Differentiating objective and subjective dimensions of social isolation and apprasing their relations with physical and
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RESEARCH ARTICLE
Open Access
Differentiating objective and subjective dimensions of social isolation and apprasing their relations with physical and mental health in italian older adults Maddalena Fiordelli1* , Gabriele Sak1, Benedetta Guggiari2, Peter J. Schulz1 and Serena Petrocchi1
Abstract Background: International research shows that social isolation is harmful for health, especially for the elderly. Its objective and subjective dimensions are important to distinguish as each stands in a different relation with health. The first aim of the present study is the validation of three scales measuring objective and subjective isolation in an Italian elderly population. The second aim is to analyze subjective and objective social isolation and to appraise their association with health among seniors. Methods: This cross-sectional survey collected data from 306 over 65 s participants. Questionnaires were administered face-to-face by one author and encompassed: social disconnectedness scale; perceived isolation scale; abbreviated Lubben Social Network Scale; measures of general and mental health, and depression. Results: The three scales measuring social isolation demonstrated acceptable psychometric properties and validity. Objective and subjective social isolation were not directly associated with physical health, whereas subjective isolation is strongly linked to worse mental health and depression. Higher level of subjective isolation was associated with lower level of physical health through the mediation of mental health. Subjective isolation served as a mediator in the relation between objective isolation and health. Moderation analysis demonstrated that low values of objective isolation predicted high values of mental health but only when subjective isolation was low. None of these relations were moderated by socio-demographic variables. Conclusion: Subjective and objective isolation are clearly two separate dimensions and the scales validated in this paper showed to be potentially culturally invariant. Researchers should work to find instruments able to depict the complexity of the construct of social isolation. Keywords: Social isolation, Loneliness, Older adults, Validation, Physical health, Mental health, Italian translation, Italian validation
Background Western cultures are experiencing social and demographic trends that pose many novel individual, * Correspondence: [email protected] 1 Institute of Communication and Health (ICH), Università della Svizzera italiana (USI), Via G. Buffi 13, 6900 Lugano, Switzerland Full list of author information is available at the end of the article
community and societal challenges. Among these issues, social isolation appears particularly relevant as it is proven to have detrimental effects on both physical and mental health [1–3]. Older adults are particularly subject to the risk of social isolation [1, 4]. Italy is the second country in the world in terms of the oldest population [5]. In their cross-national study, Fokkema
© The Author(s). 2020 Open Acces
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