Loneliness during the COVID-19 pandemic

The impact of lockdowns during the COVID-19 pandemic on fertility intentions

Lockdown edicts during the COVID-19 pandemic have led to concerns about consequences for childbirth plans and decisions. Robust empirical research to either refute or confirm these concerns, however, is lacking. To evaluate the causal impact of lockdowns on fertility, we exploited a large sample of Australians (aged 18-45) from a nationally representative household panel survey and leveraged variation from a unique natural experiment that occurred in Australia in 2020: a lockdown imposed in the state of Victoria, but not elsewhere in Australia. Difference-in-differences models were estimated comparing changes in fertility intentions of persons who resided in Victoria during lockdown, or within four weeks of the lockdown being lifted, and those living elsewhere in Australia. Results revealed a significantly larger decline in reported intentions of having another child among women who lived through the protracted lockdown. The average effect was small, with fertility intentions estimated to fall by between 2.8% and 4.3% of the pre-pandemic mean. This negative effect was, however, more pronounced among those aged over 35 years, the less educated, and those employed on fixed-term contracts. Impacts on men's fertility intentions were generally negligible, but with a notable exception being Indigenous Australians.

Impact of the COVID-19 Pandemic on Older People's Loneliness: Findings from a Longitudinal Study between 2019 and 2021 among Older Home-Dwellers in Finland

OBJECTIVES

To investigate the change in feelings of loneliness among Finnish community-dwelling older people from before the COVID-19 pandemic in 2019 to during the pandemic in 2021. Moreover, we explore the changes in other dimensions of psychological well-being (PWB) during the study period.

DESIGN

Questionnaires were mailed in the 2019 Helsinki Aging Study, a repeated cohort study. A follow-up interview was carried on over the telephone during the year 2021.

SETTING AND PARTICIPANTS

A random sample of 2,917 home-dwelling older people aged 75-104 years residing in Helsinki, Finland were mailed the questionnaire. Altogether 898 participated in the follow-up.

MEASUREMENTS

Loneliness was measured using a single item question "Do you suffer from loneliness?". Other items of psychological well-being were measured: "Are you satisfied with your life?" (yes/no), "Do you feel useful?" (yes/no), "Do you have a zest for life?" (yes/no),"Do you have plans for the future?" (yes/no), and "Do you feel depressed?"("rarely or never"/ "sometimes"/ "often or always").

RESULTS

Altogether 898 people participated both in 2019 and 2021. The subjects' mean age was 83 years and 66% were women. Between 2019 and 2021, the prevalence of experienced loneliness increased among older home-dwellers from 26% to 30%. During two years of the pandemic feelings of loneliness (RR 1.79, 95% CI: 1.30 to 2.46) and depression (RR 1.37, 95% CI: 1.12 to 1.67) increased even adjusted with various confounders.

CONCLUSION

Considering the impact loneliness has on health and well-being, the finding of increased feelings of loneliness among older people is alarming. Actions to combat loneliness need to be taken.

Gender, loneliness and happiness

We analyse a measure of loneliness from a representative sample of German individuals interviewed in both 2017 and at the beginning of the COVID-19 pandemic in 2020. Both men and women felt lonelier during the COVID-19 pandemic than they did in 2017. The pandemic more than doubled the gender loneliness gap: women were lonelier than men in 2017, and the 2017-2020 rise in loneliness was far larger for women. This rise is mirrored in life-satisfaction scores. Men's life satisfaction changed only little between 2017 and 2020; yet that of women fell dramatically, and sufficiently so to produce a female penalty in life satisfaction. We estimate that almost all of this female penalty is explained by the disproportionate rise in loneliness for women during the COVID-19 pandemic.

Intersectional inequalities in loneliness among older adults before and during the early phase of the COVID-19 pandemic: A total population survey in the Swedish eldercare setting

Loneliness among older adults is a public health problem that has received particular attention since the emergence of the COVID-19 pandemic. Studies to date have however found a rather modest psychosocial impact of the pandemic on older adults, and scarce research has analyzed this impact using a comprehensive equity lens. The present study used an intersectional approach to examine social inequalities in loneliness before and during the early phase of the pandemic among older adults receiving eldercare in Sweden. The study population (analytical N = 205,529) came from two waves (2019 and 2020) of a total population survey to all older adult (>65 years of age) home care recipients and nursing home residents in Sweden. Loneliness was self-reported by a single-item measure, and survey data were linked to population register data on age, gender, residential setting, income, and country of birth. Additive binomial regression models were used to estimate prevalence differences and discriminatory accuracy according to an analysis of individual heterogeneity and discriminatory accuracy (AIHDA) approach. Results showed inequalities in loneliness arising particularly in the intersection of country of birth, income, and residential setting. The inequalities widened slightly but ubiquitously following the emergence of the pandemic in 2020, with particularly nursing home residents emerging as a risk group. The discriminatory accuracy of inequalities was consistently low to moderate throughout the analyses but increased marginally during the pandemic in 2020. The study illustrates how social inequalities engenders heterogeneity in the psychosocial risk of older adults before and during the pandemic. These findings should stimulate more nuanced and equity-oriented depictions, research and policies about loneliness among older adults in the peri-pandemic era.

Anxiety and loneliness among older people living in residential care facilities or receiving home care services in Sweden during the COVID-19 pandemic: a national cross-sectional study

BACKGROUND

Older people were subjected to significant restrictions on physical contacts with others during the COVID-19 pandemic. Social distancing impacts older people's experiences of anxiety and loneliness. Despite a large body of research on the pandemic, there is little research on its effects on older people in residential care facilities (RCF) and in home care services (HCS), who are the frailest of the older population. We aimed to investigate the effect of the first wave of the COVID-19 pandemic in March-May 2020 on experiences of anxiety and loneliness among older people living in RCF or receiving HCS and the impact of the progression of the pandemic on these experiences.

METHODS

A retrospective cross-sectional design using data from the national user satisfaction survey (March - May 2020) by the Swedish National Board of Health and Welfare. Survey responses were retrieved from 27,872 older people in RCF (mean age 87 years) and 82,834 older people receiving HCS (mean age 84 years). Proportional-odds (cumulative logit) model was used to estimate the degree of association between dependent and independent variables.

RESULTS

Loneliness and anxiety were more prevalent among the older persons living in RCF (loneliness: 69%, anxiety: 63%) than those receiving HCS (53% and 47%, respectively). Proportional odds models revealed that among the RCF and HCS respondents, the cumulative odds ratio of experiencing higher degree of anxiety increased by 1.06% and 1.04%, respectively, and loneliness by 1.13% and 1.16%, respectively, for 1% increase in the COVID-19 infection rate. Poor self-rated health was the most influential factor for anxiety in both RCF and HCS. Living alone (with HCS) was the most influential factor affecting loneliness. Experiences of disrespect from staff were more strongly associated with anxiety and loneliness in RCF than in HCS.

CONCLUSION

Older people in RCF or receiving HCS experienced increasing levels of anxiety and loneliness as the first wave of the pandemic progressed. Older people' mental and social wellbeing should be recognized to a greater extent, such as by providing opportunities for social activities. Better preparedness for future similar events is needed, where restrictions on social interaction are balanced against the public health directives.

Loneliness in Elderly Inpatients

PURPOSE

Loneliness among the elderly is a widespread phenomenon and is connected to various negative health outcomes. Nevertheless, loneliness among elderly inpatients, especially those with a psychiatric diagnosis, has hardly been examined. Our study assessed loneliness in elderly inpatients, identified predictors, and compared levels of loneliness between inpatients on psychiatric and somatic wards.

