Subjective social isolation and associated factors in older people with mild cognitive impairment: The role of sleep quality, fear of dementia, and health empowerment.
Xu W, Lu J, et al. • Geriatric nursing (New York, N.Y.) • 2026
Subjective social isolation in older people with mild cognitive impairment is at a high level and is closely related to sleep quality, dementia fear, and health empowerment, with marital status, residential status, hobbies, health empowerment, and dementia fear explaining 21.9% of the total variance.
Key Findings
Results
Older people with mild cognitive impairment demonstrated a high level of subjective social isolation.
The participants had a subjective social isolation score of 19.46 ± 3.92 on the Perceived Isolation Scale.
A total of 310 older people with mild cognitive impairment were recruited from a tertiary hospital in Hunan Province using convenience sampling.
Participants were surveyed using the General Information Questionnaire, Perceived Isolation Scale, Pittsburgh Sleep Quality Index, Fear of Dementia Scale, and Elders Health Empowerment Scale.
Results
Subjective social isolation was positively correlated with both sleep quality (poorer sleep) and fear of dementia in older people with mild cognitive impairment.
Both correlations were statistically significant at P < 0.01.
Mean sleep quality score was 8.27 ± 3.92 on the Pittsburgh Sleep Quality Index (higher scores indicate poorer sleep quality).
Mean fear of dementia score was 58.54 ± 12.94 on the Fear of Dementia Scale.
Pearson correlation analysis was used to test these associations.
Results
Subjective social isolation was negatively correlated with health empowerment in older people with mild cognitive impairment.
The correlation was statistically significant at P < 0.01.
Mean health empowerment score was 26.17 ± 6.76 on the Elders Health Empowerment Scale.
Pearson correlation analysis was used to test this association.
Results
Multiple regression analysis identified five significant predictors of subjective social isolation in older people with mild cognitive impairment.
The five factors were marital status, residential status, hobbies, health empowerment, and dementia fear.
Together, these factors explained 21.9% of the total variance in subjective social isolation.
Multiple regression analysis was the statistical method used.
What This Means
This research suggests that older adults diagnosed with mild cognitive impairment (MCI) — a condition involving noticeable memory or thinking problems that are not yet severe enough to be called dementia — experience notably high levels of feeling socially isolated, even if they are not physically cut off from others. The study surveyed 310 such patients at a hospital in China and found that those who slept poorly, those who feared developing dementia, and those who felt less in control of their own health tended to feel more socially isolated. Conversely, those who felt more empowered to manage their own health reported feeling less isolated.
The study also found that certain life circumstances were linked to social isolation levels, including whether a person was married, whether they lived alone or with others, and whether they had hobbies. Together, all these factors explained about 22% of the differences in isolation levels between individuals, suggesting other unmeasured factors also play a role.
This research suggests that healthcare providers caring for older adults with MCI should look beyond physical health and pay attention to psychological and social factors such as fear of dementia, sleep problems, and patients' sense of control over their health. Addressing these factors through targeted support or interventions may help reduce feelings of social isolation in this vulnerable population.
Xu W, Lu J, Zhang W, Zhao F, Huang J. (2026). Subjective social isolation and associated factors in older people with mild cognitive impairment: The role of sleep quality, fear of dementia, and health empowerment.. Geriatric nursing (New York, N.Y.). https://doi.org/10.1016/j.gerinurse.2026.103807