Social isolation is associated with future decline of physical performance in community-dwelling older adults: a 1-year longitudinal study

Association of Social Network with Physical Function Among Community-Dwelling Older Adults in Rural Thailand: A Cross-Sectional Study

Purpose

As the number of older adults in society increases, their social roles and networks, as well as their physical function, decrease. This study aimed to clarify the association between social networks and physical function among people aged ≥ 60 years in rural Thailand.

Patients and Methods

This cross-sectional study was conducted in the Photharam District, Ratchaburi Province, Thailand. Participants were required to be at least 60 years old and be able to walk to the health center. Social networks were surveyed using the Thai version of Lubben Social Network Scores-6. Four physical function measures, namely hand grip strength, five-times-sit-to-stand test, timed up-and-go (TUG) test, and one-leg standing, were considered. Regression analysis was conducted with Lubben Social Network Scores-6 as the dependent variable and the four types of physical function as independent variables.

Results

A total of 497 older adults aged 60 years or more were enrolled; 82 were males, and 412 were females. The mean Lubben Social Network Scores-6 was 14.9 ± 5.7. Only the TUG test was associated in a single and multiple regression analysis with the Lubben Social Network Scores-6 as the dependent variable and the four physical function assessments as independent variables.

Conclusion

The TUG test assessed the smoothness of normal standing and walking, which are essential physical functions for maintaining a social network and meeting people. This suggests a relationship between physical function and social network.

Sex differences in physical functioning among older adults: cross-sectional results from the OUTDOOR ACTIVE study

BACKGROUND

Maintaining good functional ability is a key component of healthy ageing and a basic requirement for carrying out activities of daily living, staying independent, and delaying admission to a nursing home. Even though women have a higher life expectancy and slower age-related muscle mass loss than men, they often show a higher prevalence of limitations in physical functioning. However, the reasons behind these sex differences are still unclear. Therefore, the aims of this study were to investigate sex differences among older adults regarding physical functioning and to study which factors are explaining these sex differences.

METHODS

Cross-sectional data from participants of the OUTDOOR ACTIVE study residing in Bremen, Germany, aged 65 to 75 years, were included in the analyses. Physical functioning was assessed via a self-administered questionnaire using the SF-36 10-item Physical Functioning Scale. Social, lifestyle, and health-related factors were also assessed using the questionnaire. Physical activity was measured objectively using wrist-worn accelerometers over seven consecutive days. Descriptive analyses with absolute and relative frequencies, means and standard deviations, as well as T-tests and chi-square tests were carried out. To test for associations between sex, physical functioning, and several individual factors, linear regressions were performed.

RESULTS

Data of 2 141 participants (52.1% female) were included in the study. Women and men showed statistically significant differences in physical functioning, with men perceiving fewer limitations than women. On average, women had a physical functioning score of 81.4 ± 19.3 and men 86.7 ± 17.0. Linear regression showed a statistically significant negative association between physical functioning score and sex (β: -0.15, 95% CL: -0.19, -0.10). The association remained statistically significant when adding individual factors to the model. All factors together were only able to explain 51% of the physical functioning-sex association with health indicators and the presence of chronic diseases being the most influential factors.

CONCLUSIONS

We found sex differences in physical functioning, with older women having more limitations than older men. The results showed that health-related factors and chronic diseases played the biggest roles in the different physical functioning scores of women and men. These findings contribute to future longitudinal, more in-depth research.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018).

A Systematic Review of the Relationship between Social Isolation and Physical Health in Adults

Background: According to the World Health Organization, social isolation, particularly of older adults, is a public health issue endangering the well-being of individuals, families, and communities. Social isolation affects health through biological, behavioral, and psychological pathways and is associated with physical and psychological/emotional well-being, increases morbidity and mortality rates, and lowers quality of life. Purpose: This systematic review examined the relationship between social isolation and physical health, including subjective and objective dimensions, and factors that influence this relationship in adults. Methods: This systematic review examined six electronic databases covering the field of health and human services and included results from 1 January 2017 to 10 March 2023 with key terms including adult social connection or social isolation coupled with health, physical, psychological, emotional, mental, or behavioral. The initial search yielded 925 research articles across all databases and was narrowed to 710 when the decision was made to focus on social isolation and physical health. Covidence was used throughout the retrieval and appraisal process, as provided in a PRISMA flow diagram. Twenty-four studies that scored 90 or above in the appraisal process were included in the systematic review. Results: The studies represented included seven studies conducted in the United States and seventeen studies conducted internationally. Regarding study design, twenty-three studies were quantitative, one was qualitative, and one was mixed methods. The majority of quantitative studies were correlational in design with nine being longitudinal. The majority of studies were based on large national data sets representing in total 298,653 participants aged 50 and older. The results indicate that social isolation is related to increases in inflammatory biomarkers associated with diseases, all-cause mortality, lower expectations of longevity, and frailty. In addition, social isolation was associated with cognitive decline and disruptions in sleep. Poor oral health increased social isolation. The results further indicated that decreased physical performance/function and a decline in physical activity were associated with social isolation, as well as decreased overall physical health, poor health behaviors, and self-care, and decreased health-related quality of life. Further research is warranted to examine the possible bidirectionality of these relationships and possible mediating, moderating, or confounding variables. Implications: Future research is needed to explore the biological and behavioral pathways in which social isolation negatively impacts physical health. Going forward, studies are needed that move beyond descriptive, exploratory methods and integrate data from qualitative and mixed-method designs that will inform the development and testing of a conceptual framework related to social isolation and health. By advancing the science behind social isolation, comprehensive interventions can be identified and tested with implications at the individual, family, community, and societal levels to reduce social isolation, particularly among adults, and improve health and quality of life.

