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Healthcare
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Impact of Social Connections on Well-Being of Older Adults
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Impact of Social Connections on Well-Being of Older Adults

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Mental Health and Psychosocial Well-being".

Deadline for manuscript submissions: closed (30 April 2026) | Viewed by 15208

Special Issue Editors

Prof. Dr. Lixia Yang

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Guest Editor
Department of Psychology, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
Interests: wellbeing; migration; immigrants; health; healthcare
Special Issues, Collections and Topics in MDPI journals
Dr. Kateryna Metersky

E-Mail Website
Guest Editor
Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
Interests: vulnerable populations; nursing services and care; acute care; community care; interprofessional services and care; population-centered care; person-centered care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

With the rapid advance of technology and overall emphasis on efficiency in modern society, in-person social connection and social support have become less available or accessible. In this context, individuals have become more socially isolated and interpersonally disconnected than ever. As a result, the experience of loneliness is drastically increasing, especially among older adults who typically experience a reduction in their social network and social support.

The literature in this field has revealed some negative psychological outcomes (i.e., increased anxiety levels) of loneliness, and this relationship could be buffered by perceived social support or social connection. Given this, it is crucial to address the impact of social connection/support on older adults’ wellbeing and develop prevention or intervention programs to enhance a sense of social connection among this population. This is especially urgent in the post-pandemic era because social connection drastically reduced during the COVID-19 pandemic. Thus, it is important to acknowledge that it takes time for older adults to recover and adjust back to their in-person social routines.

This Special Issue will address these questions by determining the risk predictors and wellbeing outcomes of social connection and loneliness among older adults who are most vulnerable to social disconnection.

We are pleased to invite you to submit your research manuscripts to this Special Issue. Your contribution will inform clinicians and researchers on the risk factors and wellbeing consequences of social disconnection and loneliness among older adults. The results will inform professionals working with older adults on their clinical, community, and/or social practice.

This Special Issue aims to publish a collection of research reviews and original research articles to address the aforementioned research questions, with a specific focus on risk factors, mechanisms, social context, prevention and intervention, as well as healthcare or community policies and practices related to social connection and wellbeing among older adults.

Research themes and article types featured in this Special Issue will include, but are not limited to, the following:

  • Reviews and meta-analyses of studies on social connection and wellbeing of older adults.
  • Validation studies of existing assessment tools on social connection for older adults.
  • Cross-sectional or longitudinal studies assessing the wellbeing impact of social connection in older adults.
  • Research studies to determine the underlying factors/mechanisms and practice/training to enhance social connection among older adults.

We look forward to receiving your contributions.

Prof. Dr. Lixia Yang
Dr. Kateryna Metersky
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • social connection
  • social engagement
  • social support
  • wellbeing
  • health
  • aging
  • older adults

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (8 papers)

