{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T15:00:22Z","timestamp":1778770822212,"version":"3.51.4"},"reference-count":58,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EJIHPE"],"abstract":"<jats:p>This study aimed to translate, culturally adapt, and validate the Arabic version of the 6-Item Lubben Social Network Scale (LSNS-6). The LSNS-6 was translated, culturally adapted, and administered, alongside the Medical Outcomes Study Social Support Survey (MOS-SSS), to 327 Arabic-speaking adults aged 60 years and older. Internal consistency was examined using Cronbach\u2019s alpha and McDonald\u2019s omega. Confirmatory factor analysis (CFA) tested the hypothesized two-factor structure (Family and Friends), and measurement invariance was evaluated across key sociodemographic and lifestyle variables. Convergent validity was assessed through correlations with MOS-SSS domains. Item response theory (IRT) analyses examined item discrimination and threshold parameters. Latent class analysis (LCA) explored whether the LSNS-6 could identify subgroups with distinct patterns of social connectedness and perceived support. The Arabic LSNS-6 demonstrated good internal consistency (\u03b1 = 0.83; \u03c9 = 0.84) and supported the expected two-factor structure with satisfactory model fit (CFI = 0.963; TLI = 0.931; SRMR = 0.03). Convergent validity was evidenced by moderate correlations with overall perceived social support (r = 0.51). IRT analyses indicated strong discrimination for most items, and LCA identified four distinct latent classes. Overall, the Arabic LSNS-6 is a reliable and valid tool for assessing social isolation among older Arabic-speaking adults.<\/jats:p>","DOI":"10.3390\/ejihpe16030040","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T14:43:07Z","timestamp":1772808187000},"page":"40","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Arabic Lubben Social Network Scale-6: Psychometric Validation, Measurement Invariance, and Social Support Profiles in Arabic-Speaking Older Adults"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2623-9557","authenticated-orcid":false,"given":"Khaled","family":"Trabelsi","sequence":"first","affiliation":[{"name":"Research Laboratory Education, Motricit\u00e9, Sport et Sant\u00e9, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia"},{"name":"Department of Movement Sciences and Sports Training, School of Sport Science, The University of Jordan, Amman 11942, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3047-1834","authenticated-orcid":false,"given":"Waqar","family":"Husain","sequence":"additional","affiliation":[{"name":"Department of Humanities, COMSATS University Islamabad, Islamabad Campus, Park Road, Islamabad 45550, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3045-4153","authenticated-orcid":false,"given":"Hadeel","family":"Ghazzawi","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman 11942, Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Saif","sequence":"additional","affiliation":[{"name":"Government Hospitals, Manama 329, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0347-8053","authenticated-orcid":false,"given":"Achraf","family":"Ammar","sequence":"additional","affiliation":[{"name":"Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg University of Mainz, 55029 Mainz, Germany"},{"name":"Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax 3000, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8990-1320","authenticated-orcid":false,"given":"Haitham","family":"Jahrami","sequence":"additional","affiliation":[{"name":"Government Hospitals, Manama 329, Bahrain"},{"name":"Department of Psychiatry, College of Medicine and Health Sciences, Arabian Gulf University, Manama 329, Bahrain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1097\/00007632-200012150-00014","article-title":"Guidelines for the process of cross-cultural adaptation of self-report measures","volume":"25","author":"Beaton","year":"2000","journal-title":"Spine"},{"key":"ref_2","unstructured":"Berkman, B., and Harootyan, L. K. (2003). Centrality of social ties to the health and well-being of older adults. Social work and health care in an aging society: Education, policy, practice, and research, Springer Publishing Company."