Mediating role of health literacy in the relationship between social isolation and psychological distress among pre-frail older adults

Abstract

BACKGROUND Frailty has become a significant public health issue. The recent increase in the number of frail older adults has led to increased attention being paid to psychological care services in communities. The social isolation of pre-frail older adults can impact their psychological distress. AIM To explore the mediating effect of health literacy between social isolation and psychological distress among communitydwelling older adults with pre-frailty. METHODS This descriptive cross-sectional study was conducted with 254 pre-frail older individuals aged 60 years and over. Social isolation, health literacy, and psychological distress were comprehensively measured using the Lubben Social Network Scale-6, 12-item Short-Form Health Literacy Questionnaire, and the Kessler Psychological Distress Scale-10. Data were evaluated using the SPSS 27.0 package program and the PROCESS macro tool. Descriptive statistical analyses, correlation analyses, and bootstrap mediation tests were used to assess associations between the variables. RESULTS The results showed that social isolation had an effect on health literacy among pre-frail older adults (β = 0.240, P < 0.001), social isolation impact on psychological distress pre-frail older adults (β = -0.415, P < 0.001); health literacy was identified effect on psychological distress among pre-frail older persons (β = -0.307, P < 0.001). Health literacy partially mediated the relationship between social isolation and psychological distress among community-dwelling older adults with pre-frailty, with a mediation effect of -0.074, accounting for 17.83% of the total effect. CONCLUSION Health literacy significantly affects the relationship between social isolation and psychological distress among pre-frail older adults. Apart from fostering social connections, improved health literacy measures should be considered.