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Fang Y, Ma L, Chen H, Cai S, Jiang W, Luo F, Wang J, Zheng E, Zhou C, Zhu L, Guo Q, Yin Z. The effect of social isolation on the cognitive ability of the oldest old in Chinese nursing homes in post-COVID-19: a moderated chain mediation model. Front Psychol 2024; 15:1421729. [PMID: 39286555 PMCID: PMC11404041 DOI: 10.3389/fpsyg.2024.1421729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 08/02/2024] [Indexed: 09/19/2024] Open
Abstract
Background Both pre-or post-COVID-19, older adults residing in nursing homes are at significant risk for social isolation, which is negatively associated with cognitive ability. Currently, the elderly aged 80 years and older are the fastest-growing age group globally. The extent of social isolation within this group post-COVID-19 and its impact on cognitive abilities remain inadequately explored. Objective This research aimed to evaluate the prevalence of social isolation among the oldest old in Chinese nursing homes post-COVID-19 and to investigate the mediating and moderating roles of basic activities of daily living (BADL), depression, and subjective socioeconomic status in the relationship between social isolation and cognitive ability. Methods This cross-sectional study included 453 participants aged 80 years and older from 11 nursing homes in Ningbo, Zhejiang Province, China. Social isolation was assessed using the Lubben Social Network Scale-6 (LSNS-6), cognitive ability using the Mini-Mental State Examination (MMSE), BADL using the Barthel Index (BI), and depression using the Patient Health Questionnaire-9 items (PHQ-9). Mediation and moderation effects were statistically analyzed using SPSS 23.0 and PROCESS 3.5. Results The mean age of the study sample was 87.1 ± 3.8 years, among whom 60.3% (n = 273) were female, and 56.1% experienced social isolation, with 41.1% and 63.1% being isolated from family and friends, respectively. Social isolation indirectly affected cognitive ability through BADL and depression, respectively, and through the chain mediation effect of BADL and depression. Subjective socioeconomic status moderated the relationships between social isolation and BADL and between social isolation and depression. However, no moderating effect of subjective socioeconomic status was found between social isolation and cognitive ability. Conclusion This study deepens our understanding of the current state of social isolation and its mechanisms of action in the oldest old post-COVID-19 and provides a new basis for future public health policy development and related research.
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Affiliation(s)
- Yi Fang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Linlin Ma
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Huixian Chen
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Shuya Cai
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Wen Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Fen Luo
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Jialu Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Enjie Zheng
- School of Nursing, Wenzhou Medical University, Wenzhou, China
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chuncong Zhou
- School of Nursing, Wenzhou Medical University, Wenzhou, China
- Nursing Department, Naval Hospital of Eastern Theater, Zhoushan, China
| | - Lijuan Zhu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Qiaoqiao Guo
- School of Renji, Wenzhou Medical University, Wenzhou, China
| | - Zhiqin Yin
- School of Nursing, Wenzhou Medical University, Wenzhou, China
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Hao H, Kim M. Moderating role of depression in the association between leisure activity and cognitive function among the disabled older people. Front Public Health 2024; 12:1345699. [PMID: 38680930 PMCID: PMC11045938 DOI: 10.3389/fpubh.2024.1345699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/01/2024] [Indexed: 05/01/2024] Open
Abstract
Background This study delves into the complex interaction between leisure activities and cognitive function in older people with disabilities, with a particular emphasis on the moderating influence of depression. Despite the well-documented cognitive benefits of leisure activities among the older people, the intricate relationship between depression and the association between leisure activities and cognitive function in this specific demographic has been rarely reported. Methods Drawing on data from the 2017-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study meticulously examined a cohort of 713 participants aged 65-89 years. We constructed a moderation model to examine the impact of leisure activity on cognitive function in older people with disabilities, with depression levels as a moderating variable. Results We found a positive association between engagement in leisure activities and cognitive function, highlighting the potential cognitive advantages associated with leisure engagement among disabled older people. However, the present analysis also reveals a significant moderation effect of depression on this relationship, shedding light on the nuanced nature of this association. Specifically, elevated levels of depression emerge as a critical moderator, attenuating the otherwise favorable impact of leisure activities on cognitive function among older people contending with disabilities. Conclusion In conclusion, the findings provide a compelling rationale for tailored interventions that comprehensively target both leisure activity engagement and concurrent depression management, effectively fostering improvements in cognitive function among the cohort of disabled older people.
