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Lai ETC, Chau AKC, Ho IYY, Hashimoto H, Kim CY, Chiang TL, Chen YM, Marmot M, Woo J. The impact of social isolation on functional disability in older people: A multi-cohort study. Arch Gerontol Geriatr 2024; 125:105502. [PMID: 38876082 DOI: 10.1016/j.archger.2024.105502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES We assessed the relationship between social isolation and functional disability in older people. DESIGN Comparison of longitudinal cohort studies. SETTING AND PARTICIPANTS Harmonised longitudinal datasets from the United States, England, European countries, Japan, Korea, China and Hong Kong. METHODS Social isolation was operationalised as a composite score with five domains, such as marital status, living alone, and social contact with others. Functional disability was defined as whether the cohort participant had any difficulty in activities of daily living (ADL). In each dataset, we used robust Poisson regression models to obtain the relative risks (RRs) and the corresponding 95 % confidence intervals (CI). We combined the RRs to synthesize a pooled estimate using meta-analysis with random-effects models. RESULTS Overall, the social isolation composite score was not associated with ADL disability (pooled RR = 1.05, 95 % CI [0.97-1.14], n = 40,119). Subgroup analysis suggested social isolation composite score was associated with ADL disability in Asian regions (pooled RR = 1.09, 95 % CI [1.02, 1.16], but not in Western regions (pooled RR = 1.01, 95 % CI [0.96, 1.07]). The relationships between different domains of social isolation and ADL disability were heterogeneous, except that no participation in any social clubs or religious groups was consistently associated with ADL disability (pooled RR = 1.12, 95 % CI [1.04, 1.21]). CONCLUSION Targeting social isolation may prevent decline in functional abilities in older adults, providing an avenue to active and healthy ageing. Nonetheless, interventions tackling social isolation should tailor to the unique cultural and social underpinnings. A limitation of the study is that reverse causality could not be ruled out definitively.
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Affiliation(s)
- Eric Tsz-Chun Lai
- Institute of Health Equity, Chinese University of Hong Kong, Shatin, Hong Kong; Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Anson Kai Chun Chau
- Institute of Health Equity, Chinese University of Hong Kong, Shatin, Hong Kong; School of Psychology, University of New South Wales, Sydney, Australia
| | - Irene Yuk-Ying Ho
- Institute of Health Equity, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Hideki Hashimoto
- Department of Health and Social Behavior, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Chang-Yup Kim
- School of Public Health, Department of Health Policy and Management, Seoul National University, Seoul, South Korea
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ya-Mei Chen
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Michael Marmot
- Department of Epidemiology and Public Health, Institute of Health Equity, University College London, London, UK
| | - Jean Woo
- Institute of Health Equity, Chinese University of Hong Kong, Shatin, Hong Kong; Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong
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Wu Q, Liu M, Ma T, Hu Q, Yuan C, Zhang X, Zhang T. Research trends and hotspot analysis of age-related hearing loss: A bibliometric analysis from 2019 to 2023. Exp Gerontol 2024; 194:112489. [PMID: 38936439 DOI: 10.1016/j.exger.2024.112489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Age-related hearing loss (ARHL) - also termed presbycusis - is prevalent among older adults, leading to a range of issues. Although considerable progress in the understanding of ARHL over the decades, available reports lack data from recent years and do not comprehensively reflect the latest advancements and trends. Therefore, our study sought to assess research hotspots and trends in ARHL over the past 5 years to provide the basis for future research. MATERIALS AND METHODS The Web of Science Core Collection database was searched and screened from January 1, 2019 to October 21, 2023, according to the inclusion criteria. CiteSpace (5.8.R3), VOSviewer (1.6.19), and Microsoft Excel 2019 were employed for bibliometric analysis and visualization. RESULTS 3084 articles from 92 countries led by the United States and China were included. There has been a steady upward trend in the number of publications from 2019 to 2023. The most productive institutions, authors, and journals are Johns Hopkins University (n = 113), Lin FR (n = 66), and Ear and Hearing (n = 135), respectively. Trend topic analyses revealed that "cochlear synaptopathy" and "dementia" were the predominant foci. Keywords, including "individuals" and "national health", began to appear. CONCLUSION Over the past 5 years, the annual number of publications has increased significantly and will continue to do so. Research on the mechanism of ARHL, represented by "oxidative stress", is a continuing focus. Emerging topics such as "individual differences" and "national health" may be potential future hotspots in this field.
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Affiliation(s)
- Qilong Wu
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China
| | - Mengting Liu
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China
| | - Tianyu Ma
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China
| | - Qi Hu
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China
| | - Chenyang Yuan
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China
| | - Xiaopeng Zhang
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China
| | - Tianhong Zhang
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China.
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Che RP, Cheung MC, Herrero J. Validation of the Perceived Community Support Questionnaire for Older Chinese. THE GERONTOLOGIST 2024; 64:gnae046. [PMID: 38761037 DOI: 10.1093/geront/gnae046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Community support has a profound positive impact on older people's health and plays a crucial role in facilitating aging in place. This impact is particularly significant in the Chinese context, where community support can alleviate the pressure on traditional family caregiving. This study translated, adapted, and validated the perceived community support questionnaire (PCSQ) for use with older Chinese. RESEARCH DESIGN AND METHODS Data for this validation study were collected from a cross-sectional survey of 1,064 Chinese aged 65 years and above. Following the cultural adaptation of the PCSQ-14, confirmatory factor analysis (CFA) was conducted to examine its factor structure. Criterion validity, convergent and discriminant validity, internal consistency reliability, and test-retest reliability of the scale were also assessed. RESULTS Based on the CFA results, the adapted PCSQ-14 was found to have a 3-factor solution for community integration, community participation, and community organizations. The criterion-related validity was supported by its significant correlation with depression. Convergent and discriminant validity were established, with the internal consistency of the scale being 0.90. The test-retest reliability intraclass correlation coefficient for the scale was 0.78. DISCUSSION AND IMPLICATIONS The adapted version of the PCSQ-14 demonstrated promising psychometric properties in assessing perceived community support in older Chinese. The adapted PCSQ-14 could assist researchers in determining older Chinese adults' perceptions of community support, and could also assist practitioners and policymakers in developing targeted services for older people and allocating resources more effectively.
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Affiliation(s)
- Run-Ping Che
- Department of Social Work, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, People's Republic of China
| | - Mei-Chun Cheung
- Department of Social Work, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, People's Republic of China
| | - Juan Herrero
- Department of Psychology, University of Oviedo, Oviedo, Principado de Asturias, Spain
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4
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Jiang C, Shi J. The Long Arm of Childhood Bullying Victimization: Associations with Social Isolation, Gender Differences and Depression in Later Life. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:3184-3206. [PMID: 38312080 DOI: 10.1177/08862605241227980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
The association between childhood bullying victimization and depression has been well-explored among young adults, but little is known about whether this relationship persists into later life stages, specifically during middle-aged and older phases. Moreover, the intricate mechanisms underpinning this association and the potential existence of gender differences within this context remain inadequately elucidated. To address this gap in knowledge, this study aims to investigate the association between childhood bullying victimization and depression in later life, with a focus on exploring the mediating role of social isolation and the moderating roles of gender. A nationally representative sample of 5,070 individuals (mean age = 61.02, SD = 9.48; male = 55%) was drawn from the China Health and Retirement Longitudinal Study. By employing the bootstrapping analysis method, the mediating role of social isolation was examined, and the moderating role of gender was tested through the generation of interaction items. The results reveal a significant association between childhood bullying victimization and severe depression in later life. Additionally, social isolation plays a mediating role in this association between childhood bullying victimization and social isolation, and the association between social isolation and depression, as well as the relationship between social isolation and depression, are both moderated by gender, presenting stronger effects for female groups than for male groups. However, no moderating role of gender is found in terms of the direct association between childhood bullying victimization and depression. These findings highlight the fact that childhood bullying is not only a problem in the immediate term but also a concern that affects individuals across entire life course. This study has implications for healthcare in proactively investigating, diagnosing, and treating depression by inquiring about childhood bullying victimization experiences. Furthermore, intervention policies that aim to reduce social isolation may be particularly beneficial in mitigating the negative associations, especially for female individuals.
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Affiliation(s)
- Chaoxin Jiang
- School of Social Development,East China Normal University, Shanghai, China
| | - Jiaming Shi
- School of Public Administration,Southwestern University of Finance and Economics, Chengdu, Sichuan, China
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5
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McDonald B, Reiter AMF, Kanske P. Theater-based interventions as a means of reducing social isolation and loneliness, facilitating successful aging, and strengthening social cognition in older adults. Front Psychol 2024; 15:1364509. [PMID: 39006549 PMCID: PMC11240220 DOI: 10.3389/fpsyg.2024.1364509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/20/2024] [Indexed: 07/16/2024] Open
Affiliation(s)
- Brennan McDonald
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Saxony, Germany
| | - Andrea M F Reiter
- German Center of Prevention Research on Mental Health, Würzburg, Bavaria, Germany
- Department of Psychology, Faculty of Medicine, University of Würzburg, Würzburg, Germany
- Clinic and Polyclinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Bavaria, Germany
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Saxony, Germany
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Hall LM, Moussa-Tooks AB, Sheffield JM. Associations between social engagement, internalizing symptoms, and delusional ideation in the general population. Soc Psychiatry Psychiatr Epidemiol 2024; 59:989-1002. [PMID: 37624462 DOI: 10.1007/s00127-023-02540-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 07/30/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Delusions are a hallmark feature of psychotic disorders and lead to significant clinical and functional impairment. Internalizing symptoms-such as symptoms of depression, anxiety, and trauma exposure-are commonly cited to be related to delusions and delusional ideation and are often associated with deficits in social functioning. While emerging studies are investigating the impact of low social engagement on psychotic-like experiences, little work has examined the relationship between social engagement, internalizing symptoms, and delusional ideation, specifically. METHODS Using general population data from the Nathan Kline Institute-Rockland (NKI-Rockland) database (N = 526), we examined the relationships between self-reported delusional ideation, internalizing symptoms, and social engagement and tested four indirect effect models to understand how these factors interrelate. RESULTS Delusional ideation was significantly associated with both increased internalizing symptoms (r = 0.41, p < 0.001) and lower social engagement (r = - 0.14, p = 0.001). Within aspects of social engagement, perceived emotional support showed the strongest relationship with delusional ideation (r = - 0.17, p < 0.001). Lower social engagement was also significantly associated with increased internalizing symptoms (r = - 0.29, p < 0.001). Cross-sectional models suggest that internalizing symptoms have a significant indirect effect on the association between delusional ideation and social engagement. CONCLUSIONS These findings reveal that elevated delusional ideation in the general population is associated with lower social engagement. Elevated internalizing symptoms appear to play a critical role in reducing engagement, possibly exacerbating delusional thinking. Future work should examine the causal and temporal relationships between these factors.
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Affiliation(s)
- Lauren M Hall
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA.
| | - Alexandra B Moussa-Tooks
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA
| | - Julia M Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA
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Simone T, Peltz C, Rosenberg DE, Barnes DE, Fleckenstein LE, Dublin S, Yaffe K. The Impact of Pandemic-Related Restrictions on Dementia Risk Factors in Older Adults. J Appl Gerontol 2024; 43:515-519. [PMID: 37930366 PMCID: PMC10981572 DOI: 10.1177/07334648231210671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Adults aged 65+ are at highest risk for severe COVID-19 outcomes, and prior to the distribution of vaccines in the U.S., were strongly advised to quarantine at home to reduce risk of infection. This study examines how COVID-19 restrictions impacted various dementia risk factors and social determinants of health among older adults. Data came from the Systematic Multi-Domain Alzheimer's Risk Reduction Trial, a randomized controlled trial of a multi-domain intervention in higher-risk older adults (aged 70-89). A questionnaire was administered to participants (n = 156; 90.7% response rate) between May 2020 and March 2021. The data show a significant decline in social activity, physical activity, and mood among respondents. Compared to living with others, living alone was associated with worsened physical activity, diet, and subjective memory/thinking, adjusted for sex and age. These results suggest that the COVID-19 pandemic exacerbated several risk factors for dementia in older adults, particularly in those living alone.
