Abstract
Background Social isolation and loneliness are serious public health risks affecting a significant number of older adults globally. However, it is uncertain whether their health effects are short-term or long-term, which impedes the developing of more effective and precising interventions. We therefore assessed the varied health effects of short-term and long-term exposure of social isolation and loneliness among a nationwide sample of older adults from China. Methods We assessed social isolation and loneliness in 6,066 men and women aged 65 and older who took part in both 2011 and 2014 waves of Chinese Longitudinal Healthy Longevity Survey. Social isolation was assessed in terms of absence of key family members, including spouse, children or siblings, and a deficiency in participating in social activities. Loneliness was administered by using a questionnaire. Four health outcomes were investigated: self-rated health, activities of daily living (ADLs), Instrumental activities of daily living (IADLs), and cognitive function measured by Mini-Mental State Examination (MMSE). We used different tests and multivariate regression analyses to examine the short-term (< 3 years) and long-term (>= 3 years) effects of social isolation and loneliness on health outcomes.Results After controlling for covariates of demographic, socioeconomic, lifestyle, and baseline health factors, in the short-term effects, there are significant associations found between absence of children and poor SRH and cognitive impairment (ORs=1.53 and 9.87); absence of siblings and poor SRH, cognitive impairment, and difficulty with ADLs and IADLs (ORs=1.29, 1.35, 1.26 and 1.22 respectively); loneliness and poor SRH and difficulties with IADLs (ORs=1.92 and 1.55). While, in the long-term effects, absence of siblings is marginally significantly associated with cognitive impairment (OR=1.21), but significant associations are found between deficiency in participating in social activities and poor SRH, difficulty with ADLs and IADLs (ORs=1.33, 1.55 and 1.69, respectively); loneliness and poor SRH, difficulty with IADLs and less difficulties in ADLs (ORs=2.96, 2.45 and 0.32, respectively).Conclusions The results of this study show that social isolation at family level mainly have short-term effects, while social isolation at societal level have mainly have long-term, and loneliness has both short-term and long-term effects on older people’s health outcomes.