A critical review and development of a conceptual model of exclusion from social relations for older people

Examining the Effect of Contactless Intergenerational Befriending Intervention on Social Isolation Among Older Adults and Students' Attitude Toward Companionship: Content Analysis

BACKGROUND

Intergenerational friendship, a mechanism of social support, is an effective intervention to reduce the increasing risk of social isolation (SI) and develop companionship in the older adult population. The COVID-19 pandemic provided a unique opportunity to examine the psychosocial intervention of befriending via technology use as a primary form of contactless socialization.

OBJECTIVE

The study aims to explore the effectiveness of the befriending intervention through a contactless, intergenerational service-learning project on older adult emotions, especially boredom and loneliness as the key attributes of SI, and on students' attitude toward companionship.

METHODS

During the months of January to April 2022 , undergraduate students enrolled in a health administration course with a special focus on culture were asked to be involved in a contactless, intergenerational service-learning project (n=46). In this study, contactless intervention meant communication using the telephone and apps such as FaceTime and Zoom. Students were paired with older adults to have at least a 30-minute weekly conversation, for 8 weeks, via telephone or an internet-based app such as FaceTime. Students were asked to write a half-page diary after each interaction and a 1-page reflection at the end of the fourth week and at the end of the service-learning project. At the completion of the project, the researchers also surveyed the older adults to assess the impact of the project using a 5-item open-ended questionnaire. Following a heuristic approach and content analysis, student artifacts (110,970 words; 118-page, single-spaced Microsoft Word document) and the older adult surveys were analyzed using MAXQDA, (VERBI GmbH). Qualitative data were extracted to assess the impact of service learning on SI by measuring the attributes of boredom and loneliness among 46 older adults. Students' attitudes toward companionship were also assessed using data from their diaries and reflections.

RESULTS

Overall, three major constructs were identified: (1) meaningful engagement, defined as feeling safe, having increased confidence, and having reduced boredom; (2) internal motivation to participate in the weekly interaction, defined as discussion about daily life experience, level of happiness, and ability to exert personal control over the situation; and (3) intergenerational befriending, defined as perceived benefits from the friendly nature of the interaction, ability to comfortably connect with students, and positive feeling and attitude toward the student.

CONCLUSIONS

The contactless, intergenerational befriending intervention reduced boredom and loneliness among older adults and enhanced positive attitude and confidence among university students. Students helped older adults to develop digital skills for the use of apps and social media. Older adults showed interest in the intervention and shared their daily life experiences with the students, which helped to reduce the gap between generations. Findings indicate the effectiveness of an intergenerational service-learning intervention on SI reduction and increased positive attitude among college students.

Life-course transitions and exclusion from social relations in the lives of older men and women

There is increasing interest across European contexts in promoting active social lives in older age, and counteracting pathways and outcomes related to social isolation and loneliness for men and women in later life. This is evidenced within national and European level policy, including the 2021 Green Paper on Ageing and its concern with understanding how risks can accrue for European ageing populations in the relational sphere. Research indicates that life-course transitions can function as a source of these risks, leading to a range of potentially exclusionary impacts for the social relations of older men and women. Findings presented in this paper are drawn from the qualitative component of a larger European mixed-methods study on exclusion from social relations (GENPATH: A life course perspective on the GENdered PATHways of social exclusion in later life, and its consequences for health and well-being). We use data from 119 in-depth interviews from four jurisdictions: Austria, Czechia, Ireland and Spain. This research employed an approach that focused on capturing lived experienced insights related to relational change across the life course, the implications of these changes for multifaceted forms of exclusion from social relations and the role of gender in patterning these changes and implications. We focused on transitions that commonly emerged across those jurisdictions for older people: onset of ill-health, bereavement, retirement and relocation. We found that these transitions translate into multidimensional experiences of exclusion from social relations in the lives of older men and women by constraining their social networks, support networks, social opportunities and intimate relationships.

Multidimensional vulnerability among older adults in Germany : Social support buffers the negative association with life satisfaction

BACKGROUND

Multidimensional vulnerability among older adults, characterized by low levels of individual resources in different life domains, has been insufficiently studied. This phenomenon is considered to be associated with a marked decrease in overall life satisfaction. Social support is supposed to buffer the negative effect of multidimensional vulnerability on life satisfaction.

METHODS

Analyses are based on the German Health Update dataset (GEDA 2014/2015-EHIS). The analytic sample includes respondents ≥ 65 years (N = 5826). Confirmatory factor analyses were performed to construct a latent variable from the indicators income poverty, activities of daily living (ADL) limitations, multimorbidity, mental problems, and living alone. Multivariate linear regression models estimate the relationship between vulnerability and life satisfaction with a special focus on the interaction between vulnerability and social support.

RESULTS

The analyses supports the multidimensional construct of vulnerability. Social support considerably moderates the negative relationship between vulnerability and life satisfaction. As the degree of vulnerability increases, the influence of social support becomes more pronounced.

CONCLUSION

The assessment of vulnerability as a multidimensional construct helps to depict the life situation of older people in a more differentiated way. Vulnerable older adults with a small or unreliable social network while finding it difficult to access practical help need additional external social support to achieve a high level of life satisfaction.

Trajectories of social isolation and depressive symptoms in mid- and later life: a parallel process latent growth curve analysis

OBJECTIVES

Social isolation has subjective and objective dimensions. This study explored the change trajectories of both dimensions of isolation and depressive symptoms and their interrelationships in terms of levels and changes over time.

METHODS

Data were drawn from the 2006-2018 Health and Retirement Study, involving a nationally representative sample of middle-aged and older adults (N = 7890). Parallel process latent growth curve models were used.