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Affiliation(s)
| | - Miok Kim
- Department of Social Welfare, Jeonbuk National University, Jeonju, Republic of Korea
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Chen M, Cao X, Wang A, Zhu Y, Lu G, Zhang L, Shen L. A global perspective on risk factors for social isolation in community-dwelling older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 116:105211. [PMID: 37837787 DOI: 10.1016/j.archger.2023.105211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/16/2023] [Accepted: 09/23/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE Older people's physical and mental health are now significantly impacted by social isolation, a major threat to public health. Our goal was to identify the connections between risk factors and social isolation among this population across various geographic areas. METHODS Seven databases were thoroughly searched, from their inception until April 2023. Inclusion and exclusion criteria were used to choose the studies. For the included cross-sectional studies, we used the Agency for Healthcare Research and Quality (AHRQ) to assess the probability of bias, and the Newcastle-Ottawa scale for the cohort studies. The statistical analysis was performed using STATA 15 to calculate pooled odds ratios (OR) and 95% CI. RESULTS All 3043 papers were carefully examined, and 42 satisfied the criteria for inclusion. The results indicated that multi-domain risk factors and social isolation among older persons worldwide are significantly correlated. These multi-domain risk factors included biological factors, socioeconomic factors, and psychological and behavioral factors. It is also important to note that these factors may vary from region to region. CONCLUSION Many domain factors were linked to social isolation in older individuals living in communities throughout the world. To develop effective strategies for controlling social isolation, it is crucial to conduct assessments of social isolation risk factors in local communities.
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Affiliation(s)
- Meiqian Chen
- Department of Scientific Research, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, 1558 Sanhuan North Road, Huzhou, Zhejiang, 313000, China; School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China
| | - Xiang Cao
- School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China
| | - Afeng Wang
- School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China
| | - Yi Zhu
- School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China
| | - Guanzhen Lu
- Department of Scientific Research, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, 1558 Sanhuan North Road, Huzhou, Zhejiang, 313000, China; School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China.
| | - Li Zhang
- Department of Scientific Research, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, 1558 Sanhuan North Road, Huzhou, Zhejiang, 313000, China
| | - Lijuan Shen
- School of Medicine and Nursing, Huzhou University,759 Erhuan East Road, Huzhou, Zhejiang, 313000, China
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Lan L, Hai P, Luo J, Li R, Wang Y. Medical behaviours and medication adherence of older hypertensive patients in different medical insurance programs in Beijing, China: a cross-sectional study. BMC Geriatr 2023; 23:878. [PMID: 38124122 PMCID: PMC10734068 DOI: 10.1186/s12877-023-04476-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Grassroots medical institutions are the primary "battlefield" of hypertension management based on hierarchical diagnosis and treatment policies in China. There is a considerable difference in the insured population and reimbursement ratio between different medical insurance programs. The management of hypertension directly affects the development trend of cardiovascular and cerebrovascular diseases. METHODS To understand the difference between different medical insurance programs regarding the management of older hypertensive patients, all outpatients aged 60 and above with hypertension in the basic medical insurance database of Beijing, China, from April 1, 2019, to January 31, 2020, were included. Medical behaviours included patients' choice of hospital level, type of hospital, number of hospitals visited, grassroots medical institutions and cross-district visits. Medication adherence was evaluated by calculating the medication possession ratio of antihypertensive medications. First, we adopted a statistical description for medical behaviours and medication adherence. Then, multivariate logistic regression was used to analyse the influencing factors of medication adherence. RESULTS This study included 1.29 million patients with Urban Employee Basic Medical Insurance (UEBMI) and 0.31 million patients with Urban‒Rural Resident Basic Medical Insurance (URRBMI). The proportions of patients with UEBMI who chose tertiary hospitals, comprehensive hospitals, grassroots medical institutions and cross-district visits were 25.84%, 56.09%, 57.34% and 39.32%, respectively, while those of patients with URRBMI were 11.14%, 60.59%, 81.28% and 6.07%, respectively. The medication adherence rates of men and women taking one medication were 61.04% and 55.86%, respectively. UEBMI patients who took their medication accounted for 62.36%, while only 40.27% of URRBMI patients adhered to their medication. The percentages of young-old, old-old and oldest-old patients who took their antihypertensive medications were 58.05%, 59.09% and 56.78%, respectively. The adherence to taking ≥ 2 medications (35.47%) was lower than that to taking one medication (58.33%). The medication adherence rates of patients with UEBMI and URRBMI for taking ≥ 2 medications were 37.21% and 27.45%, respectively. CONCLUSIONS Patients with UEBMI were more inclined to choose tertiary hospitals and cross-district visits than patients with URRBMI. The adherence of patients with UEBMI was better than that of patients with URRBMI in China.
