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Impact of Social Isolation on Physical Functioning Among Older Adults: A 9-Year Longitudinal Study of a U.S.-Representative Sample

  • Borja del Pozo Cruz
    Correspondence
    Address correspondence to: Borja del Pozo Cruz, PhD, Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark.
    Affiliations
    Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark

    Epidemiology of Physical Activity and Fitness Across the Lifespan Research Group, Faculty of Education, University of Seville, Seville, Spain
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  • Francisco Perales
    Affiliations
    School of Social Science, The University of Queensland, Brisbane, Australia
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  • Rosa M. Alfonso-Rosa
    Affiliations
    Epidemiology of Physical Activity and Fitness Across the Lifespan Research Group, Faculty of Education, University of Seville, Seville, Spain

    Department of Human Motricity and Sport Performance, University of Seville, Seville, Spain
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  • Jesus del Pozo-Cruz
    Affiliations
    Epidemiology of Physical Activity and Fitness Across the Lifespan Research Group, Faculty of Education, University of Seville, Seville, Spain

    Department of Physical Education and Sport, Faculty of Education, University of Seville, Seville, Spain
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      Introduction

      Social isolation among older adults is associated with poor health and premature mortality, but its impact on physical functioning is not fully understood. Previous studies have typically relied on community samples, cross-sectional data, and suboptimal prospective designs. This study generates more robust evidence by investigating the longitudinal associations between social isolation and physical functioning in a large panel of older adults.

      Methods

      Analyses were based on 9 waves of data (2011–2019) from a sample of adults aged ≥65 years from the U.S. National Health and Aging Trends Study (N=12,427 individuals; 54,860 person-year observations) and within-individual fixed-effect panel regression models. Analyses were conducted in 2020. Social isolation was measured using the Social Isolation Index, and physical functioning was measured through the Short Physical Performance Battery.

      Results

      In fully adjusted fixed-effect regression models, each 1-unit increase in the Social Isolation Index resulted in an average decrease of 0.27 units in the Short Physical Performance Battery (95% CI= −0.31, −0.24). This relationship was moderated by age, with the Social Isolation Index bearing a significantly and substantially stronger influence on the Short Physical Performance Battery at older ages than at younger ages.

      Conclusions

      This study confirms that social isolation is associated with deficits in physical functioning among older adults in the U.S. using more robust data and methods than earlier studies. These findings highlight the importance of incorporating strategies to reduce social isolation in policies aimed at promoting successful aging.
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