RESULTS

Over time, objective isolation displayed a non-linear upward trend, subjective isolation displayed a non-linear downward trend, and depressive symptoms remained relatively stable. More objectively isolated people experienced smaller increases in objective isolation and more subjectively isolated people experienced smaller decreases in subjective isolation. Such negative intercept-slope associations were not observed for depressive symptoms. Net of sociodemographic characteristics, physical disabilities, functional limitations, and chronic diseases, each isolation dimension was associated with the level of depressive symptoms. But only the rate of change in subjective isolation was positively associated with that of depressive symptoms.

CONCLUSION

The initial level of objective isolation may be one of the common origins of subjective isolation and depressive symptoms. Recognition of such shared origins is important in mitigating the synergistic and deleterious effects of loneliness and depression in middle-aged and older adults.

A systematic review of reviews on the psychometric properties of measures of older persons' ability to build and maintain social relationships

BACKGROUND

Within the scope of the World Health Organisation's (WHO) world report on ageing and health and how healthy ageing was conceptualised, the WHO has been working with academia towards producing reviews of the psychometric properties of instruments that measure different domains of functional ability. This study aimed to conduct a review of reviews to examine existing and validated instruments measuring the ability of older persons to build and maintain social relationships and to evaluate the psychometric properties of these instruments.

METHODS

We searched for studies published in the English, Spanish and Portuguese languages. No restrictions were placed on the year of publication. The following databases were searched: PubMed, Embase, Psyinfo and Cumulated Index to Nursing and Allied Health Literature. Titles and abstracts were screened and selected articles were screened and reviewed independently by two reviewers.

RESULTS

A total of 3,879 records were retrieved, of which 39 records were retrieved for full-text analysis. None of the reviews met the inclusion criteria, thus resulting in an empty review.

CONCLUSIONS

Considering the current definition of older persons' functional ability to build and maintain social relationships, this review did not identify instruments that can measure both constructs simultaneously. We suggest the development of an instrument that simultaneously assesses the ability of older persons to build and maintain relationships.

Sense-Making of Loneliness and Exclusion From Social Relations Among Older Adults in Sweden

BACKGROUND AND OBJECTIVES

Loneliness and exclusion from social relations (ESR) are frequently addressed as public health issues for older adults. Public discourses potentially influence how loneliness and ESR are understood in society and experienced by the individual. The aim of this study was to analyze how older adults in different parts of Sweden use the discourses and concepts available to them to describe experiences of ESR and loneliness, and how these descriptions are used to construct a self-identity.

RESEARCH DESIGN AND METHODS

Qualitative semi-structured interviews were conducted with 30 individuals (14 men, 16 women) aged 67-87 years and living in Sweden. Emphasis was, in line with perspectives of discursive psychology, on how individuals draw on discourses to make sense of experiences. The empirical material was analyzed through an inductive process where we were open to finding concepts and themes.

RESULTS

Most participants emphasized the importance of not being lonely, considered achievable through maintaining an active lifestyle. "Othering" was taking place, where a general image of a "lonely" older adult was referred to when speaking about "others" loneliness. Those who expressed feelings of loneliness related these feelings to loss, being omitted, and other difficult life circumstances.

DISCUSSION AND IMPLICATIONS

States of ESR were discussed more comfortably than loneliness, whereas various linguistic resources were used to distance themselves from loneliness. These findings indicate the need for further studies elaborating on how older adults make sense of ESR and loneliness and what implications this has for older adults' well-being and identity making.

Social exclusion and critical transitions in later life: Trajectories, forms and mechanisms

Unequal ageing patterns are increasingly prevalent within the life courses of heterogeneous older populations. Critical transitions in later life may contribute to these patterns and to more multifaceted deep-rooted forms of social exclusion. Yet despite significant research in this area, knowledge gaps remain regarding the subjective experiences of these transitions, the trajectories and constituent events of these transitions, and the related mechanisms that may drive exclusion. With a focus on lived experience, this article aims to investigate the role of critical life transitions in older age in constructing multidimensional social exclusion. The onset of dementia, bereavement of a significant other, and forced migration are selected as three illustrative transitions in older age. Based on 39 in-depth life-course interviews and life-path analyses, the study sets out to illuminate common features of the transitional process that increases exclusion susceptibility, and the potential commonalities regarding transition-related exclusionary mechanisms. Transition trajectories related to each of the transitions are first described identifying shared exclusionary risk features. Transition-related mechanisms that can generate multidimensional social exclusion are then presented as arising from a transition's nature and character, its structural and management aspects, and its symbolic and normative positioning. Findings are discussed with reference to the international literature and future conceptualisation of social exclusion in later life.

Isolation or Replenishment? The Case of Partner Network Exclusivity and Partner Loss in Later Life

OBJECTIVES

People's partners and spouses often provide a wide range of essential emotional and practical support. As crucial as they may be, a nontrivial segment of the older population appears to limit close discussions to their partner alone, a phenomenon we term "partner network exclusivity." This network structure could leave people vulnerable to partner losses and subsequent social isolation. The present research has 3 aims: (a) examine the prevalence of partner-exclusive networks among European older adults; (b) consider who is most likely to inhabit such networks; and (c) investigate whether and how individuals in such precarious networks rebalance them in case of partner losses.

METHODS

The analysis uses Wave 4 (2011) and Wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) to perform logistic regression on one's possession of partner-exclusive networks and the addition of core ties.

RESULTS

More than a quarter of partnered respondents (28.1%) are in partner-exclusive core networks. Men, childless individuals, and those with financial difficulties are most likely to occupy such networks. Individuals in partner exclusivity are especially likely to enlist additional ties upon partner loss. Nevertheless, men and individuals at early old age are relatively unlikely to rebalance their core networks in case of partner death.

DISCUSSION

This study provides new evidence that network replenishment following relationship disruptions is plausible even for those from precarious network settings. Nevertheless, widowhood produces patterns of vulnerability for a subset of older adults in partner-exclusive core networks.

