Reactions to COVID-19, information and technology use, and social connectedness among older adults with pre-frailty and frailty

A systematic review of the factors associated with the psychological wellbeing of people with Parkinson's in the COVID-19 pandemic

PURPOSE

The lockdown and social distancing measures introduced as a result of the COVID-19 pandemic impacted the ability of people with Parkinson's to engage in normal health management practices. This led to documented reductions in psychological wellbeing. The aim of the present review was to identify factors associated with the psychological wellbeing of people with Parkinson's during the acute stage of the pandemic.

MATERIALS AND METHODS

Five academic databases (PsycINFO, MEDLINE, Embase, CINAHL, and Web of Science) were searched and 23 articles were identified using pre-defined inclusion and exclusion criteria. The findings are stratified by risk factor and analysed using a narrative synthesis.

RESULTS

Worsening of motor symptoms, poor motor-related daily living experiences and motor symptoms during "off time" (when symptom suppressing medication has worn off) as well as less physical activity emerged as the most consistent risk factors of worsened or poorer psychological wellbeing. A deviation from pre-pandemic risk factors was identified, with age and gender not identified as consistent risk factors.

CONCLUSIONS

The implications of this review are not limited to preparing for future pandemics but can also be applied to more common concerns with comparable contextual characteristics such as yearly flu outbreaks, social isolation, and economic uncertainty.

Efficacy of a Comprehensive and Personalised Approach for Frail Older People in Valencia (Spain): A Pre-Post Controlled Trial

Frailty is a common condition in older adults that negatively impacts health and quality of life. This study evaluated a comprehensive, personalised, and coordinated intervention under the value-based care approach to address frailty's multidimensional nature in older people in the primary care setting. It employed a pre-post randomised controlled design involving 242 frail individuals aged over 65 years living in the community in Valencia (Spain) between 2021 and 2023. Assessments were conducted at baseline, 12 months (immediately post-intervention), and 18 months. The intervention included a personalised care plan supported by technology, with monthly motivational follow-ups and plan updates by health professionals and participants. Outcomes were measured using an assessment questionnaire that included the International Consortium for Health Outcomes Measurement dataset for the older population: physical health, physical functioning, general mental health, satisfaction with social activities and relationships, ability to carry out usual social roles and activities, pain, general quality of life, loneliness, physical frailty, psychological frailty, and social frailty. The study found significant improvements in physical frailty, quality of life, reduced health resource use and hospitalisations and lower levels of pain and depression/anxiety compared to baseline. The findings suggest further research into value-based care approaches, emphasizing the development and activation of personalised, comprehensive programs for older individuals with frailty.

Post-COVID social engagement and depression among Chinese older adults: exploring rural/urban and gender differences

PURPOSE

This study investigates the impact of post-COVID social engagement on depression levels among Chinese older adults, with a focus on rural/urban and gender differences.

METHODS

Using the year 2018 and year 2020 data from the China Health and Retirement Longitudinal Study (CHARLS), this study analyzed pre- and post-COVID depression levels and social engagement indicators, including going-out, activities and networking among Chinese older adults (N = 8,793).

RESULTS

Results showed a significant increase in depression levels across all demographic groups post-COVID, with rural females exhibiting the highest levels of depression. Reduced social engagement was associated with increased depression, particularly among rural males and females. Subgroup analyses highlighted nuanced patterns: rural males suffered from decreased intense activities and online contacts, while urban males experienced heightened depression with reduced visiting and light activities. Rural females reported increased depression with decreased moderate activities and dancing outdoors but decreased levels with reduced online contacts. Conversely, urban females experience decreased depression with reduced social engagements, suggesting areevaluation of priorities amidst pandemic challenges.

CONCLUSION

This study has underscored the importance of considering individual, cultural, and contextual factors in understanding mental health outcomes among Chinese older adults. Findings inform targeted interventions aimed at promoting psychological well-being and resilience among Chinese older adults in the post-COVID era, including community-based programs and mental health screenings, to foster social connection and emotional support.

Internet use and frailty in middle-aged and older adults: findings from developed and developing countries

BACKGROUND

With increasing trend of internet use in all age groups, whether internet use can prevent frailty in middle-aged and older adults remains unclear.

METHODS

Five cohorts, including Health and Retirement Study (HRS), China Health and Retirement Longitudinal Study (CHARLS), the Survey of Health, Ageing and Retirement in Europe (SHARE), English Longitudinal Study of Aging (ELSA), and Mexican Health and Aging Study (MHAS), were used in this study. Internet use, social isolation, and frailty status was assessed using similar questions. The Generalized estimating equations models, random effects meta-analysis, COX regression, and mediation analysis were utilized.

RESULTS

In the multicohort study, a total of 155,695 participants were included in main analysis. The proportion of internet use was varied across countries, ranging from 5.56% in China (CHARLS) to 83.46% in Denmark (SHARE). According to the generalized estimating equations models and meta-analysis, internet use was inversely associated with frailty, with the pooled ORs (95%CIs) of 0.72 (0.67,0.79). The COX regression also showed that participants with internet use had a lower risk of frailty incidence. Additionally, the association was partially mediated by social isolation and slightly pronounced in participants aged 65 and over, male, not working for payment, not married or partnered, not smoking, drinking, and not co-residence with children.

CONCLUSIONS

Our findings highlight the important role of internet use in preventing frailty and recommend more engagements in social communication and activities to avoid social isolation among middle-aged and older adults.

'Nostalgic food heals for us': A qualitative exploration of experiences with nostalgia, food, and mood

ISSUE ADDRESSED

Nostalgia-the bittersweet reliving of the past-has been linked to social connection and psychological wellbeing. Although food consumption is often an intrinsically social experience, relatively little research has examined how individuals experience and understand how food consumption relates to feelings of nostalgia, food and mood.

METHODS

In the current study, semi-structured interviews were conducted with eight Australians from varying cultural backgrounds to explore their experiences with nostalgia, food and mood.

RESULTS

Reflexive thematic analysis identified three key themes from the data: (i) The bittersweet experiences of food-evoked nostalgia-individuals' descriptions of food-evoked nostalgia and how it impacted their mood both positively and negatively (ii) social connection and identity continuity-participants' description of food-evoked nostalgia and how this provides an opportunity for social connection and identity continuity throughout life, which positively influences mood, and (iii) the role and relationship of food-evoked nostalgia and mood-individual descriptions of the important role that nostalgic food plays in their life, in addition to their relationship with food, and how this impacts mood.

CONCLUSIONS

Understanding the positive component of nostalgic foods allowed individuals to bolster positive mood states with food-evoked nostalgia, increasing their quality of life. SO WHAT?: Understanding the link between food-evoked nostalgia and mood has significant implications, suggesting that negative mood states altered by nostalgic foods may result in positive mood states. Appropriate use of food-evoked nostalgia may increase the quality of life for individuals experiencing low mood states.

"Provided a window on the world and lessened my feeling of isolation": older adults' perceived COVID-19 impact and technology use in Australia during recurrent lockdowns

BACKGROUND

An informed understanding of older adults' perceptions of the impact (positive or negative) of recurrent COVID-19 long lockdowns is important for the development of targeted interventions and resources for future restrictions. This study aimed to understand self-reported impacts of COVID-19 recurrent restrictions on older adults and how technology has been used to mitigate these.

