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Cited by 504Health disparities and outcomesAging, Health, and DisabilityAging and Gerontology Research

Social isolation, depression, and psychological distress among older adults

Open access
Taylor, Harry Owen, Taylor, Robert Joseph, Nguyen, Ann W., Chatters, Linda·2018·Journal of Aging and Health
DOI 10.1177/0898264316673511PMC PMC5449253
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Abstract

Objective: To investigate the impact of objective and subjective social isolation from extended family members and friends on depressive symptoms and psychological distress among a national sample of older adults. Method: Data for older adults (55 years and above) from the National Survey of American Life ( N = 1,439) were used to assess level of objective social isolation and subjective social isolation and to test regression models examining their impact on depressive symptoms (Center for Epidemiologic Studies Depression [CES-D] Scale) and psychological distress (Kessler 6 [K6] Scale). Results: The majority of respondents were not socially isolated from family or friends; 5% were objectively isolated from family and friends, and less than 1% were subjectively isolated from family and friends. Regression analyses using both social isolation measures indicated that objective social isolation was unrelated to depressive symptoms and psychological distress. However, subjective social isolation from both family and friends and from friends only was associated with more depressive symptoms, and subjective social isolation from friends only was associated with higher levels of psychological distress. Discussion: Assessments of social isolation among older populations should account for both subjective and objective dimensions, as well as both family and friend social networks. Social isolation from friends is an important, but understudied, issue that has significant consequences for older adult mental health.

AI snapshot

Written from the paper’s full text.

TL;DR

In a national sample of older adults, objective social isolation was largely unrelated to mental health once subjective social isolation was considered, while subjective isolation—especially from friends—was associated with more depressive symptoms and psychological distress. The study supports distinguishing objective versus subjective isolation and family versus friend networks.

Key findings

  • Most respondents were not isolated: 5% were objectively isolated from both family and friends (n=64), 7% from family only (n=89), 12% from friends only (n=164), and 76% from neither (n=1090); subjectively, just over 1% were isolated from both (n=25), 3% from family only (n=42), 10% from friends only (n=128), and 86% from neither (n=1182).
  • Objective isolation from both family and friends was associated with higher depressive symptoms in the initial model (b=.35, SE=.15, p<.05), but this became non-significant when subjective isolation was added; objective isolation was unrelated to psychological distress with or without subjective isolation.
  • Subjective isolation from both family and friends was associated with more depressive symptoms (b=.39, SE=.14, p<.01), and subjective isolation from friends only was associated with more depressive symptoms (b=.40, SE=.09, p<.001) and higher psychological distress (b=.39, SE=.12, p<.01).
  • Subjective isolation from family only was not associated with either outcome; the authors report that their hypotheses were partially confirmed.

Methods

  • Used the National Survey of American Life older adult subsample aged 55+ (N=1439; 837 African American, 304 Black Caribbean, 298 non-Hispanic White), community-dwelling respondents surveyed February 2001–June 2003, overall response rate 72.3%.
  • Dependent variables were the 12-item CES-D for depressive symptoms and the Kessler 6 for psychological distress; key independent variables were four-category objective social isolation (contact frequency with family/friends) and subjective social isolation (closeness to family/friends), with covariates for age, education, gender, marital status, household income, race, and chronic health conditions.
  • Because dependent variables were overdispersed, negative binomial regression was used with survey weights; four models estimated depressive symptoms and psychological distress first with objective isolation, then with subjective isolation added, using STATA version 13.

Limitations

  • Stated by the paper: cross-sectional data prevent assessing causality or direction of effects; very few respondents reported isolation, especially subjective isolation, limiting power to examine race/ethnic differences; and the NSAL sampled community-dwelling household residents, so findings are not generalizable to homeless or institutionalized older adults.
  • Evident from the text: isolation measures rely on self-report and are dichotomized from single contact-frequency or closeness items, and the data are from 2001–2003, so associations may not reflect current older adult populations. The paper also notes future research should include sexual orientation as a covariate.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1177/0898264316673511

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 31 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Subjective social isolation from both family and friends was associated with more depressive symptoms among older adults.

