Perceived social isolation, social disconnectedness and falls: the mediating role of depression

Abstract

Objectives

to estimate the association of social disconnectedness and perceived social isolation with the risk of falls and also investigate whether depression mediated this association.

Method

Biennial longitudinal survey data from 2006 to 2012 waves of the U.S. Health and Retirement Study of adults aged 65 and older (N = 22,153 observations) were examined. The outcome variable was number of self-reported falls over the observation period. Independent variables included social isolation (social disconnectedness, perceived social isolation) and number of depressive symptoms. Generalized Estimating Equation regressions were performed to address the research questions.

Results

Regression models indicated that social disconnectedness is associated with a 5% increase in the risk of falls. Perceived social isolation (lack of perceived social support and loneliness combined) was associated with a 33% increase in falls risk. For each increase in the number of depressive symptoms, the risk of falls increased by 13%. Also, the number of depressive symptoms mediated the association between perceived social isolation and risk of falls.

Conclusion

Our findings were suggestive of the need to consider social isolation when designing falls prevention programs. More research is needed with research designs that address potential endogeneity bias.

Keywords:

• Mental health
• loneliness
• social relationships
• population-based study
• Health and Retirement Study

Acknowledgements

The authors acknowledge the Health and Retirement Study research team and study participants for their time, effort, and dedication.

Ethics

This study used the data from the HRS in which personal information of human subjects was de-identified in the publicly available data; therefore, it was exempt by the Institutional Review Board (IRB). The Michigan IRB defines public use data as data disseminated by ICPSR, Roper and the following federal agencies (Census Bureau, NCHS, and NCES).

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

The HRS (Health and Retirement Study) is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. This research was supported by the National Institutes of Health #1, under grant P2CHD065702, and the National Institutes on Aging #2, the Boston Claude D. Pepper Older Americans Independence Center, under grant P30-AG031679. The sponsors played no role in the content of this study.