# Loneliness and Social Isolation Among Older Adults with and without Alzheimer's Disease and Related Dementia in the Last Years of Life

> **NIH NIH K23** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2021 · $161,600

## Abstract

PROJECT SUMMARY/ABSTRACT
Loneliness and social isolation are related, but distinct, social risk factors critical to the health and quality of life
of older adults in their last years of life. Loneliness is a subjective feeling of being alone, whereas social
isolation is an objective loss in the number of relationships with family, friends, or the community. Both social
risk factors are common and independently associated with poor health outcomes relevant to late life such as
depression, functional impairment, and mortality. Very little is known, however, about loneliness and social
isolation among the general population of older adults in the last years of life, particularly those with cognitive
impairment or Alzheimer’s Disease and Related Dementia. Unfortunately, older adults with and without
Alzheimer’s Disease and Related Dementia may be particularly vulnerable to loneliness and social isolation
and their effects in the last years of life. While the last years of life have an intense focus on medical care, less
recognized social factors like loneliness may be more important to patients, especially for persons with
cognitive impairment or Alzheimer’s Disease and Related Dementia. The objective of this study is to establish
the epidemiology of loneliness and social isolation in the last years of life among older adults with and without
cognitive impairment or Alzheimer’s Disease and Related Dementia and determine their association with
intensive health care use at the end of life. We hypothesize that loneliness and social isolation are a common
source of suffering among older adults in their last years and associated with worse quality end-of-life health
care, especially for those with cognitive impairment or Alzheimer’s Disease and Related Dementia. To test this
hypothesis, the following aims are proposed: Aim 1) Determine the prevalence and predictors of loneliness and
social isolation during the last four years of life among older adults with and without cognitive impairment or
Alzheimer’s Disease and Related Dementia using a nationally-representative cohort; Aim 2) Determine the
relationship between loneliness and social isolation with potentially burdensome healthcare at the end of life for
those with and without cognitive impairment or Alzheimer’s Disease and Related Dementia; and Aim 3)
Develop an in-depth understanding of the experience of loneliness, social isolation, and potentially
burdensome healthcare among older adults with cognitive impairment or Alzheimer’s Disease and Related
Dementia using qualitative interviews. This proposal will have a significant impact in characterizing a
substantial source of suffering among older adults with and without Alzheimer’s Disease and Related Dementia
in the crucial end of life period and potential intervention strategies. I will obtain advanced training in
observational and health services research, qualitative analysis, implementation sciences, and clinical writing,
along with mentorship fro...

## Key facts

- **NIH application ID:** 10260385
- **Project number:** 5K23AG065438-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Ashwin Ajit Kotwal
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $161,600
- **Award type:** 5
- **Project period:** 2020-09-15 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10260385

## Citation

> US National Institutes of Health, RePORTER application 10260385, Loneliness and Social Isolation Among Older Adults with and without Alzheimer's Disease and Related Dementia in the Last Years of Life (5K23AG065438-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10260385. Licensed CC0.

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