METHODS

A cross-sectional national study of 257 community-dwelling older Australians based in Victoria (mean age = 67.6 years [SD = 7.2]; 20.6% male) completed an online or postal survey as part of a larger study examining the physical and mental health impacts of a second extended COVID-19 lockdown period. This secondary analysis reports on the findings from free-text responses to two open-ended questions included in that survey that asked participants to comment on the greatest impacts of the COVID-19 lockdowns (positive or negative) and the role of technology in supporting their wellbeing during this time. Responses were collected between July and September 2020. Data were analysed using content (COVID-19 impacts) and thematic (role of technology) analysis.

RESULTS

Respondents gave more negative responses (75.5%) than mixed (15.2%) and positive responses (6.2%) in reporting on the biggest impact of COVID-19 lockdowns. Inductive content analysis revealed two first-order main categories (Positive impacts and Negative impacts). Axial coding of main categories showed five second-order categories (Environmental, Physical Health, Social, Mental Health, and Personal) for both negative and positive main categories (totalling 10 second-order categories). Overall, respondents highlighted social loss as the key negative experience (70%), with acute feelings of social isolation contributing to negative impacts on mental wellbeing. The most commonly reported positive impact reported (11%) was having more time for relationships, relaxation, and new hobbies. Technology was primarily used to sustain socialisation and provide access to essential resources, services, and goods, which respondents perceived to contribute to maintaining their wellbeing.

CONCLUSIONS

Findings suggest a critical need for interventions that address the social loss experienced by older adults during COVID-19 recurrent lockdowns, particularly to alleviate the associated negative impact on mental wellbeing. Recognising the positive aspect of increased time for relationships and leisure activities indicates potential areas for resilience-building strategies. The pivotal role of technology in mitigating adverse effects highlights its significance in building social connections and supporting overall wellbeing during challenging times. These implications can guide future efforts to enhance older adults' resilience, mental health, and holistic wellbeing in future public health crises.

The association of technology acceptance and physical activity on frailty in older adults during the COVID-19 pandemic period

BACKGROUND

Physical activity was known to be the protective factor against frailty. Technology acceptance is associated with behavioural intention to technology usage. Technology has been effective in promoting healthy behaviour of physical activity. The purposes of this study were to examine the association between physical activity and technology acceptance with frailty and examine the moderation effect of technology acceptance on physical activity and frailty. We hypothesize that 1) physical activity and technology acceptance are associated with frailty, and 2) technology acceptance moderates the association of physical activity with frailty.

METHODS

This study employed a cross-sectional design and was conducted in the community settings of Hong Kong in 2021. Eligible participants were old people aged ≥60 and were community-dwelling. Key variables included physical activity measured by Rapid Assessment of Physical Activity (RAPA), social network measured by Lubben Social Network Scale-Six items (LSNS-6); depressive symptoms measured by Patient Health Questionnaire-Nine items (PHQ-9), technology acceptance measured by Senior Technology Acceptance Model-14 items (STAM-14) and frailty measured by Fatigue, Resistance, Ambulation, Illnesses, & Loss of Weight scale (FRAIL). Ordinal logistic regression was employed to test the hypotheses. The moderation effect was examined by introducing an interaction term formed by the multiplication of an independent variable (i.e., physical activity) and a moderating variable (i.e., technology acceptance).

RESULTS

This study recruited 380 eligible participants with a mean age of 66.5 years. Technology acceptance (Beta = - 0.031, p < 0.001, Pseudo-R2 = 0.087) and physical activity (Beta = - 0.182, p = 0.003, Pseudo-R2 = 0.027) were associated with frailty in the unadjusted models. Technology acceptance (Beta = - 0.066, p < 0.001) and physical activity (Beta = - 1.192, p < 0.001) were also associated with frailty in the fully adjusted model (Pseudo-R2 = 0.352). Interaction term formed by the multiplication of technology acceptance and physical activity (Beta = 0.012, p = 0.001) was associated with frailty. Physical activity was significantly associated with frailty in the lower technology acceptance subgroup (Beta = - 0.313, p = 0.002) in the subgroup analysis. However, in the subgroup of higher technology acceptance, the association of physical activity (Beta = 0.104, p = 408) on frailty became positive but not significant.

CONCLUSIONS

This study showed that physical activity and technology acceptance were associated with frailty, and technology acceptance moderated the association of physical activity with frailty. This study recommends engaging older adults in physical activity to combat frailty preferentially in those with a lower level of technology acceptance.

Exploring the Access and Use of Social Technologies by Older Adults in Support of Their Mental Health During the COVID-19 Pandemic: A Rapid Review

Coronavirus disease (COVID-19) lockdowns disproportionately affect older people where most suffer from social isolation and loneliness, which translate into higher rates of depression and anxiety. This study aimed to explore the accessibility, outcomes, and challenges of social technology use among community-dwelling older adults, older adults in long-term care, older adults with neurocognitive disorder, and older adults with pre-frailty and frailty, to help guide future research in this area. A rapid review was conducted, and articles were retrieved from four online databases, including Medline, AgeLine, EconLit and CINAHL, and grey literature from Google Scholar. Of the 131 articles retrieved, 24 were included in this review. The positive outcomes of social technology use include improved mental and physical health, reduced health disparities, and increased autonomy. Adverse outcomes include furthering the digital divide. More research surrounding the economic impacts of social technologies is warranted.

Resilient Adaptation Strategies: Unveiling Older Adults' Coping Dynamics Amidst the COVID-19 Pandemic

Older adults, who are particularly vulnerable to coronavirus disease 2019 (COVID-19), exhibit less stress and greater well-being than their younger peers. However, there have been no in-depth explorations of adaptive coping strategies among this population, nor has the role of frailty status been addressed. The current study examined stress and coping in 30 U.S. older adults (mean age = 81 years, range = 68 to 95 years) amidst the COVID-19 pandemic, uncovering themes of: (1) Pandemic Stresses: stresses experienced during the pandemic centered around social isolation and concern for others' well-being; (2) Resilience: older adults proved highly adaptable, with lifetime experience as a stress buffer; and (3) Silver Linings: older adults reported positive by-products, such as reconnecting with and a renewed appreciation for life and nature. Motivation for change and change itself centered around creating value and meaning in the present, especially around social isolation. Findings challenge existing ageist stereotypes, give insight into interventional design, and highlight the importance of ensuring infrastructural and societal support. [Journal of Gerontological Nursing, 49(12), 32-39.].

Older Adults' Trust and Distrust in COVID-19 Public Health Information: Qualitative Critical Incident Study

BACKGROUND

The COVID-19 infodemic has imposed a disproportionate burden on older adults who face increased challenges in accessing and assessing public health information, but little is known about factors influencing older adults' trust in public health information during COVID-19.

OBJECTIVE

This study aims to identify sources that older adults turn to for trusted COVID-19 public health information and factors that influence their trust. In addition, we explore the relationship between public health information sources and trust factors.

METHODS

Adults aged 65 years or older (N=30; mean age 71.6, SD 5.57; range 65-84 years) were recruited using Prime Panels. Semistructured phone interviews, guided by critical incident technique, were conducted in October and November 2020. Participants were asked about their sources of COVID-19 public health information, the trustworthiness of that information, and factors influencing their trust. Interview data were examined with thematic analysis.

RESULTS

Mass media, known individuals, and the internet were the older adults' main sources for COVID-19 public health information. Although they used social media for entertainment and personal communication, the older adults actively avoided accessing or sharing COVID-19 information on social media. Factors influencing their trust in COVID-19 public health information included confirmation bias, personal research, resigned acceptance, and personal relevance.