    “However, subjective social isolation from both family and friends and from friends only was associated with more depressive symptoms”
    Quote in the paperSubstantial claim
  • Findingown data

    Objective social isolation is no longer statistically significant for depressive symptoms once subjective social isolation is included in the model.

    “Objective social isolation is no longer statistically significant once subjective social isolation is included in the model.”
    Quote in the paperSubstantial claim
  • Findingown data

    Older adults objectively isolated from both family and friends had a higher level of depressive symptoms compared to those not objectively isolated from either group (b=.35, SE=.15, p<.05).

    “Results indicate that older adults who are objectively isolated from both family members and friends had a higher level of depressive symptoms in comparison to older adults who were not objectively isolated from either group (b=.35, SE=.15, p<.05).”
    Quote in the paperSubstantial claim
  • Findingown data

    Subjective social isolation from friends only was associated with more depressive symptoms among older adults.

    “However, subjective social isolation from both family and friends and from friends only was associated with more depressive symptoms”
    Quote in the paperSubstantial claim
  • Findingown data

    The majority of older adult respondents were not socially isolated from family or friends.

    “The majority of respondents were not socially isolated from family or friends”
    Quote in the paperNot a substantial claim
  • May combine two claims. 16
  • Classified as probably not a substantial claim. 12

  • May combine two claims.

    Findingown data

    The dependent variables were not normally distributed; the variance exceeded the mean, indicating overdispersion.

    “An examination of the univariate distribution of our dependent variables indicated that they were not normally distributed. In particular, the variance exceeded the mean which indicated overdispersion.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the sample, 5% of older adults were objectively isolated from both family and friends, 7% from family only, 12% from friends only, and 76% were not isolated from either group.

    “With regard to objective social isolation, five percent of the older adults in our sample (n=64) were objectively isolated from both their family members and their friends, 7% were isolated from their family only (n=89), 12% were isolated from their friends only (n=164), and 76% were not isolated from either group (n=1090).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the sample, a little more than 1% were subjectively isolated from both family and friends, 3% from family only, 10% from friends only, and 86% were not subjectively isolated from either group.

    “With regard to subjective social isolation, a little more than 1% (n=25) were subjectively isolated from both family members and friends, 3% (n=42) were subjectively isolated from family only, 10% (n=128) were subjectively isolated from friends only, and 86% (n=1182) were not subjectively isolated from either group.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The findings are consistent with previous studies concerning the negative impact of social isolation for mental health and highlight the pivotal role of subjective social isolation for depressive symptoms and psychological distress.

    “Our findings are consistent with those from previous studies concerning the negative impact of social isolation for mental health and highlight the pivotal role of subjective social isolation for depressive symptoms and psychological distress.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Survey weights were applied for all multivariate analyses.

    “Survey weights were applied for all multivariate analyses.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductcitation

    The K6 scale is a measure of non-specific psychological distress utilized as a screening tool for serious mental illness in community-based samples (Cronbach's Alpha = 0.83) and verified to accurately discriminate cases of DSM-IV psychiatric disorders.

    “The K6 scale is a measure of non-specific psychological distress that is utilized as a screening tool for serious mental illness in community-based samples (Cronbach’s Alpha = 0.83) and verified to accurately discriminate cases of DSM-IV psychiatric disorders (Cornelius, et al., 2013; Kessler, et al., 2002).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Cornelius, et al., 2013

      Not checked in the free run.

    • cites Kessler, et al., 2002

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Current prevalence estimates for social isolation among older adults range between 15% and 40%.

    “Current prevalence estimates for social isolation among older adults range between15% to 40% (Elder & Retrum, 2012)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Elder & Retrum, 2012

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    Cronbach's Alpha for the K6 in face-to-face clinical interviews and in the 1997 and 1998 National Health Interview Survey was .89 and .88, respectively.

