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Factors associated with social isolation in community-dwelling older adults: a cross-sectional study

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Abstract

Purpose

Social isolation in older adults is a major public health problem and associated with increased morbidity and mortality. There are limited data on the association between social isolation and physical function including gait speed. Hence, this study is to determine the prevalence of social isolation and its association with gait speed, frailty, cognition, depression and comorbidities amongst community-dwelling older adults.

Methods

Social isolation, depression, frailty and perceived general health were assessed using 6-item Lubben Social Network Scale (LSNS-6), Geriatric Depression Scale (GDS), FRAIL scale and EuroQol EQ-5D-5L questionnaire which includes EQ Visual Analogue Scale (EQ-VAS), respectively. Cognition was assessed using the Chinese Mini Mental State Examination (cMMSE), while physical performance test included gait speed and short physical performance battery test. Binary logistic regression was performed to determine the influence of socio-demographic, medical, functional and cognitive variables on social isolation.

Results

Out of 202 participants, 27.7% were robust, 66.8% of participants were pre-frail, and 5.4% of participants were frail. Almost half (45.5%, n = 92) of the participants were found to be at risk of social isolation. A poor social network was negatively associated with mean gait speed (OR = 0.674, CI 0.464–0.979, p = 0.039), EQ-VAS (OR = 0.561, CI 0.390–0.806, p < 0.01) and cMMSE (OR = 0.630, 95% CI 0.413–0.960, p = 0.032).

Conclusion

Almost half of older adults in the community are at risk of social isolation with a very significant association with gait speed, cMMSE and EQ-VAS scores.

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References

  1. World Population Ageing Report: United Nation. (2015). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Report.pdf. Accessed 21 October 2019.

  2. Singapore Department of Statistics. (2018).

  3. Institute for Health Metrics and Evaluation. (2018).

  4. WHO | Global health and ageing. (2011). https://www.who.int/ageing/publications/global_health.pdf?ua=1. Accessed 21 October 2019.

  5. WHO | World report on ageing and health. (2015). https://apps.who.int/iris/bitstream/handle/10665/186463/9789240694811_eng.pdf?sequence=1. Accessed 21 October 2019.

  6. Robins, L. M., Brown, T., Lalor, A. F., Stolwyk, R., McDermott, F., & Haines, T. (2018). Social isolation, physical capacity, and physical activity in older community-dwelling adults post-hospitalization. Journal of Aging and Physical Activity, 26(2), 204–213.

    PubMed  Google Scholar 

  7. Crooks, V. C., Lubben, J., Petitti, D. B., Little, D., & Chiu, V. (2008). Social network, cognitive function, and dementia incidence among elderly women. American Journal of Public Health, 98(7), 1221–1227.

    PubMed  PubMed Central  Google Scholar 

  8. Lee, D. A., Williams, C., Lalor, A. F., Brown, T., & Haines, T. P. (2018). Hospital readmission risks in older adults following inpatient subacute care: A six-month follow-up study. Archives of Gerontology and Geriatrics, 77, 142–149.

    PubMed  Google Scholar 

  9. Nicholson, N. R. (2012). A review of social isolation: An important but underassessed condition in older adults. Journal of Prime and Prevention, 33(2–3), 137–152.

    Google Scholar 

  10. Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7(7), e1000316.

    PubMed  PubMed Central  Google Scholar 

  11. Gardiner, P. A., Mishra, G. D., & Dobson, A. J. (2015). Validity and responsiveness of the FRAIL scale in a longitudinal cohort study of older Australian women. J Am Med Dir Assoc, 16(9), 781–783.

    PubMed  Google Scholar 

  12. International Federation on Ageing (IFA). (2012). Current and emerging issues facing older Canadians.

  13. WHO. (2007). Global age-friendly cities: A guide. https://www.who.int/ageing/publications/Global_age_friendly_cities_Guide_English.pdf. Accessed 21 October 2019.

  14. Beutel, M. E., Klein, E. M., Brähler, E., Reiner, I., Jünger, C., Michal, M., et al. (2017). Loneliness in the general population: Prevalence, determinants and relations to mental health. BMC Psychiatry, 17(1), 97.