The role of the Internet in later life autonomy: Silver surfers in Spain

The new digital panorama has enhanced the importance of the Internet, as well as Information and Communications Technology (ICT), in developing a society in which seniors play a proactive role. The main purpose of this article is to define a taxonomy of silver surfers according to the ways they use the Internet and ICT, with a special focus on e-commerce and e-government. A quantitative methodology was used, based on the study of 405 Spanish internet users between 60 and 79 years of age, which was conducted by telephone in February of 2019. Seven groups were identified through a combination of dimensionality reduction techniques and cluster analysis. The results indicate neither a consistent pattern in the specific ways older adults use the Internet nor a homogeneous level of digital knowledge among this demographic group. To some extent, this is a result of disparities in both the perception of digital security that seniors associate with e-commerce and/or e-government and the level of trust engendered by such operations. The Able and Daring are the most numerous clusters, which coincide with the categories of the most active and prepared users. The Sceptical take third place in terms of number of users, as they display limited use of the Internet and claim to have a low digital skills level. However, carrying out both online shopping and administrative procedures without the need for assistance is becoming increasingly frequent among all of those surveyed.

(Im)mobile ageing: risks of exclusion in later life in liminal urban peripheries

Despite the recent policy impetus for age-friendly cities, there is still scope for more geographical insights into ageing in low- and middle-income countries (LMICs). Cities in LMICs, such as Bengaluru (India), are witnessing an increase in the size of the older population in their peripheral urban regions, but there is relatively little understanding of the risks of exclusion in later age in these liminal zones. This study, set in a peripheral ward of Bengaluru, focuses on the experiences of exclusion/inclusion of socio-economically marginalised older adults and their access to work, health care and leisure. The research uses a multidimensional old-age exclusion framework to highlight how the domains of neighbourhood, material resources, mobility infrastructure and social relations influence the risks for social exclusion. We use a qualitative approach by combining behavioural mapping and in-depth interviews. Our findings highlight some ways in which institutionalised exclusion from civic infrastructure accentuates the precariousness of ageing. The rigidity of traditional hierarchies in peri-urban regions has meant that older adults who were poor, women and belonged to marginalised castes experience constrained mobilities to access labour markets, health care and social life, compounding their place-based exclusion. Despite social networks and solidarities, older adults on the periphery faced individualisation of risks while trying to access the basic amenities, thereby falling between the gap of the urban–rural milieu and governance. Age-friendly cities need to accommodate such hybrid transitionary urban processes, in the absence of which, active ageing in these rising peripheries can be impeded.

The Effects of Loneliness on Depressive Symptoms Among Older Adults During COVID-19: Longitudinal Analyses of the Canadian Longitudinal Study on Aging

Objectives

This paper examines the longitudinal effects of changes in the association between loneliness and depressive symptoms during the pandemic among older adults (65+). Methods Baseline (2011–2015) and Follow-up 1 (2015–2018) from the Canadian Longitudinal Study on Aging (CLSA), and the Baseline and Exit waves of the CLSA COVID-19 study (April–December, 2020) ( n = 12,469) were used. Loneliness was measured using the 3-item UCLA Loneliness Scale and depression using the CES_D- 9. Results Loneliness is associated with depressive symptoms pre-pandemic; and changes in level of loneliness between FUP1 and the COVID Exit survey, adjusting for covariates. No interaction between loneliness and caregiving, and with multimorbidity, on depressive symptoms were observed, and several covariates exhibited associations with depressive symptoms. Discussion Strong support is found for an association between loneliness on depressive symptoms among older adults during the pandemic. Public health approaches addressing loneliness could reduce the burden of depression on older populations.

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.

Lifestyles of Spanish elders from supervened SARS-CoV-2 variant onwards: A correlational research on life satisfaction and social-relational praxes

Objective

This study aimed to analyze the influence and measurement of the relationship and interaction between the elderly lifestyles after the appearance of the SARS-CoV-2 variant and the factors analyzed comprised life satisfaction levels, social relationships, and daily-life activities.

Methods

The study population was ≥ 65 in Castile-La Mancha (N = 390,221). The research design was quantitative and arose from primary data collected via an ad hoc survey carried out through the Computer Assisted Telephone Interview system by randomly stratified sampling. The sample size was made up of 1,065 cases, and the participants were selected through a random sampling stratified by gender quotas (55.40% women; 44.60% men), age (x¯ = 76.56), province, and habitat size.

Results

The results obtained revealed two main lifestyles, from which a notable behavioral change in personal relationships led to infer toward alternative lifestyles.

Conclusion

Notwithstanding the variation in lifestyles of the elderly after the pandemic, certain relationships remained unaltered. Thus, from the analyzed variables, relatives and friends relationships were scarcely influenced by the supervened incident.

Intergenerational relationship quality, sense of loneliness, and attitude toward later life among aging Chinese adults in Hong Kong

A positive attitude toward later life is crucial for wellbeing among older adults. Maintaining a healthy relationship with adult children can help reduce older parents’ sense of loneliness and nurture a positive life attitude. This study aimed to investigate the associations between multidimensional intergenerational relationship quality and attitudes toward later life among aging Chinese adults in Hong Kong and examine the mediating effects of a sense of loneliness. Representative survey data were collected from 801 participants (aged 50 years and over) with at least one adult child. Multiple linear regression was employed to investigate the associations between overall intergenerational relationship quality with a sense of loneliness as well as the attitude toward later life. To examine the mediating effects of a sense of loneliness, causal mediational analyses were performed. Results demonstrated that overall intergenerational relationship quality was positively associated with aging parents’ attitude toward later life, and this relationship could be partially mediated by a sense of loneliness. Among the four subdomains of intergenerational relationship quality, the influences of structural-associational solidarity and intergenerational conflict on attitude toward later life were almost fully mediated by a sense of loneliness, whereas the influences of consensual-normative solidarity and affectual closeness were partially mediated. These findings contributed to an improved understanding of the relationship between intergenerational relationship quality, sense of loneliness, and attitude toward later life, and could inform future policies and service programs that promote aging adults’ social integration and positive aging.

