Rate of Social Isolation by Geographic Location Among Older Adults: AAA LongROAD Study

Lynch, Laura; Mielenz, Thelma J.; Li, Guohua; Eby, David W.; Molnar, Lisa J.; Betz, Marian E.; DiGuiseppi, Carolyn; Hill, Linda L.; Jones, Vanya; Strogatz, David · 2021 · Frontiers in Public Health

DOI: 10.3389/fpubh.2021.791683

archive: archived pipeline: cataloged verified

Get this paper ↗ (DOI — opens at the source; we link to it, we don't host it)

Summary

This study investigates the relationship between geographic location and social isolation among older adults, addressing a gap in literature regarding how urban versus non-urban residence influences this modifiable risk factor for negative health outcomes. The research utilized data from the AAA Longitudinal Research on Aging Drivers (LongROAD) prospective cohort, which included 2,989 older adult drivers recruited from five sites across the United States. Participants were aged 65 to 79 at baseline and were required to hold a valid driver’s license and reside in their location for at least 80% of the year. Social isolation was measured at baseline and during two annual follow-ups using the PROMIS v2.0 Social Isolation 4a instrument, a validated measure normed to the US Census population. Geographic location was dichotomized into urban and non-urban categories using Rural Urban Commuting Area (RUCA) codes, with non-urban including both suburban and rural residents. The study employed multivariable regression using a generalized estimating equation (GEE) model to account for repeated measures and adjust for potential confounders, including age, race/ethnicity, marital status, education, depression, physical function, hearing, and driving exposure. The results indicated that while participants in urban areas appeared to have a lower rate of social isolation compared to those in non-urban areas, the difference was not statistically significant. The unadjusted rate ratio was 0.72 (95% CI 0.43, 1.19), suggesting urban residents were 28% less likely to be socially isolated. After adjusting for covariates, the rate ratio narrowed to 0.79 (95% CI 0.46, 1.36), indicating a 21% lower likelihood that remained non-significant. The study population was predominantly White (85.5%), married (66.0%), and highly educated, with low baseline rates of depression and social isolation. The authors conclude that while there was no significant difference in social isolation rates between geographic settings in this cohort, understanding these dynamics is crucial for tailoring public health interventions. The study highlights limitations, including the under-representation of non-urban areas, which may have reduced statistical power, and the exclusion of alternative transportation use as a confounder. The findings suggest that future research should further examine geographic disparities, particularly in the context of events like the COVID-19 pandemic, to ensure resources are appropriately allocated to mitigate social isolation among older adults.

Key finding

Urban older adult drivers exhibited a 21% lower rate of social isolation compared to non-urban drivers, but the difference was not statistically significant after adjusting for covariates.

Methodology

naturalistic

Sample size: 2989

Provenance

The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed. Discovered via author_sweep_intake on 2026-05-27 (2 acquisition events logged).

Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

Topics

Ranked by relevance to this paper. Hover a topic for its definition.

• demographic disparities