METHODS

N = 100 elderly inpatients of a somatic and psychiatric ward were included. Levels of loneliness were assessed, as were potential predictors such as depression, psychological resilience, severity of mental illness, well-being, daily functioning, and psychiatric diagnosis. Analyses of group differences and hierarchical multiple regression analysis were conducted.

RESULTS

37% of all inpatients reported elevated levels of loneliness. Significant predictor variables were self-reported depressive symptoms, well-being, severity of mental illness, being single and living with a caregiver. Hierarchical multiple regression analysis revealed that the full model explained 58% of variance in loneliness. Psychiatric inpatients' loneliness was significantly higher than loneliness in somatic inpatients. When analyzing group differences between inpatients with different main psychiatric diagnoses, highest levels were found in patients with an affective disorder, followed by those treated for organic mental disorder. Since the study took place during the COVID-19 pandemic, potential influence of different measurement points (lockdown vs. no lockdown) were analyzed: Differences in loneliness depending on the phase of the pandemic were non-significant.

CONCLUSION

Elderly inpatients experience high levels of loneliness, especially those with a mental disorder. Interventions to reduce loneliness in this population should address predictors of loneliness, preferably through multiprofessional interventions.

Loneliness before and during the COVID-19 pandemic-are unpartnered and childless older adults at higher risk?

COVID-19 mitigation efforts had the potential to exacerbate loneliness among older adults, particularly for the unpartnered or childless, yet specific studies on loneliness among these groups during the COVID-19 pandemic are lacking. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected before (October 2019-March 2020) and during the pandemic (June-August 2020), we examine two loneliness outcomes: (1) "have you felt lonely recently?" (both datasets) and (2) "have you felt lonelier than before the pandemic?" (2020), and examine differences by partnership and parenthood status. Before COVID-19, those who lacked one tie but had the other (unpartnered parents or partnered childless) were at highest loneliness risk. During COVID-19, unpartnered and childless-especially unpartnered-remain at higher risk for loneliness, entering loneliness, and not "exiting" loneliness. We discuss these findings in light of family norms and needs in pandemic and non-pandemic times and provide recommendations for future research.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10433-022-00718-x.

Effects of general and corona-specific stressors on mental burden during the SARS-CoV-2 pandemic in Germany

The SARS-CoV-2 pandemic turned out to be a serious threat to mental and physical health. However, the relative contribution of corona-specific (DH_s) and general stressors (DH_g) on mental burden, and specific protective and risk factors for mental health are still not well understood. In a representative sample (N = 3,055) of the German adult population, mental health, potential risk, and protective factors as well as DH_s and DH_g exposure were assessed online during the SARS-CoV-2 pandemic (June and July 2020). The impact of these factors on mental health was analyzed using descriptive statistics, data visualizations, multiple regressions, and moderation analyses. The most burdensome DH_g were financial and sleeping problems, respectively, and DH_s corona-media reports and exclusion from recreational activities/important social events. 31 and 24% of total mental health was explained by DH_g and DH_s, respectively. Both predictors combined explained 36%, resulting in an increase in variance due to DH_s of only 5% (R² adjusted). Being female, older and a lower educational level were identified as general risk factors, somatic diseases as a corona-specific risk factor, and self-efficacy and locus of control (LOC) proved to be corona-specific protective factors. Further analyses showed that older age and being diagnosed with a somatic illness attenuated the positive influence of LOC, self-efficacy, and social support on resilience. Although the data showed that after the first easing restrictions, the stressor load was comparable to pre-pandemic data (with DH_s not making a significant contribution), different risk and protective factors could be identified for general and corona-specific stressors. In line with observations from network analysis from other groups, the positive impact of resilience factors was especially diminished in the most vulnerable groups (elderly and somatically ill). This highlights the need to especially target these vulnerable groups to foster their resilience in upcoming waves of the corona pandemic.

Incident and Recurrent Depression among Adults Aged 50 Years and Older during the COVID-19 Pandemic: A Longitudinal Analysis of the Canadian Longitudinal Study on Aging

The COVID-19 pandemic and accompanying public health measures have exacerbated many risk factors for depression in older adulthood. The objectives of the current study are: (1) to determine the risk of incident and recurrent depression during the COVID-19 pandemic among those with, or without, a history of depression; and (2) to identify factors that were predictive of depression in these two groups. The study population included 22,622 participants of the Canadian Longitudinal Study on Aging who provided data at baseline (2011-2015), follow-up (2015-2018), and twice during the pandemic (April-May 2020, September-December 2020). The Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to classify individuals with depression. Logistic regression was used to estimate the odds of depression during COVID across a series of risk factors. Individuals with a history of depression had four times the risk of depression during the pandemic when compared to those without a history of depression, even after controlling for relevant covariates. Other factors associated with depression during the pandemic include being female, having fewer savings, and experiencing COVID-19 related stressors, such as health stressors, difficulties accessing resources, and family conflict. Clinicians working with older adults should consider interventions to support high-risk groups, such as those with recurrent depression.

Older Adults and Social Isolation and Loneliness During the COVID-19 Pandemic: An Integrated Review of Patterns, Effects, and Interventions

A scoping review was conducted to identify patterns, effects, and interventions to address social isolation and loneliness among community-dwelling older adult populations during the COVID-19 pandemic. We also integrated (1) data from the Canadian Longitudinal Study on Aging (CLSA) and (2) a scan of Canadian grey literature on pandemic interventions. CLSA data showed estimated relative increases in loneliness ranging between 33 and 67 per cent depending on age/gender group. International studies also reported increases in levels of loneliness, as well as strong associations between loneliness and depression during the pandemic. Literature has primarily emphasized the use of technology-based interventions to reduce social isolation and loneliness. Application of socio-ecological and resilience frameworks suggests that researchers should focus on exploring the wider array of potential pandemic age-friendly interventions (e.g., outdoor activities, intergenerational programs, and other outreach approaches) and strength-based approaches (e.g., building community and system-level capacity) that may be useful for reducing social isolation and loneliness.

Understanding and Addressing Older Adults' Loneliness: The Social Relationship Expectations Framework

Loneliness is an experience resulting from a perceived discrepancy between expected and actual social relationships. Although this discrepancy is widely considered the "core mechanism" of loneliness, previous research and interventions have not sufficiently addressed what older adults specifically expect from their social relationships. To address this gap and to help situate research on older adults' loneliness within broader life span developmental theories, we propose a theoretical framework that outlines six key social relationship expectations of older adults based on research from psychology, gerontology, and anthropology: availability of social contacts, receiving care and support, intimacy and understanding, enjoyment and shared interests, generativity and contribution, and being respected and valued. We further argue that a complete understanding of loneliness across the life span requires attention to the powerful impacts of contextual factors (e.g., culture, functional limitations, social network changes) on the expression and fulfillment of older adults' universal and age-specific relationship expectations. The proposed Social Relationship Expectations Framework may fruitfully inform future loneliness research and interventions for a heterogeneous aging population.

Belongingness challenged: Exploring the impact on older adults during the COVID-19 pandemic

OBJECTIVES

The sense of belonging is a fundamental human need. Enacting it through face-to-face social activities was no longer possible during the COVID-19 pandemic. In this study, we investigate how the sense of belonging, and how it is enacted, changed longitudinally amongst older adults in the UK. In addition, we examine the interplay of the sense of belonging and resilience over time.

METHODS

We employed a longitudinal qualitative research design to explore the experiences of older adults during one year of the COVID-19 pandemic (April 2020-April 2021). The analysis was undertaken with constructivist grounded theory.