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/S0277-9536(00)00065-4","article-title":"From social integration to health: Durkheim in the new millennium","volume":"51","author":"Berkman","year":"2000","journal-title":"Social Science & Medicine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1093\/oxfordjournals.aje.a112674","article-title":"Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents","volume":"109","author":"Berkman","year":"1979","journal-title":"American Journal of Epidemiology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1093\/jpepsy\/jst084","article-title":"An introduction to latent variable mixture modeling (part 1): Overview and cross-sectional latent class and latent profile analyses","volume":"39","author":"Berlin","year":"2014","journal-title":"Journal of Pediatric Psychology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e2451580","DOI":"10.1001\/jamanetworkopen.2024.51580","article-title":"Patterns of social connection among older adults in England","volume":"7","author":"Bu","year":"2024","journal-title":"JAMA Network Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e5527","DOI":"10.1111\/hsc.13977","article-title":"Validation of the abbreviated Lubben Social Network Scale (LSNS-6) and its association with self-rated health amongst older adults in Puerto Rico","volume":"30","author":"Buckley","year":"2022","journal-title":"Health & Social Care in the Community"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/oxfordjournals.aje.a112281","article-title":"The contribution of the social environment to host resistance: The Fourth Wade Hampton Frost Lecture","volume":"104","author":"Cassel","year":"1976","journal-title":"American Journal of Epidemiology"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Chang, Q., Sha, F., Chan, C. H., and Yip, P. S. (2018). Validation of an abbreviated version of the Lubben Social Network Scale (\u201cLSNS-6\u201d) and its associations with suicidality among older adults in China. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201612"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1007\/s10490-023-09871-y","article-title":"Reporting reliability, convergent and discriminant validity with structural equation modeling: A review and best-practice recommendations","volume":"41","author":"Cheung","year":"2024","journal-title":"Asia Pacific Journal of Management"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1177\/002214650905000103","article-title":"Social disconnectedness, perceived isolation, and health among older adults","volume":"50","author":"Cornwell","year":"2009","journal-title":"Journal of Health and Social Behavior"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1186\/s40064-016-2960-4","article-title":"Validity and reliability of Arabic MOS social support survey","volume":"5","author":"Dafaalla","year":"2016","journal-title":"Springerplus"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4521","DOI":"10.1111\/jan.15786","article-title":"The medical outcome study social support survey (MOS-SSS): A psychometric systematic review","volume":"79","author":"Lam","year":"2023","journal-title":"Journal of Advanced Nursing"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1001\/jamainternmed.2021.5022","article-title":"Association of social isolation with disability burden and 1-year mortality among older adults with critical illness","volume":"181","author":"Falvey","year":"2021","journal-title":"JAMA Internal Medicine"},{"key":"ref_15","unstructured":"Fulton, L., and Jupp, B. (2015). Investing to tackle loneliness: A discussion paper, Social Finance."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1177\/00131644231163813","article-title":"Evaluating model fit of measurement models in confirmatory factor analysis","volume":"84","author":"Goretzko","year":"2024","journal-title":"Educational and Psychological Measurement"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1177\/0165025420971048","article-title":"Loneliness from young adulthood to old age: Explaining age differences in loneliness","volume":"46","author":"Hawkley","year":"2022","journal-title":"International Journal of Behavioral Development"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1037\/pag0000365","article-title":"Are US older adults getting lonelier? Age, period, and cohort differences","volume":"34","author":"Hawkley","year":"2019","journal-title":"Psychology and Aging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1177\/0141076820918236","article-title":"Loneliness, social isolation, cardiovascular disease and mortality: A synthesis of the literature and conceptual framework","volume":"113","author":"Hodgson","year":"2020","journal-title":"Journal of the Royal Society of Medicine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1080\/07317115.2011.572534","article-title":"Validation of Korean versions of the Lubben social network scales in Korean Americans","volume":"34","author":"Hong","year":"2011","journal-title":"Clinical Gerontologist"},{"key":"ref_21","unstructured":"International Center for Language Studies (2025, April 07). Most spoken languages in the world, Available online: https:\/\/www.icls.edu\/blog\/most-spoken-languages-in-the-world."