Social isolation and subsequent health and well-being in older adults: A longitudinal outcome-wide analysis

Atsushi Nakagomi; Taishi Tsuji; Masashige Saito; Kazushige Ide; Katsunori Kondo; Koichiro Shiba

doi:10.1016/j.socscimed.2023.115937

Social isolation and subsequent health and well-being in older adults: A longitudinal outcome-wide analysis

Soc Sci Med. 2023 Jun:327:115937. doi: 10.1016/j.socscimed.2023.115937. Epub 2023 Apr 28.

Authors

Atsushi Nakagomi¹, Taishi Tsuji², Masashige Saito³, Kazushige Ide⁴, Katsunori Kondo⁵, Koichiro Shiba⁶

Affiliations

¹ Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Cardiology, Chiba University Hospital, Chiba, Japan. Electronic address: bay2item@yahoo.co.jp.
² Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Faculty of Health and Sport Sciences, University of Tsukuba, Bunkyo City, Tokyo, Japan.
³ Department of Social Welfare, Nihon Fukushi University, Chita-gun, Aichi, Japan; Center for Well-being and Society, Nihon Fukushi University, Nagoya City, Aichi, Japan.
⁴ Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.
⁵ Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan.
⁶ Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.

PMID: 37167920
DOI: 10.1016/j.socscimed.2023.115937

Abstract

Background: Social isolation has become a serious public health issue. However, most previous studies examine the relationship between social isolation and a single outcome. We aimed to conduct holistic assessments to understand the multidimensional impacts of social isolation on health and well-being.

Methods: We used the three-wave data (2013, 2016, and 2019) obtained from the Japan Gerontological Evaluation Study. Our exposure, obtained from the 2016 survey, was the Social Isolation Index (SII) comprising five components: no partner, poor interaction with children, poor interaction with relatives, poor interaction with friends, and no social participation). We assessed 36 health and well-being outcomes across six dimensions obtained from the 2019 survey: physical/cognitive health, health behaviours, mental health, subjective well-being, social isolation, and cognitive social capital. Pre-exposure characteristics and prior outcome levels in 2013 were adjusted. We included 47,318 respondents for 4 outcomes (death, dementia, and functional disability) and 34,187 respondents for 32 other outcomes. The Bonferroni correction was used to correct for multiple tests.

Results: The total SII scores were associated with a wide range of health and well-being outcomes across the six dimensions. Specifically, we found a robust association between an SII score of four or greater with mortality (Odds ratio: 1.89; 95% CI: 1.46-2.43). Among the five components of the SII, poor interaction with friends and no social participation showed robust associations with a wide range of health and well-being. We also found some robust evidence regarding effect modification by gender and age in the associations between the components of the SII and health and well-being.

Conclusions: Social isolation, specifically social interaction with friends and social participation, may affect a wide range of health and well-being among older adults.

Keywords: Cognitive health; Health behaviours; Physical health; Social capital; Social interaction; Social participation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Child
Friends / psychology
Humans
Longitudinal Studies
Mental Health
Social Isolation* / psychology
Social Participation*
Surveys and Questionnaires