A social exclusion perspective on loneliness in older adults in the Nordic countries

Several factors associated with loneliness are also considered indicators of social exclusion. While loneliness has been proposed as an outcome of social exclusion, there is limited empirical evidence of a link. This study examines the associations between social exclusion indicators and loneliness in older adults (60+ years) in four Nordic countries. Data from four waves of the European Social Survey were pooled, providing a total of 7755 respondents (Denmark n = 1647; Finland n = 2501, Norway n = 1540; Sweden n = 2067). Measures of loneliness, demographic characteristics, health, and eight indicators of social exclusion were selected from the survey for analysis. Country-specific and total sample hierarchical logistic regression models of loneliness were developed. Significant model improvement occurred for all models after social exclusion indicators were added to models containing only demographic and health variables. Country models explained between 15.1 (Finland) and 21.5% (Sweden) of the variance in loneliness. Lower frequency of social contacts and living alone compared to in a two-person household was associated with a higher probability of loneliness in all countries, while other indicators were associated with loneliness in specific countries: lower neighbourhood safety (Sweden and Denmark); income concern (Sweden and Finland); and no emotional support (Denmark, Finland, and Sweden). A robust relationship was apparent between indicators of social exclusion and loneliness with the direction of associations being highly consistent across countries, even if their strength and statistical significance varied. Social exclusion has considerable potential for understanding and addressing risk factors for loneliness.

Optimising function and well-being in older adults: protocol for an integrated research programme in Aotearoa/New Zealand

BACKGROUND

Maintaining independence is of key importance to older people. Ways to enable health strategies, strengthen and support whanāu (family) at the community level are needed. The Ageing Well through Eating, Sleeping, Socialising and Mobility (AWESSOM) programme in Aotearoa/New Zealand (NZ) delivers five integrated studies across different ethnicities and ages to optimise well-being and to reverse the trajectory of functional decline and dependence associated with ageing.

METHODS

Well-being, independence and the trajectory of dependence are constructs viewed differently according to ethnicity, age, and socio-cultural circumstance. For each AWESSoM study these constructs are defined and guide study development through collaboration with a wide range of stakeholders, and with reference to current evidence. The Compression of Functional Decline model (CFD) underpins aspects of the programme. Interventions vary to optimise engagement and include a co-developed whānau (family) centred initiative (Ngā Pou o Rongo), the use of a novel LifeCurve™App to support behavioural change, development of health and social initiatives to support Pacific elders, and the use of a comprehensive oral health and cognitive stimulation programme for cohorts in aged residential care. Running parallel to these interventions is analysis of large data sets from primary care providers and national health databases to understand complex multi-morbidities and identify those at risk of adverse outcomes. Themes or target areas of sleep, physical activity, oral health, and social connectedness complement social capital and community integration in a balanced programme involving older people across the ability spectrum.

DISCUSSION

AWESSoM delivers a programme of bespoke yet integrated studies. Outcomes and process analysis from this research will inform about novel approaches to implement relevant, socio-cultural interventions to optimise well-being and health, and to reverse the trajectory of decline experienced with age.

TRIAL REGISTRATION

The At-risk cohort study was registered by the Australian New Zealand Clinical Trials registry on 08/12/2021 (Registration number ACTRN 12621001679875 ).

Secularism, family ties and loneliness: A multilevel longitudinal study of ten European societies

OBJECTIVES

Mass media suggest rising political and religious concern about secularism-induced decline of the family. Implications for loneliness remain unexamined. The current study filled this gap.

METHODS

Data were from 10 national probability samples in the Survey of Health, Ageing and Retirement in Europe. Multilevel longitudinal models tested linkages of societal secularism with loneliness, their mediation by specific family relationships, and the role of this cultural dimension in weakening associations of family ties with loneliness. Both weighted Maximum Likelihood and unweighted Bayesian analyses were conducted, separately for each gender.

RESULTS

Societal secularism was not positively linked to either gender's loneliness. Associations with family ties were inconsistent, with only men's average partnered status lower in more secular settings. Nor did any positive indirect effects emerge. Moderation results were also inconsistent, with secularism only weakening linkages of some family dimensions with loneliness. Bayesian estimates were generally nonsignificant.

DISCUSSION

Societal secularism may not be a risk factor for loneliness or for weak family ties. Results stand at odds with religious and political rhetoric on secularism-induced decline of the family, and its individual and societal consequences.

Perceptions and Attitudes of Spanish “Digital Seniors” Towards E-Government

A typology of user was explored as to behaviour and perception of e-Government through a telephone survey involving 405 Internet users between 60 and 79 years of age. Ten different groups were identified by means of dimensionality reduction techniques followed by a cluster analysis. The main conclusion is that there is no consistent pattern, although among the groups which do use e-Government, they have less concerns than the rest and see less need for modifications to be applied to adapt the websites to the needs of seniors. Within this older age group, two types are clearly identified. Those who feel uncomfortable, which explains their avoidance of e-Government, and to a lesser degree, those whose lack of contact with public administration may be due to a lack of interest for such services. It appears that a senior-friendly offering together with learning opportunities would increase interest for this channel.

Negative old-age life events and well-being in later life: the moderating and mediating role of loneliness

OBJECTIVES

Although older adults often experience negative life events or loss experiences, they rarely experience large decreases in their quality of life or well-being. Emotionally satisfying relationships in older adults may serve as a protective factor that reduces the impact of negative events in decreasing well-being. The availability of these close social contacts is essential, and their potential for alleviating feelings of loneliness after negative events could have an important role in promoting well-being. The aim of this study was to test the hypothetical moderation and mediation effects of social and emotional loneliness on the occurrence of negative old-age life events and well-being in later life.