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Research

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17 pages, 370 KB  
Article
Rural Community Organizations and Mental Health Among Older Adults: Evidence of Dual Economic-Social Pathways in Rural China
by Hang Li, Zhibin Li and Huijun Liu
Healthcare 2026, 14(4), 525; https://doi.org/10.3390/healthcare14040525 - 19 Feb 2026
Viewed by 545
Abstract
Background/Objectives: Mental health issues pose a growing public health burden in aging societies, a challenge particularly accentuated in rural China. This study investigated whether the establishment of rural community organizations—specifically volunteer groups, agricultural cooperatives, cultural and sports clubs, senior dance troupes, and [...] Read more.
Background/Objectives: Mental health issues pose a growing public health burden in aging societies, a challenge particularly accentuated in rural China. This study investigated whether the establishment of rural community organizations—specifically volunteer groups, agricultural cooperatives, cultural and sports clubs, senior dance troupes, and senior associations—influences depressive symptoms and life satisfaction among rural older adults. Methods: Data were obtained from the Well-being of Elderly Survey in Anhui Province (WESAP) across three waves (2015, 2018, and 2021). The final sample comprised a balanced panel of 511 older adults, providing 1533 observations. A two-way fixed-effects model was employed to analyze the data. Results: Empirical results show that the establishment of agricultural cooperatives was associated with lower depressive symptoms. Cultural and sports clubs were associated with reduced depressive symptoms and positively correlated with life satisfaction. Mechanism analysis revealed associations consistent with a dual “economic–social” pathway: establishing agricultural cooperatives was associated with greater economic resilience and stronger social bonds. The establishment of cultural and sports clubs correlated with higher mental well-being, accompanied by increased time spent in social interaction. Notably, volunteer groups and senior associations showed no significant association with mental health outcomes. Conclusions: Rural community organizations are critical drivers of mental health equity. Policymakers should prioritize support for organizations that are deeply embedded in rural daily life and integrate economic functions with social interaction to maximize mental health benefits for older adults. Full article
(This article belongs to the Special Issue Impact of Social Connections on Well-Being of Older Adults)
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17 pages, 485 KB  
Article
Perceived Social Support and Well-Being: Mediation and Buffering of the Stress–Depression Link in Rural Older Adults
by Paul Alan Arkin Alvarado-García, Taniht Lisseth Cubas Romero, Lis Paola Reyes Sánchez, Valeria Alexxandra Sandoval Bocanegra and Marilú Roxana Soto-Vásquez
Healthcare 2026, 14(3), 336; https://doi.org/10.3390/healthcare14030336 - 29 Jan 2026
Viewed by 1033
Abstract
Background/Objectives: Rural older adults are exposed to multiple chronic stressors that may heighten depressive symptoms, and these effects can be intensified by social disconnection, particularly in resource-constrained settings. This study examined whether global and dimension-specific perceived social support—an indicator of perceived social connection—mediates [...] Read more.
Background/Objectives: Rural older adults are exposed to multiple chronic stressors that may heighten depressive symptoms, and these effects can be intensified by social disconnection, particularly in resource-constrained settings. This study examined whether global and dimension-specific perceived social support—an indicator of perceived social connection—mediates and/or buffers the association between perceived stress and depressive symptoms in rural older adults from northern Peru. Methods: A cross-sectional survey was conducted with 166 community-dwelling adults aged ≥60 years in a rural coastal district. Perceived stress (PSS-4), depressive symptoms (GDS-15), and perceived social support (MOS-SSS) were assessed. Regression-based mediation and moderation models with bootstrapped confidence intervals were estimated, adjusting for age, sex, marital status, education, income category, and chronic medical conditions. Results: Higher perceived stress was associated with greater depressive symptoms. Greater overall social support was associated with lower perceived stress and fewer depressive symptoms. Indirect effects supported a stress-process pathway for overall support, particularly socioemotional dimensions (positive social interaction and affectionate support). No buffering effect was observed for overall support; however, tangible (instrumental) support attenuated the association between stress and depressive symptoms. Conclusions: Mediation analyses supported an indirect pathway linking perceived stress to depressive symptoms via socioemotional support, whereas tangible (instrumental) support moderated the stress–depression association. Interventions that strengthen social connectedness and practical assistance may help protect mental health in rural older adults. Full article
