Abstract
Research indicates that social isolation and loneliness increase the risk of mental disorders, but less is known about the distinct contributions of different aspects of isolation. We aimed to distinguish the pathways through which social disconnectedness (eg, small social network, infrequent social interaction) and perceptions of social isolation (eg, loneliness, perceived lack of support) contribute to anxiety and depression symptom severity in community-residing older adults aged 57-85 years at baseline. We did a longitudinal mediation analysis with data from the National Social Life, Health, and Aging Project (NSHAP). The study included individuals from the USA born between 1920 and 1947. Validated measures on social disconnectedness, perceived isolation, and depression and anxiety symptoms were used. Structural equation modelling was used to construct complete longitudinal path models. Using data from 3005 adults aged 57-85 years, we identified two significant longitudinal mediation patterns with symptoms of depression, and two with anxiety symptoms. Overall, social disconnectedness predicted higher subsequent perceived isolation (β=0·09; p<0·0001), which in turn predicted higher depression symptoms (β=0·12; p<0·0001) and anxiety symptoms (β=0·12; p<0·0001). The reverse pathways were statistically supported as well, suggesting bi-directional influences. Social network structure and function are strongly intertwined with anxiety and depression symptoms in the general population of older adults. Public health initiatives could reduce perceived isolation by facilitating social network integration and participation in community activities, thereby protecting against the development of affective disorders. Nordea-fonden.
Highlights
By 2050, the number of people aged 60 years or older will increase by 1·25 billion, accounting for 22% of the global population.[1]
As a conse quence, overwhelming feelings of isolation or the loss of social relations has been shown to have implications for the decline in cognition, mood, and sensitivity to threat,[6] alongside a buildup of cortisol concentrations, worsening immune functioning, sleep disruption, and increased bodyweight.[7]. In line with these findings, it has been shown that individuals who feel lonely or isolated, those who report low social support, and those who experience strain in their relationships are more likely to develop depression symptoms.[8]. These aspects of social connectedness have been separately linked to mental health, previous work has not disen tangled the unique contributions of objective aspects of social disconnectedness from those of more subjective
To test our second hypothesis, we examined whether perceived isolation mediated the relationship between social disconnectedness and depression symptoms
Summary
By 2050, the number of people aged 60 years or older will increase by 1·25 billion, accounting for 22% of the global population.[1]. The importance of social connectedness and, social isolation in the aetiology of affective and mental health problems has been documented extensively in the scientific literature. According to theories of perceived isolation, the need for social connectedness is a deeply ingrained human characteristic that has evolved hand in hand with neural, hormonal, and genetic mechanisms directly associated with bonding, companionship, and herd behaviour as a crucial means for ensuring survival and reproduction.[6] As a conse quence, overwhelming feelings of isolation or the loss of social relations has been shown to have implications for the decline in cognition, mood, and sensitivity to threat,[6] alongside a buildup of cortisol concentrations, worsening immune functioning, sleep disruption, and increased bodyweight.[7] In line with these findings, it has been shown that individuals who feel lonely or isolated, those who report low social support, and those who experience strain in their relationships are more likely to develop depression symptoms.[8] these aspects of social connectedness have been separately linked to mental health, previous work has not disen tangled the unique contributions of objective aspects of social disconnectedness from those of more subjective
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