Research published in The Lancet Healthy Longevity highlights loneliness as an important but under-recognised issue in older adults with cancer, with potential implications for quality of life, treatment adherence, and survival.
The authors note loneliness is a subjective experience distinct from social isolation, most commonly affecting adults aged 65 years and older. It encompasses perceived deficiencies in the quantity or quality of social relationships and is increasingly prevalent in older populations with chronic conditions, including cancer.
Loneliness has been associated with a range of adverse health outcomes in general populations, including poorer physical health, higher psychological distress,s and increased mortality, and may similarly affect cancer outcomes.
CLINICAL SUMMARY
What was examined
The paper examines loneliness in older adults with cancer (generally aged 65 years and over) and its relevance to clinical care, defining loneliness as a subjective experience distinct from social isolation.
Key findings
- Loneliness is common and under-recognised in older adults with cancer.
- Contributing factors include functional decline, comorbidity, treatment effects, loss of peers, and reduced mobility.
- Loneliness has been associated with poorer psychological well-being and challenges with treatment engagement, although oncology-specific outcome data are limited.
Clinical implications
- Loneliness is not routinely assessed in oncology care and may go undetected without targeted screening.
- The authors recommend routine assessment and integration of psychosocial and community-based supports as part of holistic cancer care.
In older adults with cancer, loneliness may be shaped by a convergence of health, functional,l and social changes. These influences can interact with cancer-specific stressors, such as diagnosis and treatment burdens, frequent clinic visits, hospital admissions, ns and uncertainty about prognosis. The authors describe how loneliness may exacerbate psychological distress, lead to decreased engagement with supportive care services, and adversely affect adherence to complex treatment regimens.
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The article emphasises that loneliness is both common and modifiable, yet often overlooked in routine oncological care. Standard clinical assessments rarely capture patients’ social and emotional contexts, and loneliness may remain undetected unless specifically assessed.
The authors recommend that health systems integrate routine screening for loneliness and related psychosocial factors into care pathways for older patients with cancer. Interventions could include tailored psychosocial support, referral to community resources, peer-support programmes, structured group activities, and involvement of multidisciplinary care teams that address both medical and social needs.
Loneliness in older adults with cancer is “another issue to consider as part of adequate assessment to ensure appropriate (supportive) care,” commented A/Prof. Christopher Steer, an author of the paper.
Importantly, the authors highlight that addressing loneliness may not only improve quality of life and psychological well-being but also enhance treatment engagement and potentially influence clinical outcomes, though evidence specific to oncology remains limited. They call for more research to quantify the prevalence of loneliness in older cancer populations, clarify its mechanisms, and evaluate targeted interventions.
In conclusion, the authors noted that loneliness should be recognised as a relevant factor in the care of older adults with cancer, with systematic approaches to identification and support integrated into clinical practice.
Paper: Soto-Perez-de-Celis, Enrique et al. Defining and addressing loneliness in older adults with cancer: an international Delphi consensus from the Multinational Association of Supportive Care in Cancer Geriatrics Study Group. The Lancet Healthy Longevity, Volume 0, Issue 0, 100811. Access online here.
