The asymmetric effect of social connection and the cumulative damage of comorbidities on physical and mental health of older Virginians.

OBJECTIVES

This study explored relationships of social connection with physical and mental health in older adults, specifically examining the effects of comorbidities on these relationships and the influence of sociodemographic variables on the strength of these associations.

METHODS

This cross-sectional study enrolled 174 community-dwelling adults aged 60 years and older residing in Hampton Roads, Virginia, USA. Data were collected from April to August 2025. Hierarchical linear regression analyses examined the associations of social connection with physical and mental health. Moderated mediation analysis examined if comorbidities mediated these relationships and whether sociodemographic factors moderate the strengths of these associations.

RESULTS

In hierarchical linear regression models, comorbidity burden was significantly associated with poorer mental and physical health, explaining an additional 3% and 10% of the variance, respectively, beyond sociodemographic factors. Moderated mediation analysis revealed social connection had an indirect effect on mental health, where social connection was associated with higher comorbidities, which in turn was associated with poorer mental health, among Black relative to White participants (b = -0.80, 95% CI = -1.85, -0.02).

CONCLUSION

A conditional indirect pathway linked social connection to mental health through comorbidity burden among Black older adults, though the incremental contribution of social connection was minimal.