Older Men’s Connections Often Wither When They’re on Their Own

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At age 66, South Carolina physician Paul Rousseau decided to retire after tending for decades to the suffering of people who were seriously ill or dying. It was a difficult and emotionally fraught transition.

“I didn’t know what I was going to do, where I was going to go,” he told me, describing a period of crisis that began in 2017.

Seeking a change of venue, Rousseau moved to the mountains of North Carolina, the start of an extended period of wandering. Soon, a sense of emptiness enveloped him. He had no friends or hobbies — his work as a doctor had been all-consuming. Former colleagues didn’t get in touch, nor did he reach out.

His wife had passed away after a painful illness a decade earlier. Rousseau was estranged from one adult daughter and in only occasional contact with another. His isolation mounted as his three dogs, his most reliable companions, died.

Rousseau was completely alone — without friends, family, or a professional identity — and overcome by a sense of loss.

“I was a somewhat distinguished physician with a 60-page resume,” Rousseau, now 73, wrote in the Journal of the American Geriatrics Society in May. “Now, I’m ‘no one,’ a retired, forgotten old man who dithers away the days.”

In some ways, older men living alone are disadvantaged compared with older women in similar circumstances. Research shows that men tend to have fewer friends than women and be less inclined to make new friends. Often, they’re reluctant to ask for help.

“Men have a harder time being connected and reaching out,” said Robert Waldinger, a psychiatrist who directs the Harvard Study of Adult Development, which has traced the arc of hundreds of men’s lives over a span of more than eight decades. The men in the study who fared the worst, Waldinger said, “didn’t have friendships and things they were interested in — and couldn’t find them.” He recommends that men invest in their “social fitness” in addition to their physical fitness to ensure they have satisfying social interactions.

Slightly more than 1 in every 5 men ages 65 to 74 live alone, according to 2022 Census Bureau data. That rises to nearly 1 in 4 for those 75 or older. Nearly 40% of these men are divorced, 31% are widowed, and 21% never married.

That’s a significant change from 2000, when only 1 in 6 older men lived by themselves. Longer life spans for men and rising divorce rates are contributing to the trend. It’s difficult to find information about this group — which is dwarfed by the number of women who live alone — because it hasn’t been studied in depth. But psychologists and psychiatrists say these older men can be quite vulnerable.

When men are widowed, their health and well-being tend to decline more than women’s.

“Older men have a tendency to ruminate, to get into our heads with worries and fears and to feel more lonely and isolated,” said Jed Diamond, 80, a therapist and the author of “Surviving Male Menopause” and “The Irritable Male Syndrome.”

Add in the decline of civic institutions where men used to congregate — think of the Elks or the Shriners — and older men’s reduced ability to participate in athletic activities, and the result is a lack of stimulation and the loss of a sense of belonging.

Depression can ensue, fueling excessive alcohol use, accidents, or, in the most extreme cases, suicide. Of all age groups in the United States, men over age 75 have the highest suicide rate, by far.

For this column, I spoke at length to several older men who live alone. All but two (who’d been divorced) were widowed. Their experiences don’t represent all men who live alone. But still, they’re revealing.

The first person I called was Art Koff, 88, of Chicago, a longtime marketing executive I’d known for several years. When I reached out in January, I learned that Koff’s wife, Norma, had died the year before, leaving him hobbled by grief. Uninterested in eating and beset by unremitting loneliness, Koff lost 45 pounds.

“I’ve had a long and wonderful life, and I have lots of family and lots of friends who are terrific,” Koff told me. But now, he said, “nothing is of interest to me any longer.”

“I’m not happy living this life,” he said.

Nine days later, I learned that Koff had died. His nephew, Alexander Koff, said he had passed out and was gone within a day. The death certificate cited “end stage protein calorie malnutrition” as the cause.

The transition from being coupled to being single can be profoundly disorienting for older men. Lodovico Balducci, 80, was married to his wife, Claudia, for 52 years before she died in October 2023. Balducci, a renowned physician known as the “patriarch of geriatric oncology,” wrote about his emotional reaction in the Journal of the American Geriatrics Society, likening Claudia’s death to an “amputation.”

