Social isolation and loneliness in older adults: A growing public health challenge with evidence from Nepal

Social isolation and loneliness are increasingly recognized as major public health concerns in ageing populations, yet they remain under-addressed in low- and middle-income countries. This article examines the definitions, epidemiology, health consequences, and evidence-based responses related to social isolation and loneliness among older adults, with focused attention to Nepal. Nepal faces a dual challenge: a rapidly growing older adult population—exceeding 10% of the national total in 2021 —and large-scale youth labor migration that has eroded the family-based support structures upon which older Nepali adults have traditionally relied. Research consistently demonstrates that social support is the most powerful buffer against loneliness and its downstream health effects in this population. More recently, a study provided direct evidence that perceived social support mediates the relationship between loneliness and depression among community-dwelling older adults in Nepal. Despite this evidence, loneliness screening is largely absent from primary care, and the policy response remains fragmented. This article calls for validated screening, stronger community-based programming through Older People's Associations (OPAs), and targeted national policy reforms.