The role of social network structure and function in moderate and severe social and emotional loneliness: the Dutch SaNAE study in older adults

Background Loneliness is a serious public health problem and became even more visible during the COVID-19 pandemic. Yet it is unknown which aspects of social networks are most important. Here, we evaluated social network structure and function and associations with moderate and severe social and emotional loneliness in older adults. Methods This cross-sectional study includes online questionnaire data (SaNAE cohort, August-November 2020), in independently living Dutch adults aged 40 years and older. For the separate outcomes social and emotional loneliness, associations with structural network aspects (e.g., network diversity - having various types of relationships, and density - having network members who know each other), and functional network aspects (informational, emotional, and practical social support) were assessed and risk estimates were adjusted for the number of contacts, age, educational level, level of urbanization and chronic conditions. Multivariable logistic regression analyses were stratified by sex. Results Of 3,396 participants (55% men; mean age 65 years), 18% were socially lonely which was associated with a less diverse and less dense network, living alone, feeling less connected to friends, not having a club membership, and fewer emotional supporters (men only) or informational supporters (women only). 28% were emotionally lonely, which was associated with being socially lonely, and more exclusively online (versus in-person) contacts (men only), and fewer emotional supporters (women only). Conclusion Network structure and function beyond the mere number of contacts is key in loneliness, and in particular, the types of relationships are important. Public health strategies should be sex-tailored and promote network diversity and density, club membership, informational and emotional support, and in-person contact.