An in-person survey of the influence of the COVID-19 pandemic on physical function, functional capacity, cognitive function, and mental health among community-dwelling older adults in Japan from 2016 to 2022

BACKGROUND

The COVID-19 outbreak might have had several effects on older adults; however, much of the previous research only included self-report, cross-sectional, and online-survey data in the early stage of the pandemic. We conducted a face-to-face survey before and after the COVID-19 pandemic and investigated the influence of the pandemic on several functions to distinguish between changes due to aging and changes due to the pandemic using a linear mixed model.

METHODS

A total of 8 longitudinal surveys were conducted from 2016 to 2022. Physical function was assessed by weight, body mass index, body fat percentage, skeletal muscle mass index, calf circumference, grip strength, knee extension strength, the 5-times chair stand test, the timed up & go test and 5-m walking test. Functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology index of competence, cognitive function was measured using the Trail Making Test - A, and mental health was measured using the Geriatric Depression Scale.

RESULTS

Of a total of 73 participants, 51 (69.9%) were female. The mean age at first participation was 71.82 years (SD = 4.64). The results of the linear mixed model showed that lower-limb muscle strength and body fat percentage and cognitive function changed significantly before and after the pandemic, while grip strength, functional capacity, and mental health did not.

CONCLUSIONS

The changes in these functions between before and after the pandemic might be attributed to the diminished opportunities for the independent older individuals to go out and engage in activities. Although functional capacity did not change, lower-limb muscle strength is important for functional independence. This decline might influence the functional capacity of these individuals in the future.

Association between positive control in self-perceptions of aging and motoric cognitive risk syndrome among Chinese community-dwelling older adults: a cross-sectional study

BACKGROUND

Self-perceptions of aging (SPA) are important psychosocial factors that lead to a wide range of outcomes including dementia. However, the relationships between positive SPA and motoric cognitive risk syndrome (MCR) which is a predementia syndrome are still unknown. This study aimed to reveal the associations of positive control and aging awareness of SPA with the risk of MCR and its components.

METHODS

A cross-sectional design was conducted among 1137 Chinese community-dwelling older adults. Positive control and aging awareness were defined by two dimensions of SPA (Positive control and Timeline chronic). MCR was determined according to definition. Multivariable logistic regression was used to examine the associations.

RESULTS

The overall prevalence of MCR was 11.5% (mean age = 71.62 ± 5.22). After adjusting for depression, anxiety, and cognitive function, positive control was associated with reduced risk of MCR (OR = 0.624, 95% CI 0.402-0.969, P = 0.036), subjective cognitive complaints (SCC) (OR = 0.687, 95% CI 0.492-0.959, P = 0.027), and gait speed (GS) (OR = 0.377, 95% CI 0.197-0.720, P = 0.003), respectively. Aging awareness was merely related to increased risk of MCR (OR = 1.386, 95% CI 1.062-1.810, P = 0.016).

CONCLUSIONS

This study highlights the crucial associations of positive control and aging awareness with MCR and its components. Our results emphasize that positive belief in control and adaptive aging awareness might be promising targets for preventing MCR.

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

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.

The Effects of Neighborhood Physical and Social Environment on Physical Function among Japanese Community-Dwelling Older Adults: A One-Year Longitudinal Study

Previous studies have shown a relationship between physical and social aspects of the neighborhood environment (e.g., built environment, safety) and physical function in older adults. However, these associations are unclear in older Asian adults because longitudinal studies are lacking. This study examined the effects of neighborhood physical and social environment on longitudinal changes in physical function among Japanese older adults. We analyzed 299 Japanese community-dwelling adults aged ≥65 years. Neighborhood environment was assessed using the International Physical Activity Questionnaire Environment Module. Physical function was assessed using handgrip strength, knee extension muscle strength, 5-m walking time, and a timed up-and-go test (TUG) in baseline and follow-up surveys. Changes in physical function over one year were calculated and classified into decline or maintenance groups based on minimal detectable changes. Multiple logistic regression analysis showed that even after adjusting for confounding factors, good access to recreational facilities affected the maintenance of 5-m walking time (odds ratio [OR] = 2.31, 95% confidence interval [CI]: 1.02–5.21) and good crime safety affected the maintenance of TUG (OR = 1.87, 95%CI: 1.06–3.33). Therefore, it is important to assess both physical and social environmental neighborhood resources in predicting decline in physical function among Japanese older adults.