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Digital technologies have enabled social connection during prolonged periods of physical distancing and travel restrictions throughout the COVID-19 pandemic. These solutions may exclude older adults, who are at higher risk for social isolation, loneliness, and severe outcomes if infected with SARS-CoV-2.
This study investigated factors associated with nonuse of social media or video communications to connect with friends and family among older adults during the pandemic’s first wave.
A web-based, cross-sectional survey was administered to members of a national retired educators’ organization based in Ontario, Canada, between May 6 and 19, 2020. Respondents (N=4879) were asked about their use of social networking websites or apps to communicate with friends and family, their internet connection and smartphone access, loneliness, and sociodemographic characteristics. Factors associated with nonuse were evaluated using multivariable logistic regression. A thematic analysis was performed on open-ended survey responses that described experiences with technology and virtual connection.
Overall, 15.4% (751/4868) of respondents did not use social networking websites or apps. After adjustment, male gender (odds ratio [OR] 1.60, 95% CI 1.33-1.92), advanced age (OR 1.88, 95% CI 1.38-2.55), living alone (OR 1.68, 95% CI 1.39-2.02), poorer health (OR 1.33, 95% CI 1.04-1.71), and lower social support (OR 1.44, 95% CI 1.20-1.71) increased the odds of nonuse. The reliability of internet connection and access to a smartphone also predicted nonuse. Many respondents viewed these technologies as beneficial, especially for maintaining pre–COVID-19 social contacts and routines, despite preferences for in-person connection.
Several factors including advanced age, living alone, and low social support increased the odds of nonuse of social media in older adults to communicate with friends and family during COVID-19’s first wave. Our findings identified socially vulnerable subgroups who may benefit from intervention (eg, improved access, digital literacy, and telephone outreach) to improve social connection.
Digital technologies have brought people together while maintaining physical distance during the novel COVID-19 pandemic [
Prior to the pandemic, research has shown that older adults of advanced age, men, those with lower household income and education, those living alone, those who are Black or Hispanic, or those with a disability are less likely to use the internet and health information technology [
We conducted a closed, web-based, and cross-sectional survey with members of a national retired educators’ organization (RTOERO) between May 6 and 19, 2020. More than three-quarters of the members (76.5%, 62,000/81,000) had registered an email address with the organization and were eligible to participate. Members were invited by email from RTOERO’s chief executive officer and sent reminders at 7 and 10 days. Study materials were provided in English and French. The questionnaire was co-designed and pretested with RTOERO leadership and included 32 questions that examined the impact of COVID-19 on daily life, loneliness, and the use of digital technologies for social connectivity [
Social media and video communication use was measured by asking “Do you use any social networking websites (eg, Facebook) or apps (eg, Zoom or FaceTime) to communicate with friends and family?” (yes/no). Respondents were also asked about their internet connection, smartphone access, loneliness, and sociodemographic characteristics including age, gender, ethnicity, language, living arrangement, self-perceived health status and location of residence (rural/urban). The questionnaire was pretested in English with 18 RTOERO board members and staff and French with 1 staff member for usability, technical functionality, clarity, flow, sensitive questions, and timing. The pretest results were not included in the final analysis. In the pretest, it took respondents on average 13 minutes to complete the survey (median: 14 minutes).
Surveys were only analyzed if the respondent clicked “Submit” and responded to more than 1 question. Nonusers of social media were compared to users through Pearson chi-square tests in univariable analyses on sociodemographic factors (age, gender, rurality, health status, and ethnicity), access factors (internet connection and smartphone access), and relational factors (living arrangement, loneliness, communication frequency, and social support). Corresponding adjusted associations were made using multivariable logistic regression including all covariates in the model. Survey questions on gender and ethnicity included “Prefer to self-identify” or “Prefer not to say” response options, which were collapsed into an “Other” category and retained in the regression analysis. Otherwise, respondents with missing (ie, don’t know or blank) covariate values were excluded from the model.
We conducted an inductive thematic analysis of free-text responses to 4 survey questions that included an open-ended response option; these questions asked respondents to describe feelings of loneliness, strategies they use to avoid feeling lonely, how RTOERO could support members, and if they had any other comments or suggestions. Responses were reviewed for descriptions of experiences with virtual connection and a set of 14 initial codes were generated by the analyst (SDN) and discussed with the study team. Themes were identified by examining patterns across the codes and were presented, along with illustrative quotations, to both the study team and RTOERO members for input and reflection.
Participation was voluntary, and informed consent was obtained electronically. The study was approved by the Research Ethics Board at Women’s College Hospital (#2020-0051-E) and reporting followed the Checklist for Reporting Results of Internet E-Surveys [
The survey completion rate among those who consented to participate was 88.8% (4891/5509). There were 12 respondents excluded who answered ≤1 question, leaving 4879 respondents in the final analysis. Most respondents were women (71%, 3421/4818), aged 65-79 years (67.4%, 3279/4863), White (91.6%, 4454/4861), and in good self-reported health (89.7%, 4370/4873;
A higher proportion of nonusers were men, aged ≥80 years, who lived alone and reported fair or poor health (
Within the open-ended response data, we identified 3 relevant themes: (1) the benefits of technology, (2) maintaining pre–COVID-19 social contacts and routines, and (3) virtual connection not being a substitute for in-person connection (
Characteristics of older women and men who were survey respondents, May 2020.
