As the aged population increases, attention to their issues and problems becomes more important [6]. Aging weakens physical and social functioning and increases dependence on others [28]. Older people with physical disabilities are more likely to be lonely and isolated due to lack of social relations and social support [29, 30]. People who are socially isolated are at higher risk for cardiovascular disease, stroke [14], depression [15] and premature death [17]. Given the growing population of the elderly especially in Iran, addressing the social needs and communication network of the elderly is important. Social isolation in the elderly depends on several individual and social factors; by evaluating and recognizing the factors affecting the social isolation of the elderly, more appropriate decisions and measures can be taken to improve the quality of life of the elderly. This study aims to determine the predictors of social isolation in the elderly living in Iran.

This descriptive cross-sectional study was conducted on 301 older people in Qazvin, Iran in 2019 who were selected by a cluster sampling method. For sampling, Qazvin was divided into three regions: north, south, and the center. In each regions, 2 parks, 2 mosques, one clinic and one comprehensive urban health center were randomly selected and samples from these settings were selected using a convenience sampling method. In the comprehensive urban health centers, those who had medical records available online were randomly selected. Inclusion criteria were age ≥60 years and ability to communicate verbally.
Data collections tools were a demographic/clinical checklist, Lubben Social Network Scale (LSNS), Multidimensional Scale of Perceived Social Support (MSPSS), World Health Organization Disability Assessment Schedule (WHODAS), 5-item World Health Organization Well-Being Index (WHO-5), and Pargament’s Religious Coping Questionnaire (Brief RCOPE). The LSNS has 12 items rated on a 5-point Likert scale from 0 to 5. Higher scores indicate less social isolation, while scores <20 indicate a serious risk of social isolation [30, 31]. After obtaining ethical approval (Code: IR.QUMS.REC.1398.091), and stating the objectives of the study to the participants and becoming assured of the confidentiality of personal information, they signed an informed consent form. Then, questionnaires were completed via interview. Data were analyzed using multivariate linear regression analysis.
 

Out of 301 participants, 74.4% (n=244) were male and 25.6% (n=77) were female. Their mean age was 68.63±7.31 years. Most of participants were married (63.8%, n=192) with lower than high school education (40.2%, n=121) and a history of chronic disease (52.5%, n=158). Their mean score of LSNS was 27.82±9.85 and 15.9% (n=48) were at serious risk for social isolation. Moreover, their mean scores of WHODAS, RCOPE, WHO-5, and MSPSS was 20.33±11.16, 19.30±4.71, 10.06±5.41 and 46.70±9.69, respectively.
According to the results in Table 1, the variables of social support (P<0.001), disability (P=0.018) and living with spouse and children (P= 0.010) had a significant effect on the social isolation of the elderly such that with the increase in social support (β= 0.333), decrease in disability (β= -0.137), and living with spouse and children (β= 0.154), the scores of social isolation were increased, indicating its improvement.


 

According to social network theory, social capital creates social relationships with the community and others, which increases social support and protects the person from mental illness as a shield [54]. According to Durkheim’s theory, the social relations of the individual increase the social support of the individual, and the increase of social support increases the mental health of the individual; as a result, it increases the sense of pleasure and happiness in life [55]. Therefore, community-based programs in day care centers, focusing on the family and their expansion, communication skills training, providing a suitable environment for receiving social support, and considering effective strategies to eliminate or reduce the impact of physical disabilities on daily life in the elderly can help them to prevent social isolation and rejection and thus increase their quality of life.

The study was approved by the Ethics Committee of Qazvin University of Medical Sciences, Qazvin ( Code: IR.QUMS.REC.1398.091). Before to filling out the questionnaires, older participants were assured of the confidentiality of the information obtained and written consent was obtained from all subjects. 

This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Conceptualization, methodology, research, review of drafts, editing and finalization of writing, review of references: Elahe Taghvaei, Mohammad Ali Soleimani and Seyedeh Ameneh Motalebi; Analysis: Maryam Mafi; Financing: Elahe Taghvaei; Project Management: Mohammad Ali Soleimani.

The authors declared no conflict of interest.

The authors would like to thank the Vice-Chancellor for Research of Qazvin University of Medical Sciences and all the elderly participated in the study for their support and cooperation.

 

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