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e73","DOI":"10.1093\/geront\/gnaa156","article-title":"Performance of an abbreviated Lubben Social Network Scale (LSNS-6) in three ethnic groups of older Asian Americans","volume":"62","author":"Jang","year":"2022","journal-title":"Gerontologist"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1177\/0049124114543236","article-title":"The performance of RMSEA in models with small degrees of freedom","volume":"44","author":"Kenny","year":"2015","journal-title":"Sociological Methods & Research"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kirch, W. (2008). Pearson\u2019s correlation coefficient. Encyclopedia of public health, Springer.","DOI":"10.1007\/978-1-4020-5614-7"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"149","DOI":"10.3143\/geriatrics.48.149","article-title":"Reliability and validity of the Japanese version of the abbreviated Lubben social network scale","volume":"48","author":"Kurimoto","year":"2011","journal-title":"Nihon Ronen Igakkai Zasshi"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s12144-020-01125-0","article-title":"Validity and reliability of the Lubben Social Network Scale-Revised (LSNS-R) on older adults in Turkey","volume":"40","author":"Kalanlar","year":"2021","journal-title":"Current Psychology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/s11121-011-0201-1","article-title":"Latent class analysis: An alternative perspective on subgroup analysis in prevention and treatment","volume":"14","author":"Lanza","year":"2013","journal-title":"Prevention Science"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"19072","DOI":"10.1038\/s41598-024-69936-w","article-title":"The associations of social isolation with depression and anxiety among adults aged 65 years and older in Ningbo, China","volume":"14","author":"Li","year":"2024","journal-title":"Scientific Reports"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/S0140-6736(24)01296-0","article-title":"Dementia prevention, intervention, and care: 2024 report of the Lancet standing commission","volume":"404","author":"Livingston","year":"2024","journal-title":"Lancet"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"102930","DOI":"10.1016\/j.pmedr.2024.102930","article-title":"Social isolation and loneliness and their association with all-cause mortality: A population-based longitudinal study in Norway: The Troms\u00f8 study 1994\u20132023","volume":"48","author":"Brenn","year":"2024","journal-title":"Preventive Medicine Reports"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1093\/geront\/46.4.503","article-title":"Performance of an abbreviated version of the Lubben social network scale among three European Community-dwelling older adult populations","volume":"46","author":"Lubben","year":"2006","journal-title":"Gerontologist"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1097\/00003727-198811000-00008","article-title":"Assessing social networks among elderly populations","volume":"11","author":"Lubben","year":"1988","journal-title":"Family & Community Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"100368","DOI":"10.1016\/j.ssaho.2022.100368","article-title":"Estimating reliability: A comparison of Cronbach\u2019s \u03b1, McDonald\u2019s \u03c9t and the greatest lower bound","volume":"7","author":"Malkewitz","year":"2023","journal-title":"Social Sciences & Humanities Open"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Menec, V. H., Newall, N. E., Mackenzie, C. S., Shooshtari, S., and Nowicki, S. (2020). Examining social isolation and loneliness in combination in relation to social support and psychological distress using Canadian longitudinal study of aging (CLSA) data. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0230673"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e65","DOI":"10.1192\/j.eurpsy.2022.2320","article-title":"Social isolation and suicide risk: Literature review and perspectives","volume":"65","author":"Walter","year":"2022","journal-title":"European Psychiatry"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1080\/23761407.2018.1460734","article-title":"Revising the lubben social network scale for use in residential long-term care settings","volume":"15","author":"Munn","year":"2018","journal-title":"Journal of Evidence-Informed Social Work"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Myagmarjav, S., Burnette, D., and Goeddeke, F. (2019). Comparison of the 18-item and 6-item Lubben social network scales with community-dwelling older adults in Mongolia. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0215523"},{"key":"ref_38","unstructured":"National Academies of Sciences, Engineering, and Medicine (2020). Social isolation and loneliness in older adults: Opportunities for the health care system, The National Academies Press."},{"key":"ref_39","unstructured":"Office of the U.S. Surgeon General (2023). Our epidemic of loneliness and isolation: The U.S. surgeon general\u2019s advisory on the healing effects of social connection and community."