COVID-19 Research Paper Volume 14, Issue 6 pp 2462—2474

Association between social isolation and reduced mental well-being in Swedish older adults during the first wave of the COVID-19 pandemic: the role of cardiometabolic diseases

Abigail Dove1, *, , Jie Guo1, *, , Amaia Calderón-Larrañaga1, , Davide Liborio Vetrano1, , Laura Fratiglioni1,2, , Weili Xu1, ,

  • 1 Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
  • 2 Stockholm Gerontology Research Center, Stockholm, Sweden
* Equal contribution

Received: December 28, 2021       Accepted: March 9, 2022       Published: March 16, 2022
How to Cite

Copyright: © 2022 Dove et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Social isolation has been recommended as a strategy for reducing COVID-19 risk, but it may have unintended consequences for mental well-being. We explored the relationship between social isolation and symptoms of depression and anxiety in older adults during the first wave of the COVID-19 pandemic and assessed the role of cardiometabolic diseases (CMDs) in this association. Between May and September 2020, 1,190 older adults from the Swedish National Study on Aging and Care in Kungsholmen were surveyed about their behaviors and health consequences during the first wave of the COVID-19 pandemic. In total, 913 (76.7%) participants reported socially isolating at home to avoid infection during this period. Social isolation was associated with a greater likelihood of reduced mental well-being (i.e., feelings of depression or anxiety) (OR: 1.74, 95% CI: 1.15-2.65). In joint exposure analysis, there was a significant likelihood of reduced mental well-being only among people who were socially isolating and had CMDs (OR: 2.13, 95% CI: 1.22-3.71) (reference: not isolating, CMD-free). In conclusion, social isolation as a COVID-19 prevention strategy was related to reduced mental well-being in an urban sample of Swedish older adults, especially among individuals with CMDs.


CI: confidence interval; CMDs: cardiometabolic diseases; COVID-19: coronavirus disease 2019; CVD: cardiovascular disease; ICD-10: International Classification of Disease, 10th version; MADRS: Montgomery-Asberg Depression Rating Scale; NPR: National Patient Registry; OR: odds ratio; SNAC-K: Swedish National Study on Aging and Care in Kungsholmen; T2D: type 2 diabetes.