Social isolation trajectories in midlife and later-life: patterns and associations with health

Abstract

ObjectivesSocial isolation has objective and subjective dimensions. Few studies have simultaneously examined trajectories of both dimensions. We integrated multiple indicators of both dimensions to identify social isolation trajectory patterns and investigated how different patterns were related to adults’ physical, mental, cognitive, and self-rated health.MethodsWe used latent class growth modeling to examine social isolation trajectory patterns, based on data from the 2008—2016 waves of the Health and Retirement Study (N = 6457). Mixed-effect linear models were used to examine how trajectory patterns were associated with functional limitations, depressive symptoms, memory deficits, and self-rated health over the 8-year study period.ResultsFour social isolation trajectory patterns were identified: severe isolation (15.4%), moderate isolation (37.6%), some objective and rare subjective isolation (35.4%), and rare objective and low subjective isolation (11.6%). Social isolation trajectory patterns showed a gradient in all health domains. The rare objective and low subjective isolation group had the best health (i.e., the fewest functional limitations, depressive symptoms, and memory deficits and the best self-rated health); the some objective and rare subjective isolation group had the next best health; the moderate isolation group had the second worst health; and the severe isolation group had the worst health.ConclusionsThe prevalence and stability of severe and moderate social isolation suggest it may be necessary to address social isolation at the national level. The most favorable health outcomes associated with the rare objective and low subjective isolation group supports interventions to strengthen social networks and engagement midlife and later-life.Key pointsObjective social isolation and subjective social isolation are interrelated but different conceptsThis study conceptualizes social isolation as a multi-dimensional construct by considering objective isolation and subjective isolation simultaneouslyFour distinct patterns of social isolation trajectories are identifiedEstimates of the prevalence of severe isolation and moderate isolation among Americans aged over 50 years are 15.4% and 37.6%