DESIGN

This was a cross-sectional survey conducted as part of the Detection, Support and Care for older people - Prevention and Empowerment research project (2015-2018).

SETTING

Participants were community-dwelling older adults in Flanders (Belgium).

PARTICIPANTS

The sample composed of 770 participants aged 60 years and over.

MEASUREMENTS

Participant demographics, social and emotional loneliness, and subjective well-being were measured. Moderation and mediation analyses were performed using the regression-based approach as conducted by Hayes and Rockwood (2017).

RESULTS

Results indicated that a low degree of (social) loneliness is a protective, moderating factor and (emotional) loneliness is a mediating factor on the effects of negative life events on well-being in later life.

CONCLUSIONS

Findings highlight the importance of emotionally and socially satisfying social contacts in order to maintain positive subjective well-being in later life when negative life events may occur.

Exclusion from Social Relations in Later Life: Micro- and Macro-Level Patterns and Correlations in a European Perspective

Older adults face particular risks of exclusion from social relationships (ESR) and are especially vulnerable to its consequences. However, research so far has been limited to specific dimensions, countries, and time points. In this paper, we examine the prevalence and micro- and macro-level predictors of ESR among older adults (60+) using two waves of data obtained four years apart across 14 European countries in the Survey of Health, Ageing and Retirement in Europe (SHARE). We consider four ESR indicators (household composition, social networks, social opportunities, and loneliness) and link them to micro-level (age, gender, socioeconomic factors, health, and family responsibilities) and national macro-level factors (social expenditures, unmet health needs, individualism, social trust, and institutional trust). Findings reveal a northwest to southeast gradient, with the lowest rates of ESR in the stronger welfare states of Northwest Europe. The high rates of ESR in the southeast are especially pronounced among women. Predictably, higher age and fewer personal resources (socioeconomic factors and health) increase the risk of all ESR dimensions for both genders. Macro-level factors show significant associations with ESR beyond the effect of micro-level factors, suggesting that national policies and cultural and structural characteristics may play a role in fostering sociability and connectivity and, thus, reduce the risk of ESR in later life.

The Relationship between Political, Economic, Social, and Cultural Vulnerability and Food Insecurity among Adults Aged 50 Years and Older

Individuals experience food insecurity when they worry about or have limited access to nutritious foods. Food insecurity negatively impacts older adults' health. Social exclusion is a theoretical framework describing how unequal access to rights, resources, and capabilities results in political, economic, social, and cultural vulnerability, which leads to health disparities. We used the Health and Retirement Study to cross-sectionally examine associations between vulnerability and experiencing food insecurity in adults 50 years and older using the social exclusion framework. We tested the association between experiencing food insecurity and indicators of political, economic, social, and cultural vulnerability using logistic regression controlling for demographic and health-related factors. Analyses were performed with all respondents and sub-group of respondents with incomes less than 400% of the federal poverty level (FPL). Assets (OR = 0.97 in both samples), income (OR = 0.85, 0.80 in 400% FPL sub-sample), perceived positive social support from other family (OR = 0.86, 0.84 in 400% FPL sub-sample), and perceived everyday discrimination (OR = 1.68, 1.82 in 400% FPL sub-sample) were significantly associated with food insecurity. Perceived positive social support from spouses, children, or friends and U.S. citizenship status were not significantly associated with food insecurity. Further research is needed to define and measure each dimension of vulnerability in the social exclusion framework. Interventions and policies designed to prevent food insecurity should address these vulnerabilities.

Perceived loneliness and the role of cultural and intergenerational belonging: the case of Portuguese first-generation immigrants in Luxembourg

The risk of loneliness for migrants, particularly in older age, has been documented across multiple studies. Migration is a life-changing transition. While often retaining links to their country of origin, an important developmental task for migrants is the establishment of bonds in the receiving country. Drawing on recent studies, I will explore the role of cultural and intergenerational belonging in order to identify both protective and risk factors regarding loneliness in middle and older age in a sample of first-generation immigrants from Portugal living in Luxembourg. The sample comprises N = 131 participants (51.9% female) between the ages of 41 and 80 (M = 56.08; SD = 7.80) who have on average spent M = 31.71 years (SD = 8.81) in Luxembourg and raised children in Luxembourg. They took part in the IRMA project ('Intergenerational Relations in the Light of Migration and Ageing') which was funded by the Fonds National de la Recherche Luxembourg. A standardised questionnaire assessed socio-demographic data, aspects of cultural belonging (i.e. cultural attachment to both countries, bicultural identity orientation, acculturative stress), intergenerational belonging (i.e. family cohesion, family conflict, perceived intergenerational value consensus) and perceived loneliness. Results showed that while cultural and intergenerational belonging were protective factors, the strongest predictors for participants' perceived loneliness were cultural identity conflict and, even more so, intergenerational conflict. Our findings suggest that establishing roots and bonds in the host country is a protective factor against loneliness, whereas the feeling of not fitting in is a strong risk factor.

Physical distancing is related to fewer electronic and in-person contacts and to increased loneliness during the COVID-19 pandemic among older Europeans

PURPOSE

During the COVID-19 pandemic older adults are asked to maintain physical distancing, which can be linked to loneliness. While older people are encouraged to use electronic communication to stay socially connected, it remains an open question whether electronic contacts are related to lower loneliness during the pandemic. This study examined the associations of physical distancing during the pandemic with loneliness and the role of in-person and electronic contacts with children and non-kin as explaining these associations across European regions.

METHODS

The study used data from Survey of Health, Ageing and Retirement in Europe (SHARE), collected during the COVID-19 pandemic in 2020. Mediation and moderation analyses tested the direct and indirect associations between physical distancing, contact frequency and loneliness, as well as the differences across European regions.

