Social connections and mortality: analyses of English Longitudinal Study of Ageing

Background

Social connections are a key determinant of health, but evidence on the relationship with mortality is overly-simplistic, as the existing empirical literature predominantly focuses on single or limited definitions of social connections. This study aimed to explore the differential association between structural, functional, and quality social connections and all-cause and cause-specific mortality in a prospective cohort study up to 16 years’ follow-up.

Methods

This study used data from the English Longitudinal Study of Ageing, a nationally representative sample of older adults in the UK. Social connections are measured at Wave 4 (2008/2009) as baseline. Mortality was ascertained by linkage to the national mortality registry data up to 2024. Cox hazard regression was used.

Results

In models adjusted for sociodemographic, lifestyle, and health covariates, for structural social connections, moderate social network size and high social integration were associated with decreased risk of all-cause mortality. For functional social connections, moderately low loneliness and high social support were associated with decreased risk of all-cause mortality. For quality, low social strain was associated with decreased risk of all-cause mortality. When examining cause of death, social network size, social support and strain were most clearly associated with circulatory-related mortality. Social integration was most clearly associated with cancer-related and respiratory-related mortality. Low loneliness and social strain were most clearly associated with decreased risk of other-cause mortality.

Conclusions

Distinct constructs of social connections were associated with incident all-cause and cause-specific mortality, with the strong associations found for social integration and social strain with all-cause mortality. Findings suggest that social integration and quality of social connections could be optimal targets for early interventions to support longevity.

Key messages

• This study highlights the value of multidimensional assessments of social connection and the identification which constructs when studying the relation of social connections to health.

• The findings suggest social integration and quality of social connections will be potentially prioritized targets for early interventions to reduce the risk of mortality.