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

Table 1 General characteristics of the pre-frail older adults, n (%)

Variable	Percentage	K10 score	t/F	P value
Age			1.611	0.202
60-69	89 (35.0)	13.91 ± 5.73
70-79	144 (56.7)	13.31 ± 3.82
≥ 80	21 (8.3)	15.14 ± 4.54
Gender			-1.792	0.074
Male	112 (44.1)	13.11 ± 3.85
Female	142 (55.9)	14.12 ± 5.16
Marital status			-2.541	0.012
Married	210 (82.7)	13.34 ± 4.67
Unmarried/divorced/widowed	44 (17.3)	15.27 ± 4.18
Monthly income (CNY)			3.530	0.016
0-1000	33 (13.0)	15.79 ± 5.61
1000-2999	105 (41.3)	13.82 ± 4.48
3000-4999	69 (27.2)	13.17 ± 4.38
≥ 5000	47 (18.5)	12.60 ± 4.26
Education level			3.962	0.004
Below primary school	48 (18.9)	15.75 ± 4.27
Primary school	69 (27.2)	13.03 ± 4.05
Junior high school	84 (33.1)	13.04 ± 3.62
High school	38 (15.0)	14.29 ± 7.30
College or above	15 (5.9)	12.00 ± 2.62

K10: Kessler Psychological Distress Scale-10; CNY: China Yuan.

Table 2 The health literacy, social isolation, and psychological distress scores (n = 254)

Scale	Mean	SD
LSNS-6	19.37	4.77
HLS-SF12	28.72	5.38
K10	13.67	4.64

LSNS-6: Lubben Social Network Scale-6; HLS-SF12: 12-item Short-Form Health Literacy Questionnaire; K10: Kessler Psychological Distress Scale-10.

Table 3 The correlation between health literacy and social isolation and psychological distress scores (n = 254)

	LSNS-6	HLS-SF12	K10
LSNS-6	1	-	-
HLS-SF12	0.273a	1	-
K10	-0.430a	-0.410a	1

^aP < 0.01.

LSNS-6: Lubben Social Network Scale-6; HLS-SF12: 12-item Short-Form Health Literacy Questionnaire; K10: Kessler Psychological Distress Scale-10.

Table 4 Total, direct, and indirect effects of mediation analysis

Path	β	SE	95%LLCI	95%ULCI	Relative mediation effect
Total effect of X on Y	-0.415	0.058	-0.529	-0.300
Direct effect of X on Y	-0.341	0 .057	-0.453	-0.229	82.17%
Indirect effect (X→M→Y)	-0.074	0.030	-0.139	-0.025	17.83%

X = Social isolation; M = Health literacy; Y = Psychological distress; SE: The standard error of effects estimated; LLCI: The lower limit confidence interval of effects estimated; ULCI: The upper limit confidence interval of effects estimated.