CONCLUSIONS

These findings shed light on older adults' use of information sources and their criteria for evaluating the trustworthiness of public health information during a pandemic. They have implications for the future development of effective public health communication, policies, and interventions for older adults during health crises.

Digital communication use before and during COVID among residential older adults

Many older adults living in residential care facilities do not use digital communication technologies. The study was a retrospective pre-post study testing the impact of a digital communication program instituted at two Continuing Care Retirement Communities. We distributed a survey between March 2021 and April 2021 to examine study objectives. Data analyses were performed using JMP Pro 16.1 and SAS 9.4. One hundred twenty-six people started the survey, with 120 completing the survey and included in the analysis. The mean age was 84 years, 67.5% were female, 95.8% were White, 64.2% were widowed, and 35.3% reported at least a bachelor's degree level of education. There were minimal increases in digital communication behavior and communication frequency. Older adults most notably reported privacy concerns and have mixed responses about the utility of digital communication for social engagement. We apply the results to the Stage of Change model and provide recommendations to promote behavior change.

Reconsidering frailty from a human and social sciences standpoint: towards an interdisciplinary approach to vulnerability

Although frailty is an important, well-characterized concept in the provision of medical care to older adults, it has not been linked to the concept of vulnerability developed in the humanities and social sciences. Here, we distinguish between the two main dimensions of vulnerability: a fundamental, anthropological dimension in which people are exposed to a risk of injury, and a relational dimension in which people depend on each other and on their environment. The relational notion of vulnerability might provide healthcare professionals with a better understanding of frailty (and its potential interaction with precarity). Precarity situates people in their relationship with a social environment that might threaten their living conditions. Frailty corresponds to individual-level changes in adaptation to a living environment and the loss of ability to evolve or react in that environment. Therefore, we suggest that by considering the geriatric notion of frailty as a particular form of relational vulnerability, healthcare professionals could better understand the specific needs of frail, older people-and thus provide more appropriate care.

On the triple exclusion of older adults during COVID-19: Technology, digital literacy and social isolation

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.

The Effect of Intolerance of Uncertainty on State Anxiety in the Regular Epidemic Prevention and Control Phase in the Context of Informatization: A Moderated Chain Mediation Model

The COVID-19 pandemic has led to a generally high level of state anxiety resulting from the high contagiousness of the disease and strict prevention and control policies. The present study mainly focused on the relationship between the individual intolerance of uncertainty and state anxiety in the regular epidemic prevention and control phase in China, and aimed to investigate the mediating role of information overload and rumination, as well as the moderating role of self-compassion. A total of 992 Chinese residents from 31 provinces participated in this study, and completed questionnaires regarding intolerance of uncertainty, information overload, self-compassion, rumination, and state anxiety. Descriptive statistics and correlation analyses, as well as tests for mediating effects and moderated chain mediating effects, were performed on the data using SPSS 26.0 and Process 3.5 macro program. The findings indicated that intolerance of uncertainty significantly predicted individual state anxiety. Information overload mediates the effects of intolerance of uncertainty and state anxiety. Rumination also mediates the effect of uncertainty intolerance on state anxiety. Information overload and rumination have a chain mediation effect on the link between intolerance of uncertainty and state anxiety. Self-compassion mediates the effect of information overload on rumination. The results illuminate theoretical and practical implications in the regular epidemic prevention and control phases and reveal the protective role of self-compassion.

Changes in Internet use patterns among older adults in England from before to after the outbreak of the COVID-19 pandemic

The COVID-19 pandemic brought about an increased reliance on the Internet for various daily activities. Given the known digital divide, it is important to understand whether older adults changed their Internet use patterns, but current evidence is limited to cross-sectional studies. This study documents changes in frequency and types of Internet use among older adults from before to shortly after the outbreak of the COVID-19 pandemic (2018/2019 to June/July 2020), and the factors predicting regular use during these early days of the pandemic. Using data on 6,840 adults aged 50 + from the nationally representative English Longitudinal Study of Ageing, we apply longitudinal fixed-effects models to examine within-individual changes in Internet use behaviour. There was no change in the likelihood of daily Internet use between 2018/2019 and June/July 2020, despite the increased digitalisation of services over the pandemic. Daily use in June/July 2020 was negatively related to age, neighbourhood deprivation, and loneliness, and positively related to partnership status, education, employment, income, and organisation membership. Using the Internet for making calls and getting information about Government services increased, which was important given the social restrictions and overall uncertainty. However, Internet use for finding health-related information decreased. As the world moves towards digital alternatives post-pandemic, it is important to continually ensure older adults are not at risk of exclusion.

"I Can't Take Any Chances": A Mixed Methods Study of Frailty, Isolation, Worry, and Loneliness Among Aging Adults During the COVID-19 Pandemic

Little is known about how frailty has shaped experiences of living through the COVID-19 pandemic. In this cross-sectional mixed methods study, we analyzed data from the nationwide COVID-19 Coping Study from December 2020 through January 2021 (N = 2094 US adults aged ≥55) to investigate quantitative associations between frailty and the prevalence of physical isolation, worry about COVID-19, and loneliness. Reflexive thematic analysis explored aging adults' lived experiences of frailty during the pandemic. In multivariable-adjusted population-weighted modified Poisson regression models, we found that frailty was associated with increased prevalence of physical isolation, worry about COVID-19, and loneliness. Qualitative experiences of aging with frailty during the pandemic were diverse, and encompassed isolation, worry, and loneliness, as well as coping strategies and resilience. The findings may inform individualized multi-factorial strategies (e.g., physical activity, nutrition, and social interaction) to support well-being among adults aging with frailty during the pandemic.

The impact of COVID-19 on the psychosocial well-being of older adults: A literature review

INTRODUCTION

The novel coronavirus SARS-CoV2 (COVID-19) was declared a global pandemic in 2020 with the greatest risk to older adults. Prolonged restrictions and isolation threaten the social and emotional welfare of vulnerable groups with concerns focused on the long-term impact of this pandemic on the health and well-being of aging populations.

PURPOSE

Using the Socioemotional Selectivity Theory (STT) as a conceptual framework, the purpose of this literature review was to explore the impact of COVID-19 on the psychological and social well-being of older adults.

METHODS

Numerous academic and healthcare-related databases were searched to yield 24 relevant primary research articles, published during the pandemic (2020-2022), for analysis.

RESULTS/CONCLUSIONS

Overall results indicated the pandemic had a significant negative affect on the psychological and social well-being of older adults to include those with cognitive impairments and dementia despite perceptions of reduced awareness. There were significant differences between age groups with older adults reporting greater emotional stability and coping skills than younger cohorts. Although supportive services and the use of technology-enhanced well-being these resources were reduced during the pandemic due to lack of trained staff, funding, and other socioeconomic or political barriers. The SST proposes that feelings of satisfaction, a sense of belonging, and purpose are important for emotional well-being but the pandemic challenged these goals and, for many, resulted in stress, anxiety, and depression.

CLINICAL RELEVANCE

Healthcare providers and policymakers need to be aware of the negative consequences triggered by the prolonged pandemic and take measures to provide services that support the psychosocial well-being of older adults.

Older adults' exposure to and posting of health-related messages on Facebook by chronic health condition status

Objective

Older adults may be particularly interested in health-related content on Facebook, especially those who have chronic health conditions. The purpose of this study was to compare older adult Facebook users with and without a chronic health condition on their frequency of posting and exposure to health-related content.

