Abstract
Background Social contact, including remote contact (by telephone, email, letter or text), could help reduce social inequalities in depression and loneliness among older adults.
Design Cross-sectional survey.
Participants 8th wave of the English Longitudinal Study of Aging (2016/17), stratified by age (n=1,635 aged <65; n=4,123 aged 65+).
Methods Inverse 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.
Results Weekly 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.
Conclusions Reduced 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.
Keypoints
In-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 loneliness
Adults aged 65+ who lived alone or were less wealthy were especially at risk with universally infrequent in-person contact
Universal weekly remote social contact had little impact on inequalities in depression and loneliness.
Competing Interest Statement
The authors have declared no competing interest.
Funding Statement
This work was supported by the UK Medical Research Council (grant numbers MC_UU_12017/13, MC_PC_17217, MR/R024774/1 to CN), the Scottish Government Chief Scientist Office (SPHSU13), and National Health Service Research Scotland (SCAF/15/02 to SVK).
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I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Ethical approval for all the ELSA waves was granted from NHS Research Ethics Committees under the National Research and Ethics Service (NRES).
All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.
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Footnotes
Declaration of Sources of Funding: This work was supported by the UK Medical Research Council (grant numbers MC_UU_12017/13, MC_PC_17217, MR/R024774/1 to CN), the Scottish Government Chief Scientist Office (SPHSU13), and National Health Service Research Scotland (SCAF/15/02 to SVK).
The Chan Zuckerberg Initiative, Cold Spring Harbor Laboratory, the Sergey Brin Family Foundation, California Institute of Technology, Centre National de la Recherche Scientifique, Fred Hutchinson Cancer Center, Imperial College London, Massachusetts Institute of Technology, Stanford University, University of Washington, and Vrije Universiteit Amsterdam.
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