“I find myself talking to her all the time, most of the time in my head,” Balducci told me in a phone conversation. When I asked him whom he confides in, he admitted, “Maybe I don’t have any close friends.”

Disoriented and disorganized since Claudia died, he said his “anxiety has exploded.”

We spoke in late February. Two weeks later, Balducci moved from Tampa to New Orleans, to be near his son and daughter-in-law and their two teenagers.

“I am planning to help as much as possible with my grandchildren,” he said. “Life has to go on.”

Verne Ostrander, a carpenter in the small town of Willits, California, about 140 miles north of San Francisco, was reflective when I spoke with him, also in late February. His second wife, Cindy Morninglight, died four years ago after a long battle with cancer.

“Here I am, almost 80 years old — alone,” Ostrander said. “Who would have guessed?”

When Ostrander isn’t painting watercolors, composing music, or playing guitar, “I fall into this lonely state, and I cry quite a bit,” he told me. “I don’t ignore those feelings. I let myself feel them. It’s like therapy.”

Ostrander has lived in Willits for nearly 50 years and belongs to a men’s group and a couples’ group that’s been meeting for 20 years. He’s in remarkably good health and in close touch with his three adult children, who live within easy driving distance.

“The hard part of living alone is missing Cindy,” he told me. “The good part is the freedom to do whatever I want. My goal is to live another 20 to 30 years and become a better artist and get to know my kids when they get older.”

The Rev. Johnny Walker, 76, lives in a low-income apartment building in a financially challenged neighborhood on Chicago’s West Side. Twice divorced, he’s been on his own for five years. He, too, has close family connections. At least one of his several children and grandchildren checks in on him every day.

Walker says he had a life-changing religious conversion in 1993. Since then, he has depended on his faith and his church for a sense of meaning and community.

“It’s not hard being alone,” Walker said when I asked whether he was lonely. “I accept Christ in my life, and he said that he would never leave us or forsake us. When I wake up in the morning, that’s a new blessing. I just thank God that he has brought me this far.”

Waldinger recommended that men “make an effort every day to be in touch with people. Find what you love — golf, gardening, birdwatching, pickleball, working on a political campaign — and pursue it,” he said. “Put yourself in a situation where you’re going to see the same people over and over again. Because that’s the most natural way conversations get struck up and friendships start to develop.”

Rousseau, the retired South Carolina doctor, said he doesn’t think about the future much. After feeling lost for several years, he moved across the country to Jackson, Wyoming, in the summer of 2023. He embraced solitude, choosing a remarkably isolated spot to live — a 150-square-foot cabin with no running water and no bathroom, surrounded by 25,000 undeveloped acres of public and privately owned land.

“Yes, I’m still lonely, but the nature and the beauty here totally changed me and focused me on what’s really important,” he told me, describing a feeling of redemption in his solitude.

Rousseau realizes that the death of his parents and a very close friend in his childhood left him with a sense of loss that he kept at bay for most of his life. Now, he said, rather than denying his vulnerability, he’s trying to live with it. “There’s only so long you can put off dealing with all the things you’re trying to escape from.”

It’s not the life he envisioned, but it’s one that fits him, Rousseau said. He stays busy with volunteer activities — cleaning tanks and running tours at Jackson’s fish hatchery, serving as a part-time park ranger, and maintaining trails in nearby national forests. Those activities put him in touch with other people, mostly strangers, only intermittently.

What will happen to him when this way of living is no longer possible?

“I wish I had an answer, but I don’t,” Rousseau said. “I don’t see my daughters taking care of me. As far as someone else, I don’t think there’s anyone else who’s going to help me.”

We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care, and advice you need in dealing with the health care system. Visit http://kffhealthnews.org/columnists to submit your requests or tips.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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  • Fennel vs Onion – Which is Healthier?

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    Our Verdict

    When comparing fennel to onion, we picked the fennel.

    Why?

    First note, in case you didn’t see the picture: we are talking about white onions here (also called brown onions, by virtue of their attire).

    Looking at the macros, fennel has nearly 2x the fiber and a little more protein, while onion has more carbs. An easy win in this category for the fennel.

    In the category of vitamins, fennel has more of vitamins A, B2, B3, B5, B9, C, E, K, and choline (most of them by generous margins and some by especially large margins, we are talking, for example, 480x the vitamin A, 29x the vitamin E, and 157x the vitamin K), while onions have more of vitmains B1 and B6. Another clear win for fennel.