Methods

Participants, recruited via Qualtrics, were regular Facebook users aged 50 + years. Participants were asked separately if they had seen, posted, and shared: Health-related information; about others'/their own health behaviors (e.g., exercise); and about others'/their own medical condition. Six logistic regression models, controlling for demographics and Facebook login frequency, were run to assess whether viewing and/or posting health-related messages differed by chronic health condition status.

Results

Respondents (N = 697; 77.9% female) were on average 61.2 (SD = 7.9) years old and (n = 625; 89.7%) were White. One-half reported a chronic health condition (n = 351; 50.4%). In adjusted models, those with a chronic health condition had a higher likelihood of seeing posts containing health information (OR = 1.41; 95% CI: 1.04, 1.93) and about others' medical conditions (OR = 1.67; 95% CI: 1.22, 2.27) at least once a month compared to those with no chronic health conditions. People with and without chronic health conditions did not differ in terms of how often they see others' post about health behaviors. Those with a chronic health condition had a higher likelihood of posting or sharing health information (OR = 1.67; 95% CI: 1.22, 2.27), posting about their own health behaviors (OR = 1.55; 95% CI: 1.00, 2.44; p = 0.048), and about their health condition (OR = 1.96; 95% CI: 1.17, 3.27) at least once a month.

Conclusion

Most older adults on Facebook are exposed to and post multiple forms of health-related content. Therefore, Facebook may be an appropriate channel for conducting health-related communication targeting older adults.

Leveraging digital technology for social connectedness among adults with chronic conditions: A systematic review

Purpose

To review the evidence about the impact of digital technology on social connectedness among adults with one or more chronic health conditions.

Methods

PubMed, Embase, Social Sciences, CINAHL, and Compendex were systematically searched for full-text, peer-reviewed empirical evidence published between 2012 and 2023 and reported using the PRISMA flow diagram. Articles were critically appraised applying the Joanna Briggs Institute checklists. Specific data were extracted based on the framework for social identity and technology approaches for health outcomes and then analyzed and synthesized.

Results

Thirty-four studies met study criteria. Evidence showed heterogeneity among research methodology, chronic health conditions, digital technology, and health outcomes. Technology use was influenced by factors such as usability, anonymity, availability, and control. More advanced digital technologies require higher digital literacy and improved accessibility features/modifications. Social support was the most measured aspect of social connectedness. The emotional and informational forms of social support were most reported; instrumental support was the least likely to be delivered. Self-efficacy for using technology was considered in seven articles. Sixteen articles reported health outcomes: 31.2% (n = 5) described mental health outcomes only, 18.8% (n = 3) reported physical health outcomes only, 31.2% (n = 5) detailed both physical and mental health outcomes, whereas 18.8% (n = 3) denoted well-being or quality-of-life outcomes. Most often, health outcomes were positive, with negative outcomes for selected groups also noted.

Conclusion

Leveraging digital technology to promote social connectedness has the potential to affect positive health outcomes. Further research is needed to better understand the social integration of technology among populations with different contexts and chronic health conditions to enhance and tailor digital interventions.

Environmental determinants of infectious and chronic disease prevention behaviours: A systematic review and thematic synthesis of qualitative research

Regulatory health policies facilitate desired health behaviours in communities, and among them, smoke-free policies and COVID-19 restrictions have been widely implemented. Qualitative research studies have explored how these measures and other environmental influences shape preventive behaviours. The objective of this systematic review was to synthesize previously published qualitative research, generate across-study themes, and propose recommendations for behaviour change interventions. We used a comprehensive search strategy, relevance screening and confirmation, data extraction, quality assessment, thematic synthesis, and quality-of-evidence assessment. In total, 87 relevant studies were identified. Findings were grouped under six overarching themes and mapped under three categories: (i) the political environment, (ii) the sociocultural environment, and (iii) the physical environment. These findings provide insights into the environmental influences of behaviour and indicate future interventions may be more effective by considering moral norms, community norms, policy support, and group identity.

Current Status and Associated Factors of Health Information Literacy Among the Community Elderly in Central China in the COVID-19 Pandemic: A Cross-Sectional Study

Purpose

COVID-19 posed a threat to the public's physical and mental health, and under outbreak control, the opportunities to go outside of the elderly have been reduced and making it more difficult to access health information and detrimental to their health management. This study aims to assess the current status of health information literacy (HIL) among older adults in the community in the context of COVID-19 and to identify its associated factors.

Methods

A cross-sectional survey was conducted from April to July, 2021, for which 617 community elderly members were recruited in Chenzhou, China. Data were collected through a general information questionnaire, The Chinese residents' HIL self-rated scale and a reliability evaluation form.

Results

The average score of HIL was 75.87 ± 9.85, and after processed by the 100-point system, we found 84.12% (519/617) of the participants scored less than 60 points, which indicates that the overall level of HIL among the community elderly is low. Multiple linear regression showed that age, gender, education, annual family Income, living arrangement, and chronic disease status (β = -0.341, -0.296, 0.384, 0.327, 0.296, 0.356, respectively; all P < 0.001) were significantly associated with the level of HIL found among the community elderly, out of which education was the most important associated factor.

Conclusion

The overall HIL level among the community elderly was low in Central China during the COVID-19 pandemic. Our results further prove the need for tailor-made health education programs for this group, with particular attention paid to the low-educated and low-income among them. Those measures must highlight on three aspects of health information search, evaluation, and application skills to offer useful experiences that improve the HIL level of the elderly and strengthen their ability to cope with emerging public health events.

Moving online: Experiences and potential benefits of digital dance for older adults and people with Parkinson's disease

BACKGROUND

Dance provides a range of beneficial effects for older adults including individuals with age-related neurological conditions such as Parkinson's disease (PD). The COVID-19 pandemic accelerated the development of at-home dance programs delivered digitally through live and pre-recorded media, but little is known about how participants may engage with and benefit from these resources.

OBJECTIVE

This study explored experiences and potential benefits of digital dance participation among healthy older adults and people with PD.

METHODS

An online survey consisting of fixed-choice and open questions was designed in collaboration with dance program providers and distributed between June and November 2020.

RESULTS

Healthy older adults (N = 149) and people with PD (N = 178) participating in at-home dance programs reported frequent engagement and a range of benefits. People with PD reported greater levels of motor (e.g., ease of movement, balance) than non-motor (e.g., energy, confidence) outcomes, while healthy older adults reported similar numbers of motor and non-motor outcomes. Positive outcomes were associated with the use of movement imagery during dance in both groups, while singing was associated with benefits in people with PD and vocalising was associated with benefits in older adults. At-home dance resources were found to offer convenience and flexibility, but participants missed the interaction, support, and routine provided by in-person classes. The majority expressed a preference to continue with both digital and in-person participation in the future. Qualitative analysis of participants' comments further revealed that digital participation could help to maintain connection and well-being, as well as identifying further considerations for improving accessibility and facilitating digital engagement.

CONCLUSIONS

At-home dance appears to be accessible, engaging, and potentially beneficial for older adults and people with PD, although barriers to participation should be addressed. Digital resources will be increasingly important to enable cost-effective, large-scale provision of home-based therapeutic activities.

