The relationship between social anxiety and loneliness in older adults: a hierarchical regression and mediation analysis

Abstract

The global population of older adults is growing at an unprecedented rate and is projected to exceed 2.1 billion by 2050. This demographic transition has made addressing this group’s mental and social health challenges, including loneliness and social anxiety, an urgent global priority. This cross-sectional study included older adults aged ≥ 65 years who were referred to health centers affiliated with Kashan University of Medical Sciences from November 2024 to March 2025. Data collection was through face-to-face interviews utilizing standardized questionnaires, including Caballo’s Social Anxiety Questionnaire (SAQ-A30), De Jong Gierveld’s Loneliness Scale, Lubben’s Social Network Scale-6, and Zimet’s Multidimensional Scale of Perceived Social Support (MSPSS). A total of 279 individuals aged ≥ 65 were included. Descriptive statistics, correlation analysis, and parallel mediation analysis using Hayes’ PROCESS macro (Model 4) with 5,000 bootstrap methods were performed using SPSS version 22. A positive and significant association was observed between social anxiety and loneliness ( r = 0.30, P < 0.001). Both MSPSS ( r = − 0.47, P < 0.001) and social network ( r = − 0.33, P < 0.001) were negatively correlated with loneliness. In the hierarchical multiple regression analysis, social anxiety (β = 0.21, P < 0.001) and MSPSS (β = −0.35, P < 0.001) remained significant independent correlates of loneliness. In the parallel mediation analysis, neither the indirect effect through MSPSS nor the indirect effect through social network was statistically significant, as the bootstrap 95% confidence intervals for both indirect effects included zero. Social anxiety was significantly associated with loneliness among older adults; however, neither MSPSS nor social network appeared to mediate this association. These findings suggest that factors beyond social network characteristics and perceived support may contribute to loneliness associated with social anxiety. Future longitudinal studies are required to identify additional psychological and social mechanisms underlying this association.