    “Cronbach’s Alpha for the K6 in the face-to-face clinical interviews and in the 1997 and 1998 waves of the National Health Interview Survey was .89 (Kessler, et al., 2002) and .88, respectively.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kessler, et al., 2002

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Cornelius and colleagues verified a Cronbach's Alpha of .88 in a study of disability claimants.

    “Cornelius and colleagues (2013) verified a Cronbach’s Alpha of .88 in a study (n = 293) of disability claimants.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cornelius and colleagues (2013)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    NSAL weights were designed to correct for disproportionate sampling, non-response, and population representation across socio-demographic characteristics.

    “For all three race/ethnic samples, the NSAL weights were designed to correct for disproportionate sampling, non-response, and for population representation across various socio-demographic characteristics.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The effect of objective social isolation on self-rated mental health is mediated by subjective social isolation.

    “some evidence indicates that the effect of objective social isolation on self-rated mental health is mediated by subjective social isolation (Cornwell & Waite, 2009a).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cornwell & Waite, 2009a

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    All five measures of social embeddedness were related to psychological distress; lacking a confidant was the strongest predictor of distress.

    “All five measures of social embeddedness were related to psychological distress; lacking a confidant to share personal feelings and emotions was the strongest predictor of distress.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Snowden (2001)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The overall response rate for the NSAL was 72.3%.

    “the overall response rate was 72.3%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Social network size may be decreasing and social isolation increasing for Americans of all ages.

    “emerging evidence suggests that social network size may be decreasing and social isolation increasing for Americans of all ages (Klinenberg, 2016).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Klinenberg, 2016

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Survey weights were applied to constitute a nationally representative dataset.

    “Survey weights were applied to constitute a nationally representative dataset.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The weighted NSAL dataset is nationally representative of African Americans, Black Caribbeans, and Whites in the United States.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The NSAL is a nationally representative dataset of African Americans, Black Caribbeans, and Whites.

    “The National Survey of American Life: Coping with Stress in the 21st Century (NSAL) is a nationally representative dataset of African Americans, Black Caribbeans, and Whites.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Jackson et al., 2004

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Negative binomial regression was used instead of linear regression because it is appropriate for the non-normal, overdispersed distribution.

    “Consequently, instead of linear regression we used negative binomial regression which is the appropriate technique for this type of non-normal distribution.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The NSAL sample is a national multi-stage probability design.

    “The NSAL sample is a national multi-stage probability design.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The 12-item CES-D has acceptable reliability (Cronbach's Alpha = 0.76) and similar factor structure to the original CES-D.

    “The 12 item version of the scale has demonstrated acceptable reliability (Cronbach’s Alpha = 0.76) and similar factor structure to the original CES-D scale (Radloff, 1977).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Radloff, 1977

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The perceived isolation scale was significantly related to depressive symptoms, while the social disconnectedness scale was unrelated.

    “The perceived isolation scale was also significantly related to depressive symptoms, while the social disconnectedness scale was unrelated.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Cornwell & Waite, 2009a

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Age is significantly related to having more primary group members (spouse and children) in an older individual's social network.

    “age is significantly related to having more primary group members (i.e., spouse and children) in an older individual’s social network (Cornwell et al., 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cornwell et al., 2008

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationcitation

    Objective isolation (infrequent contact with others) and subjective isolation (diminished feelings of closeness to others) are each types of social isolation that represent separate aspects of social relationships.

    “This study clarifies the construct of social isolation by demonstrating that objective isolation (infrequent contact with others) and subjective isolation (diminished feelings of closeness to others) are each types of social isolation that represent separate aspects of social relationships (Cornwell & Waite, 2009a, 2009b; Coyle & Dugan, 2012; Elder & Retrum, 2012; Valtorta et al., 2016).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Cornwell & Waite, 2009a

      Not checked in the free run.

    • cites Cornwell & Waite, 2009b

      Not checked in the free run.