Factors affecting worriedness: A study of the COVID-19 pandemic in Japan

The global effect of COVID-19 is no longer simply a public health issue; it is causing an economic crisis that has a significant impact on the job market and people's lives. The disease has led to 43% of businesses temporarily closing, and almost all these closures are due to COVID-19. Organizations that have temporarily suspended their activities have pointed mainly to a decline in demand and employee health issues as the reasons for closure. In emergency and disaster management, perception often helps shape personality and how people act in certain situations. This study aims to examine personal risk perception of COVID-19 from many viewpoints and whether it affects motivation with regard to improving personal preparedness. We collected data from three major Japanese cities through a questionnaire survey and analyzed the results of the survey through factor analysis and multiple regression analysis by using the Partial Least Square Structural Equation Modeling (PLS-SEM). The three study areas include (1) the most damaged regions from the 2011 Great East Japan earthquake and tsunami, (2) the capital city and surrounding areas of Tokyo, and (3) Kumamoto, which has recently experienced an earthquake. The findings show a correlation between the nature of the information received during COVID-19 and worriedness and the necessity for adequate information. The expected benefit of this study is to provide guidelines for the government or organizations to make a suitable emergency management plan based on pertinent factors for future pandemics.

The effect of pecha-kucha training on fear and belief in myths of COVID-19 in elderly women

Adequate and accurate information reduces pandemic fear in elderly women with chronic disease, one of the risk groups for COVID-19. We aim to determine the effect of pecha kucha pandemic training on the fear and belief in myths of COVID-19 in elderly women. This prospective, randomized controlled experimental study with pre- and post-tests employed a total of 64 elderly women, including 32 for each of experimental and control groups. The data were collected using an introductory information form, the Questionnaire for Beliefs in COVID-19 Myths, and the Fear of COVID-19 Scale. Women in the experimental group were informed about COVID-19, using a pecha kucha presentation via smart phone. Those in the control group were given the same information using classical lecture method. The data were collected before, just after, and 3 months after the training and analyzed using Pearson's chi-square, Mann-Whitney U, Friedman, Wilcoxon Signed Ranks tests. Elderly women in the experimental group had significantly lower fear and belief in myths of COVID-19 both just after and 3 months after the training (p < 0.05, p < 0.05). A pandemic training by pecha-kucha presentation, which is a short, clear, understandable and memorable method of teaching, can reduce both fear and belief in myths of COVID-19 in elderly women.

Technology use characteristics among older adults during the COVID-19 pandemic: A cross-cultural survey

Personal computers, tablets, and smartphones may support older adults' engagement when people are required to stay home and opportunities to engage in meaningful activities are reduced during the COVID-19 period. This study aims to screen older adults' technology-use characteristics across social, leisure, and education domains during the COVID-19 pandemic from a crosscultural viewpoint. The sample included 576 participants aged 60 and older from France (n = 62), Spain (n = 110), and Israel (n = 404). Participants completed the technology-use survey, which consists of questions about their facilities, technology usability, need for adaptations to support technology use, and changes in technology use since COVID-19. Significant differences were found between countries in facilities, χ2 (2) = 25.16, p < .001, and usability, χ2 (2) = 64.14, p < .001, across the three domains. Furthermore, 34% of technological usability was predicted by country and facilities, F (4, 568) = 72.39, p < .001. Participants noted a willingness to use technology if it was adapted for social (61%-73%), leisure (51%-71%), or educational (67%-76%) activities and that they devoted substantially more time to technology across domains (>58%) due to COVID-19. These findings highlight culture and facilities as factors that play an imperative role in supporting and enhancing the usability of technology among older adults.

Social Frailty among Community-Dwelling Older Adults during the COVID-19 Pandemic in Korea: A Cross-Sectional Study

Social frailty among older adults has become a growing concern from a public health perspective in the context of the coronavirus disease 2019 (COVID-19) pandemic. This study's aim was to investigate the influence of various aspects of social frailty in community-dwelling older adults during the COVID-19 pandemic. This study carried out a secondary analysis of data collected from the 2020 National Survey of Older Koreans and performed multinomial logistic regression analysis to identify the predictive factors of social frailty. The affected factors for the social frailty group were health conditions (depression), behavioral and metabolic risk factors (exercise, nutritional status, current smoking status, drinking frequency), intrinsic capacity (cognitive functions, activities of daily living), and digital literacy (use of smartphone or tablet PCs). Since multidimensional factors could affect older adults' social frailty, comprehensive strategies are urgently needed to reduce their rate of social frailty.

The associations of pandemic-related difficulties with depressive symptoms and psychological growth among American older adults: Social support as moderators

The COVID-19 pandemic brought social, health-related, and financial risks to older adults, yet their associations with depressive symptoms and posttraumatic growth (PTG) were not systematically examined. With 3504 respondents aged 60 and over from Health and Retirement Survey, this study found pandemic-related healthcare delay and financial hardship associated with elevated depressive symptoms and decreased PTG, whereas social disruption predicted greater PTG. When confronted with multidimensional difficulties, a higher level of social support buffered depressive symptoms and enhanced PTG following healthcare delay, while those from immediate family members carried the weighing of moderation. Additionally, the moderation effect varied between support types, as exclusive instrumental support engendered more depressive symptoms and squeezed PTG by stimulating a sense of incompetence for older adults. Inversely, receiving both instrumental and emotional support helped individuals of older age against financial-related depressive symptoms. These findings shed light on older adults' mental health promotion in a pandemic context.

Engaging With Aging: A Qualitative Study of Age-Related Changes and Adaptations

Background and Objectives

In the context of global aging, there is a need to better understand how older adults adapt to their changing health status. Engaging with aging (EWA) is an emerging framework proposed by Carnevali, which provides a new lens to understand an active, conscious daily-living process of managing age-related changes (ARCs) taken on by older adults. Study aims were to (a) describe the ARCs experienced by community-dwelling older adults and (b) identify the strategies and resources used by older adults to accommodate the daily-living challenges caused by the associated ARCs.

Research Design and Methods

We conducted semistructured interviews using a virtual card sort to gather qualitative data about ARCs and strategies to manage ARCs. Interviews were conducted virtually due to coronavirus disease 2019 (COVID-19) restrictions.

Results

Participants included 19 females and 10 males. The mean age was 77.45 years old (range from 64 to 98). Sixteen ARCs (e.g., changes in hearing, changes in stability, changes in sleep, etc.) were mentioned by participants, and their corresponding adaptations were discussed. Participants linked their adaptations to their ARCs based on their changing capacities and needs. Examples of commonly used adaptations included, for example, conserving energy, utilizing tools or technology, and being more conscious before and while taking actions. The challenges caused by COVID-19 in implementing the adaptations were also discussed.

Discussion and Implications

Findings from this study demonstrate how older adults explore, generate, and utilize adaptive behaviors to address their ARCS. This study substantiates the EWA framework by showing common patterns among older adults in linking ARCs with adaptations. Implications for clinicians include using EWA to help older adults identify personalized health solutions that fit their capacities. Researchers may use EWA to design and test interventions by considering the specific ARCs older adults encounter and the attitudes they hold towards the ARCs.

Impact of the COVID-19 pandemic on community services for homebound older adults in New York City

The ongoing COVID-19 pandemic has affected multiple aspects of society. Based on data from a community program, this study examined how the pandemic influenced community services for homebound older adults and whether those services could be delivered via internet-based information and communications technology. Using mixed methods, we collected quantitative data from client profiles and service documents and qualitative data from phone interviews with program staff members and clients. The quantitative results show that during the pandemic, more services were provided for the physical well-being of homebound older adults than for their psychological and home environment needs. Service duration during the pandemic was significantly longer than prior to the pandemic. The qualitative data indicate that the pandemic has influenced inputs, activities and outcomes of the program. The program staff members and clients expressed concerns about delivering services online. Based on the findings, we provide suggestions for future practice and policy.

