Tracing the Cycle of Social Disconnectedness, Isolation & Depression in Older Adults

Social isolation has negative consequences for older adults, but little research has sought to understand how social disconnectedness (lack of contact with others) and perceptions of isolation each uniquely affect mental health. In this study, researchers investigated how these factors each relate to depression and anxiety.

Researchers examined 10-year follow-up data from the National Social Life, Health and Aging Project, a nationally representative survey of community-dwelling American older adults. Participants were between 57 and 85 years old at the beginning of the study (2005-2006), and data were also collected five years later (wave two) and ten years later (wave three). Participants self-reported information regarding social disconnectedness, social isolation, depression, and anxiety. The measure of social disconnectedness included diverse social elements, such as social network size, frequency of interactions, participation in social activities, and social network diversity. The measure of social isolation included questions about support from family and friends, companionship, feeling left out, and feeling isolated.

Researchers found that higher social disconnectedness at the beginning of the study predicted higher levels of perceived isolation at wave two. In turn, greater perceived isolation predicted greater symptoms of depression and anxiety at wave three. In addition, greater symptoms of depression and anxiety predicted more perceived isolation at wave two, which then predicted greater social disconnectedness at wave three. In this way, the study found that social disconnectedness, perceived isolation, and depression and anxiety symptoms are linked and work to create a cycle of disconnection.

The research has practical implications. For senior living, the study findings highlight the importance of residential opportunities for social engagement. For practitioners, the researchers suggested that social workers or gerontologists could regularly assess perceived isolation among older adults. This practice could identify persons at risk for depression and anxiety. In addition, the assessment may aid in determining what specific actions could reduce isolation for a given individual. Researchers noted that innovative solutions to increase social connection and community belonging include prescribing social activities such as gardening, football, and art.


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Santini ZI, Jose PE, Cornwell EY, Koyanagi A, Nielsen L, Hinrichsen C, Meilstrup C, Madsen KR, Koushede V. Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis. The Lancet Public Health, (2020); 5(1): e62-70.


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