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Affiliation(s)
- Lan Lan
- IT Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Pengcheng Hai
- Department of Internal Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jiawei Luo
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, 610044, China
| | - Rui Li
- IT Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- Chinese Institute for Brain Research, Beijing, 100070, China.
- National Center for Neurological Disorders, Beijing, 100070, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China.
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, 100070, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100070, China.
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Lo TW, Chan GH. Understanding the life experiences of elderly in social isolation from the social systems perspective: using Hong Kong as an illustrating example. Front Psychiatry 2023; 14:1114135. [PMID: 37476537 PMCID: PMC10355048 DOI: 10.3389/fpsyt.2023.1114135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/02/2023] [Indexed: 07/22/2023] Open
Abstract
Aim The elderly in social isolation often referred to as older people who experience social alienation with little social support from their family, peers, and community suffer from a poor quality of life and well-being. Since their life experiences are affected by a range of factors from different levels, this study seeks to investigate their current life situations and experiences from a social systems perspective. Methods A qualitative study was conducted to enrich the understanding of their current life situations and experiences and to generate corresponding practice implications. In this study, there were 13 elderly participants in social isolation, which were users of a social service agency in Hong Kong. They took part in a semi-structured individual interview, sharing their life stories about their daily lives, social relationships, and sense of well-being. Qualitative results were analyzed based on these dimensions. Results Results showed that the elderly participants in social isolation had a low level of social support and participation in social activities. Their life experiences and situations were affected by multiple levels of factors that were interrelated. Conclusion The results support the application of the social systems perspective in investigating the living conditions of the elderly in social isolation. The corresponding practice implications were also discussed.
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Affiliation(s)
- T. Wing Lo
- Caritas Institute of Higher Education, Tseung Kwan O, New Territories, Hong Kong SAR, China
| | - Gloria Hongyee Chan
- Department of Social and Behavioral Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
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Tang D, Mair CA, Hu Q. Widowhood, social networks, and mental health among Chinese older adults: The moderating effects of gender. Front Psychol 2023; 14:1142036. [PMID: 37077844 PMCID: PMC10106722 DOI: 10.3389/fpsyg.2023.1142036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/06/2023] [Indexed: 04/05/2023] Open
Abstract
ObjectivesThis study aimed to examine the three-way interaction between widowhood, social ties, and gender and its effects on older adults’ mental health, including depressive symptoms and life satisfaction, in the context of China.MethodsParticipants were 7,601 Chinese older adults. Their social network was divided between family and friendship ties, and their mental health was measured by depressive symptoms and life satisfaction. Linear regression was employed to analyze the associations between widowhood, social networks, and mental health, as well as to explore the moderating effect of gender.ResultsWidowhood is associated with more depressive symptoms, but not with life satisfaction, while family and friendship ties are associated with less depressive symptoms and greater life satisfaction. Furthermore, the lack of family ties is associated with more depressive symptoms for widowed men compared to married older men, while it is associated with lower life satisfaction for widowed women compared to married older women.ConclusionFamily ties are the most important social support resource for Chinese older adults, especially for the widowed group. The vulnerability of older widowed men who lack family ties in China deserves public concern and attention.
