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Tan LF, Merchant RA. Health and Community Care Workers' Knowledge and Perceptions of Social Prescribing in Singapore. Ann Geriatr Med Res 2024; 28:352-361. [PMID: 38724449 DOI: 10.4235/agmr.24.0062] [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: 03/08/2024] [Accepted: 05/08/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND This study aimed to survey knowledge and perceptions of social prescribing (SP) amongst health and community care workers, and is a cross-sectional online survey conducted in November 2023. METHODS The survey on basic demographics, awareness, knowledge, and practices of SP was completed by 123 health and community care workers. RESULTS The mean age of respondents was 39.0 years. Nearly two-thirds had heard of SP. A lower proportion of acute hospital doctors (55.6%) and nurses (56.8%) had heard of SP compared with primary and subacute care doctors (75.0%). The majority agreed that SP benefits patients' mental health and reduces healthcare utilization. Primary care physicians, community nurses, and active ageing centres were the top three professionals selected as most responsible for SP by survey respondents. The most commonly cited barriers to SP were seniors' reluctance (63.4%), lacking knowledge on how to refer (59.3%), lack of time (44.7%), and cost to seniors (44.7%). CONCLUSION Overall, health and community care workers demonstrated positive attitudes toward SP and were keen to refer patients for SP. However, additional efforts are needed to improve knowledge about how to refer to and provide training on SP.
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Affiliation(s)
- Li Feng Tan
- Healthy Ageing Programme, Alexandra Hospital, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Reshma Aziz Merchant
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore
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Zeng Q, Ding J, Tu R, He H, Wang S, Huang Y, Wang Z, Chen Q, Lu G, Li Y. The mediating effect of depressive symptoms on the association between childhood friendship and physical function in middle-aged and older adults: Evidence from the China Health and Retirement Longitudinal Study (CHARLS). J Affect Disord 2024; 359:196-205. [PMID: 38777265 DOI: 10.1016/j.jad.2024.05.087] [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: 03/19/2023] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND This study examines the extent to which depressive symptoms mediate the link between childhood friendship (CF) and physical function among middle-aged and older adults in China. METHODS China Health and Retirement Longitudinal Study (CHARLS) data were used; specifically, CHARLS life history survey (conducted from June 1-December 31, 2014) and follow-up health survey (conducted from July 1-September 30, 2015) data were used. The Sobel test, Bootstrap test and multivariable logistic regression were performed to examine the mediating role of depressive symptoms (measured by the 10-item Center for Epidemiologic Studies Depression Scale) in the association between CF (measured by a standardized retrospective questionnaire) and physical function, which was measured by basic activities of daily living (BADL) disability, instrumental activities of daily living (IADL) disability, and grip strength. RESULTS A total of 12,170 participants aged 45 years or older were included in this cross-sectional study. After controlling for covariates, low-quality CF was associated with an increased prevalence of BADL disability (OR = 1.18; 95 % CI = 1.05-1.32), IADL disability (OR = 1.25; 95 % CI = 1.12-1.40), and low grip strength (OR = 1.21; 95 % CI = 1.09-1.34). The proportion of the mediating effect of depressive symptoms was 48 % for CF and BADL, 40 % for CF and IADL, and 11 % for CF and grip strength. Depressive symptoms and worse CF have a joint effect on BADL disability (OR = 3.30; 95 % CI = 2.82-3.85), IADL disability (OR = 3.52; 95 % CI = 3.03-4.09), and low grip strength (OR = 1.65; 95 % CI = 1.43-1.92). LIMITATIONS Not all potential confounding factors (such as childhood behavioural problems, genetic factors, and memory function) were measured in the analysis, and there may have been recall bias in the retrospective collection of CF data. CONCLUSIONS Individuals with high-quality CF were more likely to have a decreased prevalence of impaired physical function in later life. Depressive symptoms acted as a mediator associated with the development of CF.
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Affiliation(s)
- Qingping Zeng
- Neuro-Intensive Care Unit, Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China; School of Nursing, Medical College of Yangzhou University, Yangzhou University, China
| | - Jiali Ding
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, China
| | - Raoping Tu
- School of Health Management, Fujian Medical University, Fuzhou, Fujian, China
| | - Huihui He
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, China
| | - Suhang Wang
- School of Nursing, Medical College of Yangzhou University, Yangzhou University, China
| | - Yujia Huang
- Neuro-Intensive Care Unit, Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Zhiyao Wang
- Neuro-Intensive Care Unit, Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China
| | - Qi Chen
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, China
| | - Guangyu Lu
- School of Public Health, Medical College of Yangzhou University, Yangzhou University, China.
| | - Yuping Li
- Neuro-Intensive Care Unit, Department of Neurosurgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.
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Ran Z, Wei J, Yang G, Yang C. Prevalence of social isolation in the elderly: A systematic review and meta-analysis. Geriatr Nurs 2024; 58:87-97. [PMID: 38781629 DOI: 10.1016/j.gerinurse.2024.05.008] [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: 03/12/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
Social isolation has become a global issue among the elderly, posing serious challenges to both social and public health. We assessed the prevalence of elderly social isolation and its related factors. Eight electronic databases were searched up to June 28th, 2023. A meta-analysis of the included literature was performed using Stata 16.0. The results showed that the incidence of social isolation in the elderly was 33 % [95 % CI (0.28, 0.38)]. The subgroup analysis revealed that people over 80, with a sample size under 500, assessed using the Lubben Social Network scale and Social Network Index scale, experienced higher social isolation, especially if they were living alone and lacked higher education. It is suggested to pay attention to the psychological well-being of elderly individuals living alone and lacking a high level of education. Early screening could help reduce the incidence of social isolation, and hence its implications, among the elderly.
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Affiliation(s)
- Zhenrong Ran
- Master's Degree, Nursing Department, Chongqing Traditional Chinese Medicine Hospital, Chongqing, PR China
| | - Jiajia Wei
- Undergraduate Degree, Nursing Department, Chongqing Traditional Chinese Medicine Hospital, Chongqing, PR China
| | - Guangjin Yang
- Undergraduate Degree, Nursing Department, Chongqing Traditional Chinese Medicine Hospital, Chongqing, PR China
| | - Chanjuan Yang
- Master's Degree, Nursing Department, Chongqing Traditional Chinese Medicine Hospital, Chongqing, PR China.
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Reiner A, Steinhoff P. The association of social networks and depression in community-dwelling older adults: a systematic review. Syst Rev 2024; 13:161. [PMID: 38902787 PMCID: PMC11188217 DOI: 10.1186/s13643-024-02581-6] [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: 03/13/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Depression is a globally prevalent mental condition, particularly among older adults. Previous research has identified that social networks have a buffering effect on depression. Existing systematic reviews have either limited their research to specific geographic areas or provided evidence from over a decade ago. The vast body of recent literature particularly from the last decade emphasizes the need for a comprehensive review. This systematic review aims to analyze the association of structural aspects of social networks and depression in older adults. METHODS The electronic databases APA PsycINFO, ProQuest, PSYINDEX, PubMed, Scopus, SocINDEX, and Web of Science were searched from date of data base inception until 11 July 2023. Studies were eligible for inclusion if they reported on community-dwelling older adults (defined as a mean age of at least 60 years old), had an acceptable definition for depression, referred to the term social network in the abstract, and were published in English. Quality was appraised using the Newcastle Ottawa Scale for cross-sectional and longitudinal studies. Outcome data were extracted independently from each study and analyzed by direction of the relationship, social network domain and cross-sectional or longitudinal study design. RESULTS In total, 127 studies were included. The study categorizes structural network aspects into seven domains and finds that larger and more diverse networks, along with closer social ties, help mitigate depression. The literature on the relationships between depression and network density, homogeneity, and geographical proximity is scarce and inconclusive. DISCUSSION AND IMPLICATIONS: Despite inconsistent findings, this review highlights the importance of quantifying complex social relations of older adults. Limitations of this review include publication and language bias as well as the exclusion of qualitative research. Further research should use longitudinal approaches to further investigate the reciprocal relationship between social networks and depression. Following this review, interventions should promote the integration of older adults in larger and more diverse social settings. Other: This work was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Grant [454899704]. This systematic review was pre-registered. The review-protocol can be accessed at https://doi.org/10.17605/OSF.IO/6QDPK .
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Affiliation(s)
- Amelie Reiner
- Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany.
| | - Paula Steinhoff
- Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, 50923, Cologne, Germany
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Lydon EA, Mois G, Shende SA, Myers D, Danilovich MK, Rogers WA, Mudar RA. Methods and baseline characteristics for a social engagement technology-based randomized controlled trial for older adults. Contemp Clin Trials Commun 2024; 39:101308. [PMID: 38841566 PMCID: PMC11152901 DOI: 10.1016/j.conctc.2024.101308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/29/2024] [Accepted: 05/12/2024] [Indexed: 06/07/2024] Open
Abstract
Background Growing evidence suggests that increasing opportunities for social engagement has the potential to support successful aging. However, many older adults may have limited access to in-person social engagement opportunities due to barriers such as transportation. We outline the development, design, methodology, and baseline characteristics of a randomized controlled trial that assessed the benefits of a social engagement intervention delivered through the OneClick video conferencing platform to older adults with varying levels of cognitive functioning. Methods Community-dwelling older adults with and without cognitive challenges were randomly assigned to a social engagement intervention group or a waitlist control group. Participants were asked to attend twice-weekly social engagement events for 8 weeks via OneClick. Outcomes included social engagement and technology acceptance for both groups at baseline, week-4, and week-8 assessments. As an extension, the waitlist control group had an opportunity to participate in the intervention, with outcomes assessed at weeks 12 and 16. Results We randomly assigned 99 participants (mean age = 74.1 ± 6.7, range: 60-99), with 50 in the immediate intervention group and 49 in the waitlist control group. About half of the participants reported living alone (53.5%), with a third (31%) falling into the cognitively impaired range on global cognitive screening. The groups did not differ at baseline on any of the outcome measures. Conclusions Outcomes from this study will provide important information regarding the feasibility and efficacy of providing technology-based social engagement interventions to older adults with a range of cognitive abilities.