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Affiliation(s)
- Tamar Simone
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Carrie Peltz
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Dori E. Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Deborah E. Barnes
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Sascha Dublin
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Kristine Yaffe
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
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8
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Chishima I, Nakagomi A, Ide K, Shioya R, Saito M, Kondo K. The Purpose of Internet Use and Face-To-Face Communication With Friends and Acquaintances Among Older Adults: A JAGES Longitudinal Study. J Appl Gerontol 2024:7334648241240562. [PMID: 38671556 DOI: 10.1177/07334648241240562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
Internet use influences social interactions in society. However, there is no consensus on whether and what kind of Internet use increases face-to-face communication (FFC). This study investigated the mode of Internet use that increases FFC among older adults after three years. Participants were 8734 adults aged 65 or older who responded to the Japan Gerontological Evaluation Study (JAGES) surveys in 2016 and 2019. The exposures were the purposes of Internet use in 2016. The outcome was the frequency of FFC with friends or acquaintances in 2019. The confounders included 13 demographic, socioeconomic, and psychological variables. We performed modified Poisson regression analyses and found that Internet use for communication in 2016 increased FFC in 2019, especially for low-frequency FFC in 2016. Internet-based non-FFC may help promote FFC and prevent social isolation among older adults who are less likely to interact with others.
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Affiliation(s)
- Iwao Chishima
- Graduate School of Medicine and Pharmaceutical Sciences, Chiba University, Chiba, Japan
- Futaba Clinic, Futaba-cho, Tochigi, Japan
| | - Atsushi Nakagomi
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Ryunosuke Shioya
- Graduate School of Medicine and Pharmaceutical Sciences, Chiba University, Chiba, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
- Center for Well-Being and Society, Nihon Fukushi University, Chita-gun, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
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Defrancesco M, Schurr TA, Hofer A. COVID-19 restrictions promoted the newly occurring loneliness in older people - a prospective study in a memory clinic population. Front Psychiatry 2024; 15:1340498. [PMID: 38528978 PMCID: PMC10961460 DOI: 10.3389/fpsyt.2024.1340498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/19/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction A high burden and many negative outcomes for older people were associated with the COVID-19 pandemic. Social isolation and loneliness are prevalent health problems impacting well-being and quality of life and may have increased due to pandemic-related restrictions. Methods: This study investigate the influence of the COVID-19 pandemic on loneliness in people visiting a mem40ory clinic between March 2020 and September 2022. We conducted a prospective, single-center, questionnaire-based observational follow-up study to assess potential predictors of newly occurring, pandemic-related loneliness. Next to a newly developed COVID-19 questionnaire, a comprehensive neuropsychological test battery, the Neuropsychiatric Inventory and the Geriatric Depression Scale were used. Results In total 426 people (mean age: 76.48 years, 12.9% cognitively intact, 33.1% diagnosed with Mild Cognitive Impairment, 49.8% diagnosed with dementia, and 4.2% diagnosed with depression) completed the COVID-19 questionnaire at baseline and 166 at follow-up. Newly occurring loneliness was indicated by 22.3% of baseline participants and by 24.1% of follow-up participants. Results of logistic regression analysis showed that living alone (OR 5.452) and having less contact with friends (OR 2.771) were most predictive of the occurrence of loneliness. The use of digital communication media as an alternative strategy for social interaction was lowest in dementia patients (6-13%). Discussion In conclusion, personal contacts and a close friendship network appear to be more decisive to prevent loneliness in older people than does the use of digital communication media. However, promoting an intensified use of digital communication media may be useful to counteract loneliness, especially in dementia patients.
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Affiliation(s)
- Michaela Defrancesco
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
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10
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Gecha TC, Glass IV, Frankenburg FR, Sharp C, Zanarini MC. Experiential avoidance in participants with borderline personality disorder and other personality disorders. Borderline Personal Disord Emot Dysregul 2024; 11:6. [PMID: 38433260 PMCID: PMC10910803 DOI: 10.1186/s40479-024-00248-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/03/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The present study has descriptive and predictive aims. The descriptive aims were to determine if participants with borderline personality disorder (BPD) reported higher levels of experiential avoidance (EA) than participants with other personality disorders (OPD) as well as determine if non-recovered participants with BPD reported higher levels of EA than participants with BPD who have recovered symptomatically and psychosocially. The predictive aim was to determine if the level of EA reported by participants with BPD was predicted by the severity of aspects of childhood or adult adversity and/or aspects of temperament. METHODS The Overall Anxiety Severity and Impairment Scale (OASIS) was administered to 248 participants at 24-year follow-up in the McLean Study of Adult Development (MSAD). Adversity and temperament were assessed during index admission using interviews (Revised Childhood Experience Questionnaire [CEQ-R], Adult History Interview [AHI], and the NEO-FFI self-report measure). RESULTS Participants with BPD reported significantly higher levels of EA than those with OPD. Within the BPD group, non-recovered participants reported significantly higher levels of EA than recovered participants. Severity of childhood sexual abuse and lower levels of extraversion were found to be significant multivariate predictors of levels of EA in those with BPD. CONCLUSIONS Taken together, these results suggest that EA is a serious problem for participants with BPD, particularly those who have not recovered. They also suggest that both the severity of childhood adversity and a temperament marked by lower levels of extroversion are significantly related to levels of EA reported by participants with BPD.
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Affiliation(s)
| | - Isabel V Glass
- McLean Hospital, 115 Mill Street, 02478, Belmont, MA, USA
| | - Frances R Frankenburg
- Edith Nourse Rogers Veterans Administration Hospital, Bedford, MA, USA
- Boston University School of Medicine, Boston, MA, USA
| | | | - Mary C Zanarini
- McLean Hospital, 115 Mill Street, 02478, Belmont, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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Gunnes M, Løe IC, Kalseth J. Exploring the impact of information and communication technologies on loneliness and social isolation in community-dwelling older adults: a scoping review of reviews. BMC Geriatr 2024; 24:215. [PMID: 38431561 PMCID: PMC10908002 DOI: 10.1186/s12877-024-04837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Recognizing the escalating public health concerns of loneliness and social isolation in aging populations, this study seeks to comprehensively explore the potential of information and communication technology (ICT)-based interventions to address these issues among older adults. This scoping review of reviews aims to map and synthesize existing evidence on the effectiveness and scope of ICT interventions targeting loneliness and social isolation in community-dwelling older adults, elucidating types of technology, impacts, facilitators, barriers, and research gaps. METHODS Following the Joanna Briggs Institute framework, we systematically searched eight diverse databases identifying relevant published reviews. We included English-written, peer-reviewed reviews of all types, with no limits regarding time of publication about ICTs targeting loneliness and/or social isolation for community-dwelling older adults. Eligible reviews were analysed and summarized, offering a holistic narrative of the reported types of ICTs and their impact, the identified facilitators and barriers influencing the implementation and adoption of ICT interventions, and the research gaps identified in the literature. RESULTS The review included 39 publications published between 2012 and 2024, spanning systematic, scoping, and reviews of reviews. Various ICTs were reported, primarily social media virtual communities, followed by video-mediated friendly visits, conversational agents, social robots, exergames and online gameplay. Predominantly positive impacts on mitigating social isolation and loneliness were evident for these ICTs, although methodological diversity and contradictory findings complicated definite conclusions. Facilitators and barriers encompassed individual competencies, access and usage, and intervention design and implementation. Research gaps involved targeting specific subgroups, exploring innovative technologies, incorporating diverse study designs, improving research methodologies, and addressing usability and accessibility. Future research should focus on identifying elderly individuals who can benefit the most from ICT use, exploring novel technologies, using a wider range of study designs, and enhancing usability and accessibility considerations. CONCLUSIONS This review sheds light on the diverse range of ICTs, their impact, and the facilitators and barriers associated with their use. Future investigations should prioritize refining outcome measures, addressing gender differences, and enhancing the usability and accessibility of interventions. The involvement of older adults in the design process and the exploration of technological training interventions hold promise in overcoming barriers.
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Affiliation(s)
- Mari Gunnes
- Department of Health Research, SINTEF Digital, Trondheim, Norway.
| | - Ida-Camilla Løe
- Department of Technology Management, SINTEF Digital, Steinkjer, Norway
| | - Jorid Kalseth
- Department of Health Research, SINTEF Digital, Trondheim, Norway
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Biglieri S, Hartt M. The 'Double Risk' of Aging: Examining Vulnerability and (Un)supportive Built Environments in Canadian Cities. Can J Aging 2024; 43:99-113. [PMID: 37665016 DOI: 10.1017/s0714980823000429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
The confluence of rapid population aging and the overwhelming desire of older adults to age in place begs the question: Do our cities support the health and well-being of aging populations? Using a neighbourhood-by-neighbourhood approach, this macro-scale investigation explores the "double risk" that many older adults live with - the potential of being disadvantaged by socio-demographic risk factors (being older, living alone, low income) and by living in an unsupportive built environment. It is an integration of what we know about supportive built form for older adults and applies this knowledge to Canadian cities, using a spectrum approach to classifying built environments. We found that most older adults with socio-demographic risk factors are living in unsupportive built environments in Canada; however, the distribution between built environments along the spectrum and between municipalities reveals a variegated landscape of double risk. Previous research suggests that unsupportive built environments can be supplemented with services, small-scale improvements in the built environment, and larger-scale retrofitting of neighbourhoods. Since the spatial distribution of vulnerability varies greatly within the 33 Canadian cities analysed, it highlights the need for this kind of inquiry to target age-friendly policy interventions.
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Affiliation(s)
- Samantha Biglieri
- School of Urban and Regional Planning, Toronto Metropolitan University, Toronto, ON, Canada
| | - Maxwell Hartt
- School of Urban and Regional Planning, Department of Geography and Planning, Queen's University, Kingston, ON, Canada
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13
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Evans MB, Li Z, Benson A. Modelling Age-Varying Associations among Group Memberships, Neighborhood Connectedness, and Well-Being. Can J Aging 2024; 43:176-184. [PMID: 37811560 DOI: 10.1017/s0714980823000569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
Individuals who maintain group memberships in their community tend to experience improved well-being relative to those who participate in few or no groups. There are, however, few investigations targeting variability in the correlates of group membership across the lifespan. The present examination probed age-related variability in the association between group memberships and subjective connectedness as well as well-being. Participants included 3,940 (mean age = 45.61 years, standard deviation [SD] = 15.62) Canadian and American respondents who completed an online survey during August of 2020 (i.e., amidst the COVID-19 pandemic). Time-varying effects modelling was used to estimate coefficients for group membership at each age within the sample. Memberships in social groups positively predicted connectedness, and this association was strongest in middle-to-older age; a similar association was also evident when predicting well-being. Connectedness was also a positive predictor of well-being throughout most ages. These findings build on emerging research conveying how group memberships have significance for people currently in middle-to-older age.
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Affiliation(s)
- M Blair Evans
- Department of Psychology, Faculty of Social Science, Western University, London, ON, Canada
| | - Zhuo Li
- Department of Psychology, Faculty of Social Science, Western University, London, ON, Canada
| | - Alex Benson
- Department of Psychology, Faculty of Social Science, Western University, London, ON, Canada
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Miki T, Cooray U, Kanai M, Hagiwara Y, Ikeda T. Cultural engagement and prevalence of pain in socially isolated older people: a longitudinal modified treatment policy approach. EClinicalMedicine 2024; 69:102477. [PMID: 38356730 PMCID: PMC10864863 DOI: 10.1016/j.eclinm.2024.102477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
Background It remains uncertain whether cultural engagement positively influences the reduction of pain risk, particularly depending on the social isolation status. The aim of this study was to examine the impact of cultural engagement on the reduction of pain prevalence over a 6-year follow-up period among older people, particularly those experiencing different dimensions of social isolation. Methods This study was a prospective longitudinal study. We analysed the English Longitudinal Study of Ageing cohort, consisting of 6468 community-dwelling adults aged ≥50 years old who provided data in waves 6 (2012-2013), 7 (2014-2015), 8 (2016-2017), and 9 (2018-2019). Self-reported cultural engagement (going to museums, art galleries, exhibitions, the theatre, concerts, or the opera) measured in waves 6-8 was used as the exposure variable. Meanwhile self-reported moderate-to-severe pain in wave 9 was used as the outcome variable. Social isolation was considered in waves 6-8, and the possibility of effect modification was captured by assessing each component of the social isolation index: not married or cohabiting with a partner, fewer than monthly contact with children/other immediate family/friends, and not engaging in any organisations, religious groups, or committees. Findings The estimated pain prevalence was 29.2% (95% confidence interval, 28.1-30.3; reference) after adjusting for time-variant, time-invariant, and loss to follow-up factors. Cultural engagement led to a reduction in pain prevalence to 24.1% for all individuals, representing a decrease of 5.1% (95% confidence interval, 0.6-9.6; P-value, 0.03). In older people who were not married or cohabiting, cultural engagement resulted in a decrease in pain prevalence to 25.8%, a reduction of 3.4% (95% confidence interval, 0.4-6.4; P-value, 0.01). For those with less frequent contact with close family members, the pain prevalence decreased to 25.3%, a reduction of 3.9% (95% confidence interval, 0.2-7.6; P-value, 0.03). Meanwhile, other dimensions of social isolation did not show a significant reduction in pain prevalence. Interpretation Cultural engagement may help to reduce the risk of pain in socially isolated older adults. Those who were single or living alone and had less frequent contact with immediate family were particularly vulnerable. While cultural engagement might help certain socially isolated older people feel better, its effectiveness varies, highlighting the need for targeted interventions. Funding The Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number (22K17648, Ikeda).