    PubMed  PubMed Central  Google Scholar 

  15. Ibrahim, R., Abolfathi Momtaz, Y., & Hamid, T. A. (2013). Social isolation in older Malaysians: Prevalence and risk factors. Psychogeriatrics, 13(2), 71–79.

    PubMed  Google Scholar 

  16. Kemperman, A., van den Berg, P., Weijs-Perree, M., & Uijtdewillegen, K. (2019). Loneliness of older adults: Social network and the living environment. International Journal on Environmental Research and Public Health, 16(3), E406.

    Google Scholar 

  17. Cudjoe, T. K. M., Roth, D. L., Szanton, S. L., Wolff, J. L., Boyd, C. M., & Thorpe, R. J. (2018). The epidemiology of social isolation: National Health & Aging Trends Study. Journal of Gerontology B. https://doi.org/10.1093/geronb/gby037.

    Article  Google Scholar 

  18. Dickens, A. P., Richards, S. H., Greaves, C. J., & Campbell, J. L. (2011). Interventions targeting social isolation in older people: A systematic review. BMC Public Health, 11, 647.

    PubMed  PubMed Central  Google Scholar 

  19. Bien, B., & Bien-Barkowska, K. (2016). Objective drivers of subjective well-being in geriatric inpatients: mobility function and level of education are general predictors of self-evaluated health, feeling of loneliness, and severity of depression symptoms. Quality of Life Research, 25(12), 3047–3056.

    PubMed  PubMed Central  Google Scholar 

  20. Chatters, L. M., Taylor, H. O., Nicklett, E. J., & Taylor, R. J. (2018). Correlates of objective social isolation from family and friends among older adults. Healthcare (Basel), 6(1), E24.

    Google Scholar 

  21. Aartsen, M. J., van Tilburg, T., Smits, C. H. M., & Knipscheer, K. C. P. M. (2004). A longitudinal study of the impact of physical and cognitive decline on the personal network in old age. Journal of Social and Personal Relationship, 21(2), 249–266.

    Google Scholar 

  22. Evans, I. E. M., Martyr, A., Collins, R., Brayne, C., & Clare, L. (2019). Social isolation and cognitive function in later life: A systematic review and meta-analysis. Journal of Alzheimers Disease, 70(s1), S119–s144.

    Google Scholar 

  23. Hortobagyi, T., Lesinski, M., Gabler, M., VanSwearingen, J. M., Malatesta, D., & Granacher, U. (2015). Effects of three types of exercise interventions on healthy old adults' gait speed: A systematic review and meta-analysis. Sports Medicine (Auckland, N. Z.), 45(12), 1627–1643.

    Google Scholar 

  24. Morley, J. E., Malmstrom, T. K., & Miller, D. K. (2012). A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. Journal of Nutrition and Health Aging, 16(7), 601–608.

    CAS  Google Scholar 

  25. Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9(3), 179–186.

    CAS  PubMed  Google Scholar 

  26. Brooks, R. (1996). EuroQol: The current state of play. Health Policy, 37(1), 53–72.

    CAS  PubMed  Google Scholar 

  27. Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., et al. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 1727–1736.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Janssen, M. F., Pickard, A. S., Golicki, D., Gudex, C., Niewada, M., Scalone, L., et al. (2013). Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: A multi-country study. Quality of Life Research, 22(7), 1717–1727.

    CAS  PubMed  Google Scholar 

  29. Woo, J., Yu, R., Wong, M., Yeung, F., Wong, M., & Lum, C. (2015). Frailty screening in the community using the FRAIL scale. Journal of American Medical Directors Association, 16(5), 412–419.

    Google Scholar 

  30. Merchant, R. A., Chen, M. Z., Tan, L. W. L., Lim, M. Y., Ho, H. K., & van Dam, R. M. (2017). Singapore Healthy Older People Everyday (HOPE) study: Prevalence of frailty and associated factors in older adults. Journal of American Medical Directors Association, 18(8), 734.e739–734.e714.

    Google Scholar 

  31. Woo, J., Leung, J., & Morley, J. E. (2012). Comparison of frailty indicators based on clinical phenotype and the multiple deficit approach in predicting mortality and physical limitation. Journal of the American Geriatrics Society, 60(8), 1478–1486.