RESULTS

The results indicate that adults who reported higher frequency of physical distancing also felt lonelier during the pandemic. This association was partly explained by social contacts-those who practiced physical distancing maintained less in-person contact with children and non-kin and less electronic contact with non-kin, which were related to feeling lonelier. Adults in Southern European countries felt lonelier and reported more frequent contacts. The moderation analyses showed that the link between physical distancing and loneliness was found in the northern region, but not in the southern and eastern regions of Europe.

CONCLUSION

This study can indicate that attention should be paid to adults who may struggle to maintain social contacts in light of physical distancing guidelines.

Social Exclusion and Subjective Well-being Among Older Adults in Europe: Findings From the European Social Survey

Objectives

The current study aims to examine how social exclusion is related to subjective well-being in older adults across different European regions.

Methods

European population-based cross-sectional study design was employed using data sampled from the eighth round of the European Social Survey (ESS). Multiple items for social exclusion were used in this round, including household income, civic participation, frequent meetings with friends and relatives, basic health services, and neighborhood cohesion. Life satisfaction, happiness, and self-rated general health were also assessed. An ANOVA was performed to examine the regional differences related to social exclusion and subjective well-being, while a regression analysis was used to examine the relationship between the social exclusion and subjective well-being.

Results

There were significant regional differences in the social exclusion and subjective well-being of older Europeans. In addition, older adults in the Nordic nations are more likely to indicate higher levels of subjective well-being and lower levels of social exclusion, while older adults from Central and Eastern European nations tend to report lower levels of subjective well-being and higher levels of social exclusion. Material resources and basic services are highlighted as the most important domains pertaining to life satisfaction, happiness, and general health.

Discussion

The study findings reinforce the inequality in subjective well-being linked to social exclusion across different societies. Both global and country-specific exclusion models in later life should be implemented in order to enhance comparable research and provide insight into EU and national guidelines for interventions to diminish social exclusion.

Is Loneliness Adaptive? A Dynamic Panel Model Study of Older U.S. Adults

OBJECTIVES

Recent evolutionary psychological theory proposes that loneliness is an adaptive mechanism, designed to trigger maintenance and repair of social ties. No population representative analyses have probed loneliness effects on sociality. The present study addressed this gap.

METHOD

Data were from the 2006, 2010, 2014, and 2018 waves of the Health and Retirement Study, nationally representative of U.S. adults over age 50. Recently developed cross-lagged models with fixed effects were used to test prospective within-person associations of loneliness with specific dimensions of sociality, taking into account reverse causality as well as all time-invariant confounders with stable effects. Both gender-combined and -specific analyses were conducted.

RESULTS

Loneliness did not consistently predict overall sociality: sparse linkages were found only among women. The same null pattern held with family ties. Non-family ties, in contrast, were associated with prior loneliness, but in a gender-specific way. Loneliness positively predicted women's social interactions with friends, but seemed linked to withdrawal from these relationships among men. There were indications that lonely men instead used religious attendance as a social outlet.

DISCUSSION

Loneliness seems to induce domain- and gender-specific sociality responses. Findings suggest implications for evolutionary models of sociality as well as for psychosocial and physical health. Pending replication in independent samples, inferences remain tentative.

Examining the role of driven-game shooting as a psycho-social resource for older adults in rural areas: a mixed-methods study

This paper explores whether regular involvement in a rural, country sport, frequently practised by older individuals, builds social capital and friendships, reduces loneliness, and positively impacts individuals’ health and wellbeing. Taking a critical realist, mixed-methods approach, using a recognised social impact assessment methodology theoretically underpinned by social capital theory, this study identifies that driven-game shooting participation creates social impact via social capital creation and identity reinforcement. Results indicate a statistically significant, positive impact on mental health and wellbeing (N = 2,424), which varies by shoot size and/or type. The results are discussed in relation to implications for managing elderly health and wellbeing in rural areas.

Loneliness during the COVID-19 pandemic

Responses to the COVID-19 pandemic in terms of physical distancing risk collateral damage such as increased loneliness. Older adults have been identified as being at higher risk of poor outcomes if infected and in many countries have been subjected to greater restrictions on physical contacts with others. Most research so far points towards an increase in loneliness during the pandemic. However, there has been a lack of prospective studies based on representative samples of older adults, with the oldest old, older adults with low or no Internet usage, and those in poor health currently underrepresented. Despite the significance of cultural norms for individuals' standards for social relations and, thus, the experience of loneliness, there has been a lack of comparative research on loneliness in older adults during the pandemic. Reviews have found little evidence for what interventions and what elements of interventions are effective in reducing loneliness. There is potential for social relations to be maintained via technology-based solutions, although there is a risk of excluding older adults with limited resources who are both least likely to use technology and most vulnerable to loneliness. Furthermore, remote social contacts cannot fully compensate for the loss of physical contacts. Where stay-at-home orders are not imposed, supporting neighbourliness and the community use of accessible open spaces are other options. Finally, policy responses to the pandemic need to be more nuanced and non-ageist in order to avoid unnecessary increases in loneliness in older adults.

Older people as active agents in their neighbourhood environments: Moving house can improve quality of life

BACKGROUND AND OBJECTIVES

Neighbourhood environments are an important aspect of well-being for older people. Developments of the general ecological model recognise older people as active agents who adapt their environments to fit their changing needs. We provide empirical support for a model suggested by Wahl et al., by examining interactions between neighbourhood environments, personal situations, relocation, and quality of life among older people.

RESEARCH DESIGN AND METHODS

Two statistical models were tested with a sample of community dwelling participants (aged 55-89) in the New Zealand Health, Work and Retirement longitudinal surveys conducted in 2016 (T1) and 2018 (T2). Multiple linear regression assessed the association of perceptions of housing and neighbourhood with quality of life (QoL) at T1 (n = 3682).