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Affiliation(s)
- Elizabeth A. Lydon
- College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - George Mois
- College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Shraddha A. Shende
- College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | | | | | - Wendy A. Rogers
- College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Raksha A. Mudar
- College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, IL, USA
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Hounkpatin H, Simpson G, Santer M, Farmer A, Dambha-Miller H. Multiple long-term conditions, loneliness and social isolation: A scoping review of recent quantitative studies. Arch Gerontol Geriatr 2024; 120:105347. [PMID: 38309103 DOI: 10.1016/j.archger.2024.105347] [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: 11/10/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Multiple long-term conditions (MLTC), loneliness and social isolation are common in older adults. Recent studies have explored the association of MLTC with loneliness and social isolation. This scoping review aimed to map this current evidence and identify gaps in the literature. METHODS A scoping review was conducted following the PRISMA guidelines for scoping reviews. Ovid Medline, Embase, CINAHL, The Cochrane Library, PsycInfo, and Bielefeld Academic Search Engine were searched for studies published between January 2020-April 2023. Quantitative studies, published in any language, that assessed the association of MLTC with loneliness and/or social isolation were included. RESULTS 1827 records were identified and screened. Of these, 17 met inclusion criteria. Most studies were cross-sectional and based on older adults. Studies were conducted in Europe, the US, Canada, and low- and middle-income countries. Ten studies focused on the association between MLTC and loneliness, six assessed the association between MLTC and social isolation and one examined associations with both loneliness and social isolation. Most studies reported a significant cross-sectional association of MLTC with loneliness, but there was weaker evidence for a longitudinal association between MLTC and loneliness and an association between MLTC and social isolation. Studies were heterogenous in terms of measures and definitions of loneliness/social isolation and MLTC, confounders adjusted for, and analytical models used, making comparisons difficult. CONCLUSIONS Further population-based longitudinal studies using consistent measures and methodological approaches are needed to improve understanding of the association of MLTC with both loneliness and social isolation.
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Affiliation(s)
- Hilda Hounkpatin
- Primary Care Research Centre, School of Primary Care Population Sciences and Medical Education, University of Southampton, UK.
| | - Glenn Simpson
- Primary Care Research Centre, School of Primary Care Population Sciences and Medical Education, University of Southampton, UK
| | - Miriam Santer
- Primary Care Research Centre, School of Primary Care Population Sciences and Medical Education, University of Southampton, UK
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Hajira Dambha-Miller
- Primary Care Research Centre, School of Primary Care Population Sciences and Medical Education, University of Southampton, UK
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Reinwarth AC, Petersen J, Beutel ME, Hautzinger M, Brähler E. Social support in older adults: Validation and norm values of a brief form of the Perceived Social Support Questionnaire (F-SozU K-6). PLoS One 2024; 19:e0299467. [PMID: 38502646 PMCID: PMC10950225 DOI: 10.1371/journal.pone.0299467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/09/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Social relations are crucial for maintaining physical and mental health across the life span. As social roles, networks and needs change with age a valid assessment of social support in older adults and age-specific norms are necessary. The present work aims to [1) assess the level of social support in individuals > 60 years of the general German population, [2) evaluate the brief six-item form of the Perceived Social Support Questionnaire (F-SozU K-6) in this age group and to [3) provide age-specific norm values. METHODS We analyze data of N = 706 people representative for the German population collected in 2021. To assess social support, we used the F-SozU K-6. We tested for selectivity, item difficulty, internal consistency, construct and factor validity, as well as factorial invariance. Additionally, we assessed correlations and associations with depression, loneliness, and sociodemographic factors. Furthermore, we reported norm values for respondents > 60 years. RESULTS Participants > 60 years reported a mean level of 23.97 (SD = 4.82) of social support. Results of the CFA confirmed a very good model fit. Measurement invariance across sex and age was shown. Associations with ADS and LS-S supported construct validity. Multiple regression analysis showed that female sex, increasing age, having a partner, and a higher equivalized household income were associated with higher levels of social support. CONCLUSION The F-SozU K-6 is a reliable and economical tool to assess perceived social support in older adults. Norm values for individual > 60 years are provided.
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Affiliation(s)
- Anna C. Reinwarth
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Julia Petersen
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Martin Hautzinger
- Department of Psychology, Clinical Psychology and Psychotherapy, Eberhard Karls University, Tübingen, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Leipzig, Leipzig, Germany
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Hanlon P, Wightman H, Politis M, Kirkpatrick S, Jones C, Andrew MK, Vetrano DL, Dent E, Hoogendijk EO. The relationship between frailty and social vulnerability: a systematic review. THE LANCET. HEALTHY LONGEVITY 2024; 5:e214-e226. [PMID: 38432249 DOI: 10.1016/s2666-7568(23)00263-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 03/05/2024] Open
Abstract
Both frailty (reduced physiological reserve) and social vulnerability (scarcity of adequate social connections, support, or interaction) become more common as people age and are associated with adverse consequences. Analyses of the relationships between these constructs can be limited by the wide range of measures used to assess them. In this systematic review, we synthesised 130 observational studies assessing the association between frailty and social vulnerability, the bidirectional longitudinal relationships between constructs, and their joint associations with adverse health outcomes. Frailty, across assessment type, was associated with increased loneliness and social isolation, perceived inadequacy of social support, and reduced social participation. Each of these social vulnerability components was also associated with more rapid progression of frailty and lower odds of improvement compared with the absence of that social vulnerability component (eg, more rapid frailty progression in people with social isolation vs those who were not socially isolated). Combinations of frailty and social vulnerability were associated with increased mortality, decline in physical function, and cognitive impairment. Clinical and public health measures targeting frailty or social vulnerability should, therefore, account for both frailty and social vulnerability.
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Affiliation(s)
- Peter Hanlon
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Heather Wightman
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Marina Politis
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Caitlin Jones
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Melissa K Andrew
- Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Stockholm Gerontological Research Center, Stockholm, Sweden
| | - Elsa Dent
- Centre for Public Health, Equity and Human Flourishing, Torrens University, Adelaide, SA, Australia
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC-Location VU University Medical Center, Amsterdam, Netherlands
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Mehrabi F, Béland F. The role of frailty in the relationships between social relationships and health outcomes: a longitudinal study. BMC Public Health 2024; 24:602. [PMID: 38402184 PMCID: PMC10894481 DOI: 10.1186/s12889-024-18111-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: 04/09/2023] [Accepted: 02/14/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Socially isolated older adults incur increased risks of adverse health outcomes, though the strength of this association is unclear. We examined whether changes in physical frailty moderated the associations between changes in social relationships and changes in health outcomes among older adults. METHODS This longitudinal study is based on three waves of the FRéLE study among 1643 Canadian community-dwelling older adults aged 65 years and older over 2 years. We performed latent growth curve modelling (LGMs) to assess changes with the assumption of missing not at random, adjusting for time-invariant covariates. We used the latent moderated structural equations (LMS) to test the interactions in LGMs. Social relationships were measured by social participation, social networks, and social support from different social ties. Frailty was assessed using the five components of the phenotype of frailty. RESULTS The results revealed that changes in frailty moderated changes in social participation (β = 3.229, 95% CI: 2.212, 4.245), social contact with friends (β = 4.980, 95% CI: 3.285, 6.675), and social support from friends (β = 2.406, 95% CI: 1.894, 2.917), children (β = 2.957, 95% CI: 1.932, 3.982), partner (β = 4.170, 95% CI: 3.036, 5.305) and extended family (β = 6.619, 95% CI: 2.309, 10.923) with changes in cognitive function and depressive symptoms, but not with chronic diseases. These results highlight the beneficial role of social relationships in declining depressive symptoms and improving cognitive health among older adults experiencing increases in frailty. CONCLUSIONS The findings suggest that changes in social support have a protective and compensatory role in decreasing depressive symptoms and enhancing cognitive health among older adults with increasing frailty. Public health policy and strategies should consider the impact of social support on multiple health outcomes among older adults with increasing frailty. Further experimental studies and interventions are warranted to extend findings on the relationships between social relationships and health outcomes, targeting frail older adults. Future studies may also consider other health-related risk factors that may impact the associations between social relationships and health outcomes among older adults.
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Affiliation(s)
- Fereshteh Mehrabi
- School of Public Health, Université de Montréal, Montréal, Québec, Canada.