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e030403","DOI":"10.1161\/JAHA.123.030403","article-title":"Longitudinal analysis of the relationship between social isolation and hypertension in early middle adulthood","volume":"13","author":"Parker","year":"2024","journal-title":"Journal of the American Heart Association"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1038\/s43587-023-00472-4","article-title":"Reflections on measures of social isolation among older adults","volume":"3","author":"Pomeroy","year":"2023","journal-title":"Nature Aging"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.gerinurse.2024.05.008","article-title":"Prevalence of social isolation in the elderly: A systematic review and meta-analysis","volume":"58","author":"Ran","year":"2024","journal-title":"Geriatric Nursing"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/S0169-7161(06)26018-8","article-title":"Multidimensional item response theory","volume":"Vol. 26","author":"Rao","year":"2006","journal-title":"Handbook of statistics"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1037\/pas0000754","article-title":"Reliability from \u03b1 to \u03c9: A tutorial","volume":"31","author":"Revelle","year":"2019","journal-title":"Psychological Assessment"},{"key":"ref_45","first-page":"217","article-title":"Vers\u00e3o Portuguesa da escala breve de redes sociais de Lubben (LSNS-6)","volume":"15","author":"Ribeiro","year":"2012","journal-title":"Revista Kair\u00f3s Gerontologia"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1097\/01.PSY.0000041470.25130.6C","article-title":"Social networks and marital status predict mortality in older women: Prospective evidence from the study of osteoporotic fractures (SOF)","volume":"65","author":"Rutledge","year":"2003","journal-title":"Psychosomatic Medicine"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1177\/13591053241238127","article-title":"Guidelines for evaluating and reporting social isolation and loneliness interventions","volume":"30","author":"Schoenmakers","year":"2025","journal-title":"Journal of Health Psychology"},{"key":"ref_48","first-page":"10","article-title":"Internal consistency: From alpha to omega","volume":"142","author":"Stensen","year":"2022","journal-title":"Tidsskrift for Den Norske Legeforening"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"53","DOI":"10.5116\/ijme.4dfb.8dfd","article-title":"Making sense of Cronbach\u2019s alpha","volume":"2","author":"Tavakol","year":"2011","journal-title":"International Journal of Medical Education"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.ijnss.2023.03.002","article-title":"Validation of the Portuguese version of the social isolation scale with a sample of community-dwelling older adults","volume":"10","author":"Tavares","year":"2023","journal-title":"International Journal of Nursing Sciences"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1037\/0022-0167.34.4.414","article-title":"Uses of factor analysis in counseling psychology research","volume":"34","author":"Tinsley","year":"1987","journal-title":"Journal of Counseling Psychology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s10865-006-9056-5","article-title":"Social support and health: A review of physiological processes potentially underlying links to disease outcomes","volume":"29","author":"Uchino","year":"2006","journal-title":"Journal of Behavioral Medicine"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"S54","DOI":"10.1177\/0022146510383501","article-title":"Social relationships and health: A flashpoint for health policy","volume":"51","author":"Umberson","year":"2010","journal-title":"Journal of Health and Social Behavior"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s10823-017-9341-5","article-title":"Validation study of the abbreviated version of the lubben social network scale Spanish translation among Mexican and Mexican-American older adults","volume":"33","author":"Lubben","year":"2018","journal-title":"Journal of Cross-Cultural Gerontology"},{"key":"ref_55","unstructured":"Woodruff, D. J., and Wu, Y.-F. (2012). Statistical considerations in choosing a test reliability coefficient, ACT, Inc.. ACT research report series, 2012 (10)."},{"key":"ref_56","unstructured":"World Health Organization (2025, April 10). Ageing, Available online: https:\/\/www.who.int\/health-topics\/ageing."},{"key":"ref_57","unstructured":"World Health Organization (2021). Social isolation and loneliness among older people: Advocacy brief, World Health Organization."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"World Medical Association (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310, 2191\u20132194.","DOI":"10.1001\/jama.2013.281053"}],"container-title":["European Journal of Investigation in Health, Psychology and Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2254-9625\/16\/3\/40\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T05:21:17Z","timestamp":1773120077000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2254-9625\/16\/3\/40"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,6]]},"references-count":58,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["ejihpe16030040"],"URL":"https:\/\/doi.org\/10.3390\/ejihpe16030040","relation":{},"ISSN":["2254-9625"],"issn-type":[{"value":"2254-9625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,6]]}}}