Relationships between in-person and digital social interactions with family and friends and loneliness among older adults in Japan: A cross-sectional analysis of the 2024 JACSIS.

Background: This study examined how the frequency of in-person, telephone, text-based communication, and video interactions with non-cohabiting family and friends relates to loneliness among older adults in Japan. Methods: We analyzed data from 6,786 adults aged ≥65 in the 2024 JACSIS study. Interaction frequency with non-cohabiting family and friends was categorized into none (reference), monthly, and weekly or more. Loneliness was measured using the 3-item UCLA Loneliness Scale and dichotomized at ≥4, indicating loneliness; a ≥7 cut-off was used in sensitivity analyses. Logistic regression models adjusted for sociodemographic, lifestyle, and health-related factors. Results: For family, significant associations with lower loneliness were observed only at weekly frequencies (in-person: adjusted odds ratio [aOR] 0.764, 95% confidence interval [CI] 0.664-0.879; text: aOR 0.747, 95% CI 0.659-0.846; telephone: aOR 0.624, 95% CI 0.543-0.718), whereas for friends, significant associations were observed at monthly frequencies (in-person: aOR 0.621, 95% CI 0.549-0.701; text: aOR 0.881, 95% CI 0.778-0.997; telephone: aOR 0.734, 95% CI 0.659-0.819). Video calls were associated with lower odds of severe loneliness (score ≥7) in sensitivity analyses (weekly calls with family: aOR 0.736, 95% CI 0.547-0.991; monthly calls with friends: aOR 0.656, 95% CI 0.470-0.917). Conclusions: Interactions with friends show associations with lower levels of loneliness at lower frequencies than family contact. While text and phone calls are broadly associated with reduced loneliness, video calls demonstrate a notable link specifically with a lower prevalence of severe loneliness, underscoring the potential for tailored communication strategies.