According to the 2021 survey by Petits Frères des Pauvres, a French charity supporting older people, social isolation among older adults affected 530,000 people aged 60 and over living in “social death.” It takes a toll on the heart, mood, memory, and life expectancy. The prevention check-up at ages 70–75 spots it with simple questions and guides people toward the municipal social services center (CCAS), community associations, and health professionals.
What is social isolation, and how does it differ from loneliness?
Social isolation is an objective situation: having few or no contacts with the four social circles, namely family, friends, neighbors, and community groups. Loneliness is a feeling: you can live alone without suffering from it, or be surrounded by people and feel lonely. Both matter for health, and the prevention check-up looks at both.
The survey “Loneliness and isolation over age 60 in France” (Solitude et isolement quand on a plus de 60 ans en France), conducted by Petits Frères des Pauvres with the CSA polling institute and France’s national pension fund (Caisse nationale d’assurance vieillesse), measures isolation by how often people have in-person contact with these four circles. Its September 30, 2021 edition counted 530,000 people aged 60 and over in “social death,” meaning they never or almost never met anyone from these circles, compared with 300,000 in 2017; the number of people isolated from both their family and their friends had more than doubled, from 900,000 to 2 million. A 2025 edition has been published. In 2018, Santé publique France, the French public health agency, estimated that isolation and loneliness affect about a quarter of people aged 75 and over. Globally, the World Health Organization estimates that social isolation affects up to one older person in three.
The at-risk situations we see most often: being widowed, retirement when work carried a person’s entire network, children moving away, a disability or illness that limits going out, losing one’s driver’s license, uncorrected hearing loss, the death of a friend, low income, and the digital divide, which cuts off access to administrative procedures and to news from loved ones: 3.6 million older people were still digitally excluded in 2021 according to the same survey.
What are the health effects of social isolation?
Isolation and loneliness are not just a misfortune: they are health risk factors, just like a sedentary lifestyle. The report of the World Health Organization’s Commission on Social Connection, published on June 30, 2025, estimates that one person in six worldwide is affected by loneliness and that it is associated with about 871,000 deaths per year, or around a hundred per hour. A 2015 meta-analysis covering several dozen studies (Holt-Lunstad et al.) associated social isolation, loneliness, and living alone with a roughly one-quarter to one-third higher likelihood of death.
| Area | Effect associated with isolation | Most common mechanism |
|---|---|---|
| Heart and blood vessels | Cardiovascular disease, stroke | Chronic stress, blood pressure, less control over smoking and alcohol, less activity |
| Mental health | Depression, anxiety, sleep disorders | Lack of support, rumination, loss of meaning and routine |
| Memory | Faster cognitive decline | Less stimulation, uncorrected hearing loss, depression |
| Nutrition | Undernutrition | Skipped meals, less enjoyment in cooking for oneself, difficulty shopping |
| Falls and independence | More frequent falls, delayed help | Less muscle, no one to raise the alarm, fear of going out |
| Care | Late consultation, poorly followed treatments | No one to notice a change, giving up on trips out |
This table describes associations observed in studies, not an individual fate. It explains why isolation is one of the official topics of the prevention check-up: when it is present, it holds back every other action in the plan. A person living alone eats less well, moves less, sees a doctor later, and takes their medications less regularly. Preventing falls and preventing isolation therefore go hand in hand; we cover this in detail in fall prevention in older adults.
How does the prevention check-up at ages 70–75 spot isolation?
Isolation and aging are listed among the topics of Mon bilan prévention, France’s national prevention check-up program. During the prevention check-up at ages 70–75, a 30- to 45-minute consultation fully covered (100%) by French National Health Insurance (Assurance Maladie), with no upfront payment, we ask direct, nonjudgmental questions:
- How many people do you see in an ordinary week, apart from shopkeepers and caregivers?
- Who do you talk to every day? Who would you call if you fell or had a problem at night?
- Do you take part in a group activity, a regular outing, a place where people expect you?
- Do you feel lonely? Since when? What has changed?
The self-assessment questionnaire for ages 70–75, filled out before the appointment, prepares these questions. We pay attention to the signs listed by the national portal pour-les-personnes-agees.gouv.fr for spotting isolation: a home falling into disrepair, an empty refrigerator, neglected clothing, mail piling up, sad remarks or a loss of interest, withdrawal after a bereavement or a hospital stay. Hearing loss is often what lies behind someone pulling away from conversations.
The topic can be anticipated as early as the prevention check-up at ages 60–65, around retirement: that is when the connections that will still hold at 75 are built. Spotting isolation only makes sense if it is followed by concrete guidance, written into the Personalized Prevention Plan: “call the CCAS this week about the memory workshop,” “befriending visit requested,” “hearing test before the end of the month.”
