By Jeremy Holloway, PhD, MBA

We often hear reminders about getting enough vitamins, eating nutritious foods, exercising regularly, and maintaining healthy habits. These recommendations are important, especially as we age. Yet there is another essential ingredient to healthy living that has historically received less attention in everyday healthcare conversations: the quality of our social connections.

I like to think of this ingredient as Vitamin S—Social Connection.

Consider an older adult recovering from a fall. Healthcare professionals may assess mobility, balance, muscle strength, nutritional intake, and the ability to perform daily activities. These assessments provide valuable information about physical functioning and recovery. Yet another question deserves our attention:

What motivates this person to get out of bed, move throughout the day, eat well, and participate in activities that support recovery?

For some, the answer may involve visiting grandchildren, sharing a meal with a friend, participating in a faith community, or returning to a cherished activity. These experiences help us understand how relationships, purpose, and belonging are connected to health.

The World Health Organization (WHO, 2025) has emphasized that social connection is an important dimension of health and well-being, with loneliness and social isolation representing significant global public health concerns.

Perhaps it is time to consider Vitamin S alongside the other ingredients that contribute to healthy aging.

The Science Behind Vitamin S

Social relationships have measurable associations with physical health, mental well-being, and longevity.

In a landmark meta-analysis involving 148 studies and more than 300,000 participants, Holt-Lunstad et al. (2010) found that people with stronger social relationships had approximately 50% higher odds of survival during the study periods than those with weaker relationships. The findings demonstrated that social relationships deserve serious consideration alongside established health-related factors.

However, understanding social connection requires attention to both the quantity and quality of relationships.

Social isolation generally refers to having limited social contact or relationships, while loneliness reflects the subjective experience of feeling disconnected from the relationships one desires (National Academies of Sciences, Engineering, and Medicine [NASEM], 2020).

This distinction matters. Someone may participate in multiple activities, interact with numerous people, and still experience loneliness. Another person may maintain a small circle of meaningful relationships and experience a strong sense of belonging.

Therefore, increasing social contact alone does not necessarily address the underlying experience of loneliness.

The quality of an interaction matters because feeling seen, heard, understood, valued, and connected is different from simply being around other people.

What Our Healthcare Assessments May Be Missing

Traditional healthcare assessments provide important information about what individuals are physically able to do. Social connection adds context about the relationships and personal meaning that influence everyday functioning.

Consider the Activity Measure for Post-Acute Care (AM-PAC), a standardized instrument developed to assess functional abilities across care settings.

Its widely used inpatient 6-Clicks short forms measure basic mobility and daily activities, helping healthcare professionals understand functional limitations and inform care planning (Jette et al., 2014).

These assessments help answer questions such as whether someone can get out of bed, walk, transfer between positions, or manage personal care.

Their value is well established. Nevertheless, the commonly used mobility and daily activity short forms are not intended to comprehensively evaluate loneliness, relationship quality, or an individual’s sense of social belonging.

This presents an opportunity to ask additional questions that complement functional assessments.

For example, when evaluating whether an older adult can safely walk across a room, we might also explore what meaningful activities encourage that person to remain mobile.

When evaluating whether someone can prepare a meal, we might ask whether they enjoy mealtimes and have opportunities for companionship.

When preparing someone for discharge from a hospital, we might consider the quality of their supportive relationships and whether meaningful social opportunities are accessible after returning home.

The purpose is to connect the information we already collect about physical functioning with a fuller understanding of the person.

A healthcare assessment may tell us whether someone can get out of a chair. A meaningful conversation may help us understand what makes that person want to get out of the chair.

Vitamin S, Falls, and Functional Independence

Social circumstances deserve attention in fall prevention because research has identified associations between social isolation and fall risk.

Bu et al. (2020) examined longitudinal data from older adults in England and found that living alone was associated with an 18% higher hazard of self-reported falls, even after accounting for several demographic, health, and lifestyle factors. Lower social contact was also associated with increased fall risk.

These findings do not establish that increasing social interactions directly prevents falls. They do, however, suggest that social circumstances deserve consideration alongside physical, environmental, and clinical risk factors.

Similarly, Gao et al. (2025) found that chronic loneliness was associated with a greater likelihood of developing functional impairment over time.

