Social connection: a key to healthy aging
Imagine if there were a 'medicine' that could extend your life, reduce your risk of diseases, and increase your sense of happiness – without side effects. It sounds too good to be true, but scientists are discovering that something like this is already within reach in our daily lives: social connection. Strong social ties with family, friends, and community prove to be a crucial factor for healthy aging. In this article, we explore what social connection entails, how it contributes to a longer and healthier life, and what science has discovered about it.
What do we mean by social connection?
Social connection refers to the relationships and interactions we have with other people, and the feeling of involvement or connectedness that results from it. It concerns both the quantity of contacts (for example, the number of friends, family members, or colleagues you regularly interact with) as well as the quality of it (for example, emotional support and trust bonds). Also the feeling belonging – the opposite of loneliness – falls under social connection.
To avoid confusion: social isolation means objectively having little contact with others (for example, living alone or having hardly any social interaction), while loneliness a subjective feeling of a lack of connectedness, regardless of how many people are around you. You can live alone without feeling lonely, or conversely, have a busy social life but still feel lonely. In all cases, a strong social connection means feeling supported, understood, and involved in relationships with others.
Social connection is one of the pillars of a healthy lifestyle, alongside factors such as nutrition, exercise, sleep, and mental challenge. From the perspective of longevity – the science of long and healthy living – social connectedness is increasingly seen as a determining factor for both our lifespan (how long we live) as our healthy life years (how long we remain in good health, in other words, our healthspan).
Social ties and physical health
It has long been known that social relationships are important for our mental well-being, but research shows that they also have a huge impact on physical health and even life expectancy. A much-cited meta-analysis (a combination of 148 studies with a total of over 300,000 participants) found that people with strong social relationships on average have a 50% greater chance of surviving a given period than people with few social contacts[1]. In other words, good social connectedness is associated with a significantly lower risk of death. This influence is so great that it is comparable to the health benefit of quitting smoking and even outweighs known risk factors such as obesity and physical inactivity[1].
How can friendship and family ties have such an effect on the body? Firstly, people with a strong social network often healthier behavior to exhibit. For example, they maintain better eating habits and a more regular daily routine, partly because their social circle can encourage healthy living[2]. Additionally, social contacts offer practical support: a friend who drives you to the doctor or a partner who helps remember to take medication for health complaints.
A second important mechanism is the stress level. Social support acts as a buffer against stress[3]. In times of adversity or illness, loved ones can provide emotional and practical help, reducing the damage caused by the physical stress response. Chronic stress – with increased cortisol levels and persistent inflammatory responses – is known as a silent killer for our health.
People who feel supported generally experience less chronic stress and recover faster from stressful events. Research confirms this: in an experiment, subjects with more diverse social contacts are better able to resist a cold virus. Volunteers were given nasal drops with a cold virus and kept in quarantine; those with the most diverse social networks (e.g., roles as partner, parent, friend, colleague, neighbor) were four times less likely to catch a cold than people with very few social roles[4][5]. This suggests that social integration strengthens the immune system. Conversely, loneliness is associated with higher levels of inflammatory markers such as C-reactive protein (CRP)[6], which can contribute to cardiovascular diseases and other chronic conditions.
Furthermore, epidemiological studies show that lack of social support is associated with higher risks of serious diseases. For example, low social support has been linked to a higher risk of coronary heart disease[7]. In fact, the U.S. Surgeon General reports that a lack of social connection increases the risk of early death about as much as smoking 15 cigarettes a day[8][9]. Of course, other factors also play a role in these findings – someone in poor health often has less opportunity for social activities. But even after adjusting for health and lifestyle, social isolation remains a significant risk factor for mortality[10]. Interestingly, this effect does not only affect the elderly: in some analyses, a lack of social connection was relatively even more harmful in adults younger than ~65 years than in seniors[10]. In other words, staying socially active is important for physical health at all ages.
Social connection and mental & cognitive health
Besides the body, the brain of staying socially active. Humans are social beings; feelings of connectedness have a direct impact on our brains and mental state. Adequate social support protects against depression and anxiety and enhances overall well-being. It is therefore no surprise that loneliness is a strong predictor of mental problems such as depressive symptoms, anxiety disorders, and even suicidality[11]. Chronic loneliness is accompanied by a persistent stress response in the body, affecting the neurochemistry of the brain and the functioning of the immune system.