What resources exist near you?
Resources against isolation are local, mostly free, and often unknown to the people who need them most. The national portal pour-les-personnes-agees.gouv.fr lists them; here are the main ones.
| Resource | Who | What it offers | How to access it |
|---|---|---|---|
| Municipal social services center (CCAS) | Town hall | Social spaces, workshops, activities, on-demand transportation, meals, heat wave register, support for caregivers | Town hall or CCAS reception desk |
| Befriending and visiting associations | Petits Frères des Pauvres, French Red Cross, Secours Catholique, Society of Saint Vincent de Paul, Familles Rurales… | Regular visits or calls by volunteers, outings, walking companions | Local branch, often via the CCAS |
| MONALISA (national mobilization against isolation of older people) | Network active since 2014, bringing together the French Red Cross, Petits Frères des Pauvres, UNCCAS, community centers, and ADMR, among others | Citizen teams that build connections at the local level; 900 teams announced across France | monalisa-asso.fr, or via the CCAS |
| Service civique solidarité seniors (civic service program supporting seniors) | Young volunteers | Visits, calls, help with online procedures | Through partner associations |
| Inclusive housing, shared housing | Local authorities, associations | An alternative to living alone at home, without moving into a care facility | Département (county-level authority), CCAS |
| Senior vacation stays | Pension funds, associations | Individual or group stays, sometimes subsidized | Pension fund, CCAS |
| Local information point | Département | Guidance toward available aid and services | Directory on the pour-les-personnes-agees.gouv.fr portal |
The first call is often the hardest; we offer to make it during the check-up, or to hand this step over to the nurse or a relative. The “balance,” “memory,” or “nutrition” workshops run by towns and pension funds have a double benefit: they work on health and recreate a weekly appointment where someone is expecting you.
What role do the regular doctor and the nurse play?
The regular doctor (médecin traitant) is often the only person an isolated individual sees regularly: they are on the front line for spotting it, and the prevention check-up gives them dedicated time. They also look for what lies behind the isolation and can be treated: depression, hearing loss, early memory problems, pain that prevents going out, a medication that causes fatigue. They coordinate, refer to the CCAS or social services, and receive the personalized plan sent after the check-up, unless the person objects; see the prevention check-up carried out by a doctor.
The nurse has one advantage: the home. The prevention check-up at ages 70–75 can be done there, with travel costs that can be billed to French National Health Insurance, which makes it possible to see the home, the refrigerator, the medicine cabinet, and the empty address book; see the prevention check-up carried out by a nurse. Nurses who already visit for care are daily lookouts, as is the pharmacist who notices that a prescription is no longer being renewed. For someone who no longer goes out, booking a prevention check-up at home is often the first accessible step.
What can loved ones, and the person themselves, do?
Loved ones are the ones who notice the change: the parent who no longer calls back, the friend who turns down invitations. Our advice to them comes down to a few steps: a call at a set time rather than random calls, a regular outing even if short, going along to the first workshop or the first association visit, help with digital tools for video calls and online procedures, and taking part in the prevention check-up with the person’s consent. We also encourage caregivers to look after themselves: caregiver burnout, in turn, leads to isolation.
The person themselves has levers, even small ones: accepting a visit, saying yes to the town’s workshop, correcting their hearing, taking up walking again with a neighbor, volunteering their time. Volunteering by retirees is one of the most effective responses to their own isolation: in MONALISA citizen teams as in associations, many volunteers are retirees themselves. Having a role and a regular commitment again matters as much as receiving help.
Key takeaways
- Social isolation (few or no contacts) and loneliness (a feeling) both matter for health: heart, mood, memory, nutrition, falls, treatment follow-through.
- In 2021, 530,000 people aged 60 and over were in “social death” in France and 2 million were isolated from their family and friends (Petits Frères des Pauvres).
- The prevention check-up at ages 70–75, which can be done at home with a nurse, spots isolation through direct questions and adds it to the personalized plan.
- CCAS, befriending associations, MONALISA citizen teams, workshops run by towns and pension funds: local resources, most often free.
- The regular doctor, the nurse, and the pharmacist act as lookouts; loved ones can take part in the check-up with the person’s consent.
What Sokrate lets you do
The Sokrate service offers an online preparation questionnaire, which the person can fill out alone or with a relative, and which covers social life, mood, hearing, falls, and treatments among its dimensions. You arrive at the check-up with your priorities already identified; the personalized plan is signed by a doctor, a letter is sent to your regular doctor unless you object, and a care coordination nurse provides follow-up over time. You can prepare a parent’s prevention check-up or your own today; the general framework is described in the prevention check-up.