RESULTS

QoL was predicted by housing satisfaction, and neighbourhood satisfaction, accessibility, and trust (controlling for age, gender, marital status, home ownership, SES, physical health and mental health). Mixed ANOVA showed that those who moved house between T1-T2 reported lower housing and neighbourhood satisfaction than non-movers at T1. Over time T1-T2, movers reported less decline in housing satisfaction, and more positive change on all neighbourhood perceptions, with higher perceptions of neighbourhood accessibility than non-movers at T2.

DISCUSSION AND IMPLICATIONS

These findings support the theoretical model and provide impetus for more detailed study of the effects of the environment on well-being in older age. Housing and neighbourhood environments are a very practical focus for social policy change at local and national levels.

Understanding older adults’ use of social technology and the factors influencing use

Having access and skills to use social technology, i.e. social internet use, social media and social applications, are considered as being vital to online social connection. Whilst evidence exists around facilitators and barriers to general technology use, evidence is limited with regards to the motivators, skills and tangible offline benefits older technology users experience with social technology. Therefore, this study used a qualitative, exploratory method to understand older adults’ experiences of using social technology to connect with others. Semi-structured interviews were conducted with 20 older adults (65+ years) across England, Scotland and Wales. Despite having access to social technology for social connection, and using this technology regularly, multiple barriers impacted motivators and skills for use, namely perceived self-efficacy and fear, the culture of online communication, absence of social capital and physical functioning. Some of these barriers of social technology use are reminiscent of barriers of wider technology use and emphasise the importance of addressing these barriers for digital exclusion, as well as social connection. However, some of these barriers were specific to social technology use and should be considered when providing guidance or interventions to increase older adults’ online social connection. Social connection was a clear tangible outcome to social technology use, and individuals discussed the benefits of using social technology, particularly visual communication tools, for online connection.

The Enabling Role of ICT to Mitigate the Negative Effects of Emotional and Social Loneliness of the Elderly during COVID-19 Pandemic

(1) Background: The COVID-19 pandemic has been especially hard on the elderly owing to their particular vulnerability to the virus. Their confinement to prevent the spread of the virus resulted in social isolation, often linked to the unwanted loneliness that hinders their emotional well-being. The enabling capacity of ICT (Information and Communication Technology) to overcome the negative effects of this isolation requires special attention. The purpose of this research is to understand the impact of the use of ICT on the emotional well-being of elderly people during their confinement. (2) Methods: A qualitative exploration method based on four focus groups with elderly people aged 60 years or older and three in-depth personal interviews with experts in education of the elderly were carried out. (3) Results: Research results evidence a negative emotional impact of the confinement (lack of physical contact with their loved ones, fear and uncertainty, feeling of loneliness, sadness at the loss of family members) on the emotional well-being of study participants. Furthermore, the operational capacity of ICT to prevent infection, as well as their positive emotional and humanizing role in providing access to entertainment and hobbies, and in improving self-esteem was also acknowledged. (4) Conclusions: ICT have become a valuable ally for elderly people aged 60 years and older to mitigate the negative effects of social isolation and loneliness imposed by the confinement.

Technology-Mediated Communication in Familial Relationships: Moderated-Mediation Models of Isolation and Loneliness

Background and Objectives

We examined whether technology-mediated communication has functional or emotional equivalence to face-to-face (FtF) contact in familial relationships, by scrutinizing the effects of phone, text/e-mail, and video contact on isolation and loneliness.

Research Design and Methods

We tested whether FtF contact with a relative would mediate the pathway between proximity to family and (i) isolation and (ii) loneliness. We then tested hypotheses that telephone, text/e-mails, and video contact would moderate this mediated pathway. We compared models for younger (<75) and older (≥75) cohorts, expecting to observe moderation effects for text/e-mail and video contact in the younger cohort only. Data were drawn from Wave 2 of CFAS Wales (United Kingdom) study (N = 2,099).

Results

Proximity to a relative had a significant indirect effect on isolation and loneliness through the mediating variable FtF contact. Phone and text/e-mail contact moderated the effect of FtF contact on isolation for all samples. None of the technologies moderated the impact of FtF contact on loneliness for the full sample. Telephone contact had a moderating influence on loneliness for the younger cohort only. Video calls had no significant moderation effect.

Discussion and Implications

Telephone and text/e-mail contact have functional equivalence to FtF contact in familial relationships. None of the forms of technological communication have emotional equivalence to the “gold standard” of embodied presence. The study demonstrates the importance of theorizing about the pathways to isolation and loneliness to better understand the likelihood of implementing successful interventions using technology-mediated communication within families.

Worry about debt is related to social loneliness in older adults in the Netherlands

The amount of financial debt held by older adults has grown substantially over the past two decades in Europe. This study examines the association of objective and subjective debt burden with social and emotional loneliness among 1,606 older adults in the Netherlands. Objective debt burden is based on financial terms, such as debt-to-income ratio; whereas subjective debt burden measures the psychological distress caused by financial debt. Data are from the 2015/2016 wave of the Longitudinal Aging Study Amsterdam. First, we use means-comparison tests to examine whether older adults who experience social and emotional loneliness differ from older adults who do not experience loneliness regarding their subjective and objective debt burdens. Subsequently, using linear regression models we address two questions: whether social loneliness and emotional loneliness are associated with objective and subjective debt burden; and whether social participation, social network size, anxiety and depression mediate these relationships. We find that subjective debt burden (i.e. the worry related to debt) is a significant predictor of social loneliness, above and beyond the role of social and psychological measures. Objective debt burden, in contrast, is unrelated to social and emotional loneliness. Social participation, social network size, anxiety and depression do not mediate the debt-burden-to-loneliness relationships. The results point to the importance of subjective debt burden in understanding social loneliness and designing interventions.