Older Adults' Preventive Behaviors During COVID-19 Outbreak: Application of Multiple Disadvantage Model

This study explored older adults' preventive behaviors during the pandemic. A sample of 2982 community-dwelling older adults was extracted from the United States National Health and Aging Trends Study. Results showed that number of preventive behaviors was decreased with rundown neighborhood and age; but increased with Blacks, Hispanics, other ethnic minorities, income, female, number of persons in household, social cohesion, social network, family/peer support, severity of COVID-19 symptoms, and anxiety during COVID-19 outbreak. The study results imply that joint effort of government and ethnic minority advocacy groups in public health education should focus on preventive measures as well as racial disparities in health, and that rejuvenating rundown neighborhoods, promoting neighboring, providing stimulus checks and unemployment insurance, and maintaining connection with family and friends will promote preventive behaviors.

Virtual Intervention for Caregivers of Persons With Lewy Body Dementia: Pilot Quasi-Experimental Single-Arm Study

BACKGROUND

Compared to other types of dementia, family caregivers of people with Lewy body dementia (LBD) report higher stress levels and more severe depressive symptoms. Although several digital support interventions for caregivers of persons with dementia exist, few target LBD specifically or leverage a fully remote and asynchronous approach suitable for pandemic circumstances.

OBJECTIVE

We performed a pilot evaluation of a digital intervention designed to help caregivers of people with LBD address challenges they have experienced, with the end goal of reducing psychological distress in this population.

METHODS

We recruited 15 family caregivers of people with LBD to participate in the quasi-experimental, single-arm, mixed methods study titled Virtual Online Communities for Aging Life Experience-Lewy Body Dementia (VOCALE-LBD). The study offers an 8-week web-based intervention that uses a digital discussion platform and involves moderation, peer-to-peer support, didactic training, and problem-solving skill enactment.

RESULTS

Participants' baseline characteristics were the following: mean age 66 (SD 8) years; 14 of 15 (93%) of them were female; all (15/15, 100%) were White; and 8 (53%) of them had at least a postgraduate degree. Throughout the intervention, participants engaged in weekly web-based discussions, generating a total of 434 posts (average 4 posts per week). Attrition was 20% (3/15). Upon study exit, participants showed the following average improvements: 3.0 (SD 6.0) in depression, 8.3 (SD 16.7) in burden, 2.9 (SD 6.8) in stress, and 0.3 (SD 0.8) in loneliness. When looking at the proportion of participants with clinically significant improvement versus those with a worsening of ≥0.5 SD for each outcome, we observed net improvements of 50% (6/12), 33% (4/12), 25% (3/12), and 25% (3/12) in depression, loneliness, burden, and stress, respectively. In terms of the benefits of participation, participants reported that participation helped them "a great deal" to (1) improve their understanding of LBD (9/12, 75%), (2) gain confidence in dealing with difficult behaviors of the care recipient (6/12, 50%), and (3) improve in one's abilities to provide care to the care recipient (4/12, 33%).

CONCLUSIONS

The study generated promising feasibility and preliminary efficacy data for a low-cost, web-based intervention designed for caregivers of persons with LBD. Though the study was not powered for significance, we observed nominal average and net improvements in important psychological outcomes. Moreover, many caregivers reported that study participation helped them better understand the disease, feel more confident in dealing with difficult behaviors of the care recipient, and improve their ability to care for the care recipient. If validated in future studies, the intervention could be an accessible, on-demand resource for caregivers, enabling them to engage in moderated remote discussions with peers at their own convenience in terms of location, time of the day, and frequency.

The value of social interactions and incentives on the use of a digital contact tracing tool post COVID-19 lockdown in Singapore

We assessed the preferences and trade-offs for social interactions, incentives, and being traced by a digital contact tracing (DCT) tool post lockdown in Singapore by a discrete choice experiment (DCE) among 3839 visitors of a large public hospital in Singapore between July 2020 – February 2021. Respondents were sampled proportionately by gender and four age categories (21 – 80 years). The DCE questionnaire had three attributes (1. Social interactions, 2. Being traced by a DCT tool, 3. Incentives to use a DCT tool) and two levels each. Panel fixed conditional logit model was used to analyse the data. Respondents were more willing to trade being traced by a DCT tool for social interactions than incentives and unwilling to trade social interactions for incentives. The proportion of respondents preferring no incentives and could only be influenced by their family members increases with age. Among proponents of monetary incentives, the preferred median value for a month’s usage of DCT tools amounted to S$10 (USD7.25) and S$50 (USD36.20) for subsidies and lucky draw. In conclusion, DCE can be used to elicit profile-specific preferences to optimize the uptake of DCT tools during a pandemic. Social interactions are highly valued by the population, who are willing to trade them for being traced by a DCT tool during the COVID-19 pandemic. Although a small amount of incentive is sufficient to increase the satisfaction of using a DCT tool, incentives alone may not increase DCT tool uptake.

Research on Older Persons’ Access and Use of Technology in the Arab Region: Critical Overview and Future Directions

This paper presents the findings of a scoping review that maps exploratory evidence and gaps in research on information and communication technology (ICT) access and use among older persons in the Arab region. This review is part of a larger project that studies ICT access and use and related challenges faced by older adults in Qatar. A search was conducted in eleven scientific databases and search engines covering empirical studies published in English and Arabic between January 2016 and June 2021. Eleven studies were retrieved in the final corpus. A thematic analysis alongside the PRISMA for scoping reviews (PRISMA-ScR) was used to retrieve the findings. Our analysis identifies smartphones and social media applications for communication and information sharing as the most accessed and used technologies by older persons in the region. Moreover, our review highlighted the importance of the sociocultural factors in shaping ICT access and use by older persons in the region. The functional limitations of older persons in interaction with certain technology factors such as usability, functionality, and accessibility were also highlighted as major challenges inhibiting ICT access and use by this population segment. This scoping review provides a comprehensive overview of ICT access and use, and the factors affecting them among older persons in the Arab region. It highlights the scarcity of research on the subject in the region. It also stresses the fact that there is a need for more research on older persons and their caregivers in the context of the Arab world. More culturally appropriate need-based and adapted technologies are also recommended. Our review is a comprehensive source for researchers and technology developers interested in targeting and engaging older adults in the Arab region.

The Factors Associated With Nonuse of Social Media or Video Communications to Connect With Friends and Family During the COVID-19 Pandemic in Older Adults: Web-Based Survey Study

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Virtual Delivery of Fresh Conversations, a SNAP-Ed Program: Participant Perceived Impact and Satisfaction

This four-month study evaluated the virtual delivery of Fresh Conversations (FC). Participants were community-residing Iowans ages 60+ years. They were placed in one of four meeting groups based on location and participant preference: Zoom™, Adobe Connect^®, group-based Zoom™ meeting, and teleconference. Participants were invited to complete a post-meeting online survey. Data analyses were completed using data from the first survey completed by each participant (n = 115). Descriptive statistics assessed response frequencies for all questions. Chi-Square and Mann-Whitney U tests assessed the differences between groups. Overall, participants were "satisfied/very satisfied" (72.1%), learned something new (85.2%), and intended to make behavior change (79.1%); no differences were detected by the group for satisfaction or reported impacts. Only 24.3% reported technical difficulties; the Adobe Connect^® group reported the most difficulties (p = .004). These findings suggest virtual delivery of FC is well-received and perceived to be effective by participants.

