Skip to main content

Advertisement

Log in

The impact of social isolation on the health status and health-related quality of life of older people

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  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 

  3. Seeman, T. E. (2000). Health promoting effects of friends and family on health outcomes in older adults. American Journal of Health Promotion, 14(6), 362–370.

    CAS  PubMed  Google Scholar 

  4. MuCulloch, A. (2001). Social environments and health: Cross sectional national survey. BMJ, 323, 208–209.

    Article  Google Scholar 

  5. Berkman, L. (1995). The role of social relations in health promotion. Psychosomatic Medicine, 57(3), 245–254.

    CAS  PubMed  Google Scholar 

  6. Alpass, F. M., & Neville, S. (2003). Loneliness, health and depression in older males. Aging & Mental Health, 7(3), 212–216.

    Article  CAS  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 

  8. Victor, C., & Scrambler, S. (2000). Being alone in later life: Loneliness, social isolation and living alone. Reviews in Clinical Gerontology, 10, 407–417.

    Article  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 

  13. de Belvis, A. G., Avolio, M., Sicuro, L., Rosano, A., Latini, E., Damiani, G., et al. (2008). Social relationships and HRQL: A cross-sectional survey among older Italian adults. BMC Public Health, 8, 348.

    Article  PubMed  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 

  16. Wenger, G. C., & Burholt, V. (2004). Changes in levels of social isolation and loneliness among older people in a rural area–a 20-year longitudinal study. Canadian Journal on Aging, 23(2), 115–127.

    Article  PubMed  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 

  22. Sherbourne, C., & Stewart, A. (1991). The MOS social support survey. Social Science and Medicine, 32(6), 705–714.

    Article  CAS  PubMed  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.

  25. Dolan, P. (1997). Modeling valuations for EuroQol health states. Medical Care, 35(11), 1095–1108.

    Article  CAS  PubMed  Google Scholar 

  26. Brazier, J., & Roberts, J. (2004). The estimation of a preference-based measures of health from the SF-12. Medical Care, 42(9), 851–859.

    Article  PubMed  Google Scholar 

  27. Sheikh, J., & Yesavage, J. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist, 5, 165–173.

    Article  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.

    Article  PubMed  Google 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.

    Article  CAS  PubMed  Google Scholar 

  30. Greaves, C., & Farbus, L. (2006). Effects of creative and social activity on the health and well-being of social isolated older people: Outcomes from a multi-method observational study. Journal of the Royal Society for the Promotion of Health, 126(3), 134–142.

    Article  PubMed  Google Scholar 

  31. Ethgen, O., Vanparijs, P., Delhalle, S., Rosant, S., Bruyere, O., & Reginster, J. -Y. (2004). Social support and health-related quality of life in hip and knee osteoarthritis. Quality of Life Research, 13, 321–330.

    Article  CAS  PubMed  Google Scholar 

  32. Kind, P., Dolan, P., Gudex, C., & Williams, A. (1998). Variations in population health status: Results from a United Kingdom national questionnaire survey. BMJ, 316, 736–741.

    CAS  PubMed  Google 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.

  34. Brazier, J., Roberts, J., Tsuchiya, A., & Busschbach, J. (2004). A comparison of the EQ-5D and SF-6D across seven patient groups. Health Economics, 13, 873–884.

    Article  PubMed  Google Scholar 

  35. Grieve, R., Grishchenko, M., & Cairns, J. (2008). SF-6D versus EQ-5D: Reasons for differences in utility scores and impact on reported cost-utility. The European Journal of Health Economics, 10(1), 15–23.

    Article  PubMed  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 

  38. Walters, S. J., & Brazier, J. E. (2005). Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Quality of Life Research, 14, 1523–1532.

    Article  PubMed  Google Scholar 

  39. Drummond, M. (2001). Introducing economic and quality of life measurements into clinical studies. Annals of Medicine, 33(5), 344–349.

    Article  CAS  PubMed  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.

    Article  PubMed  Google 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 

  42. Ryan, M., Netten, A., Skatun, D., & Smith, P. (2006). Using discrete choice experiments to estimate a preference-based measure of outcome–An application to social care for older people. Journal of Health Economics, 25, 927–944.

    Article  PubMed  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.

Download references

Acknowledgments

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.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Annie Hawton.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hawton, A., Green, C., Dickens, A.P. et al. The impact of social isolation on the health status and health-related quality of life of older people. Qual Life Res 20, 57–67 (2011). https://doi.org/10.1007/s11136-010-9717-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-010-9717-2

Keywords

Navigation