FINDINGS

Before the pandemic older adults were free to engage in social relationships with family and friends, often enacted within social activity groups where they felt valued and gained positive experiences. During the pandemic face to face enactment of belongingness was reduced; adjustments needed to be made to maintain the sense of belonging. The experience of older adults was heterogeneous. We examine three themes. First, how belongingness was enacted prior to the pandemic. Examples include: family holidays, visiting each other, sports activities, eating with friends and family, and visiting cultural events. Second, how participants adapted and maintained their social involvement. Examples include: distanced face-to-face activities; and learning new technology. Third, for some, a belongingness gap emerged and persisted. There was an irretrievable loss of family members or friends, the closure of social groups, or withdrawal from groups as priorities changed. As a consequence, of challenged belongingness, participants expressed increased loneliness, anxiety, social isolation, frustration and, feelings of depression. For many, the disrupted sense of belonging no longer fostered resilience, and some previously resilient participants were no longer resilient.

Social Workers' Involvement in Developing and Implementing Social Programs for Older Adults During the COVID-19 Pandemic in Nigeria: A Concept Paper and Suggestions for Action Plans

Social workers, especially in the Global North/developed countries such as the United States of America, Australia, Canada, and the United Kingdom, have been actively involved in implementing social programs to improve the psychosocial, health, and wellbeing of older adults during the COVID-19 pandemic. However, this is not the case in the Global South/developing countries like Nigeria, Ghana, etc. This concept paper aims to describe the current state of Nigerian social workers' role in developing and implementing social programs for older adults during the COVID-19 pandemic and to identify action plans for further strengthening their involvement. We systematically reviewed the literature to identify Nigerian social workers' role in developing and implementing social programs for older adults during COVID-19. Our review reflected that social workers are rarely involved in developing and implementing social programs; when involved, their involvement is on a consultation basis, which limits their active involvement in multidisciplinary team of COVID-19 prevention and vaccination ad hoc committees in Nigeria.

Predictors of Loneliness among Homeless Individuals in Germany during the COVID-19 Pandemic

PURPOSE

The aim of the study was to identify the frequency of loneliness and to examine the factors associated with loneliness among homeless individuals in Germany during the COVID-19 pandemic.

METHODS

Data were taken from the 'national survey on the psychiatric and somatic health of homeless individuals during the COVID-19 pandemic'. The data collection took place from 26th July to 17th September 2021 (the analytical sample included n = 491 observations). The well-established UCLA-3 tool was used to quantify loneliness. Independent variables included sex, age, marital status, the existence of children and pets, level of education, country of origin, duration of homelessness, alcohol and drug consumption, mental health concerns and concerns regarding COVID-19 illness. Multiple logistic regressions were used to examine the predictors of loneliness.

RESULTS

The frequency of loneliness was 41.7% for the total sample. Multiple logistic regression analysis stratified by gender showed that a higher likelihood of loneliness was associated with being born in Germany, being middle aged (40 to 49 years compared to 18 to 29 years), having mental health problems and a short period of homelessness (1 month compared to longer periods) among women. In men, a higher likelihood of loneliness was associated with a higher fear of COVID-19 and a short period of homelessness.

CONCLUSIONS

Our study revealed a high frequency rate of loneliness among homeless individuals. The study results highlight the associations between some explanatory variables (i.e., the duration of homelessness and mental health problems). Identifying the factors associated with loneliness may help to adequately address the problems of homeless individuals at risk of loneliness. Longitudinal studies are required to confirm our findings.

[PAPPS update on older people 2022]

This article examines the latest available evidence on preventive activities in the elderly, including sleep disorders, physical exercise, deprescription, cognitive disorders and dementias, nutrition, social isolation and frailty.

General psychiatric symptoms among Bangladeshi people approximately one year after the onset of the COVID-19 pandemic

BACKGROUND

Coronavirus disease-2019 (COVID-19) has had negative physical and mental impacts on people globally. The current study examined general psychiatric symptoms (fear, anxiety, depression, and insomnia) and loneliness, and their interrelationships and correlates among Bangladeshi individuals approximately 1 year after the onset of the COVID-19 outbreak.

METHODS

An internet-based cross-sectional survey was conducted among 1004 Bangladeshi people (51.8% male; mean age: 25.41 ± 7.80; age range: 18-60 years). Data were collected using a semi-structured e-questionnaire including informed consent, socio-demographics, lifestyle measures, and psychometric tools assessing loneliness, anxiety, depression, insomnia, and fear of COVID-19.

RESULTS

Sizeable participants screened positive for loneliness (63.5%), anxiety (26.3%), depression (46.4%), and insomnia (50.7%). Considerable numbers of respondents also reported fear of COVID-19. In hierarchical regression analyses, loneliness, anxiety, depression, insomnia, and fear of COVID-19 were associated with socio-demographic and lifestyle factors. Loneliness, anxiety, depression, insomnia, and fear of COVID-19 were positively correlated with each other (p < 0.001). In exploratory path analyses, anxiety, depression, and insomnia mediated the relationship between loneliness and fear of COVID-19.

CONCLUSIONS

The findings indicate that many people in Bangladesh have experienced psychiatric concerns approximately 1 year after the onset of the COVID-19 outbreak. Investigation into empirically supported interventions and their implementation is needed.

Surviving Through Solitude: A Prospective National Study of the Impact of the Early COVID-19 Pandemic and a Visiting Ban on Loneliness Among Nursing Home Residents in Sweden

OBJECTIVES

Targeted social distancing measures were widely implemented for nursing home residents when the extremely high coronavirus disease 2019 mortality in this setting became apparent. However, there is still scarce rigorous research examining how the pandemic and accompanying social distancing measures affected loneliness in this group. This prospective nationwide Swedish study of nursing home residents aimed to examine the impact on loneliness of the early phase of the pandemic and of a national visiting ban at nursing homes.

METHODS

A panel was selected from a total population survey of all nursing home residents in Sweden March-May 2019 and 2020 (N = 11,782; age range 70-110 years; mean age 88.2 years; 71% women). Prospective pretest-posttest and controlled interrupted time series (ITS) designs were employed, with time trends estimated by date of returned questionnaire. Generalized linear models were used for estimation of effects, adjusting for demographic-, survey-, and health-related covariates.

RESULTS

Loneliness prevalence increased from 17% to 19% from 2019 to 2020 (risk ratio, RR (95% confidence interval, CI) = 1.104 (1.060; 1.150)), but which was explained by self-reported health (RR (95% CI) = 1.023 (0.982; 1.066)). No additional impact of the visiting ban on loneliness trends was found in the ITS analyses (RR (95% CI) = 0.984 (0.961; 1.008)).

DISCUSSION

The moderate but health-dependent increased risk of loneliness, and the lack of impact of the nationwide visiting ban at nursing homes, suggests that this ostensibly vulnerable group of nursing home residents also shows signs of resilience, at least during the early phase of the pandemic.

Predictive Factors of Anxiety, Depression, and Health-Related Quality of Life in Community-Dwelling and Institutionalized Elderly during the COVID-19 Pandemic

The COVID-19 health emergency and restrictive measures have increased psychological problems, particularly anxiety and depression, in the general population. However, little is known about mental health conditions and the possible risk and protective factors of specific population groups, such as institutionalized vs. community-dwelling elderly. We investigated the abovementioned aspects in a sample of 65-89-year-old people during the third wave of COVID-19 in Italy. We employed a sociodemographic survey and four questionnaires on health-related quality of life (SF-36), loneliness (UCLA), spirituality (FACIT-Sp), and anxiety/depression (HADS). Our findings suggest that the physical, psychological, and spiritual well-being of the elderly had not been seriously impaired by the events related to the pandemic, although most of the participants reported a worsening of their social life and a moderate/high fear of COVID-19. In regression analyses, these two latter aspects turned out to be predictors of higher anxiety, while spiritual well-being and the possibility to get out of the house/institution emerged as protective factors against anxiety and for preserving quality of life, respectively. Our findings help refine the picture of the condition of the elderly in the aftermath of the pandemic, giving some hints about how to continue supporting their well-being and quality of life.

