Epidemiology and Correlates of Social Isolation Among Middle-Aged and Older Adults in China

Objective To explore the current prevalence,cumulative incidence,distribution characteristics,and correlates of social isolation among middle-aged and older adults aged 45 years and older in China. Methods This study utilized data from the China Health and Retirement Longitudinal Study.Cross-sectional studies with stratified analysis were conducted to investigate the prevalence of social isolation and its age,gender,and regional differences in 2018 and 2020.A cohort study and binary logistic regression models were employed to analyze the cumulative incidence of social isolation and its correlates from 2018 to 2020.Multiple imputation based on chained equations and sensitivity analyses based on complete-case data were employed to ensure the reliability of the analysis. Results The weighted prevalence of social isolation among middle-aged and older adults was 16.48% (95%CI=15.67%-17.32%) in 2018 and 18.84% (95%CI=17.93%-19.74%) in 2020.Weighted stratified analyses indicated that the prevalence of social isolation was higher among older adults of advanced ages,rural residents,and females (all P<0.001).The weighted cumulative incidence of social isolation during 2018-2020 was 9.24% (95%CI=8.47%-10.02%).The analysis revealed that 34.02% (95%CI=32.85%-35.19%) of middle-aged and older adults exhibited depressive symptoms.Depressive symptoms (OR=1.38,95%CI=1.07-1.78,P=0.013) were associated with an elevated risk of social isolation. Conclusions The study reveals the epidemiology of social isolation among middle-aged and older adults in China,identifying advanced age,female gender,rural residence,and depressive symptoms as key correlates.These findings emphasize the need for early health management strategies to address social isolation in these high-risk populations.