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Affiliation(s)
- Dan Tang
- Center for Population and Development Studies, Institute of Gerontology, Family and Gender Study Center, Renmin University of China, Beijing, China
| | - Christine A. Mair
- Department of Sociology, Anthropology and Public Health, University of Maryland, Baltimore County, Baltimore, MD, United States
| | - Qing Hu
- Institute of Gerontology, Renmin University of China, Beijing, China
- *Correspondence: Hu Qing,
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Yang X, Chen P, Zhang Y. How mentally healthy we are during the pandemic? Findings from changed travel behavior. JOURNAL OF TRANSPORT & HEALTH 2023; 29:101587. [PMID: 36909252 PMCID: PMC9986682 DOI: 10.1016/j.jth.2023.101587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Background Many people changed their travel behavior during the coronavirus pandemic with more telecommuting, fewer trip frequencies, and less use of transit and ride-hailing to avoid infection. The lack of outdoor activities may result in social isolation and then trigger anxiety or depressive symptoms. Research objective This study examines the relationship between anxiety and depression, and correlates various sociodemographic, income, job status, health-related factors, and travel behavior changes in six large U.S. cities. Data U.S. Census Household Pulse Survey Phases 3.0 and 3.1 are employed. Method GAD-2 and PHQ-2 are used to screen the scores of anxiety and depression. The synthetic minority oversampling technique is applied to correct sample distribution. The multivariate mixed model is employed to examine relationships. Results (1) Anxiety and depression are positively correlated, and the percentage of high anxiety is greater than the percentage of high depression. (2) The levels of anxiety and depression significantly vary across the six cities. (3) Women, young, singles, and white people have higher levels of anxiety and depression during the pandemic. (4) People who are willing to receive vaccination tend to have higher levels of anxiety and depression. (5) The prevalence of depressive disorders is significantly lower in the high-income group. (6) People who applied for unemployment insurance and experienced expense difficulties are more likely to suffer high levels of anxiety and depression. (7) Travel behavior changes, measured by increased telecommuting, reduced trip frequency, and reduced use of transit and ride-hailing, all suggest positive correlations with anxiety and depression. Conclusions More assistance and attention should be given to women, singles, and low-income households to reduce the prevalence of mental stress in vulnerable groups. Telecommuting can be but need to work with other travel demand management strategies. Travel and outdoor activities should be promoted under the new normal.
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Affiliation(s)
- Xiankui Yang
- Department of Mathematics and Statistics, University of South Florida, Tampa, FL, USA
| | - Peng Chen
- School of Public Affairs, University of South Florida, Tampa, FL, USA
| | - Yu Zhang
- Department of Civil and Environmental Engineering, University of South Florida, Tampa, FL, USA
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Sun J, Jiang W, Li H. Social isolation and loneliness among Chinese older adults: Examining aging attitudes as mediators and moderators. Front Psychol 2022; 13:1043921. [PMID: 36562076 PMCID: PMC9763440 DOI: 10.3389/fpsyg.2022.1043921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Due to labor migration and social changes, the Chinese elderly are facing significant social isolation, along with changes in aging attitudes. However, whether social isolation affects loneliness among the Chinese elderly and whether this relationship is moderated and mediated by aging attitudes is unclear. This empirical study aimed to respond to the above questions in the Chinese context, Based on the data from the 2014 China Longitudinal Aging Social Survey (N = 6,645), the results showed that social isolation is a positive predictor of loneliness; aging attitudes mediate the relationship between social isolation and loneliness. Social isolation affects the loneliness of the elderly partially by weakening positive aging attitudes and strengthening negative aging attitudes; aging attitudes moderate the effect of social isolation on loneliness. For those older adults with higher positive aging attitudes, social isolation has a much smaller effect on loneliness. While for those older adults with higher negative aging attitudes, social isolation has a more substantial effect on their feelings of loneliness. Our results indicate that less social isolation is an effective way to relieve loneliness, and maintaining higher positive aging attitudes and lower negative aging attitudes, is important for the Chinese elderly to prevent loneliness when facing social isolation.
