Social contact and inequalities in depression and loneliness among older adults: A mediation analysis of the English Longitudinal Study of Ageing
AbstractBackgroundSocial contact, including remote contact (by telephone, email, letter or text), could help reduce social inequalities in depression and loneliness among older adults.DesignCross-sectional survey.Participants8th wave of the English Longitudinal Study of Aging (2016/17), stratified by age (n=1,635 aged <65; n=4,123 aged 65+).MethodsInverse probability weighted estimation of average effects of weekly in-person and remote social contact on depression (score of 3+ on 8-item CES-D scale) and two measures of loneliness (sometimes/often feels lonely vs hardly ever/never; and top quintile of UCLA loneliness scale vs all others). We also estimated controlled direct effects of education, partner status, and wealth on loneliness and depression under two scenarios: 1) universal infrequent (<weekly) in-person social contact; and 2) universal weekly remote social contact.ResultsWeekly in-person social contact was associated with reduced odds of depression and loneliness, but associations with remote social contact were weak. Lower education raised odds of depression and loneliness, but differences were attenuated with infrequent in-person contact. Respondents living alone experienced more depression and loneliness than those living with a partner, and less wealth was associated with more depression. With universal infrequent in-person contact, differences narrowed among those aged under 65 but widened among those aged 65+. Universal weekly remote contact had little impact on inequalities.ConclusionsReduced in-person social contact may increase depression and loneliness among older adults, especially for those aged 65+ who live alone. Reliance on remote social contact seems unlikely to compensate for social inequalities.KeypointsIn-person social contact is associated with stronger decreases in depression and loneliness than remote contact.Universal infrequent in-person social contact could reduce educational inequalities in depression and lonelinessAdults aged 65+ who lived alone or were less wealthy were especially at risk with universally infrequent in-person contactUniversal weekly remote social contact had little impact on inequalities in depression and loneliness.