Social Cognition and Loneliness in Older Adults: A Population-based Study

Abstract

Background: Social isolation and loneliness represent objective and subjective aspects of low social connection. They are important psychosocial risk factors in late life, associated with poor physical health, cognitive decline, and psychiatric morbidities. Social cognition, the set of cognitive abilities essential for adaptive social interactions, could play a role in social isolation and loneliness, but has not been extensively investigated.

Methods: We investigated associations of social cognition with social isolation and loneliness in a large, prospective population-based cohort of older adults, followed for up to 5 years. Social cognition was measured by the Social Norms Questionnaire (SNQ22), measuring awareness of prevailing norms, and the Reading the Mind in the Eyes Test (RMET10), measuring cognitive empathy. Social connection was measured by composite measures of social isolation and loneliness. Cross-sectional linear regression and longitudinal linear mixed-effect models were performed to investigate the associations between social cognition, social isolation, and loneliness, adjusting for demographics, depression, anxiety, and general cognition.

Findings: The study included 792 older adults with mean age 74.9 years. Higher social norms awareness, but not cognitive empathy, was cross-sectionally associated with lesser loneliness, adjusting for all covariates, and it also predicted lesser loneliness over time. This association remained significant after adjusting for social isolation. Neither social cognition measure was associated with social isolation.

Interpretation: Better awareness of social norms, but not emotional perception and cognitive empathy, was associated with lesser loneliness concurrently and over time. These results warrant further investigation into the mechanisms linking social cognition and loneliness.

Keywords: Social connection; reading the mind in the eyes test; social norms questionnaire.