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Affiliation(s)
- Juanjuan Sun
- School of Sociology and Population Studies, Renmin University of China, Beijing, China,Center for Population and Development Studies, Renmin University of China, Beijing, China
| | - Weikang Jiang
- School of Public Administration, Xiangtan University, Xiangtan, China
| | - Haohao Li
- School of Sociology and Population Studies, Renmin University of China, Beijing, China,*Correspondence: Haohao Li,
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Friendship in Later Life: How Friends Are Significant Resources in Older Persons' Communication about Chronic Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095551. [PMID: 35564945 PMCID: PMC9103645 DOI: 10.3390/ijerph19095551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/22/2022] [Accepted: 04/30/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND This article focuses on how older persons perceive their friends' role in their daily experience of chronic pain. It reports part of the results of a study in which we interviewed 49 participants, aged 75 and older, about the way they communicate about chronic pain within their social network. METHODOLOGY Using discourse and content analysis, we first examine older persons' definition of friendship, and then identify the various dimensions of friendship that are engaged in the communication about chronic pain. RESULTS Participants define close friends as people with whom they share intimacy and social proximity (same gender, age and experience of pain). These dimensions allow older persons to talk freely about their pain without the fear of being judged or rejected, particularly when it is related to a dynamic of reciprocity. CONCLUSIONS This article shows that the contribution of friends to the everyday life of older persons with chronic pain is mainly that of providing emotional support.
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Associations of face-to-face and non-face-to-face social isolation with all-cause and cause-specific mortality: 13-year follow-up of the Guangzhou Biobank Cohort study. BMC Med 2022; 20:178. [PMID: 35501792 PMCID: PMC9059436 DOI: 10.1186/s12916-022-02368-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/06/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although social isolation has been associated with a higher mortality risk, little is known about the potential different impacts of face-to-face and non-face-to-face isolation on mortality. We examined the prospective associations of four types of social isolation, including face-to-face isolation with co-inhabitants and non-co-inhabitants, non-face-to-face isolation, and club/organization isolation, with all-cause and cause-specific mortality separately. METHODS This prospective cohort study included 30,430 adults in Guangzhou Biobank Cohort Study (GBCS), who were recruited during 2003-2008 and followed up till Dec 2019. RESULTS During an average of 13.2 years of follow-up, 4933 deaths occurred during 396,466 person-years. Participants who lived alone had higher risks of all-cause (adjusted hazard ratio (AHR) 1.24; 95% confidence interval (CI) 1.04-1.49) and cardiovascular disease (CVD) (1.61; 1.20-2.03) mortality than those who had ≥ 3 co-habitant contact after adjustment for thirteen potential confounders. Compared with those who had ≥ 1 time/month non-co-inhabitant contact, those without such contact had higher risks of all-cause (1.60; 1.20-2.00) and CVD (1.91; 1.20-2.62) mortality. The corresponding AHR (95% CI) in participants without telephone/mail contact were 1.27 (1.14-1.42) for all-cause, 1.30 (1.08-1.56) for CVD, and 1.37 (1.12-1.67) for other-cause mortality. However, no association of club/organization contact with the above mortality and no association of all four types of isolation with cancer mortality were found. CONCLUSIONS In this cohort study, face-to-face and non-face-to-face isolation were both positively associated with all-cause, CVD-, and other-cause (but not cancer) mortality. Our finding suggests a need to promote non-face-to-face contact among middle-aged and older adults.
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Cheng X, Cosco TD, Ariyo T. Decreasing Social Isolation to Enhance Mental Health among Older Adults in China: A Mediation Analysis of Aging Attitude. Front Psychol 2021; 12:735740. [PMID: 34630248 PMCID: PMC8499704 DOI: 10.3389/fpsyg.2021.735740] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
A large body of literature has examined the relationship between social isolation and mental health in older adults. However, only a few studies have examined the mediating effects of aging attitudes on this relationship. This study investigated the impact of objective isolation (family isolation, friend isolation, and community isolation), and subjective social isolation (perceived isolation) on the mental health of Chinese older adults, and the mediating effect of aging attitudes. Mental health was assessed through depressive symptoms, using the Epidemiological Studies Depression Scale. The research sample comprising 7,024 elderly adults (60 years old), was obtained from the nationally representative 2014 Chinese Longitudinal Aging Social Survey. The regression analysis indicated that objective social isolation and subjective social isolation are independently related to mental health among older adults. Furthermore, in the mediation analysis, aging attitude was found to play a significant mediating role between social isolation and mental health. Our study concludes that though, objective and subjective social isolation are issues affecting mental health in older people, however, aging attitude also needs to be factored in that relationship as we have shown that there is a significant mediating effect.
