Social Media engagement and perceived social isolation among older adults in a changing digital environment: evidence from HINTS 2022-2024.

Background: The rapid expansion of social media and emerging artificial intelligence (AI)-mediated digital environments has transformed how older adults communicate, access information, and engage with online communities. Social media platforms may provide opportunities for social connectedness and emotional support, particularly among older adults who face mobility limitations, retirement-related social changes, or reduced in-person interactions. At the same time, increased reliance on digital environments may also contribute to perceived social isolation through social comparison, exposure to misinformation, fragmented online interactions, or difficulties navigating evolving technologies. Despite growing interest in digital health and aging, limited research has examined the relationship between social media use and perceived social isolation among older adults during the emerging AI-enabled digital era. Objective: This study aimed to examine the association between social media engagement and PROMIS social isolation T-scores among U.S. adults aged 65 years and older, while accounting for sociodemographic characteristics, digital access-related factors, and survey cycle using nationally representative data from the Health Information National Trends Survey (HINTS) 2022 and 2024 cycles. The study also conducted exploratory interaction analyses by age and survey cycle to assess whether associations varied across older age and between HINTS cycles. Methods: This cross-sectional study utilized pooled nationally representative data from HINTS 7 cycles conducted in 2022 and 2024. The analytic sample included adults aged 65 years and older. Perceived social isolation was assessed using the PROMIS Social Isolation Scale T-score (PROMIS_Isolation_t), a validated composite measure of perceived social isolation derived from four survey items assessing feelings of isolation, exclusion, and social disconnection. Social media use was measured using self-reported engagement with social networking platforms. Survey-weighted descriptive statistics and multivariable regression analyses were conducted to evaluate the association between social media use and perceived social isolation while adjusting for age, sex, race/ethnicity, education, household income, and survey cycle. Results: Older adults who reported social media use demonstrated differing levels of perceived social isolation compared with nonusers. Social media engagement was positively associated with higher PROMIS social isolation T-scores after adjustment for age, sex, race/ethnicity, education, household income, and survey cycle. Higher household income was generally associated with lower PROMIS social isolation T-scores. Sensitivity analyses using binary social media engagement indicators showed consistent associations across engagement behaviors. Differences were particularly observed among individuals with lower educational attainment and limited digital literacy. Findings also suggested that the evolving AI-mediated digital environment may influence how older adults interact with online social platforms and perceive social connectedness. Discussion: The findings suggest that social media use among older adults may have both beneficial and adverse implications for perceived social isolation within the emerging AI-mediated digital environment. Social media platforms may facilitate communication, information exchange, and social participation, potentially reducing perceived social isolation for some older adults. However, unequal digital literacy, technological complexity, and potentially harmful online experiences may contribute to persistent or worsening perceptions of isolation among vulnerable populations. These findings highlight the importance of promoting digital inclusion and age-friendly online environments as part of broader healthy aging and public health strategies. Conclusion: Social media use is increasingly embedded within AI-mediated digital environments and may play an important role in shaping perceived social isolation among older adults in the United States. Public health interventions aimed at improving digital literacy, equitable technology access, and supportive online engagement may help reduce perceived social isolation and promote healthy aging among older populations.