Social isolation risk factors in older hospitalized individuals

Background: Elderly people are particularly vulnerable to the effects of social reduction, so there is an urgent need to identify the risks associated with social isolation. The aim of this paper was to analyze associations between psychological, socio-demographic, functional aspects on the risk of social isolation, mortality and re-hospitalization in older persons.

Methods: This is a longitudinal study on 580 hospitalized elderly sample aged ≥70yrs recruited from 2005 to 2007 in the Geriatrics Operative Unit of INRCA in Fermo, Italy. The comprehensive geriatric assessment (CGA) was used. Outcome measures included 36-month mortality and re-hospitalization.

Results: In all patients, approximately 20% (n=112) of the subjects were socially isolated. Women perceived their social support significantly worse than men (77.7 vs. 22.3%; p<0.001). A multiple logistic regression analysis (goodness of fit χ(2)=102.86, p<0.001) with risk of social isolation as the dependent variable, showed that women were at a greater risk than men for social isolation (OR=1.99, 95% CI=1.13-3.50). Furthermore, patients with a higher number of family components (OR=0.72, 95% CI=0.59-0.88) and good parameters of quality of life (PCS-12: OR=0.94, 95% CI=0.91-0.98; MCS-12: OR=0.94, 95% CI=0.92-0.97) were less likely to be socially isolated. Cox regression models adjusted for gender, quality of life and number of family components, showed that the social isolation did not predict mortality (HR=1.44, 95% CI=0.84-2.46, p=0.19), but was associated with higher re-hospitalization rates (HR=1.28, 95% CI=1.02-1.59, p=0.03).

Conclusions: Our findings highlight several aspects related to the risk of social isolation and re-hospitalization in a specific group of older persons.