DOI: 10.1093/geronb/gbad122 ISSN:

Social Isolation and Worsening Health Behaviors Among Older Adults During the COVID-19 Pandemic

Kyung Won Choi, Linda J Waite, Laura E Finch, Ashwin A Kotwal
  • Geriatrics and Gerontology
  • Gerontology
  • Clinical Psychology
  • Social Psychology



We examine the relationship between social isolation, poor health behaviors, and perceived worsening of older adults’ health behaviors following the coronavirus outbreak. We assess the extent to which psychological pathways mediate the relationship between social isolation and worsening health behaviors.


Drawing on data from the National Social Life Health and Aging Project Round 3 (2015) and its COVID-19 Substudy (2020; N=2,549), we use generalized linear models to explore how indicators of social isolation during the COVID-19 pandemic –infrequent in-person contact with friends and family in 2020 and decreased in-person contact with friends and family since COVID-19 started– are associated with: 1) poor health behaviors (low physical activity, drinks per week, smoking, and poor sleep) in 2020 and 2) perceived worsening of health behaviors (reports of decreased physical activity, increased drinking and smoking, and feeling less rested) since the pandemic started.


Infrequent in-person contact was not associated with poor health behaviors. Decreases in in-person contact, on the other hand, were associated with worsening health behaviors. Older adults who reported decreases in in-person contact were more likely to perceive a decrease in physical activity, an increase in drinking, and feeling less rested. Emotional well-being, particularly loneliness compared to anxiety or depressive feelings, partially mediated the relationship between perceived worsening of health behaviors and decrease in in-person contact with friends, and to a lesser extent, with family.


Our study suggests that in-person contact may play a distinct role in shaping older adults’ well-being during the pandemic.

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