Social isolation and the role of AgeTech in a post-COVID world

The COVID-19 pandemic particularly affected social connection through enforced social isolation and loss of regular activities. For healthcare systems, various initiatives have sprung up, leveraging existing technologies to connect people with services, activities, and loved ones. Here we review some AgeTech offerings to address social isolation for healthcare leadership and management to consider.

Loneliness, loneliness literacy, and change in loneliness during the COVID-19 pandemic among older adults: a cross-sectional study

BACKGROUND

Loneliness has become a significant public health concern for older people. However, little is known about the association of loneliness, loneliness literacy, and changes in loneliness during the COVID-19 pandemic with mental well-being. The purpose of this study was to explore whether loneliness literacy is related to a lower risk of loneliness, increased loneliness during the COVID-19 pandemic, and improved mental well-being for community-based older adults.

METHODS

A telephone survey was conducted to collect data from older adults aged 65 years or older in Taiwan (n = 804). Loneliness, change in loneliness during COVID-19, and loneliness literacy were the main variables. Mental well-being was assessed by depressive symptoms and life satisfaction. Related factors included personal level (demographics, health conditions, health behaviors, and problem-focused/ emotion-focused coping strategies), interpersonal level (marital status, living arrangements, social support, social participation, leisure activities, and social interactions during COVID-19), and societal level (areas and regions) factors.

RESULTS

Four dimensions of loneliness literacy were identified by factor analysis: self-efficacy, social support, socialization, and in-home support. Self-efficacy and in-home support were related to lower loneliness. Lower self-efficacy, higher social support, and higher socialization were related to changes (increases) in loneliness during COVID-19. In-home support may prevent depressive symptoms, while self-efficacy was beneficial for better life satisfaction. In addition, emotion-focused coping may increase loneliness during COVID-19, while satisfaction with family support would be a protective factor against loneliness.

CONCLUSION

Loneliness literacy is related to loneliness and increased loneliness during the COVID-19 pandemic. Building up an age-friendly community with embedded services/information and learning positive coping and mental resilience strategies are suggested.

Has Smartphone Use Influenced Loneliness during the COVID-19 Pandemic in Japan?

The influence of smartphone use on increased risk of feeling lonely has been recognized as a global public health concern. However, it is unclear whether this influence has changed during the ongoing COVID-19 pandemic, during which smartphones have become a particularly important means of communication due to health safety measures restricting personal interactions. We used Hiroshima University's online survey data collected from 18-28 February 2022, to assess the impact of smartphone use on loneliness in Japan. The final sample included 2630 participants aged over 20 years, with loneliness measured using the UCLA scale and smartphone use calculated as the duration of usage in minutes/day. Weighted logit regression analysis was used to examine the association between smartphone use and loneliness, with other demographic, socioeconomic, and psychological characteristics as explanatory variables. Contrary to conventional evidence, our findings show that smartphone use mitigated the risk of loneliness during the pandemic. This was especially true among females under 65 years old. We found that age, subjective health status, future anxiety, and depression impacted this relationship. The findings of this study can help guide policymaking by showing the importance of providing adequate digital platforms to manage loneliness and mental health during times of isolation.

Job stress and loneliness among desk workers during the COVID-19 pandemic in Japan: focus on remote working

Background

Previous studies have reported an increase in loneliness since the outbreak of coronavirus disease 2019 (COVID-19), but there are few data on the relationship between job stress and loneliness. This study aimed to assess the relationship between job stress and loneliness among desk workers, with a focus on the impact of remote working.

Methods

This study was part of the Collaborative Online Research on the Novel-coronavirus and Work (CORoNaWork) project in Japan. We extracted data from 13,468 workers who indicated that they were doing desk work. Loneliness was assessed using a single question and job stress was valuated using the Job Content Questionnaire (JCQ). Multiple logistic regression was performed.

Results

Participants who worked remotely 4 or more days per week were marginally more likely to report feeling lonely compared with those who did not work remotely (adjusted odds ratio = 1.23, 95% CI: 0.99–5.84, P = 0.066). Remote working did not explain the interaction between JCQ scale scores and loneliness. Among remote workers, the level of support provided by co-workers and supervisors was strongly associated with feelings of loneliness as well as non-remote workers (co-worker support: AOR = 4.06, 95% CI: 2.82–5.84, P < 0.001; supervisor support: AOR = 2.49, 95% CI: 1.79–3.47, P < 0.001).

Conclusions

To reduce loneliness and the risk of associated mental health problems, high-frequency remote workers should interact with supervisors and co-workers using the information and communication technology developed for this purpose.

Caste and COVID-19: Psychosocial disparities amongst rural Indian women during the coronavirus pandemic

The COVID-19 pandemic has exacerbated preexisting mental health disparities. In India, marginalization based on caste membership, gender, and rural residence are critical determinants of inequity across the lifespan. Guided by the theoretical frameworks of minority stress and intersectionality, this study examined caste-based disparities in fear of coronavirus (FOC), mental health symptoms, and perceived loneliness amongst rural women in north India during the COVID-19 pandemic. Participants (N = 316) completed self-report measures and were classified into three groups based on their responses: General caste (GC, n = 124), other backward castes (OBC, n = 122), and scheduled caste or tribe (SC/ST, n = 71). Using a three-way ANOVA and Tukey t-tests, women in SC/ST and OBC groups reported greater FOC (OBC d = .37; SC/ST d = .40) and greater mental health symptoms (OBC d = .58; SC/ST d = .43) relative to the GC group. OBC, but not SC/ST, group also reported higher perceived loneliness (d = .32). The results were consistent after adjusting for demographic variables such as wealth and highlight caste as an important social determinant for well-being during the COVID-19 pandemic amongst rural Indian women.

How the COVID-19 Pandemic Changed Adolescents’ Use of Technologies, Sense of Community, and Loneliness: A Retrospective Perception Analysis

The COVID-19 pandemic has brought important changes to how we engage in relationships of any kind. To combat the spread of the virus, schools resorted to remote-learning, and teenagers had to rely on various technologies to meet many of the needs that they used to satisfy offline (e.g., social, informational, and recreational/leisure purposes). This article was written to investigate the changes that the students at an Italian high school went through in terms of use of technologies, loneliness, and sense of community, through a survey focusing on their retrospective perceptions. The study was carried out on 917 students. In general, we have found that the COVID-19 pandemic has greatly increased the perception of loneliness in teenagers (especially in female respondents), as well as their use of technologies for social, informational, and leisure purposes. However, maybe thanks to the opportunities provided by ICTs and remote learning, the sense of community in Italian teenagers was only marginally impacted.

Psychological Wellbeing and Psychological Distress in the Elderly during the COVID-19 Pandemic

BACKGROUND: The elderly population is deemed to be the most vulnerable to the effects of the COVID-19 pandemic. From March 2020 to April 2022, the implementation of psychological distancing is still being applied in Indonesia. In the light of the pandemic, mental health problems among the elderly require further exploration. This study examines the mental health status of the elderly during the COVID-19 pandemic in Indonesia and the factors that affect their mental health, such as loneliness and attachment to God. METHODS: A sequential explanatory type of the mixed-method approach was adopted for the purposes of this study. In particular, the researchers first conducted a quantitative survey, analyzed its results, and then explained them in more detail using qualitative research. RESULTS: The results show that loneliness is a predictor of mental health in the elderly, while attachment to God does not correlate with mental health. More specifically, we described that minimal activity, inability to meet children and grandchildren, and inability to recite the Quran were the main factors triggering sadness among the elderly during the COVID-19 pandemic. Furthermore, we defined that elderly people use productive and religious activities, and communication as main coping strategies. CONCLUSION: Loneliness has been a serious problem for the elderly during the COVID-19 pandemic, impacting their mental health. The findings of this research can be used as a basis or reference for maintaining the mental health of the elderly during the pandemic.