These findings raise important questions about how meaningful relationships may influence physical activity, confidence, emotional well-being, and participation in everyday routines.

For example, an older adult may understand the importance of walking regularly yet find it difficult to maintain the habit without a meaningful purpose or accessible opportunities for engagement.

A walking group, a trusted companion, or a personally meaningful destination may provide opportunities to combine movement with social participation.

The central question becomes: How can we support physical functioning while also strengthening the social experiences that make movement meaningful?

Vitamin S and Nutrition: The Importance of Mealtime Connection

Nutrition provides another example of how social experiences may influence healthy behaviors.

Dietary recommendations commonly focus on nutrients, meal composition, caloric intake, and maintaining adequate hydration. These are essential components of nutritional care. However, the social experience surrounding a meal may also matter.

A systematic review by Wyman et al. (2026) examined 24 studies of community-dwelling older adults who ate alone compared with those who ate with others. Most studies identified associations between eating alone and outcomes such as poorer diet quality, reduced dietary diversity, weight loss, or frailty.

Although these findings do not demonstrate that shared meals directly produce better nutritional outcomes, they highlight the importance of considering mealtime habits when evaluating nutritional needs.

Imagine an older adult who knows what foods to prepare but no longer finds enjoyment in cooking or eating alone. Nutritional counseling remains important, while opportunities for meaningful companionship may also be relevant to that individual’s eating experience.

A healthcare professional may therefore gain valuable insight by asking about the person’s mealtime routines, preferences, relationships, and opportunities to enjoy food with others.

Healthy eating involves what we consume, while the experience of eating also reflects how we live and connect with others.

Vitamin S and the Age-Friendly Approach: What Matters Most?

The Age-Friendly approach provides a practical foundation for integrating meaningful social connection into healthy aging practices.

The Age-Friendly Health Systems framework emphasizes four essential elements, commonly known as the 4Ms: What Matters, Medication, Mentation, and Mobility (Institute for Healthcare Improvement, n.d.).

The related Geriatrics 5Ms framework includes Mind, Mobility, Medications, Multicomplexity, and Matters Most (Tinetti et al., 2017).

Although each area has a distinct purpose, meaningful social connection can influence how individuals experience and engage with several of these dimensions.

For example, trusted relationships may support emotional well-being and cognitive engagement. Companionship may create meaningful opportunities for mobility, while supportive relationships may help individuals navigate medication routines, transportation, and healthcare services.

The connection becomes particularly important when considering What Matters Most.

An older adult may want to improve mobility because attending a grandchild’s graduation matters deeply to them. Another may want to strengthen their ability to prepare meals because hosting family gatherings brings them joy.

These personally meaningful goals provide valuable context for healthcare decisions and everyday activities.

Healthcare professionals can use conversations about What Matters to connect clinical recommendations with the person’s interests, values, relationships, and priorities.

Ultimately, What Matters helps us understand the person, while Vitamin S helps us consider the relationships and social experiences that give those priorities meaning.

From Social Contact to Meaningful Connection

Improving social health requires thoughtful attention to how people experience relationships, including whether interactions provide opportunities for trust, belonging, purpose, and mutual understanding.

In our research examining the Tellegacy intergenerational program, my colleagues and I explored how structured conversations between nursing students and older adults supported community engagement and relationship building.

Although quantitative changes in loneliness and life satisfaction were not statistically significant, qualitative findings highlighted meaningful relationships, attentive listening, intergenerational learning, and positive participant experiences (Holloway et al., 2026).

These findings reinforce the importance of examining the experiences taking place within social interactions, along with measuring outcomes over time.

Meaningful social connection involves more than arranging a conversation. It involves understanding what matters to the person participating in it.

This is why communication approaches such as active listening, person-centered conversation, and motivational interviewing are valuable. They encourage us to explore an individual’s interests, strengths, preferences, and goals while respecting personal autonomy.

An older adult may value weekly conversations with a grandchild, meaningful exchanges with neighbors, or opportunities to mentor younger generations. Another may prefer less frequent interactions that provide a strong sense of connection.

Each experience deserves consideration within that person’s values and preferences.

Making Vitamin S Part of Everyday Healthy Living

Vitamin S can become a practical reminder to consider meaningful social experiences as part of everyday health and wellness.