    When it comes to minerals, fennel has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while onion is not higher in any minerals. No prizes for guessing: fennel wins this category too.

    You may be curious as to how they add up on the polyphenol front, and the answer is, they don’t, much. Wonderful as these two vegetables are, an abundance of polyphenols is not amongst their strengths; fennel has some lignans and onion has some flavonols, but we’re talking tiny numbers here (in contrast, red onion would have aced it with 120mg/100g quercetin, amongst others, but red onion wasn’t on trial today).

    Adding up the sections makes a clear win for fennel today.

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  • Cordyceps: Friend Or Foe?

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    Cordyceps: friend or foe?

    Cordyceps is a famously frightening fungus. It’s the one responsible for “zombie ants” and other zombie creatures, and it’s the basis for the existential threat to humanity in the TV show The Last of Us.

    It’s a parasitic fungus that controls the central and peripheral nervous systems of its host, slowly replacing the host’s body, as well as growing distinctive spines that erupt out of the host’s body. Taking over motor functions, it compels the host to do two main things, which are to eat more food, and climb to a position that will be good to release spores from.

    Fortunately, none of that matters to humans. Cordyceps does not (unlike in the TV show) affect humans that way.

    What does Cordyceps do in humans?

    Cordyceps (in various strains) is enjoyed as a health supplement, based on a long history of use in Traditional Chinese Medicine, and nowadays it’s coming under a scientific spotlight too.

    The main health claims for it are:

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    Sounds great! What does the science say?

    There’s a lot more science for the first three (which are all closely related to each other, and often overlapping in mechanism and effect).

    So let’s take a look:

    Against inflammation

    The science looks promising for this, but studies so far have either been in vitro (cell cultures in petri dishes), or else murine in vivo (mouse studies), for example:

    In summary: we can see that it has anti-inflammatory properties for mice and in the lab; we’d love to see the results of studies done on humans, though. Also, while it has anti-inflammatory properties, it performed less well than commonly-prescribed anti-inflammatory drugs, for example:

    ❝C. militaris can modulate airway inflammation in asthma, but it is less effective than prednisolone or montelukast.❞

    Source: Effects of the immunomodulatory agent Cordyceps militaris on airway inflammation in a mouse asthma model

    Against aging

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    Against cancer

    Once again, the studies here have been in vitro, or murine in vivo. They do look good though:

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    Summary of these is: Cordyceps quite reliably inhibits tumor growth in vitro (human cell cultures) and in vivo (mouse studies). However, trials in human cancer patients are so far conspicuous by their absence.

    For blood sugar management

    Cordyceps appears to mimic the action of insulin, without triggering insulin sensitivity. For example:

    The anti-hyperglycemic activity of the fruiting body of Cordyceps in diabetic rats

    There were some other rat/mouse studies with similar results. No studies in humans yet.

    For heart health

    Cordyceps contains adenosine. You may remember that caffeine owes part of its stimulant effect to blocking adenosine, the hormone that makes us feel sleepy. So in this way, Cordyceps partially does the opposite of what caffeine does, and may be useful against arrhythmia:

    Cardiovascular protection of Cordyceps sinensis act partially via adenosine receptors

    For exercise performance

    A small (30 elderly participants) study found that Cordyceps supplementation improved VO2 max by 7% over the course of six weeks:

    Randomized double-blind placebo-controlled clinical trial and assessment of fermentation product of Cordyceps sinensis in enhancing aerobic capacity and respiratory function of the healthy elderly volunteers

    However, another small study (22 young athletes) failed to reproduce those results:

    Cordyceps Sinensis supplementation does not improve endurance exercise performance

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    Cordyceps almost certainly has anti-inflammation, anti-aging, and anti-cancer benefits.

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  • Reversing Alzheimer’s – by Dr. Heather Sandison

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    The title here is bold, isn’t it? But, if the studies so far are anything to go by, she is, indeed, reversing Alzheimer’s. By this we mean: her Alzheimer’s patients have enjoyed a measurable reversal of the symptoms of cognitive decline (this is not something that usually happens).

