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Park MSA, Badham S, Vizcaino-Vickers S, Fino E. Exploring Older Adults' Subjective Views on Aging Positively: Development and Validation of the Positive Aging Scale. THE GERONTOLOGIST 2024; 64:gnae088. [PMID: 39051130 PMCID: PMC11374880 DOI: 10.1093/geront/gnae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Historically, aging research has focused primarily on health deterioration and negative aspects associated with aging. This has limited the scope of our understanding of the experience of aging and the relationships between aging and well-being from an integrative biopsychosocial perspective. In the same vein, there is a lack of reliable and valid assessments of aging that capture the positive aspects that characterize and improve the subjective experience of this period of life, particularly one that focuses on psychosocial well-being, including meaningful experiences and activities, group memberships, and general abilities. This study presents the development and validation of the Positive Aging Scale (PAS), a novel self-report assessment. RESEARCH DESIGN AND METHODS This was an online cross-sectional study conducted on 501 UK residents aged ≥60 years. A number of self-reported items and measures of positive aging, general health, well-being, and cognitive functioning were administered to the sample. We used exploratory and confirmatory factor analyses and assessed the dimensionality, reliability, and concurrent criterion-related validity of the PAS. RESULTS The results suggested that a unidimensional solution represents the data well, with the positive aging factor adequately loading on 8 items, and the solution showing factorial invariance between young-old and old participants (i.e., ≥75 years). Total PAS scores positively correlate with general health, well-being, and cognitive functioning. DISCUSSION AND IMPLICATIONS The PAS demonstrated strong psychometric properties and the findings highlight correlations between the PAS and key outcomes of positive aging, including general health. Implications for research and interventions are discussed.
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Affiliation(s)
| | - Stephen Badham
- School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | | | - Emanuele Fino
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
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McCollum SE, Canter O, Fasanello VJ, Gronsky S, Haussmann MF. Birds of a feather age together: telomere dynamics and social behavior predict life span in female Japanese quail (Coturnix japonica). Front Endocrinol (Lausanne) 2024; 15:1363468. [PMID: 38808110 PMCID: PMC11130416 DOI: 10.3389/fendo.2024.1363468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 04/23/2024] [Indexed: 05/30/2024] Open
Abstract
Social support is vital for mental and physical health and is linked to lower rates of disease and early mortality. Conversely, anti-social behavior can increase mortality risks, both for the initiator and target of the behavior. Chronic stress, which also can increase mortality, may serve as an important link between social behavior and healthy lifespan. There is a growing body of literature in both humans, and model organisms, that chronic social stress can result in more rapid telomere shortening, a measure of biological aging. Here we examine the role of anti-social behavior and social support on physiological markers of stress and aging in the social Japanese quail, Coturnix Japonica. Birds were maintained in groups for their entire lifespan, and longitudinal measures of antisocial behavior (aggressive agonistic behavior), social support (affiliative behavior), baseline corticosterone, change in telomere length, and lifespan were measured. We found quail in affiliative relationships both committed less and were the targets of less aggression compared to birds who were not in these relationships. In addition, birds displaying affiliative behavior had longer telomeres, and longer lifespans. Our work suggests a novel pathway by which social support may buffer against damage at the cellular level resulting in telomere protection and subsequent longer lifespans.
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Affiliation(s)
- Shannon E. McCollum
- Department of Biology, Bucknell University, Lewisburg, PA, United States
- Cellular and Molecular Biology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Olivia Canter
- Department of Chemistry, Duke University, Durham, NC, United States
| | | | - Sarah Gronsky
- Department of Biology, Bucknell University, Lewisburg, PA, United States
| | - Mark F. Haussmann
- Department of Biology, Bucknell University, Lewisburg, PA, United States
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3
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Cui K, Zou W, Ji X, Zhang X. Does digital technology make people healthier: the impact of digital use on the lifestyle of Chinese older adults. BMC Geriatr 2024; 24:85. [PMID: 38254001 PMCID: PMC10804579 DOI: 10.1186/s12877-023-04651-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND With the arrival of the era of large-scale production, sharing and application of data, digital use has gradually changed people's daily entertainment, consumption, social interaction, learning and other behaviors in its efficient form. This paper mainly discusses whether this fast and convenient behavior leads Chinese older adults to adopt healthier lifestyles. METHODS Using the most recent information from the Chinese Family Panel Studies (CFPS) in 2020, this paper conducted a descriptive statistical analysis on the basic situation of digital use and lifestyles among Chinese older adults and used a structural equation model to analyse the influence of frequency and types of digital use in a variety of different aspects of the real life of Chinese older adults. RESULTS Research revealed that the quality of life of Chinese older adults improved significantly as a result of their use of digital technology. The frequency of digital use (FDU) significantly improved Chinese older adults' diet, sleep, exercise, smoking and drinking, and relieved their depression. The types of digital use (TDU) had a significant positive correlation with the lifestyle of Chinese older adults, especially in the influence of digital entertainment (DE), digital consumption (DC) and digital social interaction (DI) on the lifestyle of Chinese older adults. CONCLUSIONS Digital use can improve the health of Chinese older adults by promoting a healthy lifestyle through various means. The findings of this study have a substantial positive impact on bridging the digital divide that Chinese older adults face, as well as fostering the integration of digital use into their healthy lifestyles.
