The impact of social isolation on the health status and health-related quality of life of older people
- 6.8k Downloads
To investigate for socially isolated older people, and older people at risk of social isolation: (1) health status and health-related quality of life (HRQL); (2) the relationship between social isolation and health status/HRQL; (3) the relationship between two alternative measures of health status/HRQL.
Older people at risk of social isolation (n = 393) completed the EQ-5D and the SF-12. Multiple regression analyses were performed to examine the relationship between levels of social isolation and health status/HRQL, controlling for demographic/clinical characteristics. The agreement between EQ-5D and SF-6D (SF-12) scores was explored using descriptive psychometric techniques.
Health status and health state values were much lower than UK general population age-matched norms. After controlling for depression, physical co-morbidities, age, gender, living alone status, employment and accommodation, social isolation was significantly associated, to a degree that was clinically relevant, with EQ-5D DSI, SF-6D (SF-12) and SF-12 MCS scores. The potential for ceiling effects on the EQ-5D with this population was identified.
This work highlights the burden that social isolation may have on the health and well-being of older people. The potential HRQL gains from addressing social isolation may be considerable, with those at risk of social isolation also a key target group.
KeywordsAged Frail elderly Social isolation Health status Quality of life
We would like to acknowledge the input and collaboration of Devon County Council and the community mentoring teams across the study area, and the support and enthusiasm of the study participants.
- 1.Victor, C., Scrambler, S., & Bond, J. (2009). The social world of older people. Oxford: Oxford University Press.Google Scholar
- 2.Freyne, A., Fahy, S., McAleer, A., Keogh, F., & Wrigley, M. (2005). A longitudinal study of depression in old age 1: Outcome and relationship to social networks. Irish Journal of Psychological Medicine, 22(3), 87–93.Google Scholar
- 7.Barnes, M., Blom, A., Cox, K., Lessof, C., & Walker, A. (2006). The Social exclusion of older people: Evidence from the first wave of the English Longitudinal Study of Ageing (ELSA). Final Report. London: Office of the Deputy Prime Minister.Google Scholar
- 9.Department of Health. (2001). National service framework for older people. London: The Stationery Office.Google Scholar
- 10.Victor, C., Bowling, A., Bond, J., Scrambler, S. (2003). Loneliness, social isolation and living alone in later life. http://www.growingolder.group.shef.ac.uk/ChristinaVic_F17.pdf. Accessed October 28, 2009.
- 11.Department of Health. (2000). The NHS Plan: A plan for investment, a plan for reform. London: The Stationery Office.Google Scholar
- 12.Department of Health. (1998). Modernising social services. London: The Stationery Office.Google Scholar
- 14.Townsend, P. (1957). The family life of old people. London: Routledge & Kegan Paul.Google Scholar
- 15.Tunstall, J. (1966). Old and alone. A sociological study of old people. London: Routledge & Kegan Paul.Google Scholar
- 17.Kutner, B., Fanshel, D., Togo, A. M., & Langner, T. S. (1956). Five hundred over sixty: A community survey on aging. New York: Russell Sage Foundation.Google Scholar
- 18.Scharf, T., Phillipson, C., Smith, A., & Kingston, P. (2002). Growing older in socially deprived areas: Social exclusion in later life. London: Help the Aged.Google Scholar
- 19.Scharf, T., Phillipson, C., & Smith, A. E. (2004). Poverty and social exclusion–growing older in deprived urban neighbourhoods. In A. Walker & C. H. Hennessy (Eds.), Growing older: Quality of life in old age (pp. 81–106). Maidenhead: Open University Press.Google Scholar
- 20.Dickens, A., Richards, S., Hawton, A., Green, C., Taylor, R., Edwards, R., et al. (2009). Devon Ageing and Quality of Life Study: A report on the effectiveness and cost-effectiveness of community mentoring in Devon using mentoring clients’ outcomes. Exeter: Peninsula Medical School, Universities of Exeter and Plymouth.Google Scholar
- 21.Donald, C., & Ware, J. (1984). The measurement of social support. Research in Community and Mental Health, 4, 325–370.Google Scholar
- 23.Ware, J., Kosinski, M., & Keller, S. (1995). How to score the SF-12 physical and mental health summary scales. Boston: The Health Institute, New England Medical Center.Google Scholar
- 24.The EuroQol Group (1996). EQ-5D user guide. Rotterdam, Netherlands: The EuroQol Group.Google Scholar
- 28.D’ath, P., Katona, P., Mullan, E., Evans, S., & Katona, C. (1994). Screening, detection and management of depression in elderly primary care attenders. I: The Acceptability and Performance of the 15 Item Geriatric Depression Scale (GDS15) and the Development of Short Versions. Family Practice, 11(3), 260–266.CrossRefPubMedGoogle Scholar
- 29.Jongenelis, K., Pot, A., Eisses, A., Gerritsen, D., Derksen, M., Beekman, A., et al. (2005). Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients. International Journal of Geriatric Psychiatry, 20(11), 1067–1074.CrossRefPubMedGoogle Scholar
- 33.Kind, P., Hardman, G., Macran, S. (1999). UK population norms for EQ-5D. Discussion paper 172. University of York, Centre for Health Economics.Google Scholar
- 36.Koch, G. (1982). Intraclass correlation coefficient. In S. Kotz & N. Johnson (Eds.), Encyclopedia of statistical sciences (Vol. 4, pp. 213–217). New York: Wiley.Google Scholar
- 37.Altman, D. G., & Bland, J. M. (1983). Measurement in medicine: The analysis of method comparison studies. Journal of the Royal Statistical Society. Series D (The Statistician), 32(3), 307–317.Google Scholar
- 40.Marra, C. A., Woolcott, J. C., Kopec, J. A., Shojania, K., Offer, R., Brazier, J. E., et al. (2005). A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis. Social Science and Medicine, 60(7), 1571–1582.CrossRefPubMedGoogle Scholar
- 41.Brazier, J., Ratcliffe, J., Salomon, J. A., & Tsuchiya, A. (2007). Measuring and valuing health benefits for economic evaluation. Oxford: Oxford University Press.Google Scholar
- 43.Coast, J., Flynn, T., Grewal, I., Natarajan, L., Lewis, J., & Sprotson, K. (2006). Developing an index of capability for older people: A new form of measure for public health interventions?. Cambridge: Paper for the Future of Health Conference.Google Scholar
- 44.Office for National Statistics. Population estimates. http://www.statistics.gov.uk/cci/nugget.asp?ID=6. Accessed October 28, 2009.