Roles of Social Isolation and Rurality on Functional Limitations in Older Adults Living in the US

Social isolation is a growing problem among adults aged ≥65. Using 2019 data from the National Health and Aging Trends Study (NHATS) (n=4,603), we examined the associations of social isolation and rurality with functional limitations in US older adults. We hypothesized that rural older adults would report social isolation more than non-rural adults, and social isolation and rurality would have an interaction effect on difficulty in performing activities of daily living (ADLs). Stress buffering theory guided this research suggesting individuals who have greater social connections also have greater coping skills to buffer against health-related stress. We assessed rural and non-rural older adults’ social isolation (measured by a composite score of engagement in community activities and social connections) and difficulty in completing ADLs (e.g., difficulty in dressing, bathing, and eating in the past month). Our results supported one of the hypotheses that there were differing levels of social isolation among both rural and non-rural older adults. In both rural and non-rural groups, oldest-old (85+), non-White adults, those with poor health or had multiple comorbidities were significantly isolated or experienced severe isolation. These results support (1) the premise that specific demographic characteristics are associated with social isolation as well as (2) a growing body of research showing rural adults have unique characteristics that are protective against social isolation. Our findings are related to demographic predictors which could help target interventions toward specific at-risk groups. Policymakers and healthcare practitioners should be aware of risks for social isolation and prepare to discuss these issues.