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Affiliation(s)
- Xinfeng Cheng
- School of Economics and Management, Xi’an Technological University, Xi’an, China
| | - Theodore D. Cosco
- Department of Gerontology, Gerontology Research Center, Simon Fraser University, Vancouver, BC, Canada
| | - Tolulope Ariyo
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, China
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The Enabling Role of ICT to Mitigate the Negative Effects of Emotional and Social Loneliness of the Elderly during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083923. [PMID: 33917966 PMCID: PMC8068368 DOI: 10.3390/ijerph18083923] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/21/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: The COVID-19 pandemic has been especially hard on the elderly owing to their particular vulnerability to the virus. Their confinement to prevent the spread of the virus resulted in social isolation, often linked to the unwanted loneliness that hinders their emotional well-being. The enabling capacity of ICT (Information and Communication Technology) to overcome the negative effects of this isolation requires special attention. The purpose of this research is to understand the impact of the use of ICT on the emotional well-being of elderly people during their confinement. (2) Methods: A qualitative exploration method based on four focus groups with elderly people aged 60 years or older and three in-depth personal interviews with experts in education of the elderly were carried out. (3) Results: Research results evidence a negative emotional impact of the confinement (lack of physical contact with their loved ones, fear and uncertainty, feeling of loneliness, sadness at the loss of family members) on the emotional well-being of study participants. Furthermore, the operational capacity of ICT to prevent infection, as well as their positive emotional and humanizing role in providing access to entertainment and hobbies, and in improving self-esteem was also acknowledged. (4) Conclusions: ICT have become a valuable ally for elderly people aged 60 years and older to mitigate the negative effects of social isolation and loneliness imposed by the confinement.
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Kamberi F, Jaho J, Mechili EA, Sinaj E, Skendo H. Effect of Covid-19 pandemic on mental health among Albanian people residing in the country and abroad - Implications for mental care. Arch Psychiatr Nurs 2020; 34:507-512. [PMID: 33280673 PMCID: PMC7402241 DOI: 10.1016/j.apnu.2020.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/06/2020] [Accepted: 08/03/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Coronavirus disease caused by the novel coronavirus Covid-19 is a current worldwide outbreak. The use of quarantine and isolation proved effective in containing the spread of infection. OBJECTIVES The purpose of this cross-sectional study was to assess the mental health of Albanian people residing in the country and abroad during the quarantine period for the Covid-19 pandemic. DESIGN This study was carried out from 25th March - 20th April 2020 through a web survey shared on social networks. The goal was to reach at least the minimum sample size for cross-sectional studies. The Patient Health Questionnaire (PHQ-9) was used to assess mental health. Chi-square (χ2) and Fisher -Exact test were used to assess the statistical significance among variables. P values ≤0.05 were considered statistically significant. RESULTS 715 participants were included in the final analyses (78.41% females and 21.53% males). Most were residents in Albania (80.41%) and the others resided mainly in Italy (6.89%), Greece (3.51%), Germany (2.43%), Kosovo (1.62%) and the UK (1.69%). Statistical association was found between gender, country of residency and measures taken. Summary score of PHQ-9 items was 6.4662. The total score of depression classification shows that 31.82% and 12.90% of participants have respectively mild and moderate depression. Female participants showed the highest score for some items of PHQ-9, p≤0.05. CONCLUSIONS Findings suggest that health care professionals should recognize and address mental health problems associated with Covid-19 especially in vulnerable groups. Acting in a timely and proper manner is essential in preventing these problems from becoming chronic.
