Vol.:(0123456789) 1 3
Quality of Life Research (2020) 29:2375–2381
https://doi.org/10.1007/s11136-020-02493-7
Factors associated with social isolation in community‑dwelling older
adults: a cross‑sectional study
Reshma A. Merchant
1,3
· Shumei Germaine Liu
1
· Jia Yi Lim
3
· Xiaoxi Fu
1
· Yiong Huak Chan
2
Accepted: 26 March 2020 / Published online: 6 April 2020
© Springer Nature Switzerland AG 2020
Abstract
Purpose Social isolation in older adults is a major public health problem and associated with increased morbidity and mor-
tality. 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 infuence 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 signifcant association
with gait speed, cMMSE and EQ-VAS scores.
Keywords Social isolation · Older adults · Gait speed · Quality of life
Introduction
The world’s population is ageing especially in Asia where
the number of persons aged 60 years and older is grow-
ing faster than all younger age group [1]. Older adults aged
65 years and above in Singapore accounts for 13.7% of the
total population, and will double by 2030 [2]. Singapore is
ranked third in global life expectancy ranking [3]. Commu-
nities that facilitate healthy ageing in place are increasingly
relevant in meeting these needs, especially with a growing
trend of older adults preferring to live in their own homes
and communities, even if this means living alone [4, 5].
In addition to being healthy and enabling an individual to
age in place, strong social networks have a direct impact on
health and well-being, with studies showing an association
with increased quality of life [6] and a protective efect on
cognition and the development of dementia [7]. Conversely,
social isolation in older adults has been shown to increase
hospital readmission, disease morbidity and mortality rates
[8, 9]. It has been debated that efect of social isolation on
mortality is comparable to quitting smoking and exceeds
many well-known risk factors such as obesity and physi-
cal inactivity [10]. Older adults are particularly at risk for
Electronic supplementary material The online version of this
article (https://doi.org/10.1007/s11136-020-02493-7) contains
supplementary material, which is available to authorized users.
* Reshma A. Merchant
reshmaa@nuhs.edu.sg
1
Division of Geriatric Medicine, Department of Medicine,
National University Hospital, 1E Kent Ridge Road,
Singapore 119228, Singapore
2
Biostatistics Unit, Yong Loo Lin School of Medicine,
National University of Singapore, Singapore, Singapore
3
Department of Medicine, Yong Loo Lin School of Medicine,
National University of Singapore, Singapore, Singapore