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Affiliation(s)
- Takahiro Miki
- Insight Lab, PREVENT Inc., Aichi, Japan
- Graduate School of Rehabilitation Science, Saitama Prefectural University, Japan
| | - Upul Cooray
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Masashi Kanai
- Insight Lab, PREVENT Inc., Aichi, Japan
- Institute of Transdisciplinary Sciences for Innovation, Kanazawa University, Ishikawa, Japan
| | | | - Takaaki Ikeda
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
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Low E, D’Cunha NM, Georgousopoulou E, Naumovski N, Bacon R, Isbel S, Brocklehurst M, Reynolds M, Ryan D, Kellett J. Risk of Social Isolation as a Contributing Factor to Diet Quality in Community-Dwelling Older Persons Living in the Australian Capital Territory-A Pilot Study. Healthcare (Basel) 2024; 12:539. [PMID: 38470650 PMCID: PMC10930706 DOI: 10.3390/healthcare12050539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/09/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVES Social isolation is recognised as a risk factor in the inflammatory process. This study explored the association between social isolation and the Dietary Inflammatory Index (DII) in community-dwelling older persons. METHODS This cross-sectional pilot study recruited 107 community-dwelling people aged over 55 years living in the Australian Capital Territory. Participants completed an extensive food frequency questionnaire and provided anthropometric and sociodemographic data. Social isolation was evaluated using the Lubben Social Network Scale (LSNS). Diet quality was assessed using DII. RESULTS Average age was 70.1 (±8.61) years and 62.8% were female. The average DII score was -1.10 (±1.21), indicating an anti-inflammatory diet. Higher LSNS was associated with lower DII (b (95% CI) = -0.041 (-0.066, -0.17); p < 0.01) and was positively influenced by the number of people in household (b (95% CI) = 5.731 (2.336, 9.127); p = 0.001). CONCLUSION Increased risk of social isolation was associated with an increased tendency towards a more inflammatory diet. Reducing social isolation may decrease the inflammatory component of dietary intake for older persons living independently in the community.
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Affiliation(s)
- Elizabeth Low
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
- Centre for Ageing, Research and Translation, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia;
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
| | - Nathan M. D’Cunha
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
- Centre for Ageing, Research and Translation, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia;
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
| | - Ekavi Georgousopoulou
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
| | - Nenad Naumovski
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
- University of Canberra Research Institute for Sport and Exercise (UCRISE), University of Canberra, Canberra, ACT 2601, Australia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Kallithea, 17671 Athens, Greece
| | - Rachel Bacon
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
| | - Stephen Isbel
- Centre for Ageing, Research and Translation, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia;
- Discipline of Occupational Therapy, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
| | - Megan Brocklehurst
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
| | - Matthew Reynolds
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
| | - Daena Ryan
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
| | - Jane Kellett
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
- Centre for Ageing, Research and Translation, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia;
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
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Lin Y, Zhu T, Zhang X, Zeng Z. Trends in the prevalence of social isolation among middle and older adults in China from 2011 to 2018: the China Health and Retirement Longitudinal Study. BMC Public Health 2024; 24:339. [PMID: 38302982 PMCID: PMC10832184 DOI: 10.1186/s12889-024-17734-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Epidemiological studies have shown that social isolation, which is prevalent in older adults, is associated with a range of adverse health outcomes, but the prevalence of and trends in regard to social isolation remain ambiguous in China. The aim of this study was to elucidate the trends regarding the prevalence of social isolation among middle-aged and older adults in China from 2011 to 2018 and to further identify associated risk factors. METHODS A repeated cross-sectional study, The data were derived from panel sample data of four waves conducted from May 2011 to August 2018 in the nationally representative China Health and Retirement Longitudinal Study (CHARLS) using multistage probability sampling. Social isolation was ascertained by the five item Steptoe Social Isolation Index. The potential covariates were demographic characteristics, lifestyle factors, and health status. Linear-by-linear association was used to assess the trends in regard to social isolation over time under the influence of the potential covariates. Linear-by-linear association and an age-period-cohort analysis were used to explore the trends, and two-level (time, individual) generalized estimating equation models (GEE) linked multivariate binary logistic regression were performed to identify risk factors. RESULTS A high prevalence of social isolation and a moderate upward trend from 2013 to 2018 were observed among a U-shaped trend prevalence of social isolation from 2011 to 2018 across China, with rates of 38.09% (95% CI = 36.73-39.45) in 2011, 33.66% (32.32-35.00) in 2013, 39.13% (37.59-40.67) in 2015, and 39.95% (38.59-41.31) in 2018 (p < 0.001). The prevalence of social isolation increased with age and educational attainment. Females had a higher prevalence than males. The prevalence of social isolation was found to be significantly lower in pensioners than in non-pensioners between 2011 and 2018 (p < 0.001). The prevalence of social isolation was 38.9%, 34.9%, 38.5%, and 44.08% about three times higher among those who doid not use the Internet and 13.44%, 11.64%, 12.93%, and 16.73% than among those who doid in 2011, 2013, 2015 and 2018 respectively. The participants with short (0-5 h) and long sleep (9 or more hours), and poor self-rated health had a higher prevalence of social isolation than the others. Older age, lower educational attainment, living in a rural region, lack of medical insurance or pension, lack of internet use and poor health were risk factors (p < 0.05). CONCLUSIONS We found a U-shaped prevalence of social isolation trends from 2011 to 2018 and revealed increasing trends from 2013 to 2018 among middle-aged and older adults in China. The findings of the study highlight the urgent need for interventions to reduce social isolation including improving sleep quality and internet skills. Disadvantaged groups in terms of age, economic status, and health status should be the focus of such interventions, especially in the era of COVID-19.
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Affiliation(s)
- Yanwei Lin
- Department of Social Medicine and Health Management, School of Public Health, Guangdong Medical University, Dongguan, China
- Institute of Public Health and Wellness, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, Guangdong, 523808, China
- Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, WC2A2AE, UK
| | - Tingting Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
- Institute of Public Health and Wellness, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, Guangdong, 523808, China
| | - Xiaoyan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
- Institute of Public Health and Wellness, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, Guangdong, 523808, China
| | - Zhirong Zeng
- Institute of Public Health and Wellness, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, Guangdong, 523808, China.
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17
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Memedovich A, Asante B, Khan M, Eze N, Holroyd BR, Lang E, Kashuba S, Clement F. Strategies for improving ED-related outcomes of older adults who seek care in emergency departments: a systematic review. Int J Emerg Med 2024; 17:16. [PMID: 38302890 PMCID: PMC10835906 DOI: 10.1186/s12245-024-00584-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/12/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Despite constituting 14% of the general population, older adults make up almost a quarter of all emergency department (ED) visits. These visits often do not adequately address patient needs, with nearly 80% of older patients discharged from the ED carrying at least one unattended health concern. Many interventions have been implemented and tested in the ED to care for older adults, which have not been recently synthesized. METHODS A systematic review was conducted to identify interventions initiated in the ED to address the needs of older adults. Embase, MEDLINE, CINAHL, Cochrane CENTRAL, the Cochrane Database of Systematic Reviews, and grey literature were searched from January 2013 to January 18, 2023. Comparative studies assessing interventions for older adults in the ED were included. The quality of controlled trials was assessed with the Cochrane risk-of-bias tool for randomized trials, and the quality of observational studies was assessed with the risk of bias in non-randomized studies of interventions tool. Due to heterogeneity, meta-analysis was not possible. RESULTS Sixteen studies were included, assessing 12 different types of interventions. Overall study quality was low to moderate: 10 studies had a high risk of bias, 5 had a moderate risk of bias, and only 1 had a low risk of bias. Follow-up telephone calls, referrals, geriatric assessment, pharmacist-led interventions, physical therapy services, care plans, education, case management, home visits, care transition interventions, a geriatric ED, and care coordination were assessed, many of which were combined to create multi-faceted interventions. Care coordination with additional support and early assessment and intervention were the only two interventions that consistently reported improved outcomes. Most studies did not report significant improvements in ED revisits, hospitalization, time spent in the ED, costs, or outpatient utilization. Two studies reported on patient perspectives. CONCLUSION Few interventions demonstrate promise in reducing ED revisits for older adults, and this review identified significant gaps in understanding other outcomes, patient perspectives, and the effectiveness in addressing underlying health needs. This could suggest, therefore, that most revisits in this population are unavoidable manifestations of frailty and disease trajectory. Efforts to improve older patients' needs should focus on interventions initiated outside the ED.
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Affiliation(s)
- Ally Memedovich
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Benedicta Asante
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Maha Khan
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Nkiruka Eze
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Brian R Holroyd
- Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada
- Emergency Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada
| | - Eddy Lang
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Emergency Medicine, University of Calgary, Calgary, AB, Canada
- Emergency Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
| | - Sherri Kashuba
- Emergency Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada
| | - Fiona Clement
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada.
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18
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Pan C, Yu L. Bidirectional and dynamic relationships between social isolation and activities of daily living among older adults in China. J Glob Health 2024; 14:04031. [PMID: 38275090 PMCID: PMC10811563 DOI: 10.7189/jogh.14.04031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
Background Social isolation and disability in performing activities of daily living are increasingly recognised as significant public health concerns globally. We aimed to investigate their bidirectional associations and the related temporal dynamics in Chinese older adults. Methods We retrieved data from the six waves of the Chinese Longitudinal Healthy Longevity Survey (2002-18) and used generalised cross-lagged modelling (GCLM) to assess the bidirectional associations between social isolation and disability in performing activities of daily living. Results We found that higher levels of social isolation were predictive of increased scores in disabilities in performing activities of daily living. Conversely, disabilities in performing activities of daily living showed less predictive power in relation to social isolation. The temporal dynamics analysis indicated a peak in the bidirectional associations after approximately six years, followed by decreasing trends. Conclusions Our results indicate that social isolation is dominant in the bidirectional relationship. Efforts focusing on reducing it can potentially minimise disabilities in performing activities of daily living among older adults. Reinstating preventive interventions beyond the six-year mark could help maintain their effectiveness.
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Thangavel G, Memedi M, Hedström K. Information and Communication Technology for Managing Social Isolation and Loneliness Among People Living With Parkinson Disease: Qualitative Study of Barriers and Facilitators. J Med Internet Res 2024; 26:e48175. [PMID: 38231548 PMCID: PMC10831595 DOI: 10.2196/48175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/17/2023] [Accepted: 11/20/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Parkinson disease (PD) is a complex, noncurable, and progressive neurological disease affecting different areas of the human nervous system. PD is associated with both motor and nonmotor symptoms, which negatively affect patients' quality of life and may cause changes in socialization such as intentional social withdrawal. This may further lead to social isolation and loneliness. The use of information and communication technology (ICT) plays an important role in managing social isolation and loneliness. Currently, there is a lack of research focusing on designing and developing ICT solutions that specifically address social isolation and loneliness among people living with PD. OBJECTIVE This study addresses this gap by investigating barriers and social needs in the context of social isolation, loneliness, and technology use among people living with PD. The insights gained can inform the development of effective ICT solutions, which can address social isolation and loneliness and improve the quality of life for people living with PD. METHODS A qualitative study with 2 phases of data collection were conducted. During the first phase, 9 health care professionals and 16 people living with PD were interviewed to understand how PD affects social life and technology use. During the second phase, 2 focus groups were conducted with 4 people living with PD in each group to gather insights into their needs and identify ways to manage social isolation and loneliness. Thematic analysis was used to analyze both data sets and identify key themes. RESULTS The results showed that the barriers experienced by people living with PD due to PD such as "fatigue," "psychological conditions," "social stigma," and "medication side effects" affect their social life. People living with PD also experience difficulties using a keyboard and mouse, remembering passwords, and navigating complex applications due to their PD-related physical and cognitive limitations. To manage their social isolation and loneliness, people living with PD suggested having a simple and easy-to-use solution, allowing them to participate in a digital community based on their interests, communicate with others, and receive recommendations for social events. CONCLUSIONS The new ICT solutions focusing on social isolation and loneliness among people living with PD should consider the barriers restricting user's social activities and technology use. Given the wide range of needs and barriers experienced by people living with PD, it is more suitable to adopt user-centered design approaches that emphasize the active participation of end users in the design process. Importantly, any ICT solution designed for people living with PD should not encourage internet addiction, which will further contribute to the person's withdrawal from society.