Patterns of Internet Use, and Associations with Loneliness, amongst Middle-Aged and Older Adults during the COVID-19 Pandemic

Loneliness among older adults is a major societal problem with consequences for health and wellbeing; this has been exacerbated by the coronavirus pandemic. The present study investigated associations between internet use, including frequency and type of use, and loneliness in a large UK sample of middle-aged and older adults, aged 55–75 (n = 3500) from the English Longitudinal Study of Ageing (ELSA) cohort study. Our findings indicated a clear relationship between the frequency of internet use and subjective loneliness. Those who used the internet more than once a day reported feeling less lonely than those who used the internet once a week or less. We also found that those who used the internet for e-mail communication were less lonely. However, individuals indicated higher levels of loneliness when the internet was used for information searches about health. Regarding sociodemographic factors underlying internet usage, less frequent use was seen amongst individuals who lived alone, people who were not employed, who had lower education levels, and lower sociodemographic status. Additionally, gender differences were found in the type of internet use: males report using the internet for e-mail communication more than females, while females’ internet use for health-related information searches was higher than in males. In sum, findings suggest that intervention strategies that promote internet access amongst middle-aged and older people could be useful for tackling loneliness and point to the groups within society that should be the focus of such interventions.

Music and Movement for Health: Protocol for a pragmatic cluster-randomised feasibility pilot trial of an arts-based programme for the health and wellbeing of older adults

Background: Arts-based health programmes (ABHP) can enhance the physical and psychosocial health and wellbeing of older people. However, the feasibility and usefulness of such programmes in Ireland are currently unknown. The primary aim of this study is to examine the feasibility of the study design, its application to a music and movement for health programme and associated costs. The secondary aim is to obtain preliminary effect estimates of an ABHP on health and wellbeing in older adults. Methods: This study is a pragmatic cluster-randomised controlled feasibility trial. Community-dwelling adults, aged 65 years or older will be recruited in the mid-west region of Ireland via methods including social prescription, traditional and social media. The clusters, based on geographical region, will be block randomised to either the ABHP or control using 1:1 allocation ratio. The programme will comprise a 1.5-hour music and dance session each week for 12-weeks together with a 1-hour home-based music and movement programme for 12-weeks. A qualitative and quantitative process evaluation of the arts-based health programme will be performed. Outcomes: Primary outcomes for feasibility include recruitment rates (the number of participants recruited per cluster per month); retention rate (the number of participants who complete measures at baseline and at follow up post intervention, and minimum average attendance. Secondary outcomes will include physical function, balance, physical activity, loneliness, social isolation, cognition, mood, as well as quality of life and cost. Conclusions: If this pioneering study finds evidence to support feasibility and acceptability, a future larger-scale definitive trial will be conducted to examine the effectiveness of an arts-based health programme for older adults. This research aims to strengthen collaborative efforts to implement effective, sustainable and cost-effective programmes for older adults to support community connection, enhancing health and wellbeing, in turn reducing demands on the healthcare system. ISRCTN registration: ISRCTN35313497 (18/02/2022).

Venerable vulnerability or remarkable resilience? A prospective study of the impact of the first wave of the COVID-19 pandemic and quarantine measures on loneliness in Swedish older adults with home care

OBJECTIVES

To examine the early impact of the pandemic and of quarantine measures targeting older adults introduced in March 2020 on loneliness among older adults in Sweden.Design Prospective pretest-posttest and controlled interrupted time series designs.

SETTING

The population of older adults receiving home care before and during the emergence of the first COVID-19 pandemic wave in Sweden in Spring 2020.

PARTICIPANTS

Respondents (n=45 123, mean age 85.6 years, 67.6% women) came from two waves of a total population survey targeting all community-dwelling older adults receiving home care for older adults in Sweden in Spring 2019 and 2020.

OUTCOME

Self-reported loneliness.

RESULTS

Results estimated 14% (95% CI: 10 to 19) higher loneliness in Spring 2020 compared with 2019, taking covariates into account. No impact of the quarantine measure was found (1% increase, 95% CI: -1 to 4).

CONCLUSIONS

The results illustrate the broader public health consequences of the COVID-19 pandemic for older adults, but also suggest a relative resilience among older adults in home care to quarantine measures, at least during the first months of the pandemic. Future studies should examine the long-term effects of sustained pandemic and social distancing measures on loneliness among older adults.

Who Became Lonely during the COVID-19 Pandemic? An Investigation of the Socioeconomic Aspects of Loneliness in Japan

The COVID-19 pandemic has impacted social and economic aspects of people’s lives in different ways, causing them to experience different levels of loneliness. This study examines the extent of loneliness among men and women of various ages in Japan during the pandemic and attempts to determine the underlying causes. We used data from Hiroshima University’s nationwide survey conducted before and during the pandemic in Japan. The sample consists of 3755 participants, of which 67% are men and 33% are women with an average age of 51 years (SD = 13.64). Using mean comparison tests and probit regression models, we show that loneliness is a common occurrence among the Japanese population and that a significant number of people became lonely for the first time during the pandemic. In general, loneliness was greater among younger respondents, but older people became lonelier during the pandemic. Simultaneously, we observed significant differences in loneliness across age and gender subsamples. Although depression and subjective health status contributed to loneliness, we found no single explanation for the loneliness experienced by people during the pandemic; rather, subsample analysis revealed that the causes of loneliness for each group differed. Nevertheless, we discovered that older people are at a higher risk of developing loneliness during the pandemic due to a variety of socioeconomic and behavioral factors. The findings of this study suggest that health authorities should not generalize cases of loneliness, but rather intervene individually in each group to avoid further complications.

Medievals and Moderns in Conversation: Co-Designing Creative Futures for Under-Used Historic Churches in Rural Communities

For many living in rural areas, the loss of traditional community assets and increased social fragmentation are a common feature of everyday life. The empty village church is a poignant symbol of these challenges; yet, these are sites that hold considerable potential for new placemaking solutions that respond to the needs of communities today. This means looking beyond “the traditional village church” to recognise a longer history of church adaptation and resilience within the lives of communities. In this paper we ask: how can co-design, projected through a Wicked problems and Clumsy solutions lens, help imagine new futures for communities and their historic churches today? Clumsy solutions consider a plurality of different perspectives on the nature of problems and their resolution to deliver more effective solutions with broad appeal. In the search for clumsiness, we turn to ‘long history’ and ‘slow technology’ for inspiration, uncovering deeper resonance with historical communities of place and anchoring that continuity within church sites themselves. Our paper demonstrates how Wicked/Clumsy thinking can account for the challenges faced by rural communities today, bootstrap co-design activities in the development of clumsy solutions, and uncover clumsiness in long history and slow technology dimensions—together laying the foundation for new placemaking strategies.

Post-pandemic urban design: The equilibrium between social distancing and social interactions within the built environment

The previous arguments in respect to the COVID-19 pandemic tend to support the lockdown and closure policy in order to prevent widespread infection of the epidemic within urban spaces. Using semi-structured interviews, the present study identifies that there are some serious consequences by adopting this policy due to the indispensable social interactions and uncooperative attitude of the general public to the harsh isolation approaches. These negative impacts on people's psychological health are partly caused by the inflexible urban design of the built environment in the pre-pandemic period. To create a balance between social distancing and social interactions within urban spaces, the paper proposes a general framework of post-pandemic street furniture design. It provides an innovative approach using a grid-based method, which can be applied to other cities across the world in order to deal with the potential analogous pandemic perils in the future.

