Research Article: Comparison of the 18-item and 6-item Lubben Social Network Scales with community-dwelling older adults in Mongolia

Date Published: April 18, 2019

Publisher: Public Library of Science

Author(s): Sugarmaa Myagmarjav, Denise Burnette, Frank Goeddeke, Mijung Park.


This study compares the psychometric properties of two versions of the Lubben Social Network Scale (LSNS-18 and LSNS-6) with community dwelling older adults in Mongolia. We recruited 650 older adult in the capital city of Ulaanbaatar and the country’s four rural regions. We used the Geriatric Depression Scale (GDS-15), the Short Form 12 (SF-12) physical and mental health functioning measures, and a multi-dimensional scale of social isolation for confirmatory factor analyses of the LSNS-18 and the LSNS-6. Both versions demonstrated excellent internal consistency and intraclass correlation and both correlated in expected directions with other study measures. Only the LSNS-6 provided a good fit to the data. The LSNS-6 is a viable instrument for assessing the social networks of older adults in Mongolia. The study adds to the sparse literature on measuring social and behavioral determinants of health in resource-constrained settings characterized by aging populations and high internal migration rates.

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Social and behavioral determinants of health (SBDs) are now central concerns of public health. [1] The World Health Organization (WHO) defines social determinants of health as “the conditions in which people are born, grow, live, work and age” and “the fundamental drivers of these conditions.” [2] These conditions serve, in turn, as the ecological contexts in which individual behaviors interact reciprocally with environmental and biologic determinants to affect health. [3] SBDs often involve overlapping, mutable risk factors that lead to poor health outcomes, including low sleep quality, depression, impaired executive function, accelerated cognitive decline, cardiovascular dysfunction, impaired immunity, altered hypothalamic- pituitary–adrenocortical activity, a pro-inflammatory gene expression profile and early mortality. [4].

Table 1 presents descriptive data on the study sample. Just over 60% of study participants were female, and about the same proportion were married. The mean age was 66.5 years and almost half of the sample had completed either vocational or university education.

The purpose of this study was to evaluate two versions of the LSNS for use with older adults in Mongolia. We began by noting growing interest of social and behavioral determinants of health-related outcomes for public health policy and practice. The rapid aging of populations in resource-constrained LMIC heightens the urgency to develop interventions and implement policies that are grounded in local language and culture and empirically supported. Validated instruments are essential to assessment, monitoring and evaluation of public health prevention and intervention strategies.