To explore the factors associated with social isolation among older people using the data from Building Knowledge Base on Population Ageing in India (BKPAI) survey.
Methods:
Multiple logistic regression and classification and regression tree (CART) analysis were used to identify the factors associated with social isolation using data from BKPAI survey. An individual was regarded as socially isolated if the response was “never” to all 4 activities in the last 12 months: (1) attending public meeting, (2) attending any group/club/organizational meeting, (3) attending any religious program, and (4) visiting friends or relatives.
Results:
Among 9836 older people, 19.7% were observed to be socially isolated. From multiple logistic regression, age (odds ratio [OR] = 1.85 for age 80 to 89 years and OR = 2.67 for age ≥90), religion (OR = 0.54 for Christians compared to Hindus), duration of stay in current home (OR = 0.64 for 6-10 years compared to >10 years of stay), number of activities of daily living (ADLs) for which the assistance was needed (OR = 2.09 for 1 or 2, OR = 3.14 for 3 or 4, and OR = 12.05 for 5 or 6), and Alzheimer's disease (OR = 1.65) were identified as factors associated with social isolation. Number of ADL for which the assistance was needed and self-reported health status were the factors identified through CART analysis.
Discussion:
Requiring help in performing ADL, advancing age, and Alzheimer's disease were the likely factors for socially isolation among elderly patients in this surveyed population.
Office of the Registrar General and Census Commissioner, Ministry of Home Affairs, Government of India. C-13 Single Year Age Returns by Residence and Sex. 2018. http://www.censusindia.gov.in/2011census/C-series/C-13.html. Updated July 4, 2018. Accessed July 15, 2018.
HolmesWRJosephJ. Social participation and healthy ageing: a neglected, significant protective factor for chronic non communicable conditions. Global Health. 2011;7(1):43. doi:10.1186/1744-8603-7-43.
5.
ManeAB. Ageing in India: some social challenges to elderly care. J Gerontol Geriatr Res. 2016;5(2):e136. doi:10.4172/2167-7182.1000e136.
AlspachJG. Loneliness and social isolation: risk factors long overdue for surveillance. Crit Care Nurse. 2013;33(6):8–13. doi:10.4037/ccn2013377.
9.
KaurHSainiS. Assessment of the extent of social isolation amongst the aged for various dimensions of social isolation. Anthropologist. 2011;13(2):137–146. doi:10.1080/09720073.2011.11891189.
ShankarAMc MunnABanksJSteptoeA. Loneliness, social isolation, and behavioral and biological health indicators in older adults. Health Psychol. 2011;30(4):377–385. doi:10.1037/a0022826.
12.
ValtortaNKKanaanMGilbodyS. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart. 2016;102(13):1009–1016. doi:10.1136/heartjnl-2015-308790.
13.
Holt-LunstadJSmithTBBakerM. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015;10(2):227–237. doi:10.1177/1745691614568352.
14.
SteptoeAShankarADemakakosPWardleJ. Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci U S A. 2013;110(15):5797–801. doi:10.1073/pnas.1219686110.
MapomaCCMasaitiG. Social isolation and aging in Zambia: examining the possible predictors. J Aging Res. 2012;2012:537467. doi:10.1155/2012/537467.
19.
SkirbekkVJamesKS. Abuse against elderly in India-the role of education. BMC Public Health. 2014;14:336. doi:10.1186/1471-2458-14-336.
20.
MerkleECShafferVA. Binary recursive partitioning: background, methods, and application to psychology. Br J Math Stat Psychol. 2011;64(1):161–181. doi:10.1348/000711010x503129.
21.
KoonSPetscherY. Comparing Methodologies for Developing an Early Warning System: Classification and Regression Tree Model versus Logistic Regression (REL 2015–077). Washington, DC: US Department of Education, Institute of Education Sciences, National Center for Education Evaluation and Regional Assistance, Regional Educational Laboratory Southeast; 2015. https://files.eric.ed.gov/fulltext/ED554441.pdf. Accessed May 25, 2018.
22.
MontgomeryDCPeckEAViningGG. Introduction to Linear Regression Analysis. 3rd ed. New York, NY: John Wiley & Sons Inc; 2001.
23.
HosmerDWLemeshowS. Applied Logistic Regression. 2nd ed. New York, NY: John Wiley & Sons Inc; 2000.
24.
BhattiABHaqAu. The pathophysiology of perceived social isolation: effects on health and mortality. Cureus. 2017;9(1):e994. doi:10.7759/cureus.994.
25.
PantellMRehkopfDJutteD. Social isolation: a predictor of mortality comparable to traditional clinical risk factors. Am J Public Health. 2013;103(11):2056–2062. doi:10.2105/AJPH.2013.301261.
Wright-St ClairVANevilleSForsythV. Integrative review of older adult loneliness and social isolation in Aotearoa/New Zealand. Australas J Ageing. 2017;36(2):114–123. doi:10.1111/ajag.12379.
29.
KobayashiKMCloutier-FisherDRothM. Making meaningful connections: a profile of social isolation and health among older adults in small town and small city, British Columbia. J Aging Health. 2009;21(2):374–397. doi:10.1177/0898264308329022.
MelchiorreMGChiattiCLamuraG. Social support, socio-economic status, health and abuse among older people in seven European countries. PloS One. 2013;8(1):e54856. doi:10.1371/journal.pone.0054856.
BachrachCA. Childlessness and social isolation among the elderly. J Marriage Fam. 1980;42(3):627–637. doi:10.2307/351906.
34.
HinzeyAGaudier-DiazMMLustbergMBDeVriesAC. Breast cancer and social environment: getting by with a little help from our friends. Breast Cancer Res. 2016;18(1):54. doi:10.1186/s13058-016-0700-x.
35.
McGeoughAEdwardsJChamberlainRMNogeireC. Social isolation in lung cancer patients. Soc Work Health Care. 1980;5(4):433–436. doi:10.1300/J010v05n04_08.
Fleisch MarcusAIllescasAHHohlBCLlanosAA. Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults. PloS One. 2017;12(3):e0173370. doi:10.1371/journal. pone.0173370.
38.
CornwellBSchummLPLaumannEOGraberJ. Social networks in the NSHAP Study: rationale, measurement, and preliminary findings. J Gerontol B Psychol Sci Soc Sci. 2009;64(suppl 1):I47–I55. doi:10.1371/journal. pone.0173370.
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