(This article belongs to the Special Issue Impact of Social Connections on Well-Being of Older Adults)
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17 pages, 245 KB  
Article
Lived Experiences of Social Isolation and Meaningful Relationships Among Older Adults Living with HIV with a Concurrent Mental Health Diagnosis: A Heideggerian Phenomenological Approach
by Kristina M. Kokorelias, Dean Valentine, Andrew D. Eaton, Sarah E. P. Munce, Christine L. Sheppard, Sander L. Hitzig, Marina B. Wasilewski, Alice Zhabokritsky, Reham Abdelhalim, Laura Jamieson, Maurita T. Harris and Luxey Sirisegaram
Healthcare 2026, 14(2), 257; https://doi.org/10.3390/healthcare14020257 - 20 Jan 2026
Cited by 1 | Viewed by 687
Abstract
Background/Objectives: Meaningful social connections are critical for well-being in later life, yet older adults living with HIV frequently experience social isolation and loneliness, compounded by stigma, mental health conditions, and systemic inequities. This study aimed to explore how older adults living with HIV [...] Read more.
Background/Objectives: Meaningful social connections are critical for well-being in later life, yet older adults living with HIV frequently experience social isolation and loneliness, compounded by stigma, mental health conditions, and systemic inequities. This study aimed to explore how older adults living with HIV and a concurrent mental health diagnosis experience social isolation and cultivate meaningful relationships, situating these experiences within Social Convoy Theory. Methods: Using a Heideggerian phenomenological approach, we conducted in-depth, semi-structured interviews with 33 adults aged 50 and older in Ontario, Canada, who self-identified as living with HIV and a diagnosed mental health condition. Participants were recruited through community-engaged strategies and snowball sampling. Data were analyzed iteratively, combining descriptive and interpretive coding to identify patterns in social isolation, relational meaning, and the influence of intersecting social, structural, and health determinants. Results: Participants described social isolation as both a physical and existential experience, influenced by stigma, mental health challenges, and contextual factors such as urban versus rural settings. Meaningful relationships were characterized by authenticity, trust, emotional safety, and reciprocity, often formed within peer networks sharing similar lived experiences. Community engagement and virtual platforms facilitated connection, while rural or suburban environments often intensified isolation. Relationships providing validation, agency, and continuity of experience were particularly impactful on participants’ well-being. Conclusions: Social isolation among older adults living with HIV and mental health conditions extends beyond objective network measures to include emotional and identity-related dimensions. Interventions should prioritize affirming, context-sensitive spaces that support disclosure, trust, and reciprocal relationships, recognizing the nuanced needs of this population for both social and existential connectedness. Full article
(This article belongs to the Special Issue Impact of Social Connections on Well-Being of Older Adults)
11 pages, 224 KB  
Article
Social Participation Among Older Immigrants: A Cross-Sectional Study in Nine Cities in Canada
by Sepali Guruge, Souraya Sidani, Jill Hanley and The ICOI Team
Healthcare 2025, 13(13), 1478; https://doi.org/10.3390/healthcare13131478 - 20 Jun 2025
Cited by 2 | Viewed by 1842
Abstract
Background/Objectives: Social participation is important for healthy aging but challenging for older immigrants because of factors such as the loss of cultural community, language and transportation barriers, ageism, and racism. This study aimed to examine (1) the type of social activities in which [...] Read more.
Background/Objectives: Social participation is important for healthy aging but challenging for older immigrants because of factors such as the loss of cultural community, language and transportation barriers, ageism, and racism. This study aimed to examine (1) the type of social activities in which older immigrants from Arabic (Arab), Mandarin (East Asian), and Punjabi-speaking (South Asian) communities in Canada engage; (2) their desire for more participation in social activities; and (3) factors they perceive as preventing their engagement in more social activities. Methods: Using a cross-sectional design, we collected data, using existing measures, from 476 older immigrants between fall 2022 and winter 2023. Descriptive statistics were used to analyze the data. Results: More than 75% of participants reported engagement in three solitary activities (having a hobby, going on a day trip; and using the internet and/or email) and more than 85% participated in community-based activities with family inside and outside and with friends outside the household. Most (71%) expressed a desire to participate in more social activities in the community, but they were prevented from doing so due to factors such as language barriers or not wanting to go alone. Conclusions: Interventions are needed to facilitate community-based participation among older immigrants and improve their quality of life. Full article
