Social isolation, loneliness and their relationships with depressive symptoms: A population-based study

OBJECTIVES To assess the relationship between various social isolation indicators and loneliness, and to examine the differential associations that social isolation indicators, loneliness have with depressive symptoms. METHODS Baseline data for 1,919 adults (aged 21 years and above) from a representative health survey in the Central region of Singapore was used for this study. The association between social isolation indicators (marital status, living arrangement, social connectedness with relatives and friends) and loneliness (the three-item UCLA Loneliness) were assessed, and their differential associations with depressive symptoms (the Patient Health Questionnaire-9) were examined using multiple linear regression, controling for relevant covariates. RESULTS There was significant overlap between loneliness and social isolation. Social connectedness with relatives and friends were mildly correlated with loneliness score (|r| = 0.14~0.16). Social isolation in terms of weak connectedness with relatives and with friends and loneliness were associated with depressive symptoms even after controling for age, gender, employment status and other covariates. The association of loneliness with depressive symptoms (β = 0.33) was independent of and stronger than that of any social isolation indicators (|β| = 0.00~0.07). CONCLUSIONS The results of the study establishes a significant and unique association of different social isolation indicators and loneliness with depressive symptoms in community-dwelling adults aged 21 and above.