Does social isolation and low societal participation predict disability pension? A population based study

Estimating the prevalence and characteristics of people in severe social isolation in 29 European countries: A secondary analysis of data from the European Social Survey round 9 (2018-2020)

The main aim of the present study was to estimate the prevalence of people in severe social isolation as a proxy for high risk of hikikomori using data from 29 European countries. The relationship between the presence/absence of severe social isolation and demographic and psychosocial variables was also investigated. Publicly available data from the European Social Survey (ESS) round 9 collected between August 2018 and January 2020 were used. Data from the ESS round 1 (September 2002 -December 2003) and round 10 (September 2020 -May 2022) were also examined to investigate changes in the prevalence of severe social isolation over time. Analyses were restricted to the working-age population (15-64 years). A complex sampling design to obtain weighted prevalence and results was used. The study protocol was preregistered online on the Open Science Framework (https://osf.io/6a7br/). The weighted prevalence of severe social isolation was 2.01% for the sample from the ESS 1, 1.77% for the sample from the ESS 9, and 1.71% for the sample from the ESS 10, indicating a decrease over time, mainly in males. Logistic regression models showed that different sociodemographic factors (e.g., being retired, being permanently sick or disabled, doing housework, living in Central and Eastern Europe, living uncomfortably on household income, having no income) were associated with severe social isolation. Further, feeling unsafe when walking alone in the neighbourhood after dark, low social trust, and support, decreased happiness and lack of future planning correlated with severe social isolation after adjustment for the effect of sociodemographic factors was made. In this study, the prevalence of severe social isolation as a proxy for hikikomori in European countries is in line with that found by previous representative studies conducted in Asian countries. The novelty of the findings as well as implications for hikikomori research are discussed according to recent scientific literature.

Loneliness as a Predictor of Work Disability Onset Among Nondisabled, Working Older Adults in 14 Countries

Objective: The objective of this study is to examine the relationship between loneliness and work disability and whether depression mediates the hypothesized relationship. Method: We draw on data from the 2013 and 2015 waves of the Survey of Health, Aging, and Retirement in Europe. We limited the sample to adults between the ages of 50 and 65 who were working and without work limitations in 2013, which consisted of 10,154 adults from 14 countries. We apply multivariate logistic regression and a binary mediation analysis with logistic regression to examine predictors of the onset of work disability in 2015. Results: Loneliness was predictive of future work disability onset when adjusting for other factors in the disablement process. Depression partly mediated the longitudinal relationship between loneliness and work disability. Discussion: The results indicate that addressing loneliness could mitigate the risk of depression and, in turn, work disability onset.

Sick Leave and Disability Across Three Decades After a Major Disaster

Extended functional impairment characterized by sick leave and disability after a single disaster has not been documented before. This prospective, longitudinal, case-control study applied growth mixture modeling to predict trajectories of functional impairment in oil rig workers, survivors (n = 68) and a matched comparison group (n = 84), over 27 years after the 1980 North Sea oil rig disaster. In the initial 12 years post-disaster, survivors displayed higher rates of functional impairment than the comparison group. A minor group of survivors (n = 8, 11.8%) demonstrated persistent functional impairment from the start and remained unable to work during the subsequent three decades. Long-term sick leave and disability were related to perceived peritraumatic death threat and a propensity towards social withdrawal. Most survivors (n = 60) revealed no major functional impairment. The study indicates that functional impairment should be counteracted in the early support after a single disaster.

Test-Retest Reliability and Validity of the Malay Version Life Habits Assessment (LIFE-H 3.1) to Measure Social Participation in Adults With Physical Disabilities

BACKGROUND AND PURPOSE

Social participation restriction is a common barrier encountered by older adults and individuals with physical disabilities. To best direct the limited resource to support social services for individuals with disability, there is a need to objectively measure social participation restriction. A number of tools to measure levels of social participation are available, but none of them has been translated into the Malay language. This cross-sectional study examined the test-retest reliability and concurrent validity of the Life Habits Assessment (LIFE-H 3.1) that had been translated and culturally adapted to the Malay language.

METHODS

Seventy-five individuals with physical disabilities (age, mean [standard deviation] = 58 [10] years; 49 males) participated in this study. Participants were interviewed twice with the Malay version LIFE-H 3.1, approximately 1 week apart. The Barthel Index (BI) and the World Health Organization Assessment of Quality of Life-Brief version (WHOQoL-BREF) were administered in the first interview as well. Intraclass correlation coefficients and the Bland-Altman Bias D were used to examine test-retest reliability. The Spearman correlation coefficients were computed to quantify the correlation between the Malay version LIFE-H 3.1 and the BI and the WHOQoL-BREF, respectively, to examine the concurrent validity of the Malay version LIFE-H 3.1. Furthermore, standard error of measurement and minimal detectable change were calculated.

RESULTS

The Malay version LIFE-H 3.1 had excellent test-retest reliability as evidenced by good to excellent intraclass correlation coefficients (0.71-0.95) and minimal Bland-Altman biases (0.01-0.12). The correlations between the Malay version LIFE-H 3.1 and the BI were fair to good (r = 0.28-0.69). The correlations between the Malay version LIFE-H 3.1 and the WHOQoL-BREF were weak to fair, ranging from 0.02 to 0.57.

CONCLUSIONS

The Malay version LIFE-H 3.1 demonstrates excellent test-retest reliability and satisfactory validity. This questionnaire is an appropriate tool to assess social participation in rehabilitation for native Malay language speakers.

Interaction Effects of Social Isolation and Peripheral Work Position on Risk of Disability Pension: A Prospective Study of Swedish Women and Men

PURPOSE

The study examines various combinations of levels of social isolation in private life and peripheral work position as predictors of disability pension (DP). A second aim was to test the potential interaction effects (above additivity) of social isolation and peripheral work position on the future risk of DP, and to provide results for men and women by age.

METHOD

The study was based on a sample of 45567 women and men from the Swedish population who had been interviewed between 1992 and 2007. Further information on DP and diagnoses was obtained from the Swedish Social Insurance Agency's database (1993-2011). The studied predictors were related to DP using Cox's proportional hazard regression. The analyses were stratified on sex and age (20-39 years, 40-64 years), with control for selected confounders.

RESULTS

Increased risks of DP were found for most combinations of social isolation and peripheral work position in all strata. The hazard ratios (HRs) for joint exposure to high degree of social isolation and a peripheral work position were particularly strong among men aged 20-39 (HR 5.70; CI 95% 3.74-8.69) and women aged 20-39 (HR 4.07; CI 2.99-5.56). An interaction effect from combined exposure was found for women in both age groups as well as a tendency in the same direction among young men. However, after confounder control the effects did not reach significance.

CONCLUSIONS

Individuals who were socially isolated and in a peripheral work position had an increased risk of future DP. The fact that an interaction effect was found among women indicates that a combination of social isolation and peripheral work position may reinforce adverse health effects. There was no evidence that a peripheral work position can be compensated by a high degree of social intergration in private life.