    PubMed  Google Scholar 

  32. Donoghue, O. A., Setti, A., O'Leary, N., & Kenny, R. A. (2017). Self-reported unsteadiness predicts fear of falling, activity restriction, falls, and disability. Journal of American Medical Directors Association, 18(7), 597–602.

    Google Scholar 

  33. Lubben, J., Blozik, E., Gillmann, G., Iliffe, S., von Renteln Kruse, W., Beck, J. C., et al. (2006). Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. Gerontologist, 46(4), 503–513.

    PubMed  Google Scholar 

  34. Shou, J., Du, Z., Wang, H., Ren, L., Liu, Y., & Zhu, S. (2018). Quality of life and its contributing factors in an elderly community-dwelling population in Shanghai, China. Psychogeriatrics, 18(2), 89–97.

    PubMed  Google Scholar 

  35. Zhong, B. L., Liu, X. J., Chen, W. C., Chiu, H. F., & Conwell, Y. (2018). Loneliness in Chinese older adults in primary care: Prevalence and correlates. Psychogeriatrics, 18(5), 334–342.

    PubMed  Google Scholar 

  36. Nyqvist, F., Cattan, M., Conradsson, M., Nasman, M., & Gustafsson, Y. (2017). Prevalence of loneliness over ten years among the oldest old. Scandinavian Journal of Public Health, 45(4), 411–418.

    PubMed  Google Scholar 

  37. Holmen, K., & Furukawa, H. (2002). Loneliness, health and social network among elderly people: A follow-up study. Archives of Gerontology and Geriatrics, 35(3), 261–274.

    PubMed  Google Scholar 

  38. Peel, N. M. (2018). Gait speed as a measure in geriatric assessment in clinical settings: A systematic review. The Journals of Gerontology: Series A, 68(1), 39–46.

    Google Scholar 

  39. Studenski, S., Perera, S., Patel, K., Rosano, C., Faulkner, K., Inzitari, M., et al. (2011). Gait speed and survival in older adults. JAMA, 305(1), 50–58.

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Dent, E., Morley, J. E., Cruz-Jentoft, A. J., Arai, H., Kritchevsky, S. B., Guralnik, J., et al. (2018). International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, diagnosis and management. Journal of Nutrition and Health Aging, 22(10), 1148–1161.

    CAS  Google Scholar 

  41. Middleton, A., Fritz, S. L., & Lusardi, M. (2015). Walking speed: The functional vital sign. Journal of Aging and Physical Activity, 23(2), 314–322.

    PubMed  Google Scholar 

  42. Shankar, A., McMunn, A., Demakakos, P., Hamer, M., & Steptoe, A. (2017). Social isolation and loneliness: Prospective associations with functional status in older adults. Health Psychology, 36(2), 179–187.

    PubMed  Google Scholar 

  43. Gale, C. R., Westbury, L., & Cooper, C. (2018). Social isolation and loneliness as risk factors for the progression of frailty: The English Longitudinal Study of Ageing. Age and Ageing, 47(3), 392–397.

    PubMed  Google Scholar 

  44. Martina, C. M., & Stevens, N. L. (2006). Breaking the cycle of loneliness? Psychological effects of a friendship enrichment program for older women. Aging and Mental Health, 10(5), 467–475.

    CAS  PubMed  Google Scholar 

  45. Courtin, E., & Knapp, M. (2017). Social isolation, loneliness and health in old age: A scoping review. Health and Social Care in the Community, 25(3), 799–812.

    PubMed  Google Scholar 

  46. Franck, L., Molyneux, N., & Parkinson, L. (2016). Systematic review of interventions addressing social isolation and depression in aged care clients. Quality of Life Research, 25(6), 1395–1407.

    PubMed  Google Scholar 

  47. Chipps, J., Jarvis, M. A., & Ramlall, S. (2017). The effectiveness of e-Interventions on reducing social isolation in older persons: A systematic review of systematic reviews. Journal of Telemedicine and Telecare, 23(10), 817–827.

