Geriatric nursing (New York, N.Y.) · 2026
Heterogeneous social isolation and its psychosocial and functional correlates in older adults with chronic heart failure: An integrated latent profile and network analysis.
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Lu Ying, Cao Shuai, Zeng Fanzhuo, Cui Zhenzhen, Wu Xiaolin, Diao Xiangjin, Zhao Yuqin
Аннотация
OBJECTIVE: This study aimed to identify latent subgroups of social isolation (SI) among older adults with chronic heart failure (CHF) and to explore psychosocial and functional interrelations using an integrated latent profile analysis (LPA) and network analysis (NA).
METHODS: A cross-sectional survey was conducted with 352 hospitalized CHF patients aged ≥60 years. SI was assessed using the Lubben Social Network Scale-6, frailty with the FRAIL scale, depression with the PHQ-9, family function with the APGAR index, and functional ability with the Barthel Index. LPA was applied to identify SI profiles, NA was used to map inter-variable associations, and multinomial logistic regression examined predictors of subgroup membership.
RESULTS: Three SI profiles were identified: high isolation-family reliant (18.2%), medium isolation-friend connected (55.7%), and low isolation-family supported (26.1%). The overall prevalence of SI was 51.4%. Frailty consistently emerged as the most central node across profiles, bridging depression, ADL, and family support. Depression showed particularly high centrality in the high-isolation group. Independent predictors of high isolation included older age, lower income, multimorbidity, frailty, impaired ADL, and poor family function (all P < 0.05).
CONCLUSION: SI among older CHF patients is heterogeneous. The integration of LPA and NA not only revealed distinct isolation subgroups but also identified frailty as a pivotal bridge linking physical, psychological, and social domains. Subgroup-specific vulnerabilities were also uncovered, with depressive symptoms and poor family function being especially important in medium isolation.
METHODS: A cross-sectional survey was conducted with 352 hospitalized CHF patients aged ≥60 years. SI was assessed using the Lubben Social Network Scale-6, frailty with the FRAIL scale, depression with the PHQ-9, family function with the APGAR index, and functional ability with the Barthel Index. LPA was applied to identify SI profiles, NA was used to map inter-variable associations, and multinomial logistic regression examined predictors of subgroup membership.
RESULTS: Three SI profiles were identified: high isolation-family reliant (18.2%), medium isolation-friend connected (55.7%), and low isolation-family supported (26.1%). The overall prevalence of SI was 51.4%. Frailty consistently emerged as the most central node across profiles, bridging depression, ADL, and family support. Depression showed particularly high centrality in the high-isolation group. Independent predictors of high isolation included older age, lower income, multimorbidity, frailty, impaired ADL, and poor family function (all P < 0.05).
CONCLUSION: SI among older CHF patients is heterogeneous. The integration of LPA and NA not only revealed distinct isolation subgroups but also identified frailty as a pivotal bridge linking physical, psychological, and social domains. Subgroup-specific vulnerabilities were also uncovered, with depressive symptoms and poor family function being especially important in medium isolation.