- Department of Psychology, Concordia University, Montréal, Québec, Canada.
| | - François Béland
- School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
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Hashimoto K, Takeuchi T, Ihara K, Obuchi S, Kawai H, Hirano H, Fujiwara Y, Hunkyung K, Watanabe Y, Hashizume M. Association Between Ego-Resilience and Social Isolation Among Urban Older People. Gerontol Geriatr Med 2024; 10:23337214241238069. [PMID: 38487274 PMCID: PMC10938606 DOI: 10.1177/23337214241238069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/17/2024] Open
Abstract
Social isolation among older adults affects their physical and mental health. Ego-resilience is associated with flexible adaptation to various environments and acceptable behaviors. However, its association with social isolation among older people is unclear. Therefore, a health survey was conducted with 510 adults aged 65 years or older to assess social isolation, its associated factors, and ego resilience. The results showed that the social isolation group had a lower median ego-resiliency scale score (42.0) compared to the non-social isolation group (38.0). The social isolation group were mostly males without spouses, took time to move, had more depressive moods, and poorer subjective health status. The non-social isolated group had faster maximum walking speed. Low ego-resilience was newly identified as a factor associated with social isolation among older people, as were being male, having no spouse, and depressive symptoms. Mediation analysis revealed that ego-resilience affected social isolation and was partially mediated by depressive symptoms.
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Affiliation(s)
- Kazuaki Hashimoto
- Toho University Faculty of Medicine, Tokyo, Japan
- Hirosaki University Graduate School of Medicine, Aomori, Japan
| | | | - Kazushige Ihara
- Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kim Hunkyung
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yutaka Watanabe
- Hokkaido University Faculty of Dental Medicine, Sapporo, Japan
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Chen M, Cao X, Wang A, Zhu Y, Lu G, Zhang L, Shen L. A global perspective on risk factors for social isolation in community-dwelling older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 116:105211. [PMID: 37837787 DOI: 10.1016/j.archger.2023.105211] [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: 05/18/2023] [Revised: 09/16/2023] [Accepted: 09/23/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE Older people's physical and mental health are now significantly impacted by social isolation, a major threat to public health. Our goal was to identify the connections between risk factors and social isolation among this population across various geographic areas. METHODS Seven databases were thoroughly searched, from their inception until April 2023. Inclusion and exclusion criteria were used to choose the studies. For the included cross-sectional studies, we used the Agency for Healthcare Research and Quality (AHRQ) to assess the probability of bias, and the Newcastle-Ottawa scale for the cohort studies. The statistical analysis was performed using STATA 15 to calculate pooled odds ratios (OR) and 95% CI. RESULTS All 3043 papers were carefully examined, and 42 satisfied the criteria for inclusion. The results indicated that multi-domain risk factors and social isolation among older persons worldwide are significantly correlated. These multi-domain risk factors included biological factors, socioeconomic factors, and psychological and behavioral factors. It is also important to note that these factors may vary from region to region. CONCLUSION Many domain factors were linked to social isolation in older individuals living in communities throughout the world. To develop effective strategies for controlling social isolation, it is crucial to conduct assessments of social isolation risk factors in local communities.
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Affiliation(s)
- Meiqian Chen
- Department of Scientific Research, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, 1558 Sanhuan North Road, Huzhou, Zhejiang, 313000, China; School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China
| | - Xiang Cao
- School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China
| | - Afeng Wang
- School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China
| | - Yi Zhu
- School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China
| | - Guanzhen Lu
- Department of Scientific Research, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, 1558 Sanhuan North Road, Huzhou, Zhejiang, 313000, China; School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China.
| | - Li Zhang
- Department of Scientific Research, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, 1558 Sanhuan North Road, Huzhou, Zhejiang, 313000, China
| | - Lijuan Shen
- School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China
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Yu J, Jin Y, Si H, Bian Y, Liu Q, Li Y, Wang C. Relationship between intrinsic capacity and health-related quality of life among community-dwelling older adults: the moderating role of social support. Qual Life Res 2024; 33:267-280. [PMID: 37845404 DOI: 10.1007/s11136-023-03520-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: 09/18/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE To examine how social support might moderate the relationship between intrinsic capacity and health-related quality of life (HRQoL) based on the buffering model of social support. METHODS This was a cross-sectional study with a sample of 1181 Chinese community-dwelling older adults aged ≥ 60 years in 2016. Social support was assessed using the Social Support Rating Scale. Intrinsic capacity was assessed using the revised integrated care for older people screening tool. HRQoL was measured by the 12-item Short Form Health Survey. Hierarchical linear regression analysis was implemented to test the moderating effect of social support. RESULTS Support utilization attenuated the relationship between lower intrinsic capacity and poor physical HRQoL while subjective support attenuated the relationship between lower intrinsic capacity and poor mental HRQoL. However, objective support had no significant moderating effect on the relationship between intrinsic capacity and specific domains of HRQoL. CONCLUSION The moderating effects of social support on the association between intrinsic capacity and HRQoL vary by support types. Effective interventions should target the perception and utilization of available support among older adults with lower intrinsic capacity to maintain their physical and mental HRQoL.
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Affiliation(s)
- Jiaqi Yu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yaru Jin
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Huaxin Si
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yanhui Bian
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Qinqin Liu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yanyan Li
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Cuili Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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13
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Huang L, Wu H, Zhang F, Zhao H, Chen Y, Feng M, You Y, Peng X, Guan C, Liu Y. Factors associated with the perceived need for assistance from voluntary services in home-based older adults in Chinese urban areas: a cross-sectional study. BMC Geriatr 2023; 23:624. [PMID: 37803264 PMCID: PMC10557159 DOI: 10.1186/s12877-023-04354-7] [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: 05/30/2022] [Accepted: 09/25/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND With China's rapidly aging population, meeting the diverse care needs of senior citizens is becoming more challenging. Although voluntary social services have numerous advantages and are popular among older adults, there is little information on the need for assistance from volunteer-based social services, particularly those with a medical background, and influencing factors among urban home-based older adults. This study aimed to assess the need for assistance from voluntary services and related factors among urban home-based older adults in China. METHODS A cross-sectional study was conducted in 2022 on communities in four cities in China. The 27-item Home-Based Older Adults Assistance Need Scale was used to measure the assistance needs of 498 participants aged 60 and above. Multiple linear regression models were conducted to identify salient variables associated with the need for assistance from voluntary services. RESULTS The mean score of the need for assistance from voluntary services was 88.60 ± 24.37. The mean scores of the items examining four dimensions, namely, health maintenance, visiting communication, social intercourse, and daily life, were 3.64 ± 1.08, 3.49 ± 1.04, 3.33 ± 1.08, and 2.78 ± 1.08, respectively. The level of depression, willingness to assist older adults, attaching importance to health preservation, ability to self-comfort, desire to accept assistance from others, and the presence of more children or none at all were all positively correlated with the perceived need for assistance from voluntary services. In contrast, social care obtained from visiting medical institutions was negatively correlated. These seven factors explained 28.5% of the total variance. CONCLUSIONS Urban home-based older adults in China were found to have significant requirements for assistance from volunteer services, and several complex factors were associated with more significant assistance needs. These findings may encourage the extremely limited numbers of social volunteers, particularly those with a medical background, to identify priorities in providing assistance services to the large numbers of urban home-based older adults and thus improve service delivery.
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Affiliation(s)
- Lei Huang
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hongyan Wu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Fengjian Zhang
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Huimin Zhao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yuqin Chen
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Mingjiao Feng
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yanjie You
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao Peng
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Chunyan Guan
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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14
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Yoshida T, Mori T, Shimizu H, Tachibana A, Yoshino Y, Ochi S, Yamazaki K, Ozaki Y, Kawabe K, Horiuchi F, Komori K, Iga JI, Ueno SI. Analysis of factors related to cognitive impairment in a community-based, complete enumeration survey in Japan: the Nakayama study. Psychogeriatrics 2023; 23:876-884. [PMID: 37483119 DOI: 10.1111/psyg.13012] [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: 04/03/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND The number of patients with cognitive disorders is rapidly increasing in the world, becoming not only a medical problem, but also a social problem. There have been many reports that various factors are associated with cognitive dysfunction, but the factors have not yet been fully identified. This was a community-based complete enumeration study which aimed to identify risk and protective factors for dementia. METHODS The first phase included all residents aged 65 years or older in a town in Japan. They completed many examinations, such as living conditions questionnaires, physical examination, Mini-Mental State Examination, and brain magnetic resonance imaging. The participants with suspected cognitive impairment underwent additional examinations for detailed evaluation in the second phase. Statistical analysis was performed to identify risk and protective factors for dementia after all participants were diagnosed. RESULTS There were 927 participants in the baseline evaluation; 611 (65.9%) were healthy, 165 (17.8%) had mild cognitive impairment (MCI), and 151 (16.3%) had dementia. The age-standardised prevalence of dementia was 9.5%. Statistical analyses for amnestic MCI and Alzheimer's disease showed that risk factors for cognitive decline were diabetes mellitus, low activities of daily living, and living alone, and that protective factors were history of exercise and drinking habit. CONCLUSION The present findings suggest that several lifestyle-related diseases and factors are associated with cognitive decline. These results support similar findings from previous studies and will be helpful for preventing dementia in the future.