‘She shouldn't cross the line’: experiential effectivity of social guidance trajectories for socially isolated older adults with complex problems

Social isolation of older adults is difficult to break through, and interventions that focus on network development or enhanced social participation are hardly effective, especially when the older adults have been isolated for a long time and have problems in multiple life domains. This study aimed to investigate the needs and subjective experiences of this less-researched group and obtain a deeper understanding of their goals and priorities. The study involved a qualitative study with 25 socially isolated persons who receive assistance from a social worker in an individual guidance trajectory. Data were collected via repeated in-depth interviews with the older adults. By directing the focus towards their subjective experiences, the study gives insight into the ‘experiential effectivity’ of the intervention. It shows what their experienced problems were, and to what degree they benefited from the intervention in this respect. The experience of personal attention and involvement of the social workers represents the most relevant results for them. The participants have no need for network development or engagement in local communities. Yet, the help offered by the social workers produces other results for them, such as solved practical problems, emotional support, more self-sufficiency, a point of contact or a safety net that was not there before. This knowledge can help to improve the quality of intervention for this target group.

Associations of older adults' excursions from home with health-related physical activity and sedentary behavior

BACKGROUND

As people age, they spend more time in and around their domestic environments, within which opportunities for health-enhancing physical activity (PA) may be limited. We examined the associations of frequency of excursions from home with accelerometer-determined PA and the total and prolonged sedentary behavior (SB, sitting for ≥30 min) among community-dwelling older adults.

METHODS

Overall, 434 older adults (men, 57.1 %; age, 70-79 years) wore an accelerometer (HJA-350IT, Omron Healthcare) for 7 days. Time spent in SB, light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and prolonged SB bout (≥30 min) were calculated. Frequencies of excursions from home were categorized as 0-3, 4-5, and 6-7 days/week. Associations of excursions with PA and SB were tested by analysis of covariance adjusted for sociodemographic characteristics.

RESULTS

Frequencies were 14.3 %, 31.1 %, and 54.6 % for excursions 0-3, 4-5, and 6-7 days/week, respectively. For men, less frequent excursions from home were significantly associated with less MVPA and more total and prolonged SB times (estimated means [minutes/day]: MVPA, 32, 42, and 48; total SB, 589, 549, and 539; prolonged SB, 344, 288, and 265; respectively; p < 0.05). LPA was not statistically significant (p = 0.09). For women, less frequent excursions were significantly associated with all PA outcomes (SB: 536, 497, and 467; prolonged SB: 260, 213, and 204; LPA: 328, 363, and 379; MVPA: 36, 39, and 54, respectively).

CONCLUSIONS

Among community-dwelling Japanese older adults, more frequent excursions from home were associated with more PA, less SB, and more-favorable SB patterns, suggesting a potential strategy for preventive-health initiatives.

‘It gives you a reason to be in this world’: the interdependency of communities, environments and social justice for quality of life in older people

Research regarding quality of life among older people has predominantly focused on functional elements experienced at individual or dyadic level despite the complex interplay of factors that contribute to quality of life. Perspectives which explore interdependencies within communities and the intersecting environments in which older people exercise agency have seen less study. They do, however, play an important role in influencing quality of life as experienced by older people across community settings. Qualitative data from a co-produced study of dimensions influencing quality of life in older people was subjected to secondary analysis using a critical human ecological approach. Findings demonstrate the importance of community interdependencies in supporting individual quality of life, the expression of active agency to foster quality of life within and across communities, and the importance of state infrastructures and service provision within these interdependencies. This article argues for a movement beyond functional conceptualisations of quality of life towards the inclusion of perspectives regarding communal wellbeing, alongside the role differing types of community play in influencing quality of life. Through developing conceptions of quality of life in social relations and community cohesion, in particular how quality of life is influenced by perceptions of solidarity and social justice including across generations, assessing quality of life at community level will assist in driving cultural change in policy making and practice.

Consensus statement: loneliness in older adults, the 21st century social determinant of health?

OBJECTIVE

The purpose of this consensus statement is to determine the state of the field of loneliness among older people, highlighting key issues for researchers, policymakers and those designing services and interventions.

METHODS

In December 2018, an international meeting on loneliness was held in Belfast with leaders from across the USA and Europe. A summary of the conclusions reached at this event is presented following a consensus-building exercise conducted both during this event after each presentation as well as after the event through the drafting, reviewing and agreement of this statement by all authors for over 6 months.

RESULTS

This meeting resulted in an agreement to produce a consensus statement on key issues including definitions of loneliness, measurement, antecedents, consequences and interventions.

DISCUSSION

There has been an exponential growth in research on loneliness among older adults. However, differing measurements and definitions of loneliness mean the incidence and prevalence, associated risk factors and health consequences are often conflicting or confusing especially for those developing policy and services.

Out-of-Home Mobility and Social Participation of Older People: a Photo-Based Ambulatory Assessment Study

Research has shown that social participation contributes to older people’s healthy ageing. Out-of-home mobility may promote higher levels of social participation among older people. However, mobility and social participation are sophisticated constructs. Social participation can be distinguished among different levels, such as being alone, being alone surrounded by others, interacting with others or engaging in activities together. Social participation and time spent in out-of-home-mobility can be difficult to remember and therefore difficult to assess. Picture-based ambulatory assessment provides valid and reliable information about people’s mobility as well as their level of participation with high ecological validity. The aim of the study was to investigate older people’s level of social participation and its association with high or low out-of-home mobility. In sum, 23072 pictures (mean per person = 2307; SD = 686.7) involving ten older people (mean age = 75.4 years; SD = 7.5 years) living in southwestern Germany were analysed. They were asked to wear a wearable camera for two consecutive days. Images were automatically captured every 15 seconds. Image analysis shows that study participants spent most of their time alone (at approximately 35% of analysed time). Out-of-home mobility was associated with higher levels of social participation, such as helping others (chi2 = 200,664, df = 5, p < .001). Picture-based ambulatory assessment can assist in the gathering of necessary sophisticated information that is difficult to assess via questionnaires or other similar methods.