Loneliness in older people and COVID-19: Applying the social identity approach to digital intervention design

The COVID-19 pandemic is worsening loneliness for many older people through the challenges it poses in engaging with their social worlds. Digital technology has been offered as a potential aid, however, many popular digital tools have not been designed to address the needs of older adults during times of limited contact. We propose that the Social Identity Model of Identity Change (SIMIC) could be a foundation for digital loneliness interventions. While SIMIC is a well-established approach for maintaining wellbeing during life transitions, it has not been rigorously applied to digital interventions. There are known challenges to integrating psychological theory in the design of digital technology to enable efficacy, technology acceptance, and continued use. The interdisciplinary field of Human Computer Interaction has a history of drawing on models originating from psychology to improve the design of digital technology and to design technologies in an appropriate manner. Drawing on key lessons from this literature, we consolidate research and design guidelines for multidisciplinary research applying psychological theory such as SIMIC to digital social interventions for loneliness.

Self-reported mental health during the COVID-19 pandemic and its association with alcohol and cannabis use: a latent class analysis

BACKGROUND

Mental health problems and substance use co-morbidities during and after the COVID-19 pandemic are a public health priority. Identifying individuals at high-risk of developing mental health problems and potential sequela can inform mitigating strategies. We aimed to identify distinct groups of individuals (i.e., latent classes) based on patterns of self-reported mental health symptoms and investigate their associations with alcohol and cannabis use.

METHODS

We used data from six successive waves of a web-based cross-sectional survey of adults aged 18 years and older living in Canada (6,021 participants). We applied latent class analysis to three domains of self-reported mental health most likely linked to effects of the pandemic: anxiety, depression, and loneliness. Logistic regression was used to characterize latent class membership, estimate the association of class membership with alcohol and cannabis use, and perform sex-based analyses.

RESULTS

We identified two distinct classes: (1) individuals with low scores on all three mental health indicators (no/low-symptoms) and (2) those reporting high scores across the three measures (high-symptoms). Between 73.9 and 77.1% of participants were in the no/low-symptoms class and 22.9-26.1% of participants were in the high-symptom class. We consistently found across all six waves that individuals at greater risk of being in the high-symptom class were more likely to report worrying about getting COVID-19 with adjusted odds ratios (aORs) between 1.72 (95%CI:1.17-2.51) and 3.51 (95%CI:2.20-5.60). Those aged 60 + were less likely to be in this group with aORs (95%CI) between 0.26 (0.15-0.44) and 0.48 (0.29-0.77) across waves. We also found some factors associated with class membership varied at different time points. Individuals in the high-symptom class were more likely to use cannabis at least once a week (aOR = 2.28, 95%CI:1.92-2.70), drink alcohol heavily (aOR = 1.71, 95%CI:1.49-1.96); and increase the use of cannabis (aOR = 3.50, 95%CI:2.80-4.37) and alcohol (aOR = 2.37, 95%CI:2.06-2.74) during the pandemic. Women in the high-symptom class had lower odds of drinking more alcohol during the pandemic than men.

CONCLUSIONS

We identified the determinants of experiencing high anxiety, depression, and loneliness symptoms and found a significant association with alcohol and cannabis consumption. This suggests that initiatives and supports are needed to address mental health and substance use multi-morbidities.

Social Isolation in Older Adults: A Qualitative Study on the Social Dimensions of Group Outdoor Health Walks

Physical distancing practices during the COVID-19 global pandemic contributed to a high degree of social isolation among older adults. To reduce loneliness and other ill effects of social isolation, public health experts recommended outdoor social gathering, with physical distancing. Adopting a case study approach, we explored how social aspects of group outdoor health walks (GOHWs) mitigate social isolation for older adults and improve individual social wellbeing. We used semi-structured interviews to understand the experiences of social isolation and social relationships in nine older (50–80 s) adults participating in a GOHW in Scotland, United Kingdom (UK). Verbatim transcripts were analysed through an iterative process of thematic analysis carried out by an interdisciplinary team of qualitative researchers from environmental psychology, medicine, and geography. Themes provide insight into the social dimensions of GOHWs, the mediating effects of social experiences, and the contribution these make to individual social wellbeing. GOHWs provide opportunities to be part of a group and attend to the needs of inexperienced or physically challenged individuals. Being part of the group walk fosters casual interpersonal interactions through spontaneous mixing during and after the walk. This programmatic structure counters loneliness, engenders pleasurable anticipation of regular contact with others, supports physical activity, and fosters group cohesion. These in turn contribute to individual social wellbeing, including expanding social networks, meaningful relationships, a sense of belonging, and acting on empathy for others. GOWHs may be beneficial for mitigation of social isolation as we emerge from the COVID-19 pandemic. Findings were used to propose a conceptual model to parse social constructs and inform selection or development of quantitative social measures for future studies of nature-based interventions such as GOHWs.

Loneliness Progression Among Older Adults During the Early Phase of the COVID-19 Pandemic in the United States and Canada

OBJECTIVES

Older adults are at high risk for complications from coronavirus disease 2019 (COVID-19). Health guidelines recommend limiting physical contact during the pandemic, drastically reducing opportunities for in-person social exchange. Older adults are also susceptible to negative consequences from loneliness, and the COVID-19 pandemic has likely exacerbated this age-related vulnerability.

METHODS

In 107 community-dwelling older individuals (65-90 years, 70.5% female) from Florida, the United States, and Ontario, Canada, we examined change in loneliness over the course of the pandemic after implementation of COVID-19-related physical distancing guidelines (March-September 2020; T1-T5; biweekly concurrent self-report) using multilevel modeling. We also explored gender differences in loneliness during the early phase of the COVID-19 pandemic at both data collection sites.

RESULTS

Consistent across the 2 sites, levels of loneliness remained stable over time for the full sample (T1-T5). However, our exploratory moderation analysis suggested gender differences in the trajectory of loneliness between the United States and Canada, in that older men in Florida and older women in Ontario reported an increase in loneliness over time.

DISCUSSION

Leveraging a longitudinal, binational data set collected during the early phase of the COVID-19 pandemic, this study advances understanding of stability and change in loneliness among a North American sample of individuals aged 65 and older faced with the unique challenges of social isolation. These results can inform public health policy in anticipation of future pandemics and highlight the need for targeted intervention to address acute loneliness among older populations.

Factors Associated with Non-Use of Social Media or Video Communications to Connect with Friends and Family During the COVID-19 Pandemic in Older Adults: Online Survey Study

Background

Digital technologies have enabled social connection during prolonged periods of physical distancing and travel restrictions throughout the COVID-19 pandemic. These solutions may exclude older adults, who are at higher risk for social isolation, loneliness, and severe outcomes if infected with SARS-CoV-2.

Objective

This study investigated factors associated with nonuse of social media or video communications to connect with friends and family among older adults during the pandemic’s first wave.

Methods

A web-based, cross-sectional survey was administered to members of a national retired educators’ organization based in Ontario, Canada, between May 6 and 19, 2020. Respondents (N=4879) were asked about their use of social networking websites or apps to communicate with friends and family, their internet connection and smartphone access, loneliness, and sociodemographic characteristics. Factors associated with nonuse were evaluated using multivariable logistic regression. A thematic analysis was performed on open-ended survey responses that described experiences with technology and virtual connection.