Additionally, social interaction has a positive direct effect on our cognition. A good conversation, playing a game together, or staying active in a club challenges the brain and keeps it sharp. Long-term cohort studies show that people who socially active remain a slower decline of their cognitive abilities compared to socially isolated peers[12]. In other words, frequent interaction with family, friends, or, for example, fellow members of an association is associated with better preservation of memory and cognitive abilities in later life. The Lancet Commission on Dementia Prevention (2020) even estimates that worldwide about 4% of dementia cases could be prevented if social isolation is reduced[13]. Recent figures from the World Health Organization support this: in the elderly, chronic loneliness is associated with approximately 50% higher risk of developing dementia in the long term[14]. For comparison: this effect is as large as, or larger than, other known risk factors for dementia. Additionally, researchers observed an approximately 30% increased risk of cardiovascular diseases (such as a heart attack or stroke) among lonely elderly[14]. Social life thus affects not only our mood but also our brain health and the cardiovascular system.
The exact causal relationships are complex. It is possible that early cognitive decline makes people more socially isolated (they withdraw or have difficulty maintaining contacts). However, several studies indicate that social activity itself plays a protective role, likely through various routes. Psychologists speak of cognitive reserve: challenging interactions and conversations stimulate the brain and build a sort of buffer, delaying the onset of symptoms of, for example, Alzheimer's. At the same time, a social network provides practical help, allowing someone with mild memory problems to remain independent longer. Although further research is needed into the precise mechanisms, the message is clear: "Use it or lose it" also applies socially to our brains.
Social support as a source of resilience and quality of life
Social connection is not only about preventing diseases, but also about the promotion of quality of life. People with strong social ties generally report higher life satisfaction and a stronger sense of purpose. Having a meaningful role within a family, group of friends, or community can give someone purpose and structure. Think of the grandmother who looks after the grandchildren, or the neighbor who volunteers in the community garden – such social roles give life meaning and enhance the resilience.
Resilience is reflected in better coping with setbacks. Those with a strong safety net generally recover mentally and physically more quickly from difficult events such as surgery, the loss of a partner, or retirement (a phase that for some is accompanied by loneliness or a sense of emptiness). This is scientifically difficult to quantify in exact numbers, but there are indications that patients with good social support recovering faster and have a greater chance of returning to their previous level of independent functioning after, for example, a hospital stay. Conversely, doctors see that a lack of a support network can lead to reduced adherence to therapy (for example, no one to help remind them to take medication) and longer recovery periods.
Social support and community spirit also contribute to the maintenance of autonomy as they age. Someone with helpful neighbors, family, or friends nearby can often remain living independently at home for longer. In societies where the elderly remain integrated into the family (for example, cultures where multiple generations live under one roof), the need for formal elder care is often lower. The feeling of connectedness also has a direct impact on mental fitness: simply knowing that there are people you can rely on gives confidence and reduces the fear of asking for help when needed. All this contributes to a longer retention of physical independence and self-reliance – an important aspect of healthspan (healthy life years).
An inspiring example can be found in the so-called Blue Zones – regions in the world with an exceptionally high number of vital centenarians (e.g., Okinawa in Japan, Ikaria in Greece, Sardinia in Italy). Although these areas are geographically far apart, they share striking lifestyle characteristics. One of these is a close social cohesion: people live in close communities with strong family ties and a culture of caring for each other. In Okinawa, for example, the elderly traditionally form a moai: a kind of lifelong friendship group of neighbors or friends who support each other emotionally and practically. Such social structures prove to be an important pillar of their long, healthy lives. Supportive social networks and lifelong friendships contribute just as much to the remarkable lifespan as healthy eating or sufficient exercise[15][16]. In other words: in Blue Zones, no one stands alone, and that social involvement protects them against many ailments of old age.
Facts and nuance: what do we know and what do we not know yet?
The scientific findings around social connection and health are convincing: those who remain socially connected have, on average, better prospects of living healthily for longer. Yet it is important to look at this with nuance. Much evidence comes from observational studies (following people for years and seeing if those with strong vs. weak social relationships differ in outcome). Such studies show strong correlations, but do not necessarily directly prove causality. Perhaps people who are naturally healthy and energetic automatically have a better chance of an active social life (rather than the social life improving their health). Researchers try to correct for such factors (e.g., only including healthy participants, or considering demographics and lifestyle), but it cannot be completely ruled out.