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Affiliation(s)
- Gomathi Thangavel
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
| | - Mevludin Memedi
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
- College of Business, Alfaisal University, Riyadh, Saudi Arabia
| | - Karin Hedström
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
- Department of Communication, Quality Management and Information Systems, Mid Sweden University, Sundsvall, Sweden
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20
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Adepoju OE, Ojinnaka CO, Pieratt J, Dobbins J. Racial and ethnic differences in predictors of participation in an intergenerational social connectedness intervention for older adults. BMC Geriatr 2024; 24:70. [PMID: 38233782 PMCID: PMC10795227 DOI: 10.1186/s12877-024-04679-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Social connectedness is a key determinant of health and interventions have been developed to prevent social isolation in older adults. However, these interventions have historically had a low participation rate amongst minority populations. Given the sustained isolation caused by the COVID-19 pandemic, it is even more important to understand what factors are associated with an individual's decision to participate in a social intervention. To achieve this, we used machine learning techniques to model the racial and ethnic differences in participation in social connectedness interventions. METHODS Data were obtained from a social connectedness intervention that paired college students with Houston-area community-dwelling older adults (> 65 yo) enrolled in Medicare Advantage plans. Eligible participants were contacted telephonically and asked to complete the 3-item UCLA Loneliness Scale. We used the following machine-learning methods to identify significant predictors of participation in the program: k-nearest neighbors, logistic regression, decision tree, gradient-boosted decision tree, and random forest. RESULTS The gradient-boosted decision tree models yielded the best parameters for all race/ethnicity groups (96.1% test accuracy, 0.739 AUROC). Among non-Hispanic White older adults, key features of the predictive model included Functional Comorbidity Index (FCI) score, Medicare prescription risk score, Medicare risk score, and depression and anxiety indicators within the FCI. Among non-Hispanic Black older adults, key features included disability, Medicare prescription risk score, FCI and Medicare risk scores. Among Hispanic older adults, key features included depression, FCI and Medicare risk scores. CONCLUSIONS These findings offer a substantial opportunity for the design of interventions that maximize engagement among minority groups at greater risk for adverse health outcomes.
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Affiliation(s)
- Omolola E Adepoju
- Humana Integrated Health Systems Sciences Institute, University of Houston, Houston, USA.
- Tilman J Fertitta Family College of Medicine, Department of Health Systems and Population Health Sciences, University of Houston, Houston, USA.
| | | | | | - Jessica Dobbins
- Tilman J Fertitta Family College of Medicine, Department of Health Systems and Population Health Sciences, University of Houston, Houston, USA
- Humana Inc, Louisville, USA
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Offermann J, Wilkowska W, Laurentius T, Bollheimer LC, Ziefle M. How age and health status impact attitudes towards aging and technologies in care: a quantitative analysis. BMC Geriatr 2024; 24:9. [PMID: 38172721 PMCID: PMC10765835 DOI: 10.1186/s12877-023-04616-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Increasing proportions of geriatric patients pose tremendous challenges for our society. Developments in assistive technologies have the potential to support older and frail people in aging and care. To reach a sustainable adoption of these technologies, the perceptions and wishes of future users must be understood. In particular, the relationships between individual health-related factors, and the perceptions of aging and using assistive technologies in severe health situations must be empirically examined. METHODS Addressing this research gap, our quantitative study (N = 570) investigates the impact of diverse future users' age and health status on their a) perceptions of aging, b) perceptions and acceptance of using assistive technologies in aging and care, as well as c) end-of-life decisions regarding technology usage. For this, four groups were segmented for the comparison of younger (< 50 years) healthy, younger chronically ill, older (50 + years) healthy, and older chronically ill participants. RESULTS The results revealed that health status is more decisive for age-related perceptions compared to age. The technology-related perceptions were slightly impacted by either chronological age or health status. The end-of-life decisions showed the most striking differences in the willingness to use assistive technologies, revealing older chronically ill participants to have more restrained attitudes towards technology usage than older healthy as well as all younger participants. CONCLUSIONS The findings suggest that the benefits of assistive technologies in private or professional care contexts should be communicated and implemented tailored to the respective user group's needs. Moreover, the results allow us to derive practical implications within the geriatric care context.
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Affiliation(s)
- Julia Offermann
- Chair for Communication Science & Human-Computer Interaction Center, RWTH Aachen University, Campus-Boulevard 57, 52074, Aachen, Germany.
| | - Wiktoria Wilkowska
- Chair for Communication Science & Human-Computer Interaction Center, RWTH Aachen University, Campus-Boulevard 57, 52074, Aachen, Germany
| | - Thea Laurentius
- Chair of Geriatrics & Department of Geriatric Medicine, RWTH Aachen University Hospital, Aachen, Germany
| | - L Cornelius Bollheimer
- Chair of Geriatrics & Department of Geriatric Medicine, RWTH Aachen University Hospital, Aachen, Germany
| | - Martina Ziefle
- Chair for Communication Science & Human-Computer Interaction Center, RWTH Aachen University, Campus-Boulevard 57, 52074, Aachen, Germany
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22
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Anandarajah AP, Yi L, Anandarajah AA, Shelton N, Feng C, Williams EM. Impact of COVID-19 pandemic on social isolation and loneliness among minority populations. Am J Med Sci 2024; 367:21-27. [PMID: 37769872 DOI: 10.1016/j.amjms.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/29/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND The impact of social isolation and loneliness (SIL) was heightened during the COVID-19 pandemic. Although the pandemic disproportionately affected racial/ ethnic minorities, no studies have investigated the ramifications of the pandemic on SIL among these populations. This study aimed to determine the prevalence and pervasiveness of SIL during the COVID-19 pandemic on minority communities. MATERIALS AND METHODS This was a single center, cross sectional study conducted by scientists from the University of Rochester Medical Center (URMC) working in collaboration with members of the Rochester community. Adult patients presenting to the emergency department at URMC who identified themselves as belonging to minority communities were asked to complete a survey that comprised questions from the Lubben Social Network Scale-6 and questions from the Campaign to End Loneliness Measurement Tool. We analyzed the percentage of SIL and conducted linear regression models to study the association between these outcomes and race/ ethnicity, age, gender, chronic disease status and the frequency of hospitalizations. RESULTS A total of 1,029 subjects completed the survey. Social isolation was reported by 375 (37%) persons. Those of Latinx ethnicity had higher prevalence of social isolation (41%) compared to those of Black/African American race (36%) and also had higher degrees of isolation (14.8%) (15.42; p = 0.07). Loneliness was documented by 215 (21%) for the cohort with no differences based on race or ethnicity. CONCLUSIONS Social isolation was common among minority communities during the pandemic but loneliness was less pervasive. The study highlights the need to address the specific needs of these populations.
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Affiliation(s)
| | - Leta Yi
- University of North Carolina, Chapel Hill, NC, USA
| | | | | | - Changyong Feng
- University of Rochester Medical Center, Rochester, NY, USA
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Maiden N, Hide S, Lockerbie J, Stumpf S, Hoe J, Hirani S. Evaluating an interactive tool that reasons about quality of life to support life planning by older people. Digit Health 2024; 10:20552076241255633. [PMID: 38854918 PMCID: PMC11159557 DOI: 10.1177/20552076241255633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 04/18/2024] [Indexed: 06/11/2024] Open
Abstract
Objectives In response to the lack of digital support for older people to plan their lives for quality of life, research was undertaken to co-design and then evaluate a new digital tool that combined interactive guidance for life planning with a computerised model of quality of life. Method First, a workshop-based process for co-designing the SCAMPI tool with older people is reported. A first version of this tool was then evaluated over eight consecutive weeks by nine older people living in their own homes. Four of these people were living with Parkinson's disease, one with early-stage dementia, and four without any diagnosed chronic condition. Regular semi-structured interviews were undertaken with each individual older person and, where wanted, their life partner. A more in-depth exit interview was conducted at the end of the period of tool use. Themes arising from analyses of content from these interviews were combined with first-hand data collected from the tool's use to develop a description of how each older person used the tool over the 8 weeks. Results The findings provided the first evidence that the co-designed tool, and in particular the computerised model, could offer some value to older people. Although some struggled to use the tool as it was designed, which led to limited uptake of the tool's suggestions, the older people reported factoring these suggestions into their longer-term planning, as health and/or circumstances might change. Conclusions The article contributes to the evolving discussion about how to deploy such digital technologies to support quality of life more effectively.
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Affiliation(s)
- Neil Maiden
- Bayes Business School, City, University of London, London, UK
| | - Sophie Hide
- Bayes Business School, City, University of London, London, UK
| | - James Lockerbie
- Bayes Business School, City, University of London, London, UK
| | - Simone Stumpf
- School of Computing Science, University of Glasgow, Glasgow, UK
| | - Juanita Hoe
- School of Medicine and Biosciences, University of West London, London, UK
| | - Shashi Hirani
- School of Health Sciences, City, University of London, London, UK
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24
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Nelson MLA, Saragosa M, Singh H, Yi J. Examining the Role of Third Sector Organization Volunteers in Facilitating Hospital-to-Home Transitions for Older Adults - a Collective Case Study. Int J Integr Care 2024; 24:16. [PMID: 38434712 PMCID: PMC10906339 DOI: 10.5334/ijic.7670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction With increasing attention to models of transitional support delivered through multisectoral approaches, third-sector organizations (TSOs) have supported community reintegration and independent living post-hospitalization. This study aimed to identify the core elements of these types of programs, the facilitators, and barriers to service implementation and to understand the perspectives of providers and recipients of their experiences with the programs. Methods and Analysis A collective case study collected data from two UK-based 'Home from Hospital' programs. An inductive thematic analysis generated rich descriptions of each program, and analytical activities generated insights across the cases. Results Programs provided a range of personalized support for older adults and addressed many post-discharge needs, including well-being assessments, support for instrumental activities of daily living, psychosocial support, and other individualized services directed by the needs and preferences of the service user. Results suggest that these programs can act as a 'safety net' and promote independent living. Skilled volunteers can positively impact older adults' experience returning home. Conclusions When the programs under study are considered in tandem with existing evidence, it facilitates a discussion of how TSO services could be made available more widely to support older adults in their transition experiences.
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Affiliation(s)
- Michelle L. A. Nelson
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, CA
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, CA
| | | | - Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, CA
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, CA
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, CA
| | - Juliana Yi
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, CA
- Clinical Institutes and Quality Programs, Ontario Health, CA
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25
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Wellman CD, Ferguson A, McIntosh T, Korkmaz A, Walker RB, Franks AM. Nutrition and Isolation in a Rural US Population over 80 Years Old: A Descriptive Analysis of a Vulnerable Population. J Nutr Gerontol Geriatr 2024; 43:36-45. [PMID: 38235599 DOI: 10.1080/21551197.2024.2304019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Factors allowing rural, community-dwelling 80+ year-olds to thrive remain unexplored. Isolation can impact this vulnerable population. In this study, patients were prospectively surveyed for age, gender, cohabitation (self, spouse, family) and location (suburban, rural, and isolated). Mini-nutritional assessment short form (MNA-SF) and BMI were obtained. A p < 0.05 represented statistical significance. Patients (n = 167) were mostly female (120; 71.9%) with an average overweight BMI (26.5) and low-normal MNA-SF scores (11.8). Most live alone (49.7%), followed by spousal (31.7%) and family (18.6%) cohabitation. Over 80% are rural (71) or rural-isolated (67), and of these, 83% had normal nutrition. Self-habitation correlated with lower MNA-SF scores (p = 0.02). Normal BMIs correlated with family cohabitation (OR = 0.90 [CI: 0.82-0.99]) and nourished MNA-SF scores with spousal cohabitation (OR = 1.69; CI: 1.15-2.47) rather than living alone. Self-habitation increases vulnerability to obesity and malnutrition. Interventions should aim to maintain independence while improving the effects of habitation on nutrition.
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Affiliation(s)
- Courtney D Wellman
- Department of Family Medicine and Community Health, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Andrew Ferguson
- Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Thomas McIntosh
- Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Alperen Korkmaz
- Department of Family Medicine and Community Health, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Robert B Walker
- Department of Family Medicine and Community Health, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Adam M Franks
- Department of Family Medicine and Community Health, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
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Deslauriers V, Bignami S, Delaunay V, Sandberg J. Does social integration really protect against loneliness? Gender determinants in a rural population in Senegal. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 35:423-434. [PMID: 38078637 DOI: 10.3917/spub.234.0423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Introduction This study aims to test a measure of loneliness and to document its determinants among rural men and women in Senegal. Methods Data from the Niakhar Social Networks and Health Project were used. The analysis sample was composed of 1261 residents aged 16 years and older. Analyses were stratified by gender. Associations between loneliness and its determinants (socio-demographic characteristics and level of social integration) were examined with multivariate logistic regressions. Results Loneliness affects almost one in three people. Its prevalence is more significant for women. Multivariate analyses indicate that for both men and women, older age intensifies loneliness and recent migration experience protects against loneliness. Other factors act differently according to gender. Widowhood or divorce for men, and residential isolation for women, worsen the experience of loneliness. Social integration protects men against loneliness, but this relationship is not found for women. Finally, the effect of the level of social integration on loneliness varies with age. Conclusions This study, which documents a phenomenon which is often neglected by misconceptions about social solidarities in these societies, suggests that loneliness is not linked to the same issues for men and women. For men, being socially integrated and being in a union are protective, whereas for women, poor social integration does not appear to be a clear source of loneliness, unlike residential isolation.
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Affiliation(s)
| | | | - Valérie Delaunay
- Institut de recherche pour le développement, Laboratoire Population Environnement Développement – Marseille – France
| | - John Sandberg
- George Washington University, School of public health – Washington – USA
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27
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Reid JC, Carbone S, Shaw JF, Gallibois M, Hawkins SA. "My Biggest Fear Is She'll Die Alone": Care Partner Perspectives of Institutional COVID-19 Visitor Restrictions in Ontario, Canada. Can J Aging 2023; 42:710-718. [PMID: 37287305 DOI: 10.1017/s071498082300017x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
In March 2020, the Government of Ontario, Canada implemented public health measures, including visitor restrictions in institutional care settings, to protect vulnerable populations, including older adults (> 65 years), against COVID-19 infection. Prior research has shown that visitor restrictions can negatively influence older adults' physical and mental health and can cause increased stress and anxiety for care partners. This study explores the experiences of care partners separated from the person they care for because of institutional visitor restrictions during the COVID-19 pandemic. We interviewed 14 care partners between the ages of 50 and 89; 11 were female. The main themes that emerged were changing public health and infection prevention and control policies, shifting care partner roles as a result of visitor restrictions, resident isolation and deterioration from the care partner perspective, communication challenges, and reflections on the impacts of visitor restrictions. Findings may be used to inform future health policy and system reforms.
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Affiliation(s)
- Julie C Reid
- Canadian Frailty Network/Le Réseau Canadien des soins aux personnes fragilisées, Kidd House, Kingston, ON, Canada
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Sarah Carbone
- Canadian Frailty Network/Le Réseau Canadien des soins aux personnes fragilisées, Kidd House, Kingston, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Julia F Shaw
- Canadian Frailty Network/Le Réseau Canadien des soins aux personnes fragilisées, Kidd House, Kingston, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Molly Gallibois
- Canadian Frailty Network/Le Réseau Canadien des soins aux personnes fragilisées, Kidd House, Kingston, ON, Canada
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| | - Stacey A Hawkins
- Canadian Frailty Network/Le Réseau Canadien des soins aux personnes fragilisées, Kidd House, Kingston, ON, Canada
- Ontario Tech University, Oshawa, ON, Canada
- Seniors Care Network, Port Hope, ON, Canada
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Weldrick R, Dunn JR, Andrews GJ, Ploeg J. Friendly Visiting Programs for Older People Experiencing Social Isolation: A Realist Review of what Works, for whom, and under what Conditions. Can J Aging 2023; 42:538-550. [PMID: 37551541 DOI: 10.1017/s0714980823000302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Many social interventions have been developed with the hopes of reducing and preventing social isolation among older people (e.g., recreation, arts-based programs and social prescription). Friendly visiting programs, also known as befriending schemes, have been a mainstay in this area for decades and are largely thought to be effective at reconnecting older people (≥ 60 years of age) experiencing isolation. Research and evaluations have yet to determine, however, how and why these programs may be most successful, and under what conditions. This article presents the findings of a realist synthesis aimed at identifying the critical mechanisms and contextual factors that lead to successful outcomes in friendly visiting programs. Seven studies are synthesized to inform a friendly visiting program theory accounting for key mechanisms (e.g., provision of informal support) and underlying contexts (e.g., training of volunteers) that can be used to inform future programs. Recommendations for future research are also presented.
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Affiliation(s)
- Rachel Weldrick
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
- School of Urban and Regional Planning, Toronto Metropolitan University, Toronto, ON, Canada
| | - James R Dunn
- Department of Health, Aging & Society, McMaster University, Hamilton, ON, Canada
| | - Gavin J Andrews
- Department of Health, Aging & Society, McMaster University, Hamilton, ON, Canada
| | - Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, ON, Canada
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Dawe J, Cassano D, Keane R, Ruth S, Wilkinson AL, Elsum I, Gunn J, Brown G, West M, Hoy J, Power J, Stoové M. Quality of life among people living with HIV aged 50 years and over in Australia: Identifying opportunities to support better ageing. HIV Med 2023; 24:1253-1267. [PMID: 37990812 DOI: 10.1111/hiv.13592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES Improved life expectancy has led to an ageing population of people living with HIV in most countries. Research on ageing among people living with HIV has predominantly focused on physical and health-related quality of life rather than multidimensional quality of life. We measured quality of life among older people living with HIV in Australia and identified opportunities to guide the development and implementation of appropriate interventions. METHODS In a national health and wellbeing survey of Australian people living with HIV, participants aged ≥50 years completed additional questions relevant to ageing. Quality of life was measured using PozQoL, a validated multidimensional instrument assessing quality of life among people living with HIV (range 1-5). Exploratory bivariate analyses aimed to identify sociodemographic characteristics associated with quality of life. Adjusted linear regressions aimed to assess changes in PozQoL score associated with recent experiences (last 12 months) of four exposures: food insecurity, HIV-related stigma, isolation from the HIV community, and difficulties accessing non-HIV health services. RESULTS Among 319 older people living with HIV, the mean PozQol score was 3.30 (95% confidence interval [CI] 3.20-3.39). In bivariate analyses, PozQol scores were significantly higher among participants who were older (p = 0.006), had higher educational attainment (p = 0.009), were in a relationship (p = 0.005), were employed (p = 0.005), and had a higher income (p = 0.001). In adjusted regression models, PozQoL scores were lower among participants who reported recent experiences of food insecurity (β -0.49; 95% CI -0.74 to -0.24), stigma (β -0.53; 95% CI -0.73 to -0.33), isolation from the HIV community (β -0.49; 95% CI -0.70 to -0.29), and difficulties accessing non-HIV health services (β -0.50; 95% CI -0.71 to -0.30). CONCLUSIONS Overall, older people living with HIV in this study had a moderate quality of life. Our findings suggest that HIV services should integrate programmes to support economic security and foster connections within the HIV community and across health services.
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Affiliation(s)
- Joshua Dawe
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Dean Cassano
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Richard Keane
- Living Positive Victoria, Melbourne, Victoria, Australia
| | - Simon Ruth
- Thorne Harbour Health, Melbourne, Victoria, Australia
| | - Anna Lee Wilkinson
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- University of Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Imogen Elsum
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Jack Gunn
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
| | - Graham Brown
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Michael West
- Department of Health, Melbourne, Victoria, Australia
| | - Jennifer Hoy
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Jennifer Power
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Mark Stoové
- Burnet Institute, Public Health Discipline, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
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Welch V, Ghogomu ET, Barbeau VI, Dowling S, Doyle R, Beveridge E, Boulton E, Desai P, Huang J, Elmestekawy N, Hussain T, Wadhwani A, Boutin S, Haitas N, Kneale D, Salzwedel DM, Simard R, Hébert P, Mikton C. Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1369. [PMID: 38024780 PMCID: PMC10681039 DOI: 10.1002/cl2.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background Social isolation and loneliness are more common in older adults and are associated with a serious impact on their well-being, mental health, physical health, and longevity. They are a public health concern highlighted by the COVID-19 pandemic restrictions, hence the need for digital technology tools to enable remotely delivered interventions to alleviate the impact of social isolation and loneliness during the COVID-19 restrictions. Objectives To map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings. Search Methods We searched the following databases from inception to May 16, 2021, with no language restrictions. Ovid MEDLINE, Embase, APA PsycInfo via Ovid, CINAHL via EBSCO, Web of Science via Clarivate, ProQuest (all databases), International Bibliography of the Social Sciences (IBSS) via ProQuest, EBSCO (all databases except CINAHL), Global Index Medicus, and Epistemonikos. Selection Criteria Titles and abstracts and full text of potentially eligible articles were independently screened in duplicate following the eligibility criteria. Data Collection and Analysis We developed and pilot tested a data extraction code set in Eppi-Reviewer and data were individually extracted and coded based on an intervention-outcome framework which was also used to define the dimensions of the evidence and gap map. Main Results We included 200 articles (103 primary studies and 97 systematic reviews) that assessed the effects of digital interventions to reduce social isolation and/or loneliness in older adults. Most of the systematic reviews (72%) were classified as critically low quality, only 2% as high quality and 25% were published since the COVID-19 pandemic. The evidence is unevenly distributed with clusters predominantly in high-income countries and none in low-income countries. The most common interventions identified are digital interventions to enhance social interactions with family and friends and the community via videoconferencing and telephone calls. Digital interventions to enhance social support, particularly socially assistive robots, and virtual pets were also common. Most interventions focused on reducing loneliness and depression and improving quality of life of older adults. Major gaps were identified in community level outcomes and process indicators. No included studies or reviews assessed affordability or digital divide although the value of accessibility and barriers caused by digital divide were discussed in three primary studies and three reviews. Adverse effects were reported in only two studies and six reviews. No study or review included participants from the LGBTQIA2S+ community and only one study restricted participants to 80 years and older. Very few described how at-risk populations were recruited or conducted any equity analysis to assess differences in effects for populations experiencing inequities across PROGRESS-Plus categories. Authors' Conclusions The restrictions placed on people during the pandemic have shone a spotlight onto social isolation and loneliness, particularly for older adults. This evidence and gap map shows available evidence on the effectiveness of digital interventions for reducing social isolation or loneliness in older adults. Although the evidence is relatively large and recent, it is unevenly distributed and there is need for more high-quality research. This map can guide researchers and funders to consider areas of major gaps as priorities for further research.
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Affiliation(s)
- Vivian Welch
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Sierra Dowling
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | - Ella Beveridge
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Elisabeth Boulton
- School of Health Sciences, Division of Nursing, Midwifery and Social WorkUniversity of ManchesterManchesterUK
| | - Payaam Desai
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Jimmy Huang
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Arpana Wadhwani
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Dylan Kneale
- Social Science Research Unit, EPPI‐Centre, UCL Institute of EducationUniversity College LondonLondonUK
| | - Douglas M. Salzwedel
- Department of Anesthesiology, Pharmacology and TherapeuticsUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Paul Hébert
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
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Mortazavi S, Delbari A, Vahedi M, Fadayevatan R, Moodi M, Fakhrzadeh H, Khorashadizadeh M, Sobhani A, Payab M, Ebrahimpur M, Ejtahed HS, Sharifi F. Low physical activity and depression are the prominent predictive factors for falling in older adults: the Birjand Longitudinal Aging Study (BLAS). BMC Geriatr 2023; 23:758. [PMID: 37986050 PMCID: PMC10662773 DOI: 10.1186/s12877-023-04469-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Falling in the older adults has many irreparable consequences, including hospitalization to long-term care centers and loss of independence, depression and social isolation, financial burden, and death. The present study was conducted to estimate the incidence of falls and their associated factors among community-dwelling older adults. METHODS This program is a population-based prospective cohort study (≥ 60 years) in Birjand City from 2019 to 2020. A total of 1418 participants were included in the study, and 1344 participants were analyzed according to the inclusion criteria. Thirty-nine risk factors were evaluated. Basic information included demographic information, lifestyle factors, general health and medical history, and mental and functional health. RESULT The incidence of falls among community-dwelling older adults in the previous approximately 24 months in the present study was 9.26% in women and 2.65% in men. In the multiple Cox proportional regression model based on fall risk factors, there was a strong significant relationship between male sex (HR = 0.37, CI = 0.21 to 0.64), being physically active (HR = 0.59, CI = 0.36 to 0.96), moderate-to-severe depression (HR = 2.97, CI = 1.47 to 6.01), severe depression (HR = 3.26, CI = 1.24 to 8.54), and high risk of falls according to the TUG test (HR = 1.73, CI = 1.10 to 2.72). CONCLUSIONS Inactivity and depression were recognized as important factors in falls in older adults. It is recommended for older adults to have an active lifestyle to prevent falls and to prioritize the diagnosis and treatment of depression in older adults. Women as a group at higher risk should be considered in prevention programs. In addition, the use of the TUG test to identify high-risk older adults should be considered.
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Affiliation(s)
- Sara Mortazavi
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ahmad Delbari
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Mohsen Vahedi
- Department of Biostatistics and Epidemiology, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Reza Fadayevatan
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Khorashadizadeh
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Ameneh Sobhani
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Payab
- Non-communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahbube Ebrahimpur
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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S De Main A, Powers DA, Xie B, Choi N. Longitudinal associations between mental health and social environment in older adults: a multilevel growth modeling. Aging Ment Health 2023; 27:2278-2288. [PMID: 37293783 DOI: 10.1080/13607863.2023.2220304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES This study aimed to assess longitudinal relationships between social environment indicators (social connectedness, social engagement, social contribution) and mental health indicators (depression and anxiety) among community-dwelling adults age 55 years and older. METHODS Data were drawn from 3-waves of the national longitudinal survey of Midlife Development in the United States (MIDUS) (N = 2,020; age range = 55-94 years). We developed multilevel growth models to ascertain the relationships of interest, controlling for sociodemographic and physical health factors. RESULTS Over the 20-year period of study, lower levels of emotional social support, social integration and social contribution significantly predicted depression and anxiety, whereas social network and social engagement were not significant predictors of these mental health outcomes in older adults. The models also indicated a moderation effect of the number of chronic conditions on the slopes of depression and anxiety. DISCUSSION Considering our findings, interventions to enhance social contribution and social connectedness could be effective to help older adults maintain positive mental health, as well as programs that facilitate older adults' connections with their families, communities and health care providers. These interventions must also account for multiple chronic conditions since functional limitations drive declining integration in the community and participation in social activities.
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Affiliation(s)
- Atami S De Main
- Weill Cornell Medicine Division of Geriatrics and Palliative Medicine, New York, NY, USA
| | - Daniel A Powers
- Department of Sociology, The University of Texas at Austin, Austin, TX, USA
| | - Bo Xie
- Department of Sociology, The University of Texas at Austin, Austin, TX, USA
- School of Information, The University of Texas at Austin, Austin, TX, USA
| | - Namkee Choi
- School of Social Work, The University of Texas at Austin, Austin, TX, USA
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Ashida T, Fujiwara T, Kondo K. Association between adverse childhood experiences and social integration among older people in Japan: Results from the JAGES study. Arch Gerontol Geriatr 2023; 114:105099. [PMID: 37329767 DOI: 10.1016/j.archger.2023.105099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/30/2023] [Accepted: 06/07/2023] [Indexed: 06/19/2023]
Abstract
Social integration, network, and support are beneficial to health. However, there is little evidence of the association between adverse childhood experiences (ACEs) and social integration in later life. This study investigates the association between ACE history and social integration in older people. We used data from the Japan Gerontological Evaluation Study (JAGES) 2013, which conducted a self-reported survey of functionally independent people aged ≥ 65 years from 30 municipalities across Japan and yielded information on ACE history. We conducted a Poisson regression analysis with robust error variances to assess the association between ACE history and social integration, adjusting for sex, age, childhood economic hardship, adult socioeconomic status, health status, living status, and trust in others. The number of respondents with at least one incident of ACE was approximately 36.8%. The prevalence ratios for those who reported a history of ACEs were as follows: housebound 1.495 (95% confidence interval [CI]: 1.19-1.88), small network size 1.146 (95% CI: 1.10-1.19), low network contact 1.059 (95% CI: 1.00-1.059), non-membership sports group 1.038 (95% CI: 1.00-1.07), and non-membership hobby group 1.06 (95% CI: 1.03-1.09). Among older people in Japan, a history of ACEs is inversely associated with social integration. These findings support the life course approach and suggest that adverse events in early life may have an impact on social life in old age. In order to promote healthy aging, it is important to recognize the significant impact of early-life adversities that can extend into later life.
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Affiliation(s)
- Toyo Ashida
- Faculty of Economics, Keio University, Tokyo, Japan.
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Nagda D, Pathak K, Shah V, Pillai S, Kalasapudi V, Afable A, Mehta D. A Needs Assessment of Older Bangladeshi Immigrants in New York During the COVID-19 Pandemic. J Immigr Minor Health 2023; 25:1202-1206. [PMID: 37314608 DOI: 10.1007/s10903-023-01507-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 06/15/2023]
Abstract
Though immigrants from Bangladesh are a fast-growing and under-resourced immigrant community in the United States, little has been studied about their overall health and social needs. Older immigrant adults from Bangladesh are at increased risk for adverse effects from the COVID-19 pandemic, as they have existing risk factors for isolation including language barriers and more recent immigration. This study examined measures of health and connectedness amongst 297 South Asian adults in New York City who were 60 years or older using a phone-based survey instrument. Surveys were conducted from August 2021 to April 2022. We found that immigrants from Bangladesh were more likely to report a higher effect of the COVID-19 pandemic on financial and food insecurity and faced significantly higher levels of loneliness than South Asian immigrants from other countries. Our findings suggest that older immigrants from Bangladesh disproportionally face social isolation compared to older immigrants from other South Asian countries and our study encourages further research and intervention for this immigrant subgroup.
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Affiliation(s)
- Dipal Nagda
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
| | - Kavya Pathak
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
| | - Vivek Shah
- College of Medicine, Downstate Health Sciences University, Brooklyn, NY, 11203, USA
| | | | | | - Aimee Afable
- Department of Community Health Sciences, School of Public Health, Downstate Health Sciences University, Brooklyn, NY, 11203, USA
| | - Darshan Mehta
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, USA
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, MA, USA
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Shannon B, Bowles KA, Williams C, Ravipati T, Deighton E, Andrew N. Does a Community Care programme reach a high health need population and high users of acute care hospital services in Melbourne, Australia? An observational cohort study. BMJ Open 2023; 13:e077195. [PMID: 37751947 PMCID: PMC10533720 DOI: 10.1136/bmjopen-2023-077195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/05/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVE The Community Care programme is an initiative aimed at reducing hospitalisations and emergency department (ED) presentations among patients with complex needs. We aimed to describe the characteristics of the programme participants and identify factors associated with enrolment into the programme. DESIGN This observational cohort study was conducted using routinely collected data from the National Centre for Healthy Ageing data platform. SETTING The study was carried out at Peninsula Health, a health service provider serving a population in Melbourne, Victoria, Australia. PARTICIPANTS We included all adults with unplanned ED presentation or hospital admission to Peninsula Health between 1 November 2016 and 31 October 2017, the programme's first operational year. OUTCOME MEASURES Community Care programme enrolment was the primary outcome. Participants' demographics, health factors and enrolment influences were analysed using a staged multivariable logistic regression. RESULTS We included 47 148 adults, of these, 914 were enrolled in the Community Care programme. Participants were older (median 66 vs 51 years), less likely to have a partner (34% vs 57%) and had more frequent hospitalisations and ED visits. In the multivariable analysis, factors most strongly associated with enrolment included not having a partner (adjusted OR (aOR) 1.83, 95% CI 1.57 to 2.12), increasing age (aOR 1.01, 95% CI 1.01 to 1.02), frequent hospitalisations (aOR 7.32, 95% CI 5.78 to 9.24), frequent ED visits (aOR 2.0, 95% CI 1.37 to 2.85) and having chronic diseases, such as chronic pulmonary disease (aOR 2.48, 95% CI 2.06 to 2.98), obesity (aOR 2.06, 95% CI 1.39 to 2.99) and diabetes mellitus (complicated) (aOR 1.75, 95% CI 1.44 to 2.13). Residing in aged care home and having high socioeconomic status) independently associated with reduced odds of enrolment. CONCLUSIONS The Community Care programme targets patients with high-readmission risks under-representation of individuals residing in residential aged care homes warrants further investigation. This study aids service planning and offers valuable feedback to clinicians about programme beneficiaries.
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Affiliation(s)
- Brendan Shannon
- Department of Paramedicine, Monash University, Franskton, Victoria, Australia
| | - Kelly-Ann Bowles
- Department of Paramedicine, Monash University, Franskton, Victoria, Australia
| | - Cylie Williams
- School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
| | - Tanya Ravipati
- Peninsula Clinical School, Monash University, Frankston, Victoria, Australia
- National Centre for Healthy Ageing, Monash University and Peninsula Health, Frankston, Victoria, Australia
| | - Elise Deighton
- Community Care, Peninsula Health, Frankston, Victoria, Australia
| | - Nadine Andrew
- Peninsula Clinical School, Monash University, Frankston, Victoria, Australia
- National Centre for Healthy Ageing, Monash University and Peninsula Health, Frankston, Victoria, Australia
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He Y, Wei B, Li Y. The impact of using community home-based elderly care services on older adults' self-reported health: fresh evidence from China. Front Public Health 2023; 11:1257463. [PMID: 37799160 PMCID: PMC10549933 DOI: 10.3389/fpubh.2023.1257463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/28/2023] [Indexed: 10/07/2023] Open
Abstract
Background The rapid population aging in China, characterized by a higher prevalence of illnesses, earlier onset of diseases, and longer durations of living with ailments, substantially engenders challenges within the domain of older adults' healthcare. Community home-based elderly care services (CHECS) are a feasible solution to solve the problem of older adults' care and protect older adults' health. The aim of this study is to investigate the relationship, heterogeneity effects and influential mechanisms between older adults' use of CHECS and their self- reported health. Methods The study employs the Instrumental Variable technique and empirically investigates the relationship, heterogeneity effects and influential mechanisms between older adults using CHECS and their self-reported health using data from the China Longitudinal Aging Social Survey from 2018. Results The findings indicate, firstly, that using CHECS considerably improves older adults' self-reported health. Secondly, the heterogeneity test reveals that the effect is more pronounced for older adults who are under the age of 80, have functional disabilities, are free of chronic diseases, have never attended school, reside in lower-income households, are single, rarely interact with their children, and live in central urban or city/county regions. Thirdly, the mechanism test reveals that the "social network effect" and "family care effect" are the key influence channels of using CHECS. Conclusion An empirical foundation for the policy reform of community home-based care for seniors is provided by this study with the limitations to discuss the other socioeconomic aspects such as government health expenditure and discuss the specific services aspects such as health care. The findings carry substantial implications for improving the health of older individuals and provide suggestions for establishing a socialized aged care system in China.
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Affiliation(s)
- Yang He
- School of Business, Xiangtan University, Xiangtan, Hunan, China
| | - Baojian Wei
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
| | - Yushang Li
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
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Wang X, Zhang C, Luan W. Social isolation, depression, nutritional status and quality of life during COVID-19 among Chinese community-dwelling older adults: a cross-sectional study. BMJ Open 2023; 13:e072305. [PMID: 37723110 PMCID: PMC10510871 DOI: 10.1136/bmjopen-2023-072305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/30/2023] [Indexed: 09/20/2023] Open
Abstract
OBJECTIVE This survey investigated the relationship between social isolation, depression, nutritional status and quality of life among community-dwelling older adults during COVID-19. DESIGN This was a cross-sectional survey study. SETTING Communities in Pudong New Area, Shanghai, China that have contracted with Renji Hospital, affiliated with Shanghai Jiao Tong University School of Medicine. PARTICIPANTS From May to July 2022, 406 community-dwelling older adults were selected by convenience sampling in Shanghai, China. PRIMARY AND SECONDARY OUTCOME MEASURES The Lubben Social Network Scale, Geriatric Depression Scale, 36-item Short Form Health Survey Scale and risk assessment of malnutrition were used in older adults. Mediation models were constructed to determine the mediating role of depression and nutritional status on social isolation and quality of life among older adults. RESULTS The prevalence of social isolation among older adults in the community was 44.3%. The total social isolation score in community-dwelling older adults was positively associated with the total malnutrition risk and quality of life scores, and negatively associated with depression (p<0.01). Logistic regression demonstrated that living alone, loss of families or friends during COVID-19 and depression were risk factors for social isolation among community-dwelling older adults (p<0.05). Social isolation could directly affect the quality of life (β=0.306). In addition, depression (β=0.334) and nutritional status (β=0.058) had a significant mediating effect on the relationship between social isolation and quality of life. CONCLUSIONS Our findings showed that the prevalence of social isolation among older adults increased during COVID-19. Depression and nutritional status played parallel mediating roles on the effect of social isolation on quality of life. Community workers and healthcare providers should develop intervention plans to improve the status of social isolation in older adults, eliminating existing and ongoing adverse effects.
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Affiliation(s)
- Xinxin Wang
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, China
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Chengrui Zhang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Wei Luan
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, China
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Liu Y, Huang C. Why elderly in rural China didn't wear masks during the COVID-19 pandemic? A qualitative narrative interview study. BMC Public Health 2023; 23:1757. [PMID: 37689669 PMCID: PMC10492314 DOI: 10.1186/s12889-023-16653-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 08/30/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, ageism and stigmatization towards the elderly have been prominent issues. In addition, there have been debates on Chinese social media as to why elderly people in rural areas are not wearing masks. While some factors that affect the mask-wearing behaviour of the elderly have been analyzed, little attention has been given to the lived experiences and behavioral intentions of rural elderly people who choose not to wear masks, despite government mandates to do so. METHOD In this research, 50 semi-structured interviews with 30 elderly individuals in three Chinese villages were carried out using the qualitative method of semi-structured interviews. Following verbatim recording and transcription of the conversations, the subject was analyzed using the Theory of Reasoned Action. RESULTS We identified four factors that influence the non-masking behaviour of rural elderly, including past experiences, cultural concepts, cognitive attitudes, and health and safety anxiety, and identified nine sub-themes based on the four overarching themes. Past knowledge, experience, and history have led rural elderly people to distrust the government's mandatory "mask mandate," believing that they do not need to wear masks. Rural cultural concepts and habits make the elderly feel that masks not only fail to provide protection but also become obstacles, resulting in poor daily experiences. Cognitive attitudes and emotions determine the elderly's evaluation of masks, which in turn affects their use of masks. Finally, elderly individuals'chronic diseases directly affect the physical pain and life safety caused by their use of masks, which is a major objective factor for their non-masking. CONCLUSIONS Although numerous studies have concluded that Chinese people wore masks out of collectivism and conformity during the pandemic, marginalized groups' opposition to wearing masks also contains distinctive, individualized elements and underlying causes. By exposing these elements and reasons, we can better comprehend the peculiar behavior of particular groups while fighting the pandemic. The needs of marginalized populations should be prioritized by public health policy makers to provide more equitable services.
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Affiliation(s)
- Yunlai Liu
- School of Media, Anqing Normal University, Anqing, China.
| | - Chunyan Huang
- The Department of Communication, University of Macau, Macau, China
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DeBroux Leduc R, Bier N, Couture M, Ansaldo AI, Belleville S, Ben Gaied N, Chesneau S, Belchior P, Fonseca R, Hebblethwaite S, Jarema G, Lacerda A, Rousseau J, Van De Velde C, Filiatrault J. Social Isolation of Older Adults Living in a Neighbourhood of Montreal: A Qualitative Descriptive Study of the Perspectives of Older Adults and Community Stakeholders. Can J Aging 2023; 42:434-445. [PMID: 36847179 DOI: 10.1017/s071498082300003x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
The purpose of this study was to describe the social isolation of older adults in the Côte-des-Neiges neighbourhood (Montreal, Canada) from the perspectives of older adults and community stakeholders. To do so, a descriptive qualitative study was conducted, involving community-dwelling older adults and a variety of key stakeholders from the neighbourhood. Seven focus groups were held, with a total of 37 participants. Focus group transcripts were analyzed using the approach of Miles, Huberman, and Saldaña. Participants reported that social isolation of older adults is characterized by gaps in social interactions (scarcity of social interactions, lack of social support, and unsatisfying relationships) as well as by low social participation that can be depicted in three ways: (1) exclusion by society, (2) self-restriction of participation, and (3) low eagerness to socialize. This study highlights that there is a diversity in how social isolation of older adults manifests itself. It can be the result of a deliberate choice (or not), as well as being desired (or not). These aspects of the phenomenon of social isolation of older adults are still not well described. However, they offer relevant avenues for rethinking approaches to intervention development.
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Affiliation(s)
- Roxane DeBroux Leduc
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Nathalie Bier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Mélanie Couture
- Centre de recherche et d'expertise en gérontologie sociale, CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Ana Inès Ansaldo
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Sylvie Belleville
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Faculté des arts et des sciences, Université de Montréal, Montréal, Québec, Canada
| | - Nouha Ben Gaied
- Fédération québécoise des Sociétés Alzheimer, Montréal, Québec, Canada
| | - Sophie Chesneau
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Patricia Belchior
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Faculté de médecine et des sciences de la santé, Université McGill, Montréal, Québec, Canada
| | - Raquel Fonseca
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- École des sciences de la gestion, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Shannon Hebblethwaite
- Centre de recherche et d'expertise en gérontologie sociale, CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Université Concordia, Montréal, Québec, Canada
| | - Gonia Jarema
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Faculté des arts et des sciences, Université de Montréal, Montréal, Québec, Canada
| | - Adriana Lacerda
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Jacqueline Rousseau
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Cécile Van De Velde
- Faculté des arts et des sciences, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche de Montréal sur les inégalités sociales, les discriminations et les pratiques alternatives de citoyenneté, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Johanne Filiatrault
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
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Zhao D, Chai S, Gao T, Li J, Zhou C. Physical Mobility, Social Isolation and Cognitive Function: Are There Really Gender Differences? Am J Geriatr Psychiatry 2023; 31:726-736. [PMID: 37147164 DOI: 10.1016/j.jagp.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/19/2023] [Accepted: 04/05/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE This study aimed to examine the mediating role of social isolation between physical mobility and cognitive function, and whether there are gender differences in the above mediating effects among Chinese older adults. METHODS This is a prospective and cohort study. We obtained data from the 2011 (Time 1, T1), 2015 (Time 2, T2) and 2018 (Time 3, T3) waves of China Health and Retirement Longitudinal Study, including 3,395 participants aged 60 years or above. Cognition was evaluated by Telephone Interview of Cognitive Status, words recall, and figure drawing, which was widely used in previous research. We used a cross-lagged model to test the hypothesis that social isolation mediated the association between physical mobility and cognitive function among Chinese older adults. RESULTS The total effects of T1 physical mobility limitations on T3 cognitive function (β = -0.055, bootstrap p < 0.001) were significantly negative. Social isolation played a mediating role among both males and females (male: β = -0.008, bootstrap p = 0.012; female: β = -0.006, bootstrap p = 0.023), demonstrating that the mediating effect of social isolation between physical mobility and cognitive function was not gender specific. CONCLUSION This study confirmed that social isolation mediated the association between physical mobility and cognitive function among both Chinese male and female older adults. These findings indicate that reversing social isolation can be a priority intervention target for cognitive decline prevention and promote successful ageing, particularly among older adults with impaired physical mobility.
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Affiliation(s)
- Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Shujun Chai
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Tingting Gao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine (DZ, SC, TG, JL, CZ), Shandong University, Jinan, China; NHC Key Lab of Health Economics and Policy Research (Shandong University) (CZ), Jinan, China; Institute of Health and Elderly Care, Shandong University (CZ), Jinan, China.
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Spangler KR, Adams QH, Hu JK, Braun D, Weinberger KR, Dominici F, Wellenius GA. Does choice of outdoor heat metric affect heat-related epidemiologic analyses in the US Medicare population? Environ Epidemiol 2023; 7:e261. [PMID: 37545812 PMCID: PMC10402938 DOI: 10.1097/ee9.0000000000000261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 06/15/2023] [Indexed: 08/08/2023] Open
Abstract
Outdoor air temperature is associated with increased morbidity and mortality. Other thermal indices theoretically confer greater physiological relevance by incorporating additional meteorological variables. However, the optimal metric for predicting excess deaths or hospitalizations owing to extreme heat among US Medicare beneficiaries remains unknown. Methods We calculated daily maximum, minimum, and mean outdoor air temperature (T), heat index (HI), wet-bulb globe temperature (WBGT), and Universal Thermal Climate Index (UTCI) for populous US counties and linked estimates with daily all-cause mortality and heat-related hospitalizations among Medicare beneficiaries (2006-2016). We fit distributed-lag nonlinear models for each metric and compared relative risks (RRs) at the 99th percentile. Results Across all heat metrics, extreme heat was statistically significantly associated with elevated risks of morbidity and mortality. Associations were more pronounced for maximum daily values versus the corresponding minimum for the same metric. The starkest example was between HImax (RR = 1.14; 95% confidence interval [CI] = 1.12, 1.15) and HImin (RR = 1.10; 95% CI = 1.09, 1.11) for hospitalizations. When comparing RRs across heat metrics, we found no statistically significant differences within the minimum and maximum heat values (i.e., no significant differences between Tmax/HImax/WBGTmax/UTCImax or between Tmin/HImin/WBGTmin/UTCImin). We found similar relationships across the National Climate Assessment regions. Conclusion Among Medicare beneficiaries in populous US counties, daily maximum and mean values of outdoor heat are associated with greater RRs of heat-related morbidity and all-cause mortality versus minimum values of the same metric. The choice of heat metric (e.g., temperature versus HI) does not appear to substantively affect risk calculations in this population.
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Affiliation(s)
- Keith R. Spangler
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | - Quinn H. Adams
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | - Jie Kate Hu
- Department of Biostatistics, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts
| | - Danielle Braun
- Department of Biostatistics, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Kate R. Weinberger
- University of British Columbia, School of Population and Public Health, Vancouver, British Columbia, Canada
| | - Francesca Dominici
- Department of Biostatistics, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts
| | - Gregory A. Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
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Spitzer ER, Waltzman SB. Cochlear implants: the effects of age on outcomes. Expert Rev Med Devices 2023; 20:1131-1141. [PMID: 37969071 DOI: 10.1080/17434440.2023.2283619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/10/2023] [Indexed: 11/17/2023]
Abstract
INTRODUCTION Cochlear implants (CIs) provide access to sound for children and adults who do not receive adequate benefit from hearing aids. Age at implantation is known to affect outcomes across the lifespan. AREAS COVERED The effects of age on CI outcomes are examined for infants, children, adolescents, and older adults. A variety of outcome measures are considered, including speech perception, language, cognition, and quality of life measures. EXPERT OPINION/COMMENTARY For those meeting candidacy criteria, CIs are beneficial at any age. In general, younger age is related to greater benefit when considering pre-lingual deafness. Other factors such as additional disabilities, may mitigate this effect. Post-lingually deafened adults demonstrate similar benefit regardless of age, though the oldest individuals (80+) may see smaller degrees of improvement from preoperative scores. Benefit can be measured in many ways, and the areas of greatest benefit may vary based on age: young children appear to see the greatest effects of age at implantation on language measures, whereas scores on cognitive measures appear to be most impacted for the oldest population. Future research should consider implantation at extreme ages (5-9 months or > 90 years), unconventional measures of CI benefit including qualitative assessments, and longitudinal designs.
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Affiliation(s)
- Emily R Spitzer
- Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Susan B Waltzman
- Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
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Beselt LJ, McDonough MH, Walsh CA, Kenny SJ. Experiences with social support among older adult women participating in gay square dancing. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 67:102443. [PMID: 37665893 DOI: 10.1016/j.psychsport.2023.102443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 09/06/2023]
Abstract
LGBTQI2S+ (lesbian, gay, bisexual, transgender, questioning, intersex, and two-spirit, etc.) individuals face unique challenges to physical activity participation, such as discrimination and exclusion. Square dance is a form of collaborative group dancing and while traditionally a heteronormative form of dance, gay square dance is typically open to everyone, regardless of sexual orientation. Square dancing offers opportunities to belong to a community of others engaged in the same activity, which older adults often find satisfying. The aim of this research was to understand how older adults who identify as women experience social support in the context of participating in gay square dance and the role previous experiences of social exclusion play in influencing these experiences. Fourteen self-identified women (age range 55-79 years; n = 11 White, n = 1 Black, n = 2 Jewish) belonging to a gay square dance club participated. Participants self-identified as heterosexual (n = 7), lesbian (n = 3), pansexual (n = 1), bisexual (n = 1), or did not identify with existing terminology (n = 2). Interviews were conducted during a gay square-dancing festival and thematically analyzed. Findings highlighted that participants experienced acceptance which affirmed their sense of self and enabled their authentic selves. To foster a sense of belonging and close relationships, specific actions (e.g., demonstrative welcoming of newcomers, mutual support) were taken by other participants in the group. Physical touch is an inherent part of square dancing, which took on different meanings for participants and was overall perceived as safe. Inclusive groups like gay square dance clubs are an important and consistent means where older adult women can experience meaningful social relationships and interactions.
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Affiliation(s)
| | | | | | - Sarah J Kenny
- Faculty of Kinesiology, University of Calgary, Canada; School of Creative and Performing Arts, Faculty of Arts, University of Calgary, Canada
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Umberson D, Donnelly R. Social Isolation: An Unequally Distributed Health Hazard. ANNUAL REVIEW OF SOCIOLOGY 2023; 49:379-399. [PMID: 38106980 PMCID: PMC10722883 DOI: 10.1146/annurev-soc-031021-012001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Social isolation is a potent predictor of poor health, mortality, and dementia risk. A great deal of research across national contexts provides causal evidence for these linkages and identifies key explanatory mechanisms through which isolation affects health. Research on social isolation recognizes that some people are more likely than others to be isolated, but over the past several decades, researchers have focused primarily on the consequences of isolation for health rather than a systematic assessment of the social conditions that foster isolation over the life course. In this article, we review the available evidence on inequities in social isolation and develop a conceptual framework to guide future research on structural systems that fuel social isolation over the life course. Future work in this area has the potential to identify root causes of inequality in social isolation, as well as targeted policy levers to reduce isolation in vulnerable populations.