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Affiliation(s)
- Taku Yoshida
- Department of Psychiatry, Zaidan Niihama Hospital, Niihama, Japan
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Takaaki Mori
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
- Department of Psychiatry, Heisei Hospital, Ozu, Japan
| | - Hideaki Shimizu
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
- Department of Psychiatry, Heisei Hospital, Ozu, Japan
| | - Ayumi Tachibana
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
- Department of Psychiatry, Matsukaze Hospital, Shikokuchuou, Japan
| | - Yuta Yoshino
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Shinichiro Ochi
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kiyohiro Yamazaki
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yuki Ozaki
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kentaro Kawabe
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Fumie Horiuchi
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kenjiro Komori
- Department of Psychiatry, Zaidan Niihama Hospital, Niihama, Japan
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
- Office of Psychology, Department of Psychiatry, Juzen-Yurinoki Hospital, Niihama, Japan
| | - Jun-Ichi Iga
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Shu-Ichi Ueno
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
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15
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Kuang K, Huisingh-Scheetz M, Miller MJ, Waite L, Kotwal AA. The association of gait speed and self-reported difficulty walking with social isolation: A nationally-representative study. J Am Geriatr Soc 2023; 71:2549-2556. [PMID: 37000466 PMCID: PMC10524495 DOI: 10.1111/jgs.18348] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/21/2023] [Accepted: 03/07/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Mobility assessments are commonly used among older adults as risk stratification for falls, preoperative function, frailty, and mortality. We determined if gait speed and self-reported difficulty walking are similarly associated with social isolation and loneliness, which are key markers of social well-being and linked to health outcomes. METHODS We used 2015-2016 data from the National Social life Health and Aging Project (NSHAP), an in-person nationally-representative survey of 2640 community-dwelling adults ≥65 years old. We measured gait speed (timed 3-m walk: unable to walk, ≥5.7 s, and <5.7 s), and self-reported difficulty walking one block or across the room (unable, "much," "some," or "no" difficulty). Social measures included loneliness (3-item UCLA scale), social isolation (12-item scale), and individual social activities (frequency socializing, religious participation, community participation, and volunteering). We used logistic regression to determine the adjusted probability of each social measure by gait speed and difficulty walking, adjusting for sociodemographic and health characteristics, and tested for interaction terms with age. RESULTS Participants were on average 75 years old (SD = 7.1), 54% female, 9% Black/African American, and 6% Hispanic. Difficulty walking one block was associated with (p < 0.05): social isolation (much difficulty: 26% vs no difficulty: 18%), low socializing (33% vs 19%), low volunteering (67% vs 53%), low community participation (54% vs 43%), low religious participation (51% vs 46%), and loneliness (25% vs 14%). Difficulty walking across the room was similarly strongly associated with social isolation and individual activities. The association between self-reported difficulty walking and social isolation was stronger at older ages (p-value of interaction <0.001). CONCLUSIONS Self-reported mobility difficulty is a widely used clinical assessment that is strongly associated with loneliness and social isolation, particularly at older ages. Among persons with limited mobility, clinicians should consider a careful social history to identify social needs and interventions addressing mobility to enhance social connections.
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Affiliation(s)
- Kathy Kuang
- University of Arizona College of Medicine – Tucson, Tucson, AZ
| | - Megan Huisingh-Scheetz
- Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, IL
| | - Matthew J. Miller
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA
| | - Linda Waite
- Department of Sociology, University of Chicago, Chicago, IL
| | - Ashwin A. Kotwal
- Division of Geriatrics, Department of Medicine, University of California, San Francisco
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center
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16
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Ma S, Lou G, Duan Y. Prevention of the social isolation of older persons: the impact of community environmental satisfaction on social isolation. Front Public Health 2023; 11:1177483. [PMID: 37342271 PMCID: PMC10278941 DOI: 10.3389/fpubh.2023.1177483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/09/2023] [Indexed: 06/22/2023] Open
Abstract
Background To explore how to prevent the social isolation of the older adult, this study constructed a model of the influence of community environmental satisfaction on the social isolation of the older adult from the three dimensions of environmental facilities, transportation, and supporting facilities around the community. Methods: The social network scale and environmental satisfaction scale were used to collect the sample data of nine communities in Xi'an, and the maximum likelihood estimation method was used to analyze the data and test the model. Results (1) Environmental facilities, transportation, and community surrounding facilities promoted community environment satisfaction (R2 = 0.904). Among them, environmental facilities (β = 0.869) had the greatest impact on community environmental satisfaction, followed by transportation (β = 0.118), and surrounding facilities (β = 0.084) had the least impact on community environmental satisfaction. (2) Environmental satisfaction had a direct positive impact on social isolation. Among them, the impact of environmental satisfaction on friend isolation (R2 = 0.895, β = 0.829) was greater than that on family isolation (R2 = 0.718, β = 0.747). Conclusion Environmental satisfaction can directly affect the social isolation of the older adult in the community and can be used as an intermediate variable of environmental facilities, transportation, and surrounding facilities in the community so that it can indirectly affect the social isolation of the older adult. The results of this study provide a scientific basis for the design of aging environments in the future.
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Affiliation(s)
- Sen Ma
- College of Landscape Architecture and Arts, Northwest A&F University, Xianyang, China
| | - Gang Lou
- College of Landscape Architecture and Arts, Northwest A&F University, Xianyang, China
| | - Yifan Duan
- College of Architecture, Chang’an University, Xi’an, China
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17
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On the triple exclusion of older adults during COVID-19: Technology, digital literacy and social isolation. SOCIAL SCIENCES & HUMANITIES OPEN 2023; 8:100511. [PMID: 37021073 PMCID: PMC10060191 DOI: 10.1016/j.ssaho.2023.100511] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 03/15/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023]
Abstract
During the COVID-19 pandemic, the relationship between older adults and digital technology became complicated. Prior to the pandemic, some older adults may have faced a double exclusion due to a lack of digital literacy and social interaction, and the pandemic-imposed transition to nearly all aspects of life being online magnified the requirement for people to be increasingly digitally literate. This paper presents an exploratory analysis to understand how the increased online nature of the world during the pandemic may have impacted older adults’ relationship with digital technology by conducting an expansion on a prior study of older adults who, pre-pandemic, self-identified as occasional or non-users of digital technology. Follow-up interviews were conducted with 12 of these people during the pandemic. Our findings demonstrate the ways that their risk of precarity became heightened and how they began to use digital technology more frequently, strengthening and applying their digital literacy skills to remain virtually connected with friends and family. Further, the paper advances the concept of a triple exclusion for older adults who are non-users of digital technology and describes how digital literacy and remaining virtually connected can work in tandem, helping older adults to remain included in society.
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18
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Factors Associated With Social Isolation in Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2023; 24:322-330.e6. [PMID: 36549651 DOI: 10.1016/j.jamda.2022.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Social isolation is a global health issue that affects older adults throughout their lives. This study aimed to identify the factors associated with social isolation in older adults. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Adults aged 60 years and older. METHODS We searched for observational studies without language restrictions in 11 databases from inception to August 2022. Pooled odds ratio (OR) and 95% CI were calculated using the R software (version 4.2.1). The modified Newcastle-Ottawa Scale was used to evaluate the risk of bias. RESULTS Eighteen factors were grouped into 5 themes. The following 13 factors were statistically significant: (1) demographics theme: aged 80 years and older (OR: 2.41; 95% CI: 1.20-4.85), less than or equal to a high school degree (OR: 1.68; 95% CI: 1.44-1.97), smoking (OR: 1.43; 95% CI: 1.18-1.73), and male (OR: 1.38; 95% CI: 1.01-1.89); (2) environment theme: low social support (OR: 7.77; 95% CI: 3.45-17.50) and no homeownership (OR: 1.38; 95% CI: 1.25-1.51); (3) role theme: no social participation (OR: 3.18; 95% CI: 1.30-7.80) and no spouse (OR: 2.61; 95% CI: 1.37-4.99); (4) physical health: hearing loss (OR: 2.78; 95% CI: 1.54-5.01), activities of daily living impairment (OR: 2.38; 95% CI: 1.57-3.61), and poor health status (OR: 1.52; 95% CI: 1.32-1.74); and (5) mental health: cognitive decline (OR: 1.85; 95% CI: 1.40-2.45) and depression (OR: 1.72; 95% CI: 1.21-2.44). CONCLUSIONS AND IMPLICATIONS Social isolation in older adults is associated with various factors. Hence, focused intervention should be adopted for older adults. In addition, further longitudinal studies are required to confirm a direct link between multiple factors and social isolation.
