There is a dearth of programs to support older adults living alone with cognitive impairment, creating a need for novel programs and interventions, found a recent study.1

“We did the study because we felt the needs of those living alone was a missing piece of Alzheimer’s disease research,” says Kenneth Covinsky, MD, MPH, one of the study’s authors.

Previous research suggests that older adults living alone often experience a sense of precarity. The researchers were interested in exploring this in older adults living alone with a diagnosis of cognitive impairment.

“We felt it was important to better understand the needs of these persons from their own perspective,” says Covinsky, a clinician-researcher in the division of geriatrics at University of California, San Francisco.

The qualitative study of 12 adults aged 65 and older identified these three themes:

• the distress stemming from the uncertainty of living with cognitive impairment that has an unpredictable course;

• the tendency of participants to feel responsible for managing their cognitive impairment;

• the pressures stemming from the lack of appropriate services to support independent living for persons with cognitive impairment.

“I think many will be surprised at the depth of insight those with cognitive impairment are often capable of,” says Covinsky.

Despite the large medical costs incurred by persons with dementia, society is failing to provide basic social service needs to this population, notes Covinsky.

“This is ironic,” says Covinsky. “Many medical treatments and services that are provided to these patients do more harm than good, while more social services could be of tremendous benefit.”


1. Portacolone E, Rubinstein RL, Covinsky, KE, et al. The precarity of older adults living alone with cognitive impairment. Gerontologist 2018 Jan 24. doi: 10.1093/geront/gnx193. [Epub ahead of print]


• Kenneth Covinsky, MD, MPH, Division of Geriatrics, University of California, San Francisco. Email: