Social Prescribing can Help Lonely, Older Adults

Lonely, older adults who use opioids, sedatives and anti-anxiety medications two times more than others, are vulnerable to drug dependency, impaired attention, falls and other accidents, and further cognitive impairment, according to a study by researchers at UC San Francisco.

The study found that 40 percent of 6,000 respondents in a nationally representative survey of seniors were moderately lonely, and 7 percent were highly lonely.

‘Social prescribing can help lonely, older adults to cope distress instead of long-term medications.’

The researchers used data from the National Social Life, Health and Aging Project, a population-based study of health and social factors, and checked each participant's medications if they were used on a regular schedule, like every day or every week.

The study published in JAMA Internal Medicine also found that the proportion of seniors who had prescriptions for opioids and anti-anxiety medications and sedatives, correlated with their degree of loneliness.

The highly lonely group was also more likely to be on five or more medications - 58 percent versus 46 percent for the non-lonely participants. Prescription antidepressants and NSAIDs, and over-the-counter painkillers may cause ulcers and bleeding in long-term use by older adults.

"There's a misconception that as we age, we become more withdrawn and less sociable. In fact, older people are more socially active than other age groups and frequently play major roles in their communities. When older people are not socially active, we need to recognize that there's a problem", said first author Ashwin Kotwal, MD, of the UCSF Division of Geriatrics and of the San Francisco VA Medical Center.

Based on these results, researchers believe Instead of these medications, "social prescribing" can be done by "link workers," based in primary care practices or within the community, with connections to amenities like senior centers, exercise classes, grief groups or volunteer programs.

The pandemic has taken the stigma out of loneliness, giving older adults an opportunity to discuss their feelings in clinic. Asking patients what might help can be a good first step to referring them to programs that might fit their needs.

"We don't want to pathologize loneliness. Most people experience loneliness at some point in their lives, but when experiences of loneliness persist for many months or years, it can cause physiologic changes, such as a ramped-up stress response, sleep problems, and even heart disease," added Kotwal.

While physicians are well aware of the dangers of prescribing medications that should not be used in the long term, it takes time and effort to de-prescribe and switch from a drug that acts promptly with one that may take several weeks to have an effect can be very challenging to patients in distress.

In busy practices with complex patients, these drug contraindications may not come to light until a patient is suddenly hospitalized.



Source: Medindia