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19
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Siqeca F, Yip O, Mendieta MJ, Schwenkglenks M, Zeller A, De Geest S, Zúñiga F, Stenz S, Briel M, Quinto C, Blozik E, Deschodt M, Obas K, Dhaini S. Factors associated with health-related quality of life among home-dwelling older adults aged 75 or older in Switzerland: a cross-sectional study. Health Qual Life Outcomes 2022; 20:166. [PMID: 36544173 PMCID: PMC9773624 DOI: 10.1186/s12955-022-02080-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND HRQoL is an indicator of individuals' perception of their overall health, including social and environmental aspects. As a multidimensional concept, HRQoL can be influenced by a multitude of factors. Studies of HRQoL and factors associated with it among home-dwelling older adults have often been limited to inpatient settings or to a sub-population with a chronic disease. Studying HRQoL and its correlating factors among this population, by providing an ecological lens on factors beyond the individual level, can provide a better understanding of the construct and the role of the environment on how they perceive their HRQoL. Thus, we aimed to assess the HRQoL and investigate the correlates of HRQOL among home-dwelling older adults, guided by the levels of the ecological model. METHODS This is a cross-sectional population survey conducted in 2019 in Canton Basel-Landschaft, in northwestern Switzerland, and includes a sample of 8786 home-dwelling older adults aged 75 and above. We assessed HRQoL by using the EQ-index and the EQ-VAS. The influence of independent variables at the macro, meso and micro level on HRQoL was tested using Tobit multiple linear regression modelling. RESULTS We found that having a better socio-economic status as denoted by higher income, having supplementary insurance and a higher level of education were all associated with a better HRQoL among home-dwelling older adults. Furthermore, being engaged in social activities was also related to an improved HRQoL. On the other hand, older age, female gender, presence of multimorbidity and polypharmacy as well as social isolation and loneliness were found to all have a negative impact on HRQoL. CONCLUSIONS Understanding factors related to HRQoL by using an ecological lens can help identify factors beyond the individual level that impact the HRQoL of home-dwelling older adults. Our study emphasises the importance of social determinants of health and potential disparities that exists, encouraging policymakers to focus on policies to reduce socio-economic disparities using a life-course approach, which consequently could also impact HRQoL in later stages of life.
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Affiliation(s)
- Flaka Siqeca
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Nursing Science, University of Basel, 4051 Basel, Switzerland
| | - Olivia Yip
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Nursing Science, University of Basel, 4051 Basel, Switzerland
| | - Maria José Mendieta
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Nursing Science, University of Basel, 4051 Basel, Switzerland ,grid.5596.f0000 0001 0668 7884Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, 3000 Leuven, Belgium
| | - Matthias Schwenkglenks
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Pharmaceutical Medicine (ECPM), University of Basel, 4051 Basel, Switzerland
| | - Andreas Zeller
- grid.6612.30000 0004 1937 0642Department of Clinical Research, Center for Primary Health Care, University of Basel, 4051 Basel, Switzerland
| | - Sabina De Geest
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Nursing Science, University of Basel, 4051 Basel, Switzerland ,grid.5596.f0000 0001 0668 7884Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, 3000 Leuven, Belgium
| | - Franziska Zúñiga
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Nursing Science, University of Basel, 4051 Basel, Switzerland
| | - Samuel Stenz
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Nursing Science, University of Basel, 4051 Basel, Switzerland
| | - Matthias Briel
- grid.410567.1Department of Clinical Research, Division of Clinical Epidemiology, University Hospital Basel and University of Basel, 4051 Basel, Switzerland ,grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Carlos Quinto
- Aerztegesellschaft Baselland, 4132 Muttenz, Switzerland
| | - Eva Blozik
- Helsana-Gruppe, 8001 Zurich, Switzerland ,grid.412004.30000 0004 0478 9977Institute of Primary Care, University of Zurich and University Hospital of Zurich, 8091 Zurich, Switzerland
| | - Mieke Deschodt
- grid.5596.f0000 0001 0668 7884Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, 3000 Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Competence Center of Nursing, University Hospitals Leuven, Leuven, Belgium
| | - Katrina Obas
- grid.416786.a0000 0004 0587 0574Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland
| | - Suzanne Dhaini
- grid.6612.30000 0004 1937 0642Department of Public Health, Institute of Nursing Science, University of Basel, 4051 Basel, Switzerland
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20
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Ngiam NHW, Yee WQ, Teo N, Yow KS, Soundararajan A, Lim JX, Lim HA, Tey A, Tang KWA, Tham CYX, Tan JPY, Lu SY, Yoon S, Ng KYY, Low LL. Building Digital Literacy in Older Adults of Low Socioeconomic Status in Singapore (Project Wire Up): Nonrandomized Controlled Trial. J Med Internet Res 2022; 24:e40341. [PMID: 36459398 DOI: 10.2196/40341] [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: 06/16/2022] [Revised: 09/05/2022] [Accepted: 11/13/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND In a rapidly digitalizing world, the inability of older adults to leverage digital technology has been associated with weaker social connections and poorer health outcomes. Despite the widespread digital adoption in Singapore, older adults, especially those of lower socioeconomic status (SES), still face difficulties in adopting information and communications technology and are typically digitally excluded. OBJECTIVE We aimed to examine the impact of the volunteer-led, one-on-one, and home-based digital literacy program on digital literacy and health-related outcomes such as self-reported loneliness, social connectedness, quality of life, and well-being for older adults of low SES. METHODS A nonrandomized controlled study was carried out in Singapore between July 2020 and November 2021 involving 138 digitally excluded community-dwelling older adults aged ≥55 years and of lower SES. Older adults awaiting participation in the program served as controls. Older adults under the intervention were equipped with a smartphone and cellular data, underwent fortnightly to monthly digital literacy training with volunteers to learn digital skills, and digitally connected to their existing social networks. Primary outcome was the improvement in self-reported digital literacy. Secondary outcomes included improvements in University of California, Los Angeles 3-item loneliness scale, Lubben Social Network Scale-6, EQ-5D-3L and EQ visual analogue scale scores, and Personal Wellbeing Score. RESULTS There were significant improvements in digital literacy scores in the intervention group as compared to controls (mean difference 2.28, 95% CI 1.37-3.20; P<.001). Through multiple linear regression analyses, this difference in digital literacy scores remained independently associated with group membership after adjusting for differences in baseline scores, age, gender, education, living arrangement, housing type, and baseline social connectivity and loneliness status. There was no statistically significant difference in University of California, Los Angeles 3-item loneliness scale, Lubben Social Network Scale-6, Personal Wellbeing Score, or EQ-5D Utility and visual analogue scale score. CONCLUSIONS This study adds to the growing research on digital inclusion by showing that a volunteer-led, one-on-one, and home-based digital literacy program contributed to increase digital literacy in older adults of low SES. Future studies should look into developing more older adult-friendly digital spaces and technology design to encourage continued digital adoption in older adults and, eventually, impact health-related outcomes.
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Affiliation(s)
- Nerice Heng Wen Ngiam
- TriGen - Trigenerational Homecare, Singapore, Singapore.,Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore.,Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore
| | - Wan Qi Yee
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Nigel Teo
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Ka Shing Yow
- TriGen - Trigenerational Homecare, Singapore, Singapore.,Department of Internal Medicine, National University Health System, Singapore, Singapore
| | - Amrish Soundararajan
- TriGen - Trigenerational Homecare, Singapore, Singapore.,Department of Family Medicine, National University Health System, Singapore, Singapore
| | - Jie Xin Lim
- TriGen - Trigenerational Homecare, Singapore, Singapore.,Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
| | - Haikel A Lim
- TriGen - Trigenerational Homecare, Singapore, Singapore.,Department of Psychiatry, National Healthcare Group, Singapore, Singapore.,Medical Education Office, Duke-NUS Medical School, Singapore, Singapore
| | - Angeline Tey
- TriGen - Trigenerational Homecare, Singapore, Singapore.,Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore.,Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Kai Wen Aaron Tang
- TriGen - Trigenerational Homecare, Singapore, Singapore.,Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore.,Department of Psychiatry, National Healthcare Group, Singapore, Singapore
| | - Celine Yi Xin Tham
- TriGen - Trigenerational Homecare, Singapore, Singapore.,Medical Social Services, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Jamaica Pei Ying Tan
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Si Yinn Lu
- Research and Translational Innovation Office, SingHealth Community Hospitals, Singapore, Singapore
| | - Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, Singapore
| | - Kennedy Yao Yi Ng
- TriGen - Trigenerational Homecare, Singapore, Singapore.,Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore.,Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Lian Leng Low
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore.,Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore, Singapore.,SingHealth Duke-NUS Department of Family Medicine, Singapore, Singapore.,Outram Community Hospital, SingHealth Community Hospitals, Singapore, Singapore
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21
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Morgan E, Caba AE, Eaton LA, Watson RJ. PrEP Access Affected by COVID-19 Is Associated With Increased Odds of HIV Seroconversion. J Acquir Immune Defic Syndr 2022; 91:138-143. [PMID: 36094479 PMCID: PMC10284373 DOI: 10.1097/qai.0000000000003036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/02/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT Black and Hispanic/Latino sexual minority men and gender diverse (SMMGD) individuals report lower uptake and adherence to pre-exposure prophylaxis (PrEP) compared with White SMMGD. For some, the COVID-19 pandemic has resulted in reduced access to PrEP prescriptions and related changes to PrEP use, yet little is known how pandemic-related changes to PrEP access and sexual activity might influence sexually transmitted infection (STI) status and HIV seroconversion among SMMGD of color. We used data from 4 waves of a national study of Black and Hispanic/Latino SMMGD's HIV, PrEP, and health experiences to assess whether self-reported changes to sexual activity were associated with STI status, and whether self-reported changes to PrEP access were associated with HIV seroconversion. Those who reported greater impact to their sexual activity during the pandemic [adjusted odds ratio (aOR) = 1.24; 95% confidence interval (CI): 1.10 to 1.40] and a greater number of sexual partners (aOR = 1.29; 95% CI: 1.21 to 1.38) were more likely to report a positive STI test. In addition, we found that compared with those who did not report pandemic-related changes to PrEP access, those who did report changes to PrEP access had significantly higher odds of HIV seroconversion during the study period (aOR = 2.80; 95% CI: 1.02 to 7.68). These findings have implications for HIV and STI prevention and highlight the importance of novel interventions to improve PrEP access among Black and Hispanic/Latino SMMGD. Importantly, these findings also demonstrate the need to stay focused on key populations at risk of HIV infection during emerging public health crises to avoid an increase in rates of new diagnoses.
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Affiliation(s)
- Ethan Morgan
- College of Nursing, The Ohio State University, Columbus, OH
- Infectious Disease Institute, The Ohio State University, Columbus, OH
| | - Antonia E. Caba
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, US
| | - Lisa A. Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, US
| | - Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, US
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22
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Older Women Who Practiced Physical Exercises before the COVID-19 Pandemic Present Metabolic Alterations and Worsened Functional Physical Capacity after One Year of Social Isolation. Healthcare (Basel) 2022; 10:healthcare10091736. [PMID: 36141348 PMCID: PMC9498301 DOI: 10.3390/healthcare10091736] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/03/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Because the consequences of the lifestyle changes in older adults associated with the social isolation imposed in response to the COVID-19 pandemic are not fully understood, here, we investigated the effects of one year of social isolation imposed by COVID-19 on the metabolic parameters and functional physical capacity of older women who regularly practiced physical exercises before the pandemic. Methods: Systemic lipid and protein profiles, estimated creatinine clearance (ECC), and functional physical capacity (FPC) were assessed before (January-February 2020) and 12 months after social isolation in 30 older women (mean age 73.77 ± 6.22) who were engaged in a combined-exercise training program for at least 3 years before the COVID-19 pandemic. Results: In this group, we observed increased plasma levels of triglycerides and creatinine, an increase in the time necessary to perform gait speed and time-up-and-go tests, and reduced muscle strength assessed by the handgrip test and ECC post-COVID-19 pandemic relative to values recorded pre-pandemic. In addition, we observed significant correlations (both negative and positive) between anthropometric, some metabolic parameters, and physical tests. Conclusion: One year of interruption of physical exercise practice imposed in response to the COVID-19 pandemic significantly altered some systemic metabolic parameters and worsened ECC and FPC in older women.
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23
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Freytag J, Touchett HN, Bryan JL, Lindsay JA, Gould CE. Advances in Psychotherapy for Older Adults Using Video-to-Home Treatment. ADVANCES IN PSYCHIATRY AND BEHAVIORAL HEALTH 2022; 2:71-78. [PMID: 38013747 PMCID: PMC9458515 DOI: 10.1016/j.ypsc.2022.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Providing telemental health services to older adults has become especially important during the COVID-19 pandemic. Video-to-home (VTH) treatment is an effective treatment modality; research shows that older adults are open to using VTH. However, there are unique barriers to using VTH with older adults. Barriers include access to technology, acceptance of technology, and physical and cognitive limitations. Additional concerns include establishing rapport with older patients and the policy and ethical concerns surrounding the use of VTH. Methods of addressing these barriers have been developed, and more research is needed to develop evidence-based VTH practice.
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Affiliation(s)
- Jennifer Freytag
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX 77030, USA
- VA South Central Mental Illness Research, Education and Clinical Center, 2200 Fort Roots Drive, Bldg. 58, North Little Rock, AR 72114, USA
| | - Hilary N Touchett
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX 77030, USA
- VA South Central Mental Illness Research, Education and Clinical Center, 2200 Fort Roots Drive, Bldg. 58, North Little Rock, AR 72114, USA
| | - Jennifer L Bryan
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX 77030, USA
- VA South Central Mental Illness Research, Education and Clinical Center, 2200 Fort Roots Drive, Bldg. 58, North Little Rock, AR 72114, USA
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA 94305-5101, USA
| | - Jan A Lindsay
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, (MEDVAMC 152), 2002 Holcombe Boulevard, Houston, TX 77030, USA
- VA South Central Mental Illness Research, Education and Clinical Center, 2200 Fort Roots Drive, Bldg. 58, North Little Rock, AR 72114, USA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Lee and Joe Jamail Specialty Care Center, 1977 Butler Boulevard, Houston, TX 77030, USA
| | - Christine E Gould
- Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304-1207, USA
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 291 Campus Drive, Li Ka Shing Building, Stanford, CA 94305-5101, USA
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24
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Kojima G, Aoyama R, Tanabe M. Associations Between Social Isolation and Physical Frailty in Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2022; 23:e3-e6. [PMID: 35810790 PMCID: PMC9263479 DOI: 10.1016/j.jamda.2022.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/07/2022] [Accepted: 06/12/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Gotaro Kojima
- Department of Japanese Studies, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Reijiro Aoyama
- Department of Japanese Studies, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Marianne Tanabe
- Veterans Affairs Pacific Islands Health Care System, Honolulu, HI, USA
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25
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Hu RX, Li LW. Social Disconnectedness and Loneliness: Do Self-Perceptions of Aging Play a Role? J Gerontol B Psychol Sci Soc Sci 2022; 77:936-945. [PMID: 35085397 PMCID: PMC9071429 DOI: 10.1093/geronb/gbac008] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES Research suggests that self-perceptions of aging (SPA) have effects on physical, mental, cognitive, and emotional well-being among older adults. Few studies have examined the effects of SPA on social well-being. This study investigates the association of SPA with trajectories of social disconnectedness and loneliness in older Americans and explores mechanisms linking SPA and the 2 forms of social isolation. METHODS We conducted Latent Growth Curve Modeling and path analysis using 3-wave data spanning 8 years (2008/2010-2016/2018) from the Health and Retirement Study. The sample included respondents aged 65 and older (N = 3,597) at baseline (2008/2010). SPA was measured by the Attitudes Toward Own Aging Scale. Social disconnectedness was an index including 6 indicators of social networks and social engagement. Loneliness was measured using the 11-item UCLA Loneliness Scale. RESULTS Older adults with more negative SPA at baseline were more lonely but had slower rates of increase in loneliness during the 8-year study period. More negative SPA also predicted greater social disconnectedness but was not significantly related to the rate of change in social disconnectedness over time. The effects of SPA on social disconnectedness were primarily indirect through loneliness, whereas SPA had direct effects on loneliness. Overall, SPA had a stronger association with loneliness than with social disconnectedness. DISCUSSION The results suggest that older adults with negative SPA are at risk of loneliness which then leads to social disconnectedness. Asking about SPA during individual assessment with older adults may help to discern issues with loneliness.
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Affiliation(s)
- Rita Xiaochen Hu
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Lydia W Li
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
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26
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Ho V, Merchant RA. The Acceptability of Digital Technology and Tele-Exercise in the Age of COVID-19: Cross-sectional Study. JMIR Aging 2022; 5:e33165. [PMID: 35294921 PMCID: PMC9009381 DOI: 10.2196/33165] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/14/2022] [Accepted: 03/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND With the COVID-19 pandemic, telehealth has been increasingly used to offset the negative outcomes of social isolation and functional decline in older adults. Crucial to the success of telehealth is end user adoption. OBJECTIVE This study aims to investigate perception and acceptability of digital technology among Asian older adults. METHODS The Healthy Ageing Promotion Program for You (HAPPY) dual-task exercise was conducted virtually to participants aged ≥60 years. Questionnaires were administered digitally and collected data on demographics, perceptions of digital technology and evaluation of HAPPY, the 6-item Lubben Social Network Scale, intrinsic capacity using the Integrated Care for Older People tool, and a functional screening with the FRAIL scale and five chair rises. Descriptive analysis was used. RESULTS A total of 42 participants were digitally interviewed. The mean age was 69.1 (4.7) years. Hearing, vision, and 3-item recall difficulty were present in 14% (n=6), 12% (n=5), and 24% (n=10) of participants, respectively. Of the participants, 29% (n=12) had possible sarcopenia and 14% (n=6) were prefrail. Around 24% (n=10) were at risk of social isolation. Most of the participants (n=38, 91%) agreed that technology is good, and 79% (n=33) agreed that technology would allow them to be independent for longer. Over three-quarters of participants (n=33, 79%) agreed that they have the necessary knowledge, and 91% (n=38) had technological assistance available. However, 57% (n=24) were still apprehensive about using technology. Despite 71% (n=30) of older adults owning their devices, 36% (n=15) felt finances were limiting. Through digital HAPPY, 45% (n=19) of participants reported feeling stronger, 48% (n=20) had improved spirits, and 40% (n=17) and 38% (n=16) had improved mood and memory, respectively. CONCLUSIONS The majority of older adults in this study believed in digital technology and had the necessary knowledge and help, but almost half still felt apprehensive and had financial barriers to adopting technology. A digitally administered exercise program especially in a group setting is a feasible option to enhance intrinsic capacity in older adults. However, more work is needed in elucidating sources of apprehension and financial barriers to adopting technology.