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Affiliation(s)
- Fatjona Kamberi
- Faculty of Public Health, Research Center of Public Health, University of Vlore "Ismail Qemali", 9400, Vlore, Albania.
| | - Jerina Jaho
- Faculty of Public Health, Research Center of Public Health, University of Vlore "Ismail Qemali", 9400, Vlore, Albania
| | - Enkeleint Aggelos Mechili
- Faculty of Public Health, Department of Health Care, University of Vlore "Ismail Qemali", 9400, Vlore, Albania
| | - Enkeleda Sinaj
- University of Medicine Tirana, Department of Rehabilitation, Faculty of Technical Medical Sciences, 1001 Tirana, Albania
| | - Hera Skendo
- University of Bonn, The Faculty of Mathematics and Natural Sciences, Institute of Pharmacy, An der Immenburg 4, 53121 Bonn, Germany
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Jiao W, Chang AWY. Unhealthy aging? Featuring older people in television food commercials in China. Int J Nurs Sci 2020; 7:S67-S73. [PMID: 32995382 PMCID: PMC7501497 DOI: 10.1016/j.ijnss.2020.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/03/2020] [Accepted: 07/14/2020] [Indexed: 11/25/2022] Open
Abstract
Objectives Advertising messages can affect the public as a risk or protective factor for socially disadvantaged groups, and they may reflect how characters reflect perceptions are perceived in a society. This study aimed to investigate how older people are portrayed in televised food commercials from the approach of a healthy aging perspective in contemporary Chinese society. Methods All televised advertising in the Ad Topic archive were screened against inclusion and exclusion criteria, and a total of 164 commercials from the years of 2016–2019 that portrayed Chinese older people were sampled. The association between the main older characters with the product categories, healthy vs. unhealthy foods, use of health claims, sex, type of spokesperson, companions, and tones and manners were included in the analysis. Results Older people more frequently appeared in unhealthy food products than in healthy food products. Health claims involving older adults were portrayed adequately, whereas nursing professions as companions of older adults were overlooked. Positive advertising that delivered happy, caring, or warm tones was overwhelmingly represented. Thus, the advertising messages circulated in China represent a binary stereotype model of images of older adults’ characteristics that reflect ageist and the so-called agelessism, referring to the new application of the look from the approach of social psychology and marketing field. Conclusions This study examined aging discrimination reflected in advertisements. Studies exploring the impact of a crisis remain limited. Research is needed to improve the accuracy of advertised healthy older adults and normal aging.
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Affiliation(s)
- Wen Jiao
- Department of Communication, Faculty of Social Sciences, University of Macau, China
| | - Angela Wen-Yu Chang
- Department of Communication, Faculty of Social Sciences, University of Macau, China
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15
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Zhao L, Liang C, Gu D. Mobile Social Media Use and Trailing Parents' Life Satisfaction: Social Capital and Social Integration Perspective. Int J Aging Hum Dev 2020; 92:383-405. [PMID: 32098476 DOI: 10.1177/0091415020905549] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In recent years, a special group of elderly migrants emerged in some developing countries, namely "trailing parents," who migrated with adult children in their later years. Lots of developing countries such as China have an increasing number of old people using mobile social media for social interaction, information, and entertainment. Based on social capital theory, we developed a research model and investigated the relationship between mobile social media use (MSMU) and social capital, social integration, and life satisfaction of trailing parents. We completed an empirical study by collecting 244 valid samples. The results show that MSMU has a positive impact on trailing parents' life satisfaction, and bonding social capital, bridging social capital and social integration are all important predictors of trailing parents' life satisfaction. Furthermore, social capital and social integration play an important chain mediation role in the relationship between MSMU and trailing parents' life satisfaction.
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Affiliation(s)
- Lei Zhao
- 12513 School of Management, Hefei University of Technology, Hefei, Anhui, China.,Wendian College, Anhui University, Hefei, Anhui, China
| | - Changyong Liang
- 12513 School of Management, Hefei University of Technology, Hefei, Anhui, China
| | - Dongxiao Gu
- 12513 School of Management, Hefei University of Technology, Hefei, Anhui, China
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