For Better or for Worse? A Scoping Review of the Relationship between Internet Use and Mental Health in Older Adults during the COVID-19 Pandemic

Older adults were advised to avoid social activities during the outbreak of COVID-19. Consequently, they no longer received the social and emotional support they had gained from such activities. Internet use might be a solution to remedy the situation. Therefore, this scoping review sought to map the literature on Internet use and mental health in the older population during the pandemic to examine the extent and nature of the research. A scoping review was conducted using eight databases—PubMed, Scopus, Ebscohost Medline, Ebscohost Academic Search, Ebscohost CINAHL Plus, Ebscohost Cochrane, Ebscohost Psychology and Behavioural Sciences Collection, and Ebscohost SPORTDiscus, according to PRISMA guidelines. Two pre-tested templates (quantitative and qualitative studies) were developed to extract data and perform descriptive analysis and thematic summary. A total of ten articles met the eligibility criteria. Seven out of ten studies were quantitative, while the remainder were qualitative. Five common themes were identified from all the included studies. Our review revealed that Internet use for communication purposes seems to be associated with better mental health in older adults during the COVID-19 pandemic. Directions for future research and limitations of review are also discussed.

Psychological impacts and online interventions of social isolation amongst older adults during COVID-19 pandemic: A scoping review

AIM

To summarise the psychological impacts of social isolation amongst older adults during COVID-19 and review the benefits and limitations of online interventions used to combat social isolation.

DESIGN

A scoping review was performed.

DATA SOURCES

A systematic search was performed from October 2020 to January 2021 in seven electronic databases: China National Knowledge Infrastructure (CNKI), PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Cochrane Library and Web of Science. A hand search of the reference lists of included papers and WHO publications was performed. Grey literature search was carried out from Scopus, ProQuest Dissertation and Google Scholar.

REVIEW METHODS

Studies were screened, appraised and extracted independently by two reviewers. Thematic analysis was used to synthesise data, which were presented in a descriptive manner and organised into categories and themes.

RESULTS

Totally, 33 studies were included. Four themes and eight sub-themes emerged: (1) negative impacts and experiences of older adults during social isolation, (2) adopting coping behaviours in the midst of COVID-19, (3) online interventions to combat the consequences of social isolation, (4) barriers to online intervention.

CONCLUSION

The COVID-19 pandemic has taken an emotional toll on older adults' psychological wellbeing and has highlighted the untapped strengths of older adults facing isolation. Online interventions, which could be a new normal in the COVID era, were beneficial in combating social isolation. Strategies by various stakeholders were recommended to tackle the barriers of online interventions.

IMPACT

With the COVID-19 pandemic still in progress, this review provides insights on the psychological impacts of social isolation amongst older adults. Nurses in the community and long-term care facilities could adopt strategies and online intervention to better support the older adults, contribute to a stronger COVID-19 response and support system, and an overall better road to recovery from this crisis.

Perceived Information Overload and Unverified Information Sharing on WeChat Amid the COVID-19 Pandemic: A Moderated Mediation Model of Anxiety and Perceived Herd

Individuals' unverified information sharing on social media, namely, sharing information without verification, is a major cause of the widespread misinformation amid the COVID-19 pandemic. The association between perceived information overload and unverified information sharing has been well documented in the cognitive overload approach. However, little is known about the underlying mechanism of this process. This study aims to explore the mediating role of anxiety and the moderating role of perceived herd between perceived information overload and unverified information sharing on WeChat. Anxiety demonstrates people's emotional response to the pandemic, whereas perceived herd describes a willingness to share certain information if it has been shared by many. The results of an online survey in China (N = 525) showed that perceived information overload was positively associated with unverified information sharing. In addition, this relationship was partially mediated by anxiety. Moreover, perceived herd positively moderated the link between anxiety and unverified information sharing, such that the indirect effect of perceived information overload on unverified information sharing via anxiety was significant in conditions where the level of perceived herd was high, whereas the indirect effect was not significant in conditions where the level of perceived herd was low. The moderated mediation model extends the cognitive overload approach and indicates that unverified information sharing is not only an individual strategy to cope with information overload but also a herding behavior to manage anxiety. Practical implications for curbing people's tendencies toward unverified information sharing on social media are discussed.

Saturation, acceleration and information pathologies: the conditions that influence the emergence of information literacy safeguarding practice in COVID-19-environments

Purpose

The purpose of this second study into information literacy practice during the COVID-19 pandemic is to identify the conditions that influence the emergence of information literacy as a safeguarding practice.

Design/methodology/approach

The qualitative research design comprised one to one in-depth interviews conducted virtually during the UK's second and third lockdown phase between November 2020 and February 2021. Data were coded and analysed by the researchers using constant comparative techniques.

Findings

Continual exposure to information creates the “noisy” conditions that lead to saturation and the potential for “information pathologies” to act as a form of resistance. Participants alter their information practices by actively avoiding and resisting formal and informal sources of information. These reactive activities have implications for standard information literacy empowerment discourses.

Research limitations/implications

The paper is limited to the UK context.

Practical implications

Findings will be useful for librarians and researchers who are interested in the theorisation of information literacy as well as public health and information professionals tasked with designing long-term health promotion strategies.

Social implications

This paper contributes to our understandings of the role that information literacy practices play within ongoing and long-term crises.

Originality/value

This paper develops research into the role of information literacy practice in times of crises and extends understanding related to the concept of empowerment, which forms a central idea within information literacy discourse.

Facing double jeopardy: Experiences of driving cessation in older adults during COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic is a multidimensional phenomenon whose consequences can be detected in various economic, social, cultural, and political areas. Driving cessation in older adults is one of the areas affected by the social consequences of this crisis. This study aimed to explain the concept of facing the double jeopardy of the COVID-19 pandemic and driving cessation in older adults.

METHODS

This qualitative study was conducted using a thematic analysis approach. Fifteen older adults aged 60 years and above who lived in a community-based setting of Shiraz, Iran were selected based on purposive sampling. The data were collected using semi-structured interviews.

RESULTS

The findings indicated two themes, namely dualization of common challenges and fitness with limitations, and nine sub-themes, which showed the experiences of older adults regarding the main theme of facing the double jeopardy of the COVID-19 pandemic and driving cessation.

DISCUSSION

Facing the double jeopardy created unique challenges for older adults, as the combined adverse effects of the two sources simultaneously put them at a greater risk. This double jeopardy endangered the health of older adults in various dimensions. This can be the beginning of a new era in older adults' life and care. In this context, application of telecommunication technology and home-based applications increases the flexibility of older adults as well as their ability to cope with stress to meet their mental, social, and physical health needs.

Too old for technology? Use of wearable healthcare devices by older adults and their willingness to share health data with providers

Wearable healthcare devices offer tremendous promise to effectively track and improve the well-being of older adults. Yet, little is known about the use of wearable devices by older adults. Drawing upon a national survey in US with 1481 older adults, we examine the use of wearable healthcare devices and the key predictors of use viz. sociodemographic factors, health conditions, and technology self-efficacy. We also examine if the predictors are associated with elders' willingness to share health data from wearable devices with healthcare providers. We find low level of wearable use (17.49%) among US older adults. We find significant positive associations between technology self-efficacy, health conditions, and demographic factors (gender, race, education, and annual household income) and use of wearable devices. Men were less likely (OR = 0.62, 95% CI 0.36-1.04) and Asians were more likely (OR = 2.60, 95% CI 0.89-7.64) to use wearables, as did healthy adults (OR = 1.98, 95% CI 1.37-2.87). Those who electronically communicated with their doctors (OR = 1.86, 95% CI 1.16-2.97), and those who searched online for health information (OR = 1.79, 95% CI 1.03-3.10) were more likely to use wearables. Though 80.15% of wearable users are willing to share health data with providers, those with greater technology self-efficacy and favorable attitudes toward exercise are more willing.