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    You can get sick with norovirus even if you’ve had it before, since there are many different strains.

    How can families help protect against the spread of norovirus at home?

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    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • More Salt, Not Less?

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    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝I’m curious about the salt part – learning about LMNT and what they say about us needing more salt than what’s recommended by the government, would you mind looking into that? From a personal experience, I definitely noticed a massive positive difference during my 3-5 day water fasts when I added salt to my water compared to when I just drank water. So I’m curious what the actual range for salt intake is that we should be aiming for.❞

    That’s a fascinating question, and we’ll have to tackle it in several parts:

    When fasting

    3–5 days is a long time to take only water; we’re sure you know most people fast from food for much less time than that. Nevertheless, when fasting, the body needs more water than usual—because of the increase in metabolism due to freeing up bodily resources for cellular maintenance. Water is necessary when replacing cells (most of which are mostly water, by mass), and for ferrying nutrients around the body—as well as escorting unwanted substances out of the body.

    Normally, the body’s natural osmoregulatory process handles this, balancing water with salts of various kinds, to maintain homeostasis.

    However, it can only do that if it has the requisite parts (e.g. water and salts), and if you’re fasting from food, you’re not replenishing lost salts unless you supplement.

    Normally, monitoring our salt intake can be a bit of a guessing game, but when fasting for an entire day, it’s clear how much salt we consumed in our food that day: zero

    So, taking the recommended amount of sodium, which varies but is usually in the 1200–1500mg range (low end if over aged 70+; high end if aged under 50), becomes sensible.

    More detail: How Much Sodium You Need Per Day

    See also, on a related note:

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    When not fasting

    Our readers here are probably not “the average person” (since we have a very health-conscious subscriber-base), but the average person in N. America consumes about 9g of salt per day, which is several multiples of the maximum recommended safe amount.

    The WHO recommends no more than 5g per day, and the AHA recommends no more than 2.3g per day, and that we should aim for 1.5g per day (this is, you’ll note, consistent with the previous “1200–1500mg range”).

    Read more: Massive efforts needed to reduce salt intake and protect lives

    Questionable claims

    We can’t speak for LMNT (and indeed, had to look them up to discover they are an electrolytes supplement brand), but we can say that sometimes there are articles about such things as “The doctor who says we should eat more salt, not less”, and that’s usually about Dr. James DiNicolantonio, a doctor of pharmacy, who wrote a book that, because of this question today, we’ve now also reviewed:

    The Salt Fix: Why the Experts Got It All Wrong—and How Eating More Might Save Your Life – by Dr. James DiNicolantonio

    Spoiler, our review was not favorable.

    The body knows

    Our kidneys (unless they are diseased or missing) do a full-time job of getting rid of excess things from our blood, and dumping them into one’s urine.

    That includes excess sugar (which is how diabetes was originally diagnosed) and excess salt. In both cases, they can only process so much, but they do their best.

    Dr. DiNicolantino recognizes this in his book, but chalks it up to “if we do take too much salt, we’ll just pass it in urine, so no big deal”.

    Unfortunately, this assumes that our kidneys have infinite operating capacity, and they’re good, but they’re not that good. They can only filter so much per hour (it’s about 1 liter of fluids). Remember we have about 5 liters of blood, consume 2–3 liters of water per day, and depending on our diet, several more liters of water in food (easy to consume several more liters of water in food if one eats fruit, let alone soups and stews etc), and when things arrive in our body, the body gets to work on them right away, because it doesn’t know how much time it’s going to have to get it done, before the next intake comes.

    It is reasonable to believe that if we needed 8–10g of salt per day, as Dr. DiNicolantonio claims, our kidneys would not start dumping once we hit much, much lower levels in our blood (lower even than the daily recommended intake, because not all of the salt in our body is in our blood, obviously).

    See also: How Too Much Salt Can Lead To Organ Failure

    Lastly, a note about high blood pressure

    This is one where the “salt’s not the bad guy” crowd have at least something close to a point, because while salt is indeed still a bad guy (if taken above the recommended amounts, without good medical reason), when it comes to high blood pressure specifically, it’s not the worst bad guy, nor is it even in the top 5:

    Hypertension: Factors Far More Relevant Than Salt

    Thanks for writing in with such an interesting question!

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