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Affiliation(s)
- Debra Umberson
- Department of Sociology, Center on Aging & Population Sciences, and Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Rachel Donnelly
- Department of Sociology, Vanderbilt University, Nashville, Tennessee, USA
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Kumar S, Kumar R, Dixit V, Chaudhury S. Motivation for solitude, COVID-19-related anxiety and resilience among Indian medical students. Ind Psychiatry J 2023; 32:423-430. [PMID: 38161472 PMCID: PMC10756591 DOI: 10.4103/ipj.ipj_98_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 07/19/2023] Open
Abstract
Background Recent reports indicate that self-isolation because of coronavirus disease 2019 (COVID-19)-related lockdowns had significant influence on mental health of medical students. Aim To understand the relationship between two different motivations for solitude - self-determined versus non-self-determined with medical students' COVID-19-related anxiety and psychological resilience during their self-isolation because of COVID-19-related lockdowns. Materials and Methods After the approval of the Institutional Ethics Committee, this online survey was done on undergraduate Indian medical students during the COVID-19 pandemic. Expressing consent at the beginning of the online form, enabled the students to proceed to the next section comprising their sociodemographic details and clinical details. The last section of the form comprised the Motivation for Solitude Scale-Short Form, the COVID-19 Anxiety Scale, and the Connor-Davidson Resilience Scale-Abbreviated. Results 282 out of 286 students of either sex gave their consent and completed the given form. Both self-determined and non-self-determined motivations for solitude were higher in female medical students. The self-determined motivation for solitude was directly related to all students' resilience. A past history of psychiatric illness was directly associated with the non-self-determined motivation for solitude of the students. The non-self-directed motivation for solitude of female students was indirectly related to their resilience. The COVID-19-related anxiety was not related to either type of motivation for solitude as well as the resilience of the medical students. Conclusion Indian female medical students are more motivated for solitude, be it self-determined or non-self-determined, than their male counterparts. The student's resilience has a direct relationship with students' self-determined motivation. The COVID-19-related anxiety among the medical students is not related to their motivations for solitude or resilience.
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Affiliation(s)
- Santosh Kumar
- Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Patna, India
| | - Rajesh Kumar
- Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Patna, India
| | - Vidhata Dixit
- Department of Psychology, J D Womens College, Patna, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr D Y Patil Medical College, Dr D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
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Guarnera J, Yuen E, Macpherson H. The Impact of Loneliness and Social Isolation on Cognitive Aging: A Narrative Review. J Alzheimers Dis Rep 2023; 7:699-714. [PMID: 37483321 PMCID: PMC10357115 DOI: 10.3233/adr-230011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/28/2023] [Indexed: 07/25/2023] Open
Abstract
Social concepts such as loneliness and social isolation are fairly new factors that have been recently gaining attention as to their involvement in changes in cognitive function and association with dementia. The primary aim of this narrative review was to describe the current understanding of how loneliness and social isolation influence cognitive aging and how they are linked to dementia. Studies have shown that there is an association between loneliness, social isolation, and reduced cognitive function, in older adults, across multiple cognitive domains, as well as a heightened risk of dementia. Numerous changes to underlying neural biomechanisms including cortisol secretion and brain volume alterations (e.g., white/grey matter, hippocampus) may contribute to these relationships. However, due to poor quality research, mixed and inconclusive findings, and issues accurately defining and measuring loneliness and social isolation, more consistent high-quality interventions are needed to determine whether studies addressing loneliness and social isolation can impact longer term risk of dementia. This is especially important given the long-term impact of the COVID-19 pandemic on social isolation in older people is yet to be fully understood.
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Affiliation(s)
- Jade Guarnera
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Eva Yuen
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, VIC, Australia
- Centre for Quality and Patient Safety-Monash Health Partnership, Institute for Health Transformation, Deakin University, Melbourne, VIC, Australia
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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Skolarus L, Thrash-Sall E, Hellem AK, Giacalone M, Burke J, Lin CC, Bailey S, Corches C, Dinh M, Casetti A, Mansour M, Bowie K, Roth R, Whitfield C, Sales A. Community-Led, Cross-Sector Partnership of Housing and Health Care to Promote Aging in Place (Unite Health Project): Protocol for a Prospective Observational Study. JMIR Res Protoc 2023; 12:e47855. [PMID: 37384383 PMCID: PMC10365602 DOI: 10.2196/47855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND For many older Americans, aging in place is their preferred living arrangement. Minoritized and socioeconomically disadvantaged older adults are up to 3 times more likely to experience disability than other groups, which increases their likelihood of being unable to age in place. Bold ideas to facilitate aging in place, particularly among vulnerable populations, are needed. One such idea is the Unite care model, a community-initiated, academic-supported, cross-sector initiative that combines 2 sectors: housing and health care. The Unite care model colocates a federally qualified health center clinic on an older adult affordable housing campus in Flint, Michigan. OBJECTIVE There are two aims to this study. Aim 1 is to evaluate the implementation of the Unite care model in terms of acceptability, adoption, and penetration. Aim 2 is to determine which older adults use the care model and whether the care model promotes aging in place through risk factor reduction and improvement in the physical and social environment. METHODS We will assess the care model using a concurrent, exploratory mixed methods design. For aim 1, acceptability will be assessed through semistructured interviews with key stakeholder groups; adoption and penetration will be assessed using housing and health care records. For aim 2, residents residing in the Unite clinic building will participate in structured outcome assessments at 6 and 12 months. Risk factor reduction will be measured by change in systolic blood pressure from baseline to 12 months and change in the physical and social environment (item counts) will also be assessed from baseline to 12 months. RESULTS Data collection for aim 1 began in July 2021 and is anticipated to end in April 2023. Data collection for aim 2 began in June 2021 and concluded in November 2022. Data analysis for aim 1 is anticipated to begin in the summer of 2023 and analysis for aim 2 will begin in the spring of 2023. CONCLUSIONS If successful, the Unite care model could serve as a new care model to promote aging in place among older adults living in poverty and older Black Americans. The results of this proposal will inform whether larger scale testing of this new model of care is warranted. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47855.
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Affiliation(s)
- Lesli Skolarus
- Davee Department of Neurology, Northwestern University, Chicago, IL, United States
| | | | - Abby Katherine Hellem
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | | | - James Burke
- Department of Neurology, The Ohio State University, Columbus, OH, United States
| | - Chun Chieh Lin
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Sarah Bailey
- Bridges Into the Future, Flint, MI, United States
| | - Casey Corches
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Mackenzie Dinh
- Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Amanda Casetti
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Maria Mansour
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Kaitlyn Bowie
- Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Rylyn Roth
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Candace Whitfield
- Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Anne Sales
- Sinclair School of Nursing, University of Missouri, Columbia, MO, United States
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, United States
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Sandri E, Pérez-Bermejo M, Cabo A, Cerdá-Olmedo G. Living Alone: Associations with Diet and Health in the Spanish Young Adult Population. Nutrients 2023; 15:nu15112516. [PMID: 37299479 DOI: 10.3390/nu15112516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Eating together as a family has important health benefits, as the diet is more balanced and of a higher quality. Eating together is also a factor in the prevention of diet-related diseases. The promotion of family and shared meals is currently a public health strategy. The aim of this research was to study the eating habits of the Spanish young adult population and their impact on health. An observational, descriptive, cross-sectional study was carried out using surveys. A questionnaire was designed and validated to explore a set of variables related to food and health. The dissemination was carried out through social networks by means of an online form, using non-probabilistic snowball sampling to obtain a sample of 17,969 subjects aged between 18 and 45 years. We found statistically significant differences between people living in a family home compared to people living outside a family home in the healthy eating index for the Spanish population, fish consumption, and fried food consumption. This suggests that the nutrition of people living in a family home is healthier, although their BMI is higher. People living together have a statistically higher healthy eating index value than people living alone; consume fast food, fried food, and ultra-processed food less frequently; and eat fish more often. On the other hand, people who live in a family home or are accompanied are more likely to have a sedentary lifestyle and are less physically active. It was concluded that people living alone have a worse healthy eating index than those living with company, which seems to indicate that nutritional interventions should pay attention to people living alone as a variable to be taken into account in future analyses.
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Affiliation(s)
- Elena Sandri
- Doctoral School, Catholic University of Valencia San Vicente Mártir, c/Quevedo 2, 46001 Valencia, Spain
- Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, c/Quevedo 2, 46001 Valencia, Spain
| | - Marcelino Pérez-Bermejo
- SONEV Research Group, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, c/Quevedo 2, 46001 Valencia, Spain
| | - Asensi Cabo
- Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, c/Quevedo 2, 46001 Valencia, Spain
| | - Germán Cerdá-Olmedo
- Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, c/Quevedo 2, 46001 Valencia, Spain
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Muhammad T, Pai M, Afsal K, Saravanakumar P, Irshad CV. The association between loneliness and life satisfaction: examining spirituality, religiosity, and religious participation as moderators. BMC Geriatr 2023; 23:301. [PMID: 37193948 DOI: 10.1186/s12877-023-04017-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/04/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Future cohort of older adults may have to rely on non-family sources and forms of support, religion being one of them. This may be especially so, considering the recent longitudinal evidence that individuals are inclined to become more religious with increasing age. Thus, the purpose of the present study was to assess the association between loneliness and life satisfaction among older adults in India, and the extent to which the association between loneliness and life satisfaction is moderated by spirituality, religiosity, and religious participation. METHODS Data come from the Longitudinal Ageing Study in India, with a sample of 31,464 individuals aged 60 years and above. Multivariable logistic regression models were employed to examine the independent association of loneliness and life satisfaction. Further, an interaction analysis was conducted to examine the extent to which the association between perceived loneliness and life satisfaction is moderated by spirituality, religiosity and religious participation among older Indians. RESULTS The prevalence of low life satisfaction (LLS) was 30.84%; a total of 37.25% of participants reported feeling lonely, 12.54% reported a lack of spiritual experience, 21.24% reported not being religious, and 19.31% reported not participating in religious activities. Older adults who felt lonely had higher odds of LLS relative to peers who were not lonely. Further, the adverse impact of loneliness on LLS among older Indians is moderated by their spirituality, religiosity, and religious participation. Specifically, the adverse impact of loneliness on LLS was less negatively pronounced among older adults who were spiritual, religious, and engaged in religious activities. CONCLUSIONS The study found an independent association between loneliness and lower life satisfaction among older adults in India. It also revealed that religiosity, spirituality and religious participation moderate the association between loneliness and lower life satisfaction. These findings, which underscore the health promoting benefits of religiosity and religious engagement, may be used to build on the interaction between religious and faith-based groups and public health professionals.
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Affiliation(s)
- T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India.
| | - Manacy Pai
- Department of Sociology and Criminology, Kent State University, Kent, OH, 44242, USA
| | - K Afsal
- Department of Migration & Urban Studies, International Institute for Population Sciences, Mumbai, 400088, India
| | - Priya Saravanakumar
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Building 10, Level 7, 235 Jones St, Ultimo, NSW, 2007, Australia
| | - C V Irshad
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, 632014, India
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de Melo RC, Schutz V, Wachholz PA, Villalonga-Olives E, Myer D, Corazzini K, Lepore M. Long-Term Care Staff Perspectives on the Care of Persons Living With Dementia During the COVID-19 Pandemic in São Paulo State, Brazil. J Gerontol Nurs 2023; 49:45-52. [PMID: 37126010 DOI: 10.3928/00989134-20230414-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, the Brazilian long-term care (LTC) sector faced many challenges, which accentuated other common issues experienced by persons living with dementia (PLWD). The current pilot study evaluated staff perspectives regarding the care of institutionalized PLWD during the COVID-19 pandemic. Using an online survey, we collected the perspectives of 24 workers from seven long-term care facilities (LTCFs) located in São Paulo State, Brazil, about the impact of COVID-19 in caring for PLWD. Results highlight concerns about challenges related to following precautionary measures and the negative effects of social distancing on PLWD. Aspects related to workforce and staffing and person-centered care approaches were recognized by staff as important to provide good care for PLWD. Future research is needed to consider how to support LTCFs in achieving a balance between the protection and well-being of PLWD. [Journal of Gerontological Nursing, 49(5), 45-52.].
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