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Affiliation(s)
- Vanda Ho
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Reshma A Merchant
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
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27
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Li Q, Zhang Q, Zhang S, Du M, Wang X, Hu S, Li L. Relationship between frailty and cognitive decline in Chinese older patients with Alzheimer's disease: The mediating role of social contact. Geriatr Nurs 2021; 43:175-181. [PMID: 34911018 DOI: 10.1016/j.gerinurse.2021.11.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 12/13/2022]
Abstract
This study aimed to evaluate the effects of frailty and social contact on cognitive decline among Chinese older patients with Alzheimer's disease (AD), and examine the mediating role of social contact between frailty and cognitive decline. A total of 205 eligible participants were recruited from a tertiary A hospital in Anhui province, China. A structural equation modeling was conducted to test the hypothetical mediating model. Frailty and cognitive decline were significantly and negatively correlated with social contact. Meanwhile, frailty exerted a significant positive effect on cognitive decline. The indirect effect of frailty on the cognitive decline through social contact was 0.401. Social contact could exert a partial mediating effect on the relationship between frailty and cognitive decline in this population. These findings could help guide effective interventions to improve the cognitive abilities of AD patients, thereby reducing the burden of this population on their caregivers.
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Affiliation(s)
- Qingfeng Li
- Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Qianqian Zhang
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Shuping Zhang
- Department of Emergency Surgery, The Fourth Affiliated Hospital of Anhui Medical University, Hefei 230011, China
| | - Mingchao Du
- Department of Information Centre, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Xia Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Shaohua Hu
- Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Lunlan Li
- Department of Personnel, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
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28
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Freed SA, Sprague BN, Stephan AT, Doyle CE, Tian J, Phillips CB, Ross LA. Feasibility and Enjoyment of Exercise Video Games in Older Adults. Front Public Health 2021; 9:751289. [PMID: 34805074 PMCID: PMC8602072 DOI: 10.3389/fpubh.2021.751289] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Several interventions have been developed to enhance social connectedness among older adults. However, little research has demonstrated their performance in a social distancing environment. Exergames are not only beneficial to older adults' physical and cognitive health, but they also allow players to interact with each other at a distance, which can reduce loneliness and increase social connection. The aim of this pilot study was to investigate older adults' perceptions of two commercially available exergames. Methods: Twenty healthy community-dwelling older adults (M age = 73.30, SD = 5.95, range = 65–84 years, 80% women) were recruited in this pilot study between July 2019 and February 2020. They were asked to play two exergames for 10 min each on the Xbox One with Kinect console: Just Dance and Kinect Sports Rivals. After gameplay, they provided both quantitative and qualitative feedback on these games. Results: Participants reported an average rating for exergame enjoyment. Greater enjoyment was significantly related with younger age and greater extraversion but not gender. Participants were highly motivated to do well on the games but reported lower scores for likelihood of playing these games in the future. Greater likelihood of future play was associated with younger age but not gender or extraversion. “Not aerobic or strengthen enough; not enough exertion,” and “slower movements, repetition, clear purpose of doing the exercise” were some factors that would influence their decision to buy and play these games. Discussion: The preliminary results of this pilot study suggest that exergames may help address social isolation and loneliness—particularly during times of social distancing. Before applying exergames as a social isolation or loneliness intervention for older adults, study replication in larger representative studies and future work that examines important design issues related to older adults' experiences with these games is needed.
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Affiliation(s)
- Sara A Freed
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, State College, PA, United States
| | - Briana N Sprague
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Abigail T Stephan
- Department of Education and Human Development, Institute for Engaged Aging, Clemson University, Clemson, SC, United States
| | - Cassidy E Doyle
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, State College, PA, United States
| | - Junyan Tian
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, State College, PA, United States
| | - Christine B Phillips
- Department of Psychology, Institute for Engaged Aging, Clemson University, Clemson, SC, United States
| | - Lesley A Ross
- Department of Psychology, Institute for Engaged Aging, Clemson University, Clemson, SC, United States
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29
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Cayenne NA, Jacobsohn GC, Jones CMC, DuGoff EH, Cochran AL, Caprio TV, Cushman JT, Green RK, Kind AJH, Lohmeier M, Mi R, Shah MN. Association between social isolation and outpatient follow-up in older adults following emergency department discharge. Arch Gerontol Geriatr 2021; 93:104298. [PMID: 33307444 PMCID: PMC7887021 DOI: 10.1016/j.archger.2020.104298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/01/2020] [Accepted: 11/15/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Follow-up with outpatient clinicians after discharge from the emergency department (ED) reduces adverse outcomes among older adults, but rates are suboptimal. Social isolation, a common factor associated with poor health outcomes, may help explain these low rates. This study evaluates social isolation as a predictor of outpatient follow-up after discharge from the ED. MATERIALS AND METHODS This cohort study uses the control group from a randomized-controlled trial investigating a community paramedic-delivered Care Transitions Intervention with older patients (age≥60 years) at three EDs in mid-sized cities. Social Isolation scores were measured at baseline using the PROMIS 4-item social isolation questionnaire, grouped into tertiles for analysis. Chart abstraction was conducted to identify follow-up with outpatient primary or specialty healthcare providers and method of contact within 7 and 30 days of discharge. RESULTS Of 642 patients, highly socially-isolated adults reported significantly worse overall health, as well as increased anxiety, depressive symptoms, functional limitations, and co-morbid conditions compared to those less socially-isolated (p<0.01). We found no effect of social isolation on 30-day follow-up. Patients with high social isolation, however, were 37% less likely to follow-up with a provider in-person within 7 days of ED discharge compared to low social isolation (OR:0.63, 95% CI:0.42-0.96). CONCLUSION This study adds to our understanding of how and when socially-isolated older adults seek outpatient care following ED discharge. Increased social isolation was not significantly associated with all-contact follow-up rates after ED discharge. However, patients reporting higher social isolation had lower rates of in-person follow-up in the week following ED discharge.
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Affiliation(s)
- Nia A Cayenne
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Gwen Costa Jacobsohn
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States.
| | - Courtney M C Jones
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, United States; Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Eva H DuGoff
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, United States; Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States; Berkeley Research Group, Washington, DC, United States
| | - Amy L Cochran
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Thomas V Caprio
- Division of Geriatrics, Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Jeremy T Cushman
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, United States; Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Rebecca K Green
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Amy J H Kind
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States; William S. Middleton Veterans Affairs Geriatrics Research, Education, and Clinical Center, Madison, WI, United States
| | - Michael Lohmeier
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Ranran Mi
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Manish N Shah
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States; Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States; Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
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The association between social isolation and musculoskeletal health in older community-dwelling adults: findings from the Hertfordshire Cohort Study. Qual Life Res 2021; 30:1913-1924. [PMID: 33595825 PMCID: PMC8233263 DOI: 10.1007/s11136-021-02784-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 10/29/2022]
Abstract
PURPOSE Social isolation has been associated with both physical and psychological adverse outcomes and is prevalent in older adults. We investigated the impact of social isolation on bone mineral density (BMD) and physical capability in community-dwelling older adults. METHODS Data were collected in 2011 and 2017 from the Hertfordshire Cohort Study. In 2011, we assessed social isolation using the six-item Lubben Social Network Scale (LSNS-6) and the Maastricht Social Participation Profile (MSSP) and depressive and anxiety symptoms using the Hospital Anxiety and Depression Scale (HADS). Physical capability was assessed by performing tests of gait speed, chair stands, timed up and go and balance at both time points. BMD was assessed using dual X-ray absorptiometry (DXA) at both time points. RESULTS Data were available from 369 participants in 2011 and 184 in 2017. Forty percent of men and 42.4% of women were socially isolated. Isolated participants had higher odds of depressive disorder (OR 3.01, 95% CI 1.27-7.11, p < 0.02). Social isolation at baseline was associated with poor physical capability scores at follow-up (OR 5.53, 95% CI 1.09-27.99, p < 0.04). No associations were found between social isolation and BMD at either time point. CONCLUSIONS Social isolation was associated with higher odds of having depressive symptoms and predicted the development of poor physical capability 6 years later. Further longitudinal studies that include loneliness as a covariate are warranted.
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Bahat Öztürk G, Kılıç C, Bozkurt ME, Karan MA. Prevalence and Associates of Fear of Falling among Community-Dwelling Older Adults. J Nutr Health Aging 2021; 25:433-439. [PMID: 33786559 DOI: 10.1007/s12603-020-1535-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES We aimed to study the prevalence of fear of falling (FOF), and its association with physical performance, functionality, frailty, sarcopenia, and a variety of geriatric syndromes including cognitive impairment, depression, quality of life and hearing. DESIGN Retrospective, cross-sectional study. SETTING Community-dwelling older adults applied to the geriatric outpatient clinic of a university hospital. PARTICIPANTS A total of 1021community-dwelling older adults >= 60 years of age applying to the geriatric outpatient clinic of a university hospital. MEASUREMENTS We screened for falls and FOF by single close-ended questions. We performed screening and assessment of probable sarcopenia by SARC-F test and handgrip strength evaluation according to EWGSOP2. We used timed up and go test (TUG), usual gait speed (UGS) for physical performance, and Katz- activities of daily living (ADL) and Lawton-Brody instrumental activities of daily living (IADL) for functional evaluation. We screened anxiety with the Generalized Anxiety Disorder-7 scale. RESULTS The prevalence of FOF was 44.6% and falls, 37.7%. Prevalence of FOF in sarcopenia screening positive participants was 30.1%; in probable sarcopenic (35/20 kg) participants, 43.9%; in those with undernutrition, 45.7%; in fallers, 51.1%; in females, 80.4%; and in prefrail/frail was 74.7% Multivariate regression analyses revealed that female sex (OR=4.1, 95%CI= 2.0-8.4, p<0.001), anxiety (OR=2.7, 95%CI= 1.1-6.5, p=0.03) and ADL limitation (OR=2.5, 95%CI= 1.03-6.3, p=0.04) were independent associates of FOF. CONCLUSION FOF accompanied by fall experience or not is prevalent in community-dwelling older adults. It is associated with anxiety and ADL limitations apart from the female sex.