(This article belongs to the Special Issue Impact of Social Connections on Well-Being of Older Adults)
16 pages, 994 KB  
Article
Loneliness and Social Isolation of Older Adults and Quality of Dyadic Relationships with Migrant Domestic Workers: A Mixed-Method Study
by Maria Shuk Yu Hung, Ken Hok Man Ho, Michael Man Ho Li and Edward Kwok Yiu Choi
Healthcare 2024, 12(24), 2496; https://doi.org/10.3390/healthcare12242496 - 10 Dec 2024
Cited by 4 | Viewed by 2799
Abstract
Background/Objectives: Loneliness among older individuals is widespread globally, leading to increasing public health and policy concerns. Migrant domestic workers (MDWs) offer continuous services for older adults worldwide, recompensing for dwindling support from family members. The study objectives were to explain how the quality [...] Read more.
Background/Objectives: Loneliness among older individuals is widespread globally, leading to increasing public health and policy concerns. Migrant domestic workers (MDWs) offer continuous services for older adults worldwide, recompensing for dwindling support from family members. The study objectives were to explain how the quality of dyadic relationships with MDWs is associated with older adults’ loneliness and further explore older adults’ perceived experiences of care by MDWs. Methods: A mixed-methods study was conducted from 2021 to 2023. Convenience and snowball samplings of older adults aged ≥60 living with MDWs were recruited by elderly community centers in Hong Kong for a survey, and purposive sampling of in-depth interviews followed. The survey comprised several well-validated scales assessing loneliness, perceived social networks, and the quality of dyadic relationships. Face-to-face in-depth interviews were audio-recorded and transcribed for preliminary content analysis. A total of 288 older adults participated in the first phase of the survey interviews. Among them, 19 joined the in-depth interviews in the second phase. Results: There is a high prevalence of loneliness among older adults being cared for by MDWs in Hong Kong. In addition, the results showed that social loneliness negatively and significantly correlated with perceived dyadic relationship quality and social network. Two major interrelated themes were identified along with eight subthemes: (1) established relational interaction with MDWs and (2) enjoyed functional assistance and support from MDWs. Conclusions: Our study findings illustrated that good dyadic relationships among MDWs and older adults enhance older adults’ social connections and networking, alleviating loneliness and social isolation. Appropriate strategies are suggested to strengthen older adults’ social support and improve the quality of dyadic relationships with MDWs, which may reduce loneliness among older adults. Full article
(This article belongs to the Special Issue Impact of Social Connections on Well-Being of Older Adults)
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15 pages, 308 KB  
Article
Psychological Wellbeing and Life Satisfaction among Chinese Older Immigrants in Canada across the Early and Late Stages of the COVID-19 Pandemic
by Lixia Yang, Andrea D. Y. Lee and Linying Dong
Healthcare 2024, 12(18), 1899; https://doi.org/10.3390/healthcare12181899 - 22 Sep 2024
Cited by 4 | Viewed by 2137
Abstract
Objectives: This study compared the psychological wellbeing, life satisfaction, and perceived social support in Chinese older immigrants living in Canada between the early (i.e., Wave 1: September–November 2020) and late (i.e., Wave 2: January–February 2023) stages of the COVID-19 pandemic. Additionally, it assessed [...] Read more.
Objectives: This study compared the psychological wellbeing, life satisfaction, and perceived social support in Chinese older immigrants living in Canada between the early (i.e., Wave 1: September–November 2020) and late (i.e., Wave 2: January–February 2023) stages of the COVID-19 pandemic. Additionally, it assessed perceived social support from family, friends, or others as predictors for psychological wellbeing and life satisfaction in this population. Methods: These questions were addressed with a cross-sectional survey design with two independent samples at Wave 1 (n = 171) and Wave 2 (n = 191), respectively. Results: The results revealed lower levels of psychological wellbeing, life satisfaction, and perceived social support in Wave 2 compared to Wave 1. The hierarchical regression models identified social support from friends (but not from family or others) as a significant predictor for psychological wellbeing and life satisfaction. Additionally, a higher level of income and being a male predicted better psychological wellbeing. A higher level of income and a lower level of education predicted greater life satisfaction. Conclusions: The findings suggest a deterioration in psychological wellbeing and life satisfaction from the early to late stages of the pandemic and highlight the protective effect of social support from friends among Chinese older immigrants. Full article
(This article belongs to the Special Issue Impact of Social Connections on Well-Being of Older Adults)

