TY - JOUR
T1 - Social Dysfunction in Older Age and Relationships with Cognition, Depression, and Apathy
T2 - The GreatAGE Study
AU - Lozupone, Madia
AU - Panza, Francesco
AU - Piccininni, Marco
AU - Copetti, Massimiliano
AU - Sardone, Rodolfo
AU - Imbimbo, Bruno P
AU - Stella, Eleonora
AU - D'Urso, Francesca
AU - Barulli, Maria Rosaria
AU - Battista, Petronilla
AU - Grasso, Alessandra
AU - Tortelli, Rosanna
AU - Capozzo, Rosa
AU - Coppola, Francesco
AU - Abbrescia, Daniela Isabel
AU - Bellomo, Antonello
AU - Giannelli, Gianluigi
AU - Quaranta, Nicola
AU - Seripa, Davide
AU - Logroscino, Giancarlo
PY - 2018
Y1 - 2018
N2 - BACKGROUND: Most studies focused on only one measure of social dysfunction in older age, without proper validation and distinction across different dimensions including subjectivity, structural, and functional aspects.OBJECTIVE: We sought to validate the Social Dysfunction Rating Scale (SDRS) and its factorial structure, also determining the association of SDRS with cognitive functions, global psychopathology, and social deprivation.METHODS: The SDRS was administered to 484 Italian community-dwelling elderly, recruited in the GreatAGE study, a population-based study on aging conducted in Castellana Grotte, Bari, Southern Italy. We determined objective and subjective psychometric properties of SDRS against the gold standard evaluation of social dysfunction according to the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID-I) criterion.RESULTS: The SDRS showed a moderate accuracy with an optimal cut-off of 26 maximized with higher sensitivity (0.74,95% CI:0.63-0.84) than specificity (0.57,95% CI:0.50-0.64). A five-factor structure was carried out and five dimensions of SDRS were identified (loneliness; social isolation; feeling of contribution/uselessness; lack of leisure activities; anxiety for the health). Education and global cognitive functions were inversely correlated to SDRS, while a direct association with global psychopathology, depression, and apathy was found. The prevalence of higher SDRS scores was major in subjects with current psychiatric disorders versus other subjects.∥Conclusion: The SDRS could be a valid instrument to capture both size and quality of social dysfunction, both in subjects with psychiatric disorders and in normal subjects. Several categories of social dysfunction differed only in the degree of health deprivation, not in social or material deprivation.
AB - BACKGROUND: Most studies focused on only one measure of social dysfunction in older age, without proper validation and distinction across different dimensions including subjectivity, structural, and functional aspects.OBJECTIVE: We sought to validate the Social Dysfunction Rating Scale (SDRS) and its factorial structure, also determining the association of SDRS with cognitive functions, global psychopathology, and social deprivation.METHODS: The SDRS was administered to 484 Italian community-dwelling elderly, recruited in the GreatAGE study, a population-based study on aging conducted in Castellana Grotte, Bari, Southern Italy. We determined objective and subjective psychometric properties of SDRS against the gold standard evaluation of social dysfunction according to the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID-I) criterion.RESULTS: The SDRS showed a moderate accuracy with an optimal cut-off of 26 maximized with higher sensitivity (0.74,95% CI:0.63-0.84) than specificity (0.57,95% CI:0.50-0.64). A five-factor structure was carried out and five dimensions of SDRS were identified (loneliness; social isolation; feeling of contribution/uselessness; lack of leisure activities; anxiety for the health). Education and global cognitive functions were inversely correlated to SDRS, while a direct association with global psychopathology, depression, and apathy was found. The prevalence of higher SDRS scores was major in subjects with current psychiatric disorders versus other subjects.∥Conclusion: The SDRS could be a valid instrument to capture both size and quality of social dysfunction, both in subjects with psychiatric disorders and in normal subjects. Several categories of social dysfunction differed only in the degree of health deprivation, not in social or material deprivation.
KW - Aged
KW - Aged, 80 and over
KW - Apathy
KW - Cognition
KW - Cross-Sectional Studies
KW - Depression/epidemiology
KW - Factor Analysis, Statistical
KW - Female
KW - Humans
KW - Interview, Psychological
KW - Italy
KW - Male
KW - Mental Disorders/epidemiology
KW - Prevalence
KW - Psychiatric Status Rating Scales
KW - Psychometrics
KW - Sensitivity and Specificity
KW - Social Isolation/psychology
U2 - 10.3233/JAD-180466
DO - 10.3233/JAD-180466
M3 - Article
C2 - 30103335
VL - 65
SP - 989
EP - 1000
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
SN - 1387-2877
IS - 3
ER -