Recent findings from the English Longitudinal Study on Aging (ESLA)Footnote 27 revealed that household size is inversely related with prevalence of loneliness: seniors who live in larger households are less likely to be lonely (Iparraguirre, 2015).
Seniors living alone are also much more likely to be living in low income, which may increase the risk of being isolated (see below). Similarly, while living in a deprived neighbourhood increases the risk of all seniors of living in isolation, the effect is even greater among seniors who live alone. Transportation issues may also arise for single or widowed seniors who have never learned to drive (British Columbia Ministry of Health, 2004).
Data from the Canadian Community Health Survey – Healthy Aging, revealed that people living alone are particularly likely to need help with transportation, and that inadequate access to transportation or difficulty getting around may be a barrier to social participation (Turcotte, 2012).
While living alone and social isolation and loneliness share many of the same correlates (e.g., age, gender, widowhood, childlessness, entry into care, and mortality), they differ in terms of various resource-based risk factors, especially those linked to social class, physical and mental health status (Victor et al., 2000; Holt-Lunstad et al., 2015). Thus, it may not be living alone that contributes to social isolation and loneliness, but rather, other risk factors associated with both (Perissinotto and Covinsky, 2014). For instance, Ng and Northcott (2015) found that, among a sample of South Asian seniors living in Edmonton (who tend to live in extended families – see above), loneliness was associated with the quality of relationships and walking time, rather than living arrangement per se. Also, in a recent systematic review, Holt-Lunstad et al. (2015) found that mortality risk was increased by 29%, 26%, and 32% respectively for persons experiencing social isolation, loneliness and living alone, controlling for other correlates. This underscores the importance of examining the cumulative effects of risk and protective factors underlying social isolation and loneliness.
There is a need for research that can disentangle the common and distinct causes and consequences of living alone, loneliness and social isolation, before living alone can be used as a proxy or correlate of the latter.