Results

Overall, 15.4% (751/4868) of respondents did not use social networking websites or apps. After adjustment, male gender (odds ratio [OR] 1.60, 95% CI 1.33-1.92), advanced age (OR 1.88, 95% CI 1.38-2.55), living alone (OR 1.68, 95% CI 1.39-2.02), poorer health (OR 1.33, 95% CI 1.04-1.71), and lower social support (OR 1.44, 95% CI 1.20-1.71) increased the odds of nonuse. The reliability of internet connection and access to a smartphone also predicted nonuse. Many respondents viewed these technologies as beneficial, especially for maintaining pre–COVID-19 social contacts and routines, despite preferences for in-person connection.

Conclusions

Several factors including advanced age, living alone, and low social support increased the odds of nonuse of social media in older adults to communicate with friends and family during COVID-19’s first wave. Our findings identified socially vulnerable subgroups who may benefit from intervention (eg, improved access, digital literacy, and telephone outreach) to improve social connection.

Psychological Health and Digital Social Participation of the Older Adults during the COVID-19 Pandemic in Blekinge, Sweden-An Exploratory Study

COVID-19 has affected the psychological health of older adults directly and indirectly through recommendations of social distancing and isolation. Using the internet or digital tools to participate in society, one might mitigate the effects of COVID-19 on psychological health. This study explores the social participation of older adults through internet use as a social platform during COVID-19 and its relationship with various psychological health aspects. In this study, we used the survey as a research method, and we collected data through telephonic interviews; and online and paper-based questionnaires. The results showed an association of digital social participation with age and feeling lack of company. Furthermore, in addition, to the increase in internet use in older adults in Sweden during COVID-19, we conclude that digital social participation is essential to maintain psychological health in older adults.

Loneliness as risk factor for Alzheimer´s disease

There is considerable empirical evidence that unequivocally points to loneliness as a modifiable risk factor for the development of Alzheimer's disease and other related dementias. With the emergence of the COVID-19 pandemic and the resulting lockdown and social distancing, there has been renewed interest in studying this topic. The present review examines the links between loneliness and Alzheimer's disease, with particular emphasis on the mechanisms common to both conditions.

Creativity, Boredom Proneness and Well-Being in the Pandemic

Throughout the course of the pandemic, it has become clear that the strictures of social isolation and various levels of lockdown constraints have impacted people’s well-being. Here, our aim was to explore relations between trait dispositions associated with boredom proneness, self-regulation and well-being using data collected early in the pandemic. Specifically, we explored whether the tendency to engage in everyday creative pursuits (e.g., making your own greeting cards) would act as a prophylactic against poor well-being. Results showed that well-being was higher for those individuals who increased engagement with creative pursuits during the early stages of the pandemic. That is, people who engaged more in everyday creative activities also reported higher levels of self-esteem, optimism, and positive affect. In contrast, those who pursued fewer creative outlets had higher levels of depression and anxiety, were higher in boredom proneness, and reported experiencing more negative affect. As we emerge from the pandemic, these data provide a clue as to how people might plan to cope adaptively with the restrictive circumstances this extreme world event engendered. More generally, these data provide support for the notion that everyday creativity (and not necessarily creative expertise) has positive associations for well-being.

Feminist Loneliness Studies: an introduction

Writing about loneliness has been a struggle in the midst of the pandemic. Characterized by loneliness, isolation, anxiety, and fear, the COVID-19 pandemic is an exceptionally challenging time. At various points while navigating this loneliness project amid a particularly lonely time, we lamented the seeming futility of it all. A main goal of developing a Feminist Loneliness Studies in this introduction is to understand the ways that systems of oppression – white supremacy, settler colonialism, anti-queer bias, misogyny, neoliberal capitalism, and so on – create our lonely world. To date, there remains no comprehensive feminist analysis of the structural conditions that both produce and intensify experiences of loneliness. We aim to remedy this gap. That is, we seek to address what a Feminist Loneliness Studies can contribute to understanding the complexities of this complicated emotion. For example, what is the unique loneliness of the feminist killjoy who calls out, or calls in, existing forms of queerphobia, racism, and sexism? What does it mean to be a politicized person and how does that result in both alienation and isolation? What might the relationship be between white supremacy and loneliness? How is loneliness both individual and systemic, and what is the relationship between the two? What distinctive forms of loneliness are created by ableism, sanism, neoliberalism, capitalism, globalization, and the gig economy? Ought loneliness be avoided at all costs? What are the ethics of loneliness? In our introduction to this special issue, we unpack and theorize the potential perils and generative possibilities offered up by this profound emotion. Establishing a Feminist Loneliness Studies provides us with the space we need to begin addressing and comprehending loneliness.

Cancer as a risk factor for distress and its interactions with sociodemographic variables in the context of the first wave of the COVID-19 pandemic in Germany

The COVID-19 pandemic poses a psychological challenge, especially for individuals with chronic illnesses. The aim of this study was to investigate associations of cancer with distress, including its interplay with further risk and protective factors. We conducted a representative survey of the German population (N = 2503, including N = 144 with a cancer diagnosis) during the first wave of the pandemic. In multiple linear and logistic regression analyses, we tested associations of cancer with depression and anxiety symptoms and suicidal ideation. We also investigated moderating effects of age, gender, income, living situation, marital status, and loneliness. Individuals with cancer were more likely to report anxiety symptoms (φ = .061), suicidal ideation (φ = .050), and loneliness (φ = .044) than other participants. In regression analyses that controlled for sociodemographic differences, cancer was still associated with anxiety symptoms. We also observed interaction effects, indicating that this relation was especially strong in men with cancer and that cancer survivors with a low income were particularly likely to report anxiety symptoms. The findings demonstrate that cancer survivors are a vulnerable group and that factors of different life domains interact in shaping well-being in the population, necessitating comprehensive risk assessment and support offers during the pandemic and beyond.

Determinants of social health trajectories during the COVID-19 pandemic in older adults: the Rotterdam Study

OBJECTIVES

The coronavirus disease-2019 (COVID-19) pandemic and accompanying lockdown restrictions impacted social life significantly. We studied associations of sociodemographic factors, mental and social health markers, and brain structure with social health trajectories during the COVID-19 pandemic.

DESIGN

Prospective longitudinal population-based cohort study.

SETTING

Community-dwelling inhabitants of Rotterdam, the Netherlands.

PARTICIPANTS

Repeated questionnaires including questions on social health were sent to Rotterdam Study participants from April 2020 onwards. Social health data at study baseline were available for 5017 participants (mean age: 68.7 ± 11.3; 56.9% women).

MEASUREMENTS

Determinants were assessed in routine Rotterdam Study follow-up (1990-2020), including global brain volumes in a subset of participants (N = 1720). We applied linear mixed models and generalized estimating equations to quantify associations between determinants and trajectories of loneliness, perceived social isolation and social connectedness over three time points from April 22nd to July 31st 2020.

RESULTS

Loneliness prevalence was 27.9% in April 2020 versus 12.6% prepandemic. Social isolation (baseline mean 4.7 ± 2.4) and loneliness scores (baseline mean 4.9 ± 1.5) decreased over time, whereas social connectedness trajectories remained stable. Depressive symptoms, female sex, prepandemic loneliness, living alone, and not owning a pet were independently associated with lower social connectedness and higher social isolation and loneliness at COVID-19 baseline, but recovery of social health was similar for all determinants. Larger intracranial volume was associated with higher social connectedness.

CONCLUSIONS

Despite baseline differences for specific determinants, older adults showed similar recovery of loneliness and social isolation alongside stable social connectedness over time during the pandemic. Social health is multidimensional, especially during a global health crisis.