Predictive Model of Preventive Behaviors against COVID-19 in the Older Adult: The PREASOC-COVID-19 Study

Background: The purpose of this study was to analyze the relationship between COVID-19 preventive behaviors, as the dependent variable, with risk perception, coping style and sense of coherence, as independent variables, in older people living in the community. Methods: An observational design for predictive model development. This study was reported following the STROBE statement. The subjects were people over 65 years of age living in the community. Data collection included sociodemographic variables related to COVID-19, risk perception and types, coping styles in the face of contagion, sense of coherence, and preventive behaviors in the face of COVID-19. The data collection period was from November 2020 to January 2021. Results: A total of 305 people participated in this study (71.5% women, mean age 71.34 years; 6.9% suffered from COVID-19 and 44.3% knew someone close to them who suffered from the virus). The coping style variables problem-focused, emotion-focused, and sense of coherence subscales Significance and manageability explained 17% of the variable preventive behaviors against COVID-19. There were statistically significant differences by gender in all subscales, with women scoring higher in all of them; Conclusions: Men with low risk perception, extrinsic risk perception, and low sense of coherence presented worse COVID-19 preventive behaviors. It would be interesting to develop specific prevention and health education campaigns for this population.

Exploring the Interpretation of COVID-19 Messaging on Older Adults’ Experiences of Vulnerability

Public health messages and societal discourse during the COVID-19 pandemic have consistently indicated a higher morbidity and mortality risk for older people, particularly those with multiple health conditions. Older adults’ interpretations of pandemic messaging can shape their perceived vulnerability and behaviours. This study examined their perspectives on COVID-19 messaging. Eighteen community-dwelling older adults residing in Manitoba (Canada) participated in semi-structured telephone interviews between July and August 2020, a period of low COVID-19 cases within the province. Inductive thematic analysis was used to identify key themes that described participants’ processes of information interpretation when consuming pandemic-related messages, their emotional responses to messaging and consequent vulnerability, and the impacts of messaging on their everyday lives. Understanding how older adults have construed COVID-19 and pandemic-related messages, and the subsequent impact on their daily behaviours, is the first step towards shaping societal discourse and sets the stage for examining the pandemic’s long-term effects.

Direct and Indirect Effects of COVID-19 in Frail Elderly: Interventions and Recommendations

Frailty is a state of vulnerability to stressors because of a decreased physiological reserve, resulting in poor health outcomes. This state is related to chronic conditions, many of which are risk factors for outcomes in elderly patients having SARS-COV-2. This review aims to describe frailty as a physiological vulnerability agent during the COVID-19 pandemic in elderly patients, summarizing the direct and indirect effects caused by the SARS-COV-2 infection and its prognosis in frail individuals, as well as the interventions and recommendations to reduce their effects. Cohort studies have shown that patients with a Clinical Frailty Scale higher than five have a higher risk of mortality and use of mechanical ventilation after COVID-19; nonetheless, other scales have also associated frailty with longer hospital stays and more severe forms of the disease. Additionally, the indirect effects caused by the pandemic have a negative impact on the health status of older people. Due to the above, a holistic intervention is proposed based on a comprehensive geriatric assessment for frail patients (preventive or post-infection) with emphasis on physical activity and nutritional recommendations, which could be a potential preventive intervention in viral infections by COVID-19.

Evaluation of a self-care education program for older adults in Iran using a lifestyle improvement model

BACKGROUND

Older adults and their caregivers often believe it is either too late or too difficult to make health-focused lifestyle changes. However, this is inaccurate, as older adults can make health promotion focused lifestyle changes thereby improving their health. This study developed and evaluated a self-care education program using Pender's Health Promotion Model and its influence on health-focused behaviour changes among older Iranians.

METHOD

This was a quasi-experimental study with a convenience sample of 136 community-living older adults from Tabriz, Iran. The participants were randomly assigned to either an intervention (n = 69) or control (n = 67) group. Chi-square test, independent t tests and Analysis of covariance (ANCOVA) statistical methods were used to compare pre- and post-intervention data, control and intervention groups and changes over time. The intervention was an eight-week educational program with pre- and post-intervention data collected using the Health Promoting Lifestyle Profile II (HPLP II) questionnaire.

RESULTS

The mean difference and confidence limits of the older adults' health behaviours pre- and post-intervention scores were 2.228 (-5.450 - 9.916) and - 35.820 (-32.051 - 39.588). The covariance analysis adjusting for the baseline values showed significant differences post-intervention (p<0.0001) in the areas of interpersonal communication, physical activity, nutrition, stress management and spiritual growth.

CONCLUSION

The health promotion education intervention illustrated that older Iranians could improve their health outcomes in several areas. Thus, culturally tailored intervention programs can be successful in challenging the opinion that older adults cannot make behaviour changes supporting their health.

Using Technology the Right Way to Support Social Connectedness for Older People in the Era of COVID-19

The restrictions imposed in response to the COVID-19 pandemic pose significant risks to the human rights of older people from limitations in how people are able to engage with their social lives and from increased risk of discrimination linked to conceptualization of COVID-19 as a disease of the old. Further, COVID-19 increases risks of social isolation through public health and societal responses such as lockdowns. These responses have resulted in significant shifts in how citizens and service providers think about technology as a tool to allow people to stay socially connected. However, there are risks to the rights of older people inherent in the use of technology related to their ability to access technology and ageist assumptions that may limit engagement. The ‘Technology and Social Connectedness’ project was a pre-pandemic mixed-methods study involving evidence review, secondary analyses, and qualitative methods. Cross-dataset analyses led to evidence-based guidance to inform a rights-based approach to using technology. This paper provides analysis from the project that foregrounds a rights-based approach demonstrating how we developed the guidance within this framework and, contextualized within the pandemic response in Scotland, how that guidance can help others to protect and uphold the human rights of older people.

Information and Communication Technologies for Managing Frailty: A Systematic Literature Review

Frailty is a prevalent condition among Canadians; over one million are diagnosed as medically frail, and in the next ten years this number will double. Information and telecommunication technologies can provide a low-cost method for managing frailty more proactively. This study aims to examine the range and extent of information and telecommunication technologies for managing frailty in older adults, their technology readiness level, the evidence, and the associated outcomes. A systematic literature review was conducted. Four databases were searched for studies: Medline, EMBASE, CINAHL, and Web of Science. In total, we included 19 studies (out of 9,930) for the data abstraction. Overall, our findings indicate that (1) the proposed frailty phenotype is the most common ground truth to be used for assessing frailty; (2) the most common uses of information and telecommunication technologies for managing frailty are detection, and monitoring and detection, while interventional studies on frailty are very rare; (3) the five main types of information and telecommunication technologies for managing frailty in older adults are information and telecommunication technology-based platforms, smartphones, telemonitoring (home monitoring), wearable sensors and devices (commercial off-the-shelf), and multimedia formats for online access; (4) the technology readiness level of information and telecommunication technologies for managing frailty in older adults is the “Technology Demonstration” level, i.e., not yet ready to be operated in an actual operating environment; and (5) the level of evidence is still low for information and telecommunication technology studies that manage frailty in older adults. In conclusion, information and telecommunication technologies for managing frailty in the older adult population are not yet ready to be full-fledged technologies for this purpose.