    • cites Coyle & Dugan, 2012

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Objective and subjective social isolation have different associations with mental health outcomes, and subjective social isolation from specific groups (friends and family vs. friends only) may be differentially important for particular outcomes.

    “Collectively, these findings suggest that objective and subjective social isolation have different associations with mental health outcomes and that subjective social isolation from specific groups (friends and family vs. friends only) may be differentially important for particular outcomes (Valtorta et al., 2016).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Valtorta et al., 2016

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Study findings validated the importance of friendships by demonstrating that being subjectively socially isolated from friends (but not family) was detrimental for mental well-being (depressive symptoms and psychological distress).

    “Study findings validated the importance of friendships by demonstrating that being subjectively socially isolated from friends (but not family) was detrimental for mental well-being (depressive symptoms and psychological distress).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    The NSAL sampled community-dwelling older adults who reside in households (non-institutional settings), so study findings are not generalizable to older adults who are homeless or institutionalized.

    “Third, the NSAL sampled community-dwelling older adults who reside in households (i.e., non-institutional settings). Study findings are not generalizable to older adults who are homeless or institutionalized”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Despite a relatively large sample size, very few respondents indicated being socially isolated from family and friends, especially for subjective social isolation, so the study lacks sufficient power to investigate specific differences by race or ethnicity for associations between social isolation and depressive symptoms and psychological distress.

    “Second, despite a relatively large sample size, very few respondents indicated being socially isolated from family and friends. This is especially true for subjective social isolation. Consequently, we lack sufficient power to investigate specific differences by race or ethnicity for associations between social isolation and depressive symptoms and psychological distress.”
    Quote in the paperSubstantial claim
26 of 26

  • The paper relies on this without support.

    Questions about social isolation and its mental health consequences for older adults are largely understudied.

    “However, questions with respect to social isolation and its mental health consequences for older adults are largely understudied.”

  • The paper relies on this without support.

    The weighted NSAL dataset is nationally representative of African Americans, Black Caribbeans, and Whites in the United States.

    “Survey weights were applied to constitute a nationally representative dataset.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting conclusions about isolation from both groups and psychological distress

    Major

    The discussion calls subjective isolation from both family and friends significant for psychological distress, but later says that this group had higher depressive symptoms, not psychological distress.

  • Conflicting prevalence of subjective isolation from both family and friends

    Minor

    The abstract says fewer than 1% were subjectively isolated from both groups, while the results say a little more than 1%.

2 of 2

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References 23 · Cited by 504

Research works printed but not linked: 1

  1. Lubben J., 2015, Social isolation presents a grand challenge for social work

Authors
Taylor, H. O., Taylor, R. J., Nguyen, A. W., & Chatters, L.
Affiliations
  • Washington University in St. Louis (US)
  • University of Michigan (US)
  • University of Southern California (US)
Corresponding author
Taylor, Harry Owen
ORCID
Venue
Journal of Aging and Health
Publisher
SAGE Publications
Published
2016-10-17
Volume
30
Issue
2
Pages
229-246
ISSN
  • 0898-2643 (ISSN-L)
  • 1552-6887
DOI
10.1177/0898264316673511
PMC
PMC5449253
OpenAlex
W2537928511
Semantic Scholar
a2033b242b5f320187b76bb3e35bfc7bdc714ae9
Cited by
504
References
23
Citations by year
2026: 35 · 2025: 89 · 2024: 68 · 2023: 90 · 2022: 76 · 2021: 62 · 2020: 55 · 2019: 19 · 2018: 6 · 2017: 2 · 2016: 2
FWCI
12.76
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of Aging and Health (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of General Medical Sciences (R25GM058641)
  • National Institute on Aging (P30-AG15281)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
Keywords
social isolation, objective social isolation, depressive symptoms, psychological distress, older adults, family relationships, friendship networks, social networks, mental health
MeSH terms
Aged, Aging, Depression, Family, Female, Humans, Interpersonal Relations, Male, Middle Aged, Surveys and Questionnaires, Social Isolation, Social Support, Stress, Psychological, United States, Friends

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