Additionally, social connection difficult to capture in a single number. It encompasses various aspects – from the structure (how many contacts, do you live together or alone, are you a member of clubs or church) to the function (practical/emotional support you receive) and the quality (how close and satisfied are you in your relationships). These aspects partially overlap but are not the same. For example, you can have a large social network but still feel lonely, or have few contacts but be very satisfied with them. Meta-analyses show that especially multidimensional standards – so combinations of factors, such as an active social life + frequent contact + feeling supported feel – the strongest predictors are of positive health outcomes[1]. Simple indicators like “does someone live alone or not” turn out to be much less powerful[17], which makes sense: someone can live alone but still have a rich social life, or live together but be emotionally isolated.
Another point of nuance is that quality over quantity is about. It's not about collecting as many acquaintances or followers on social media as possible; a few close bonds can already make a big difference. In fact, chronic conflicts or toxic relationships can cause stress and thus be harmful to health – not every social contact is positive by definition. It's about meaningful connection: support, trust, and positive interactions.
Finally, social connectedness is not a miracle cure that overshadows all other factors. Someone with unhealthy habits cannot expect a busy social life to compensate for all physical damage. Ideally, the different pillars go hand in hand: for example, exercising with friends, or as a family motivating each other to eat healthily and keep up with medical check-ups. Social connection is part of the broader longevity palette, along with physical activity, nutrition, sleep, not smoking, moderate alcohol consumption, and keeping the mind challenged. Within that holistic framework, however, social health deserves a prominent place – something that until recently was sometimes overlooked by both individuals and policymakers.
The current consensus among experts is therefore that we should consider social relationships should take just as seriously as other health factors. As a prominent study aptly summarized it in 1988: “Social relationships, or the relative lack thereof, are a major risk factor for health – comparable to known risk factors such as smoking, high blood pressure, elevated cholesterol, obesity, and physical inactivity.”[18]. This realization is now dawning: in 2023, the World Health Organization declared loneliness an urgent global health issue, with the U.S. Surgeon General comparing the health impact to smoking 15 cigarettes a day[8]. At the same time, there is a need for more intervention research: now that we know that social connection helps, what is the best way to combat loneliness or increase social participation among the elderly? Initial trials with, for example buddy projects, group activities, therapy animals, or technology in elderly care show encouraging results, but the differences between studies are large and not every approach works equally well[19]. The challenge for the coming years is to develop evidence-based programs that truly bring people out of their isolation and promote lasting, meaningful connections.
Conclusion
Social connection is a powerful and essential element of healthy aging. Strong relationships and a sense of belonging contribute to both a longer lifespan as – even more importantly – more healthy and happy years. Where lifespan is about how long we live, focuses healthspan focus on how healthy and vital we spend those years – and in that area, social connectedness excels. It improves our physical health by reducing stress and supporting healthy behavior; it sharpens our mind and protects against cognitive decline; and it gives us resilience, meaning, and quality of life.
For everyone between 30 and 60 (and far beyond), it applies: investing in relationships is investing in your future self. Whether it's making time for family and friends, participating in community activities, or simply having a chat with the neighbor – social interaction is not a luxury, but a necessity of life. In the quest for a long and healthy life, social connection deserves a place on the stage just as much as good nutrition, sufficient exercise, and sleep. The beauty is that we can start with it today. Building a closer bond with others might just be the best sustainable recipe can be for well-being in later life.
[1] [17] Social Relationships and Mortality Risk: A Meta-analytic Review | PLOS Medicine
https://journals.plos.org/plosmedicine/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000316
[2] [7] The protective effect of social support on all-cause and cardio-cerebrovascular mortality among middle-aged and older adults in the US | Scientific Reports
[3] [18] Social Relationships and Mortality Risk | College Reading and Writing
[4] [5] Social ties and susceptibility to the common cold - PubMed
https://pubmed.ncbi.nlm.nih.gov/9200634/
[6] [11] The Association Between Loneliness and Inflammation: Findings From an Older Adult Sample - PMC
https://pmc.ncbi.nlm.nih.gov/articles/PMC8787084/
[8] [9] [14] WHO declares loneliness a ‘global public health concern’ | Global development | The Guardian
[10] Loneliness and social isolation as risk factors for mortality: a meta-analytic review - PubMed
https://pubmed.ncbi.nlm.nih.gov/25910392/
[12] [13] Associations between social connections and cognition: a global collaborative individual participant data meta-analysis - PMC
https://pmc.ncbi.nlm.nih.gov/articles/PMC9750173/
[15] [16] Living in the Blue Zone - Harvard Health
https://www.health.harvard.edu/staying-healthy/living-in-the-blue-zone
[19] Interventions Associated With Reduced Loneliness and Social Isolation in Older Adults: A Systematic Review and Meta-analysis | Geriatrics | JAMA Network Open | JAMA Network
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797399
