Later-life depressive symptoms during the Covid-19 pandemic: Investigations of individual, cumulative, and synergistic effects of social isolation

Abstract

Objectives

This study examines associations between social isolation and depressive symptoms among Hong Kong Chinese adults aged 65 and older by investigating the distinct effects of individual indicators, cumulative index, and typologies of social isolation during the Covid-19 pandemic.

Methods

We used a sample of 260 older adults from a cross-sectional, city-wide online survey targeting 1,109 aged 45+ adults through purposive sampling. Seven indicators of social isolation (not married; living alone; not engaging in social/organizational activities; no social contact with friends or families; lack of family and friends networks; loneliness) using Cornwell & Waite’s framework were selected to construct three unique types of social isolation measures. We used latent class analysis (LCA) and regression models to examine the effects of varied typologies of social isolation on depressive symptoms.

Results

Individual model of social isolation showed that lack of social contact and feeling lonely were significant predictors of depressive symptoms. A strong linear-trend gradient effect of cumulative social isolation on depressive symptoms was also observed. The LCA model identified four typologies of social isolation (socially isolated; living alone but socially engaged; married but lacking social ties, and not socially isolated); those in the ‘socially isolated’ and ‘married but lacking social ties’ groups had the most depressive symptoms.

Conclusion

Three operationalizations of social isolation demonstrated different utilities and implications in assessing the impacts of social isolation on depressive symptoms. Social contacts and loneliness, rather than living status or other characteristics of isolation, were the factors most strongly associated with depressive symptoms. Support programs should target lonely older adults who lack social engagement opportunities, as they are at increased risk of depression.

Keywords:

• Social isolation
• loneliness
• social supports
• social networks
• Hong Kong Chinese

Acknowledgements

Y.C. Chen conceptualized the study, developed the theoretical and conceptual framework, carried out the analyses, and wrote the initial draft of the article. H.O. Taylor contributed to the conceptualization and theoretical framework. N. Hung assisted in data management and revised the manuscript. C.LW. Chan contributed to the overall framework. All authors contributed to revising the article and approved the final draft as submitted. We thank Rebecca Choy Yung and Ellmon Fung at the Golden Age Foundation for their assistance in the data collection process. We would like to thank the reviewers for their comments on this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.