For individuals and families, this may begin by reflecting on relationships that bring enjoyment, encouragement, and a sense of belonging.

For healthcare professionals, it may involve asking a question that adds valuable social context to a clinical assessment.

For organizations serving older adults, it may mean creating opportunities for sustained relationships, meaningful participation, and conversations centered on individual preferences.

Three questions can provide a useful starting point:

• Who are the people who help you feel seen, heard, and valued?
• What meaningful activities or relationships do you look forward to?
• What would help you enjoy those connections more often?

The answers may reveal strengths that are already supporting well-being, along with opportunities to strengthen social experiences.

They may also reveal practical barriers involving transportation, accessibility, communication, finances, or changing life circumstances. Addressing these conditions connects social health with the larger social determinants of health.

Importantly, Vitamin S is a metaphor for meaningful social connection, not a prescribed quantity of interaction. There is no universal number of daily conversations that guarantees good health. Relationships are personal, and the quality, safety, and meaning of social experiences deserve attention.

Have You Had Your Vitamin S Today?

Healthy aging is strengthened when we consider the whole person, including the relationships and experiences that bring meaning to everyday life.

Nutrition, physical activity, functional rehabilitation, and medication management remain fundamental components of healthcare. The growing evidence surrounding social connection invites us to examine how these practices intersect with the relationships, motivations, and social environments of the people we serve.

As researchers, healthcare professionals, caregivers, and community members, we have opportunities to recognize social connection as an important part of health and to develop practical ways of incorporating meaningful relationships into care.

Perhaps one of the most valuable questions we can begin asking is also one of the simplest:

Have you had your Vitamin S today?

And perhaps an even more meaningful follow-up is:

Did your social experiences today help you feel seen, heard, valued, and connected?

Because healthy aging involves the ability to live well—and the opportunity to experience a life filled with meaning, belonging, and relationships that matter.

References

Bu, F., Abell, J., Zaninotto, P., & Fancourt, D. (2020). A longitudinal analysis of loneliness, social isolation and falls amongst older people in England. Scientific Reports, 10, Article 20064. https://doi.org/10.1038/s41598-020-77104-z

Gao, Q., Steptoe, A., & Fancourt, D. (2025). Chronic loneliness and isolation phenotypes, incident functional impairment and mortality in England between 2004 and 2018. Nature Mental Health, 3, 667–674. https://doi.org/10.1038/s44220-025-00436-0

Holloway, J., Mustafa, Y., Acosta, R., Sayeed, O., Ringhiser, C., & Shaffer, L. (2026). Social care curriculum: Lessons learned from a community-based program to address intergenerational needs of older adults. Health & Social Care in the Community, 2026, Article 6758518. https://doi.org/10.1155/hsc/6758518

Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLOS Medicine, 7(7), Article e1000316. https://doi.org/10.1371/journal.pmed.1000316

Institute for Healthcare Improvement. (n.d.). Age-friendly health systems. https://www.ihi.org/partner/initiatives/age-friendly-health-systems

Jette, D. U., Stilphen, M., Ranganathan, V. K., Passek, S. D., Frost, F. S., & Jette, A. M. (2014). Validity of the AM-PAC “6-Clicks” inpatient daily activity and basic mobility short forms. Physical Therapy, 94(3), 379–391. https://doi.org/10.2522/ptj.20130199

National Academies of Sciences, Engineering, and Medicine. (2020). Social isolation and loneliness in older adults: Opportunities for the health care system. The National Academies Press. https://doi.org/10.17226/25663

Tinetti, M., Huang, A., & Molnar, F. (2017). The Geriatrics 5M’s: A new way of communicating what we do. Journal of the American Geriatrics Society, 65(9), 2115. https://doi.org/10.1111/jgs.14979

World Health Organization. (2025). From loneliness to social connection: Charting a path to healthier societies: Report of the WHO Commission on Social Connection. https://www.who.int/groups/commission-on-social-connection/report

Wyman, C., Thomas, J., Lawless, M., & Yaxley, A. (2026). Associations between nutritional and physical outcomes of community-dwelling older adults eating alone, versus with others: A systematic review. Appetite, 217, Article 108327. https://doi.org/10.1016/j.appet.2025.108327