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Social contact and inequalities in depression and loneliness among older adults: A mediation analysis of the English Longitudinal Study of Ageing

By Michael J Green, Elise Whitley, Claire L Niedzwiedz, Richard John Shaw, Srinivasa Vittal Katikireddi

Posted 02 Jul 2020
medRxiv DOI: 10.1101/2020.07.01.20143990

Background: Social contact, including remote contact (by telephone, email, letter or text), could help reduce social inequalities in depression and loneliness among older adults. Methods: Data were from the 8th wave of the English Longitudinal Study of Aging (2016/17), stratified by age (n=1,635 aged <65; n=4,123 aged 65+). Inverse probability weighting was used to estimate 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, these 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.

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