Characteristic | All respondents (N=4879), n (%) | Womena (n=3421), n (%) | Mena (n=1397), n (%) | ||||
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<65 | 1027 (21.1) | 846 (24.8) | 174 (12.5) | |||
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65-79 | 3279 (67.4) | 2295 (67.2) | 945 (67.7) | |||
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≥80 | 557 (11.5) | 275 (8.1) | 276 (19.8) | |||
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Lives alone | 1415 (29.7) | 1138 (33.9) | 266 (19.7) | |||
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Does not live alone | 3347 (70.3) | 2218 (66.1) | 1085 (80.3) | |||
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Urban | 3962 (83.4) | 2791 (83.4) | 1132 (83.6) | |||
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Rural | 751 (15.8) | 531 (15.9) | 209 (15.4) | |||
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Outside Canada | 39 (0.8) | 26 (0.8) | 13 (1) | |||
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Excellent or very good or good | 4370 (89.7) | 3082 (90.2) | 1238 (88.6) | |||
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Fair or poor | 492 (10.1) | 330 (9.7) | 154 (11) | |||
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Don’t Know | 11 (0.2) | 5 (0.2) | 5 (0.4) | |||
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White | 4454 (91.6) | 3153 (92.5) | 1264 (90.5) | |||
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Non-White | 269 (5.5) | 189 (5.5) | 76 (5.4) | |||
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Otherb | 138 (2.8) | 68 (2) | 57 (4.1) | |||
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Yes | 4113 (84.5) | 2983 (87.3) | 1090 (78.2) | |||
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No | 751 (15.4) | 434 (12.7) | 301 (21.6) | |||
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Don’t Know | 4 (0.1) | 1 (0) | 3 (0.2) |
a61 respondents did not identify their gender.
bIncludes respondents who selected either “Prefer to self-identify” or “Prefer not to say.”
Odds ratios for nonuse of social media or video communications in a sample of older Canadians, May 2020 (N=4526).
Characteristic | Social media use | Odds ratio | |||||
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Nonuser, n (%) | User, n (%) | Crude ORa (95% CI) | Adjusted OR (95% CI) | ||
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Men | 301 (41) | 1090 (26.8) | 1.90 (1.61-2.23) | 1.60 (1.33-1.92) | ||
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Women | 434 (59) | 2983 (73.2) | refb | ref | ||
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<65 | 103 (13.8) | 924 (22.5) | ref | ref | ||
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65-79 | 488 (65.2) | 2782 (67.8) | 1.57 (1.26-1.97) | 1.24 (0.98-1.57) | ||
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≥80 | 158 (21.1) | 396 (9.7) | 3.58 (2.72-4.71) | 1.88 (1.38-2.55) | ||
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Yes | 286 (39.2) | 1124 (28) | 1.55 (0.96-2.49) | 1.68 (1.39-2.02) | ||
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No | 443 (60.8) | 2896 (72) | ref | ref | ||
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Yes | 105 (14.5) | 646 (16.2) | 0.88 (0.70-1.10) | 0.90 (0.71-1.14) | ||
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No | 618 (85.5) | 3330 (83.8) | ref | ref | ||
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Excellent or very good or good | 633 (84.6) | 3725 (90.9) | ref | ref | ||
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Fair or poor | 115 (15.4) | 375 (9.1) | 1.81 (1.44-2.26) | 1.33 (1.04-1.71) | ||
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White | 41 (5.6) | 227 (5.7) | ref | ref | ||
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Non-White | 689 (94.4) | 3754 (94.3) | 0.98 (0.70-1.39) | 0.85 (0.59-1.22) | ||
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Very good or good | 647 (87.8) | 3709 (91) | ref | ref | ||
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Moderate or poor | 90 (12.2) | 369 (9) | 1.40 (1.09-1.79) | 1.39 (1.06-1.82) | ||
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Yes | 436 (58.5) | 3460 (84.4) | ref | ref | ||
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No | 309 (41.5) | 638 (15.6) | 3.84 (3.25-4.55) | 3.08 (2.58-3.69) | ||
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Always or often | 82 (11.3) | 321 (8) | 1.37 (1.05-1.78) | 1.05 (0.78-1.41) | ||
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Some of the time | 226 (31.1) | 1455 (36.2) | 0.83 (0.70-0.99) | 0.81 (0.67-0.98) | ||
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No | 419 (57.6) | 2246 (55.8) | ref | ref | ||
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High (≥3 times in past week) | 645 (86.1) | 3866 (94.2) | ref | ref | ||
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Low (0-2 times in past week) | 104 (13.9) | 236 (5.8) | 2.64 (2.07-3.38) | 2.01 (1.54-2.62) | ||
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Yes | 248 (33.4) | 1660 (40.6) | ref | ref | ||
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No | 494 (66.6) | 2432 (59.4) | 1.36 (1.15-1.60) | 1.44 (1.20-1.71) |
bOR: odds ratio.
aRef: reference category.