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Affiliation(s)
- G Bahat Öztürk
- Prof.Dr. Gülistan Bahat Öztürk, Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University Capa, Istanbul, Turkey, , +90532 796 9748
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Merchant RA, Tsoi CT, Tan WM, Lau W, Sandrasageran S, Arai H. Community-Based Peer-Led Intervention for Healthy Ageing and Evaluation of the 'HAPPY' Program. J Nutr Health Aging 2021; 25:520-527. [PMID: 33786571 PMCID: PMC7883995 DOI: 10.1007/s12603-021-1606-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 01/21/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Population ageing impacts many areas of society from health and social care cost to housing and future workforce, and whole-of-society approach is required to promote healthy ageing. The Decade of Healthy Ageing report has called upon multi-sectoral collaboration to promote age-friendly communities. The Healthy Ageing Promotion Program for You (HAPPY) is a community-based dual-task exercise program for older adults led by health coaches (HC) or trained volunteers (HAPPY leaders) to promote healthy ageing. The primary objective was to observe improvement in cognition. The secondary objective was to observe improvement in frailty status, functional status, perceived health and reduction of social isolation. We also aim to evaluate the effectiveness and describe the implementation of the HAPPY program. DESIGN To engage older adults with prefrailty, frailty and/or cognitive impairment in dual-task exercise program. Recruitment and publicity were through country-wide multisectoral collaboration. SETTING Community setting. PARTICIPANTS More than 700 older adults participated in ≥ 50 different sites including senior activity centres. Five hundred and sixty-nine participants attended phase 1 screening. Pre-frail or frail ambulant participants or those with underlying cognitive impairment were invited to participate in phase 2 screening. Among them 296 participants enrolled in phase 2 with 66.6% follow up rate at 3 months. MEASUREMENTS Phase 1 and 2 screening consisted of screening for frailty (FRAIL), cognition (Montreal Cognitive Assessment [MoCA]), falls, vision, grip strength, perceived health (EuroQol vertical visual analogue scale), depression (geriatric depression scale), social network (6-item Lubben Social Network Scale), gait speed and physical function (Short physical performance battery [SPPB]). RESULTS HC led 61.7% of the participants, and HAPPY was conducted twice weekly for 64% of the participants. There was significant improvement in the MoCA scores both in the HC and HAPPY leaders' led groups. Overall physical function, chair-stand and balance domain improved significantly especially in the groups led by HC and those participating in twice-weekly exercises. There was significant improvement in perceived health, reduction in social isolation, improvement in frailty status and reduction of falls at 3 months. CONCLUSION Community embedded peer-led program to promote healthy ageing like HAPPY can improve cognition, physical function, and frailty status, reduce social isolation, and improve perceived health. It takes a "village" to promote healthy ageing, and the need to have a life course approach to healthy longevity which must involve local government and ministerial organisations, non-profit organisations, industries, academia, and community to redesign health.
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Affiliation(s)
- Reshma A Merchant
- Associate Professor Reshma A Merchant, Division of Geriatric Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 119228, , ORCID iD: 0000-0002-9032-0184
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Huizenga D, Rashford L, Darcy B, Lundin E, Medas R, Shultz ST, DuBose E, Reed KB. Wearable gait device for stroke gait rehabilitation at home. Top Stroke Rehabil 2020; 28:443-455. [PMID: 33261520 DOI: 10.1080/10749357.2020.1834272] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hemiparesis is a common disabling consequence of stroke that leads to abnormal gait patterns marked by asymmetries in step length, stance, and swing phases. Asymmetric gait patterns are correlated with decreased gait velocity and increased susceptibility to falls that can lead to serious injuries and hospitalizations. OBJECTIVE In this single group, before and after study, treatment with the iStrideTM gait device, designed to improve the gait patterns of individuals with hemiparesis, is adapted to the home environment. Previously tested in clinical settings, this study investigates if using the iStrideTM gait device within the home environment can provide safe and effective gait treatment for individuals with hemiparetic gait impairments caused by stroke. METHODS Twelve 30-minute sessions of walking on the device were administered in each participant's home environment. Twenty-one participants who were more than one-year post-stroke received the treatment. The Ten-Meter Walk Test, Timed Up and Go Test, Berg Balance Scale, Functional Gait Assessment, and Stroke Specific Quality of Life Scale were performed before and one week after treatment. Safety, treatment plan compliance, and subjective responses were also recorded during the study period. RESULTS Results demonstrate statistically significant improvement on all five outcome measures from before treatment to one week after the last treatment session (p < 0.01) using two-tailed paired t-tests. 76% of participants improved beyond the small meaningful change or minimal detectable change on three or more outcome measures. 67% of participants improved clinically in gait speed and on at least one of the fall risk assessment inventories. 81% of the participants were able to perform the treatment in their home without assistance before the end of week three. CONCLUSIONS The results indicate that the iStrideTM gait device can facilitate effective, safe, and home-accessible gait treatment opportunities for individuals with hemiparesis from stroke.
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Affiliation(s)
| | | | | | | | - Ryan Medas
- Moterum Technologies, Inc., Salt Lake City, UT, USA
| | | | | | - Kyle B Reed
- Department of Mechanical Engineering, University of South Florida, Tampa, FL, USA
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Merchant RA, Chen MZ, Wong BLL, Ng SE, Shirooka H, Lim JY, Sandrasageran S, Morley JE. Relationship Between Fear of Falling, Fear‐Related Activity Restriction, Frailty, and Sarcopenia. J Am Geriatr Soc 2020; 68:2602-2608. [DOI: 10.1111/jgs.16719] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Reshma Aziz Merchant
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
- Department of Medicine Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Matthew Zhixuan Chen
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
| | - Beatrix Ling Ling Wong
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
| | - Shu Ee Ng
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
| | - Hidehiko Shirooka
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
| | - Jia Yi Lim
- Department of Medicine Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore
| | - Surein Sandrasageran
- Division of Geriatric Medicine, Department of Medicine National University Hospital Singapore Singapore
| | - John E. Morley
- Division of Geriatric Medicine Saint Louis University School of Medicine St Louis Missouri USA
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Mosen DM, Banegas MP, Tucker-Seeley RD, Keast E, Hu W, Ertz-Berger B, Brooks N. Social Isolation Associated with Future Health Care Utilization. Popul Health Manag 2020; 24:333-337. [PMID: 32780631 DOI: 10.1089/pop.2020.0106] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Social isolation among individuals ages 65 years and older is associated with poor health outcomes. However, little is known about health care utilization patterns of socially isolated individuals. This retrospective, observational study evaluated associations between social isolation and hospital and emergency department (ED) utilization among Medicare patients ages 65 years and older. In a cohort of 18,557 Medicare members age 65 years and older at Kaiser Permanente Northwest, the authors compared rates of hospitalization and ED visits in the 12 months following a baseline survey between respondents who reported feeling lonely or socially isolated and those who did not, controlling for demographic and health variables and utilization in the 12 months prior to the survey. Statistical analysis was conducted in February 2020. In adjusted models, those who reported "sometimes" experiencing social isolation were more likely to have at least 1 hospital admission (odds ratio [ORsometimes]: 1.17, 95% confidence interval [CI]: 1.01-1.35, P = 0.04), than those who "rarely" or "never" experienced social isolation. Those who experienced social isolation "sometimes" or "often/always" were more likely to have at least 1 ED visit (ORsometimes: 1.28, 95% CI: 1.15-1.41, P < 0.0001, and ORoften/always: 1.51, 95% CI: 1.25-1.84, P < 0.0001, respectively) than those who "rarely" or "never" experienced social isolation. These findings suggest that self-reported social isolation may be predictive of future hospital admissions and ED utilization. Research is needed to determine how addressing social isolation needs within the health care system affects health care utilization and health outcomes.
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Affiliation(s)
- David M Mosen
- Kaiser Permanente Center for Health Research, Portland, Oregon, USA
| | | | - Reginald D Tucker-Seeley
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Erin Keast
- Kaiser Permanente Center for Health Research, Portland, Oregon, USA
| | - Weiming Hu
- Kaiser Permanente Center for Health Research, Portland, Oregon, USA
| | - Briar Ertz-Berger
- Continuum of Care Department, Northwest Permanente, Portland, Oregon, USA
| | - Neon Brooks
- Kaiser Permanente Center for Health Research, Portland, Oregon, USA
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Merchant RA, Chen MZ, Ng SE, Sandrasageran S, Wong BLL. Letter to the Editor: The Role of a Geriatrician Has Become Even More Important in an Academic Institution during COVID-19. J Nutr Health Aging 2020; 24:681-682. [PMID: 32510123 PMCID: PMC7220849 DOI: 10.1007/s12603-020-1387-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/11/2020] [Indexed: 11/29/2022]
Affiliation(s)
- R A Merchant
- Reshma A Merchant, National University Hospital, Singapore,
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