We are now two years removed from the initial outbreak of Covid and the subsequent lockdown. During this period of mandatory isolation, many of us experienced severe hardships, and it seemed like society, as we knew it, was crumbling around us. However, it must be said that looking at how much of the world has quickly returned to normal is a testament to what can be achieved when humanity works together. But it would be remiss not to mention the negative effects the lockdown had on many, to say nothing of what Covid itself brought.
Humans are social creatures by nature. Our biology is wired to be part of a group rather than purely solitary. Naturally, we, as individuals, experience this need in varying degrees, but even the most anti-social person has some level of requirement. It has been observed that social isolation can increase the overall mortality risk by 29%, with just a sense of loneliness increasing it by 26%. This is particularly true for those experiencing cognitive decline; as mentioned in previous posts, being afforded the opportunity to socialize has been proven to have drastic effects on reducing the speed at which the disease progresses. This is why many dementia facilities prioritize group activities and encourage family visits. Unfortunately, the lockdown hit such facilities harder than most, with many being forced to shut their doors to all but essential staff and patients; due to the frail nature of the patients and the presence of many co-morbidities, a Covid outbreak could prove incredibly dire. In the time since, researchers have been examining the long-term effects the lockdown had on these patients and have made some very interesting observations.
Loneliness is an incredibly subjective term; it isn’t a measurable occurrence like isolation but rather something that is experienced only by the individual. Nevertheless, the effect it has on the individual is quite measurable. It has been observed that those who claim they live with or experience long bouts of loneliness begin to manifest an increased amyloid burden on the brain, a biomarker that we went into more detail about in our previous post. This shows that experiencing loneliness has an observable effect on the physiology of the brain, subjective or not. It must be said that experiencing loneliness isn’t going to cause a person to develop dementia, but it can be considered one of the risk factors that make it more likely to develop. By the same token, feeling socialized can help your brain defend against it.
From this data, we are able to reinforce the importance of socializing for those experiencing cognitive decline; long stints of isolation and loneliness can speed the decline, while regular socializing can go a long way in improving the quality of life. This is particularly true if some of that time is spent outdoors. While interacting with strangers or acquaintances can provide some relief, spending time with friends and family is vastly preferable. In milder cases, the best results have been observed when patients are able to engage in story-sharing; reliving memories and reminiscing about “the good ol’ days.” Even amongst severe cases wherein the disease has progressed to the point of rendering a patient non-verbal, there is evidence to show that merely being present for these conversations can have a positive impact.
Another positive that came from the lockdown was the increased prioritization placed on developing and improving communication technology. When all work and interaction had to be done remotely, the need to provide stable and accessible means of communication meant we saw an upsurge in the quality of what was available. While how technology-mediated interaction affects patients and whether it is a viable alternative or supplement is still understudied, it could prove to be an incredibly fruitful area to research for the future.
Thankfully, the time of lockdowns and mandatory isolation is now behind us, but we still feel its effects. It was a very lonely time for a lot of people and taught us much about ourselves as a society. Going forward, we know to prioritize social time for our patients, but we also know not to force it upon them. Loneliness being subjective as it is, there cannot be a one-size-fits-all approach to this, as many patients will prefer more alone time than others. Therefore, a patient-centered approach will be required, placing a large burden on staff in care facilities as they try to balance the varying needs of all their patients. But, as previously stated, there really is no substitute for time spent with family and friends. With all the new technology available to us, it is easier than ever to check in on your loved ones and spend just a little bit of time chatting about “the good ol’ days.”