Pandemic-Related Challenges and Organizational Support Among Personnel in Canada's Defense Establishment

In the final week of March 2020, 2.8 million Canadians were away from their usual places of work and engaging in remote and/or telework to mitigate the spread of COVID-19 (Statistics Canada, 2020). The Government of Canada's Department of National Defence (DND) and the Canadian Armed Forces (CAF) were no exception, with most members from the regular force (Reg F), the primary reserve force (P Res), and the DND public service (DND PS) working from home. The COVID-19 Defence Team Survey was administered from April 29th, 2020, and May 22nd, 2020, to gain insight into work, health, and family-related challenges since the onset of the pandemic and change in work arrangements. Responses from five open-ended questions were qualitatively analyzed to determine general themes of concern regarding work, personal, and family related challenges, stress-management and coping strategies, and recommendations for improving the work situation and personal well-being. Given the different roles and conditions of employment, responses of the different groups or “components” of respondents (Reg F, P Res, DND PS) were compared to identify common and unique challenges to inform targeted organizational responses. A total of 26,207 members (Reg F = 13,668, 52.2%; P Res = 5,052, 19.3%; DND PS = 7,487, 28.6%) responded to the survey's five open-ended questions, which yielded a total of 75,000 open-ended responses. When asked about work-related challenges, respondents' most common challenges included dissatisfaction with technology/software, work arrangements, ergonomics, work-life balance, communication within the organization, and the uncertainties regarding career development. In terms of personal and/or family-related challenges, the most common challenges included social isolation, the impact of the pandemic on mental health, school closures and homeschooling, caring for vulnerable family members, and childcare concerns. The most common stress-management and coping strategies included exercise, spending time outdoors, communicating or spending time with family members, household chores/projects, mind-body wellness exercises, and playing games. The most common recommendations made by respondents to improve their work- or personal-related situations included improving technological capabilities, streamlining communication, providing hardware and software necessary to ensure comfortable ergonomics, the provision of flexibility in terms of telework schedules, return-to-work decisions, and the expansion of benefits and access to childcare services. In terms of differences among the components, DND PS personnel were most likely to report dissatisfaction with technological changes and ergonomics, and to recommend improving these technological limitations to maximize productivity. Reg F members, on the other hand, were most likely to recommend increased support and access to childcare, and both Reg F and P Res members were more likely to mention that increased benefits and entitlements in response to the COVID-19 pandemic would be ameliorative. The results of this study highlight several important facts about the impact of the COVID-19 pandemic on personnel working in large, diverse organizations. For example, advancements in organizational technological capabilities were highlighted herein, and these are likely to grow to maintain productivity should remote work come to be used more extensively in the long-term. This study also highlighted the importance of flexibility and accommodation in relation to individual needs – a trend that was already underway but has taken on greater relevance and urgency in light of the pandemic. This is clearly essential to the organization's role in supporting the well-being of personnel and their families. Clear and streamlined communication regarding organizational changes and support services is also essential to minimize uncertainty and to provide useful supports for coping with this and other stressful situations.

Investigating the Relationships between COVID-19 Quality of Life, Loneliness, Happiness, and Internet Addiction among K-12 Teachers and School Administrators-A Structural Equation Modeling Approach

It is well acknowledged that the roles of both school administrators and teachers have changed due to the global education crisis caused by COVID-19. During this challenging and critical period, it is essential to investigate how those working in the education sector who undertake strategic tasks for sustainable education are affected by the new conditions brought about by the COVID-19 pandemic. This study investigates the interrelationships between COVID-19 quality of life, loneliness, happiness, and Internet addiction. The research was designed according to the relational survey model, was conducted with 432 school administrators and teachers working in K-12 schools. The research data was collected through online questionnaires, and structural equation modelling (SEM) was used to test and analyze proposed hypotheses. The study’s results revealed a positive relationship between the COVID-19 related quality of life and loneliness, and that loneliness significantly positively predicts Internet addiction. In this context, due to the impact of COVID-19 on the life quality, the participants’ loneliness levels significantly increased, and this increase in loneliness caused them to become addicted to using the Internet. Interestingly, it was also determined that a positive relationship exists between loneliness and happiness and that as the loneliness of individuals increased, their level of happiness also increased. In many studies conducted prior to the COVID-19 pandemic, a negative relationship was revealed between loneliness and happiness. In the current study conducted during the pandemic, the relationship between the two variables was positive. SEM results revealed that COVID-19 directly affects the quality of life, Internet addiction, loneliness, and happiness of school administrators and teachers. Furthermore, it was determined that Internet addiction indirectly affects the relationship between loneliness and happiness.

Personal Social Networks of Community-Dwelling Oldest Old During the Covid-19 Pandemic-A Qualitative Study

The COVID-19 pandemic and its related restrictions have affected the everyday life of older people. Advanced age is a significant predisposing factor for a more severe COVID-19 infection, increasing the risk for hospitalization and mortality. Even though restrictions have been, thus, well-grounded, they may also have had detrimental effects on the social well-being of older people. Personal networks and social activity are known protective factors against the premature decline in health and functioning, and it is widely acknowledged that social isolation increases feelings of loneliness, poor quality of life, and even the risk for diseases and disabilities among older adults. This qualitative study investigated changes in personal networks among community-dwelling oldest-old individuals (persons aged 80 and over) during the first and second waves of the COVID-19 pandemic in Finland. The data is part of the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE85+) study, which is an ongoing large longitudinal population-based study in Finland. In this qualitative sub-study, we analyzed fifteen in-depth telephone interviews using directed content analyses and identified five types of changes in personal social networks during the pandemic. In type 1, all social contacts were significantly reduced due to official recommendations and fear of the virus. Type 2 included modified ways of being socially active i.e., by deploying new technology, and in type 3, social contacts increased during the lockdown. In type 4, personal social networks were changed unexpectedly or dramatically due to a death of a spouse, for example. In type 5, we observed stable social networks, which had not been affected by the pandemic. At an individual level, one person could have had different types of changes during the pandemic. These results highlight the heterogeneity of the oldest olds' personal social networks and changes related to them during the exceptional times of the COVID-19 pandemic. Social activity and personal networks play an important role in the well-being of the oldest old, but individual situations, needs, and preferences toward personal social networks should be taken into account when planning social activities, policies, and interventions.

Resident loneliness, social isolation and unplanned emergency department visits from supportive living facilities: a population-based study in Alberta, Canada

BACKGROUND

Supportive living (SL) facilities are intended to provide a residential care setting in a less restrictive and more cost-effective way than nursing homes (NH). SL residents with poor social relationships may be at risk for increased health service use. We describe the demographic and health service use patterns of lonely and socially isolated SL residents and to quantify associations between loneliness and social isolation on unplanned emergency department (ED) visits.

METHODS

We conducted a retrospective cohort study using population-based linked health administrative data from Alberta, Canada. All SL residents aged 18 to 105 years who had at least one Resident Assessment Instrument-Home Care (RAI-HC) assessment between April 1, 2013 and March 31, 2018 were observed. Loneliness and social isolation were measured as a resident indicating that he/she feels lonely and if the resident had neither a primary nor secondary caregiver, respectively. Health service use in the 1 year following assessment included unplanned ED visits, hospital admissions, admission to higher levels of SL, admission to NH and death. Multivariable Cox proportional hazard models examined the association between loneliness and social isolation on the time to first unplanned ED visit.

RESULTS

We identified 18,191 individuals living in Alberta SL facilities. The prevalence of loneliness was 18% (n = 3238), social isolation was 4% (n = 713). Lonely residents had the greatest overall health service use. Risk of unplanned ED visit increased with loneliness (aHR = 1.10, 95% CI: 1.04-1.15) but did not increase with social isolation (aHR = 0.95, 95% CI: 0.84-1.06).

CONCLUSIONS

Lonely residents had a different demographic profile (older, female, cognitively impaired) from socially isolated residents and were more likely to experience an unplanned ED visit. Our findings suggest the need to develop interventions to assist SL care providers with how to identify and address social factors to reduce risk of unplanned ED visits.