Review

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13 pages, 247 KB  
Review
Supporting Migrant 2SLGBTQIA+ Unpaid Caregivers for Family Members Living with Chronic Illnesses
by Roya Haghiri-Vijeh, Robin Coatsworth-Puspoky, Harish Ramesh, Arvin Shakibai, Willian Roger Dullius and Marcus Allan
Healthcare 2025, 13(13), 1533; https://doi.org/10.3390/healthcare13131533 - 27 Jun 2025
Viewed by 1790
Abstract
The literature details the healthcare needs of migrant people living with chronic illnesses and the consequent economic, social, and healthcare needs of their caregivers. Similarly, some studies have underscored the social and healthcare needs of 2SLGBTQIA+ (two-spirit, lesbian, gay, bisexual, transgender, queer, and [...] Read more.
The literature details the healthcare needs of migrant people living with chronic illnesses and the consequent economic, social, and healthcare needs of their caregivers. Similarly, some studies have underscored the social and healthcare needs of 2SLGBTQIA+ (two-spirit, lesbian, gay, bisexual, transgender, queer, and intersex individuals, including diverse sexual and gender identities under the “+” symbol) adults living with chronic illnesses and their caregivers. This narrative review presents the context of migrant 2SLGBTQIA+ unpaid caregivers and how their intersecting identities influence their caregiving roles for family members with chronic illnesses. In this article, caregivers are defined as family members or chosen families who provide unpaid support that may last for three months or longer for people living with chronic illnesses. Most studies and policies overlook 2SLGBTQIA+ migrants who are also unpaid caregivers of individuals living with chronic illnesses, leaving them unsupported through discrimination at the intersection of racism, homophobia, transphobia, ageism, and ableism, forcing them to remain vulnerable to increased emotional and physical strain. There is a presence of pervasive systemic barriers, including a lack of training and education among social and healthcare providers, about the needs of migrant 2SLGBTQIA+ unpaid caregivers. Additional challenges stem from inadequate policies and insufficient targeted resources, particularly for caregivers from marginalized racial and ethnic backgrounds. The findings of this study highlight the necessity for a call to action to address these gaps and improve support systems for these highly marginalized communities. Full article
(This article belongs to the Special Issue Impact of Social Connections on Well-Being of Older Adults)
17 pages, 1003 KB  
Review
Home Healthcare Among Aging Migrants: A Joanna Briggs Institute Scoping Review
by Areej Al-Hamad, Yasin M. Yasin, Lujain Yasin and Grace Jung
Healthcare 2025, 13(8), 863; https://doi.org/10.3390/healthcare13080863 - 10 Apr 2025
Cited by 8 | Viewed by 2843
Abstract
Background/Objectives: The aging migrant population faces unique healthcare challenges due to linguistic, cultural, and systemic barriers. Home healthcare services play a crucial role in supporting aging migrants, yet accessibility and effectiveness remain inconsistent across different healthcare systems. This scoping review examines the experiences [...] Read more.
Background/Objectives: The aging migrant population faces unique healthcare challenges due to linguistic, cultural, and systemic barriers. Home healthcare services play a crucial role in supporting aging migrants, yet accessibility and effectiveness remain inconsistent across different healthcare systems. This scoping review examines the experiences of aging migrants in home healthcare settings and explores the impact of these services on their health and well-being. This review aims to synthesize the existing literature on home healthcare experiences among aging migrants, highlighting the facilitators and barriers to effective service delivery and the implications for policy and practice. Method: A scoping review was conducted using the Joanna Briggs Institute (JBI) framework. A comprehensive search was performed across multiple databases, including CINAHL, Medline, and Scopus, for articles published between 2000 and 2024. Studies were selected based on predefined inclusion criteria focusing on home healthcare experiences among aging migrants. Data extraction and thematic analysis were conducted to identify key themes. Results: The review identified 35 studies across various geographical regions, highlighting four key themes: (1) Cultural and Linguistic Accessibility, (2) The Role of Informal Caregiving, (3) Structural and Systemic Challenges, and (4) Health Outcomes and Identity Preservation. The findings indicate that language barriers, cultural stigma, and systemic exclusion significantly hinder equitable access to home healthcare. Informal caregiving by family members remains a primary support mechanism, though it places considerable strain on caregivers. The lack of culturally competent healthcare services and inadequate policy frameworks exacerbate disparities in care. Conclusions: This review highlights the critical need for systemic reforms to improve healthcare accessibility for aging migrants. Policies must prioritize cultural competence training for healthcare providers, expand multilingual healthcare services, and integrate informal caregiving into formal support structures. Investment in community-driven healthcare initiatives and targeted outreach programs can help bridge existing service gaps. While home healthcare plays a vital role in supporting aging migrants, structural inequities and cultural barriers continue to hinder equitable access. Addressing these disparities requires comprehensive policy interventions, enhanced provider training, and culturally inclusive care models. Future research should explore innovative frameworks that incorporate culturally responsive practices to ensure effective and equitable home healthcare for aging migrant populations. Full article
(This article belongs to the Special Issue Impact of Social Connections on Well-Being of Older Adults)
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