Themes and illustrative quotes based on free-text responses to the web-based survey, May 2020.
Theme | Description | Illustrative quotes |
Technology and virtual connection is beneficial for some older adults to stay connected | Considering the COVID-19 pandemic, some older adults have found using technology to stay connected virtually to be beneficial as they are unable to see people in person. They may be using technology for various activities, including, but not limited to, video calling, emailing, and messaging their friends and family. |
“Zoom, What’s App etc have been excellent platforms for keeping families connected across the globe and for maintaining local social activities such as card games, yoga, book clubs etc.” “I find I'm doing more emails and video-chats, especially with friends and relatives who live alone. Those communications benefit them and me, I feel.” “Zoom app has been very helpful, able to see my mom, family members and girlfriends.” |
Technology and virtual connection has allowed for some older adults to maintain connections and help to enable their routine | The internet has allowed for older adults to shift their regular activities to the web to facilitate social interactions. Some of those who were previously engaged in various activities with others were able to continue this engagement virtually during the pandemic. In this sense, the move to web-based activities is assisting in maintaining existing relationships and social connections. The theme of routine and regularity was also discussed as older adults indicated activities occurring a certain number of times a week or having scheduled calls with friends and family. |
“My book club, my walking group, my outdoor club and my monthly lunch friends now meet on Zoom.” “Virtual Storytelling on-line events 3 times per week; Church groups three time per week; Book club once a week; weekly family gatherings online; daily work with political social justice groups; long walks in nature; great friends; lots of exercise scheduled at the same time daily” “I participate in a virtual exercise class twice a week, virtual bridge club twice a week and Facetime chats twice a week. Family zoom calls periodically. I text a friend that I am coming by and walk past her house and wave and talk through an open window.” |
Technology and virtual connection is not a replacement for social interaction | Although technology and virtual connection has been positive for some, there is still critiques that it is not the same as or a replacement for in-person interactions. Respondents indicated that although they are using virtual connection or technology to stay connected now, they still long for that in-person interaction and connection. |
“Although I've connected with family and friends by telephone, it isn't the same as face to face” “Virtual book club however human closeness and touching (i.e. hugs) is imperative for high quality living” “I try to reach out via social media to my best friend daily. I phone family members who are not on social media. However, regardless of the advances of social media, nothing will ever replace face-to-face contact or the human touch.” |
Women described how technology allowed them to shift their regular activities to the web to maintain pre—COVID-19 routines: “
Despite this, some respondents acknowledged the limitations of these technologies, still longing for in-person interaction: “
In a survey of 4879 older retirees of the education sector, we found that 1 in 7 were not using social networking websites or apps to communicate with friends and family early in the COVID-19 pandemic. We identified several characteristics associated with an increased likelihood of nonuse including male gender, advanced age, living alone, poorer health, poor internet connection, a lack of smartphone access, and lower social support. Our findings are consistent with studies of technology use in older adults, which similarly show that advanced age, male gender, being unmarried, and poorer self-reported health are important predictors of nonuse and telemedicine unreadiness [
We found that sentiments toward technology use during the early weeks of the pandemic were mostly positive, with respondents describing how technology facilitated social connections, allowed them to maintain routines, or helped them adjust to a new way of life. Qualitative studies on the experiences of older adults during the pandemic’s first wave report similar findings, with technology being described as having a facilitative role in allowing older adults to engage in the things that matter most to them despite ongoing restrictions [
Loneliness and social isolation are top concerns of older adults during the COVID-19 pandemic [
Despite its benefits, technology-based solutions are not a panacea for social connection. In our study and others [
These findings underscore that the value of in-person and offline connections cannot be forgotten. Weekly telephone call interventions with volunteers have shown benefit to both older adults living in long-term care [
Our study has several limitations. Our study is based on a convenience sample of community-dwelling, retired educators who had internet access. Due to this sample, the prevalence of social media use was likely overestimated in our study. Estimates of social media use by older adults during the pandemic for social connection are wide-ranging (eg, 37% to 80% based on surveys using similar methodologies conducted during the first wave in the United States and Canada) [
Among a sample of retired educators with internet access, we found that male gender, advanced age, living alone, poorer health, and lower social support increased the odds of nonuse of social media to communicate with friends and family during the first wave of the COVID-19 pandemic. The reliability of internet connection and smartphone access also predicted nonuse. Strategies to improve the uptake of digital technologies for social connection must address structural barriers to accessing technology and build digital literacy among older adults. Complementary approaches, such as telephone outreach, are also needed to improve social connection without further excluding older adults who remain offline.
Characteristics of social media users and nonusers, stratified by gender, May 2020.
odds ratio
The study authors thank RTOERO staff who assisted in the survey and the members who completed the survey. PAR is the RTOERO Chair in Geriatric Medicine at the University of Toronto. RDS, VG, and PAR received funding from the Canadian Institutes of Health Research to investigate the burden and health system impact of loneliness in older adults (PJT162221).
None declared.