Solo Aging: Health Risks to Know Before It’s Too Late

November 2024

Issue 17: November 2024  

In This Issue: People aging without the support traditionally provided by families face increased health risks. In part two of our three-part Solo Aging series, we explore the medical challenges that solo agers encounter. If there are specific topics you’d like to learn more about, comment below, and I’ll cover them in a future issue. 

Solo Aging: Health Risks to Know Before It’s Too Late

Last time, I wrote about the rise in solo aging. In this month’s essay, I will discuss the increased health risks for those who are aging alone. We should all care about this issue because you could become one even if you aren’t a solo ager now.    

There are multiple medical downsides to solo aging, some of them quite specific. Being aware of the risks can help solo agers proactively prevent or correct them. I’m not trying to be the Debbie Downer of physician advocates; rather, I’m trying to bring useful information that the solo ager and others can use to improve their chances of healthy aging.    

People often assume that solo agers are lonely. Just because someone doesn’t have family nearby that they can count on for the things traditionally done by family doesn’t mean they are lonely or socially isolated. Many solo agers have robust relationships with people or are quite content on their own.   

Society and researchers tend to assume that people living alone are lonely (Eleanor Rigby, I’m thinking of you). The literature is a hodge podge of terms. Undoubtedly some of the adverse health effects of solo aging can be chalked up to loneliness; it’s not for nothing that our surgeon general, Dr. Vivek Murthy, declared loneliness to be a national epidemic in 2023.     

There may be physiologic changes associated with loneliness. For example, a 2023 study showed an association (correlation, though not necessarily causation) between loneliness and Parkinson’s disease.  

We know that solo agers are at elevated risk for hearing loss. Many people don’t get their hearing checked unless someone close to them, like a spouse, notices that they don’t seem to be catching as many words as they used to and urges them to visit an audiologist. Take me as an example: I got hearing aids in my early fifties. Even though I was working full time, nobody at work noticed a problem in my hearing. Well, okay, if they noticed, they decided not to tell me. I thought I was just fine. But my husband and adult children teased me mercilessly. They made me take my grumpy, aging backside to the audiologist to get tested.  

Using hearing aids early on is crucial to preventing further hearing loss because if you don’t correct hearing loss, it can become too late—over time, you can lose the ability to understand word meaning. If you wait too long, the wiring in the brain changes and the amplification from hearing aids won’t make speech understandable. This is why you’ll see some older people, who have finally given in and gotten hearing aids, sitting in the midst of other people, leaning forward, ear cupped in hand, unable to understand a thing. They hear loud sounds, but they have limited word discrimination. They waited too long; they’ll never completely get their hearing functionality back.  

For solo agers, there are other elevated health risks, such as dementia. Social isolation is a risk factor for dementia, and uncorrected hearing loss is a risk factor for dementia too.   

Solo agers have a 25- 30 percent increased risk of cardiovascular disease (stroke and heart disease). It’s not clear why this is, but it may be because contributors to cardiovascular disease, including diabetes, obesity, and smoking, are all higher in solo agers.  

There are many reasons why solo agers’ health is more at risk. It can be as simple as not having a sounding board or someone to notice changes that might be concerning. I noticed a new spot on my husband’s delightfully bald head and encouraged him to see a dermatologist. He was diagnosed with skin cancer. It was toward the back of his head where he never would have seen it on his own. (And before you ask, no, before then he didn’t go to a dermatologist for skin checks.)  

All solo agers are more at risk for nutritional shortfalls (cooking for one can lose its glamour). Many solos tell me they rely on prepackaged food and eat more ultra-processed food than they did in the past.   

Falls are also a risk for solo agers. We know that falls are a leading cause of injury and emergency room visits for older people. If you live alone, there is no one to tell you that you should take small stumbles seriously. Or you might be down, with no one to get you up.   

When my dad, who had a progressive neuromuscular disease, fell trying to get up from the toilet, my mom told me about it. It turned out that he was too weak to stand up unassisted from the low seat, so he developed this funky rocking technique in which he used momentum to throw himself forward and up. Until it was forward and down. After I heard about the fall, I installed a raised toilet seat with rails. Dad was embarrassed and never would have told me. If he lived alone, he would have continued his inventive but unsafe ways until he broke something.    

It could be basic logistics that put a solo ager’s health at risk. If you don’t have someone to take you home from your colonoscopy, you are going to put it off. If you are hospitalized, and there is no one to oversee your care at home, you could end up staying in a facility where you pick up a nasty infection or get a complication.   

Interestingly, some of the specific risks associated with solo aging vary between the sexes. Women tend to live about five years longer than men. This means they must stretch their money longer, making running out of money a common, sometimes overwhelming, fear of women solo agers. Men who live alone are more likely to experience depression, and more likely to seek solace in the harmful use of addictive substances, like alcohol or prescription medications.   

And as women overtake men in education level, the longevity gap increases. Here’s an incredible statistic: a never-married man with less than a high school education can expect to live twenty fewer years than a married woman with a master’s degree.   

No matter your sex, race, or education level, there could be solo aging in your future. Which means that you should think about how to avoid its pitfalls. The strategies for healthy solo aging are what I will address in my next newsletter.  

Email me with your questions, comments, or subscription requests at gm@mymdadvisor.com. I’d love to hear from you.

Wishing you peace and understanding in your healthcare journey,  

Gerda Maissel, MD, BCPA

Dr. Gerda Maissel, Author

Dr. Maissel is a Board-Certified Physical Medicine and Rehabilitation physician and a Board-Certified Patient Advocate.