    PubMed  Google Scholar 

  48. Poscia, A., Stojanovic, J., La Milia, D. I., Duplaga, M., Grysztar, M., Moscato, U., et al. (2018). Interventions targeting loneliness and social isolation among the older people: An update systematic review. Experimental Gerontology, 102, 133–144.

    PubMed  Google Scholar 

  49. Brady, S., D'Ambrosio, L. A., Felts, A., Rula, E. Y., Kell, K. P., & Coughlin, J. F. (2018). Reducing isolation and loneliness through membership in a fitness program for older adults: Implications for health. Journal of Applied Gerontology, 39, 301.

    PubMed  PubMed Central  Google Scholar 

  50. Syed, M. A., McDonald, L., Smirle, C., Lau, K., Mirza, R. M., & Hitzig, S. L. (2017). Social isolation in Chinese older adults: Scoping review for age-friendly community planning. Canadian Journal of Aging, 36(2), 223–245.

    Google Scholar 

  51. Sander, R. (2005). Preventing social isolation and loneliness among older people: A systematic review of health promotion interventions. Nursing Older People, 17(1), 40.

    PubMed  Google Scholar 

  52. Simon, M. A., Chang, E. S., Zhang, M., Ruan, J., & Dong, X. (2014). The prevalence of loneliness among U.S. Chinese older adults. Journal of Aging Health, 26(7), 1172–1188.

    PubMed  Google Scholar 

  53. Cantarero-Prieto, D., Pascual-Saez, M., & Blazquez-Fernandez, C. (2018). Social isolation and multiple chronic diseases after age 50: A European macro-regional analysis. PLoS ONE, 13(10), e0205062.

    PubMed  PubMed Central  Google Scholar 

  54. DiNapoli, E. A., Wu, B., & Scogin, F. (2014). Social isolation and cognitive function in Appalachian older adults. Research on Aging, 36(2), 161–179.

    PubMed  Google Scholar 

  55. Bassuk, S. S., Glass, T. A., & Berkman, L. F. (1999). Social disengagement and incident cognitive decline in community-dwelling elderly persons. Annals of Internal Medicine, 131(3), 165–173.

    CAS  PubMed  Google Scholar 

  56. Verghese, J., Annweiler, C., Ayers, E., Barzilai, N., Beauchet, O., Bennett, D. A., et al. (2014). Motoric cognitive risk syndrome: Multicountry prevalence and dementia risk. Neurology, 83(8), 718–726.

    PubMed  PubMed Central  Google Scholar 

  57. Subramaniam, M., Abdin, E., Sambasivam, R., Vaingankar, J. A., Picco, L., Pang, S., et al. (2016). Prevalence of depression among older adults-results from the well-being of the Singapore Elderly Study. Annals of the Academy of Medicine, Singapore, 45(4), 123–133.

    PubMed  Google Scholar 

  58. Glass, T. A., De Leon, C. F., Bassuk, S. S., & Berkman, L. F. (2006). Social engagement and depressive symptoms in late life: Longitudinal findings. Journal of Aging Health, 18(4), 604–628.

    PubMed  Google Scholar 

  59. Choi, H., Irwin, M. R., & Cho, H. J. (2015). Impact of social isolation on behavioral health in elderly: Systematic review. World Journal of Psychiatry, 5(4), 432–438.

    PubMed  PubMed Central  Google Scholar 

  60. Taylor, R. J., Taylor, H. O., & Chatters, L. M. (2016). Social isolation from extended family members and friends among African Americans: Findings from a National Survey. Journal of Family Social Work, 19(5), 443–461.

    PubMed  PubMed Central  Google Scholar 

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Funding

Ministry of Health, Singapore.

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Authors and Affiliations

  1. Division of Geriatric Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore, 119228, Singapore

    Reshma A. Merchant, Shumei Germaine Liu & Xiaoxi Fu

  2. Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Yiong Huak Chan

  3. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Reshma A. Merchant & Jia Yi Lim

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  1. Reshma A. Merchant
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Merchant, R.A., Liu, S.G., Lim, J.Y. et al. Factors associated with social isolation in community-dwelling older adults: a cross-sectional study. Qual Life Res 29, 2375–2381 (2020). https://doi.org/10.1007/s11136-020-02493-7

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