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Affiliation(s)
- Kaichang Cui
- Social Security Research Center, Shanghai University of Engineering Science, Shanghai, China
| | - Wei Zou
- School of Management, Shanghai University of Engineering Science, Shanghai, China.
| | - Xiang Ji
- School of Management, Shanghai University of Engineering Science, Shanghai, China
| | - Xinghui Zhang
- School of Management, Shanghai University of Engineering Science, Shanghai, China
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Thompson González N, Machanda Z, Emery Thompson M. Age-related social selectivity: An adaptive lens on a later life social phenotype. Neurosci Biobehav Rev 2023; 152:105294. [PMID: 37380041 PMCID: PMC10529433 DOI: 10.1016/j.neubiorev.2023.105294] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
Age-related social selectivity is a process in which older humans reduce their number of social partners to a subset of positive and emotionally fulfilling relationships. Although selectivity has been attributed to humans' unique perceptions of time horizons, recent evidence demonstrates that these social patterns and processes occur in other non-human primates, suggesting an evolutionarily wider phenomenon. Here, we develop the hypothesis that selective social behavior is an adaptive strategy that allows social animals to balance the costs and benefits of navigating social environments in the face of age-related functional declines. We first aim to distinguish social selectivity from the non-adaptive social consequences of aging. We then outline multiple mechanisms by which social selectivity in old age may enhance fitness and healthspan. Our goal is to lay out a research agenda to identify selective strategies and their potential benefits. Given the importance of social support for health across primates, understanding why aging individuals lose social connections and how they can remain resilient has vital applications to public health research.
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Affiliation(s)
- Nicole Thompson González
- Integrative Anthropological Sciences, University of California Santa Barbara, Santa Barbara, CA 93106, USA
| | - Zarin Machanda
- Department of Anthropology, Tufts University, Medford, MA 02155, USA
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Lee SH, Cole SW, Choi I, Sung K, Kim S, Youm Y, Chey J. Social network position and the Conserved Transcriptional Response to Adversity in older Koreans. Psychoneuroendocrinology 2023; 155:106342. [PMID: 37523898 DOI: 10.1016/j.psyneuen.2023.106342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/16/2023] [Accepted: 07/20/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Social connections are crucial to human health and well-being. Previous research on molecular mechanisms in health has focused primarily on the individual-level perception of social connections (e.g., loneliness). This study adopted socio-centric social network analysis that includes all social ties from the entire population of interest to examine the group-level social connections and their association with a molecular genomic measure of health. METHODS Using socio-centric (global) social network data from an entire village in Korea, we investigated how social network characteristics are related to immune cell gene expression among older adults. Blood samples were collected (N = 53, 65-79 years) and mixed effect linear model analyses were performed to examine the association between social network characteristics and Conserved Transcriptional Response to Adversity (CTRA) RNA expression patterns. RESULTS Social network positions measured by k-core score, the degree of cohesive core positions in an entire village, were significantly associated with CTRA downregulation. Such associations emerged above and beyond the effects of perceived social isolation (loneliness) and biobehavioral risk factors (smoking, alcohol, BMI, etc.). Social network size, defined as degree centrality, was also associated with reduced CTRA gene expression, but its association mimicked that of perceived social isolation (loneliness). CONCLUSIONS The current findings implicate community-level social network characteristics in the regulation of individual human genome function above and beyond individual-level perceptions of connectedness.
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Affiliation(s)
- Sung-Ha Lee
- Center for Happiness Studies, Seoul National University, South Korea
| | - Steven W Cole
- Departments of Medicine and Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Incheol Choi
- Center for Happiness Studies, Seoul National University, South Korea; Department of Psychology, Seoul National University, South Korea
| | - Kiho Sung
- Department of Sociology, Yonsei University, South Korea
| | - Somin Kim
- Department of Psychology, Seoul National University, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, South Korea.
| | - Jeanyung Chey
- Department of Psychology, Seoul National University, South Korea.
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Ibáñez-del Valle V, Corchón S, Zaharia G, Cauli O. Social and Emotional Loneliness in Older Community Dwelling-Individuals: The Role of Socio-Demographics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16622. [PMID: 36554512 PMCID: PMC9779629 DOI: 10.3390/ijerph192416622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/30/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Social determinants have a major influence on individuals' health, and among them, loneliness has an important impact on the health of the elderly. OBJECTIVES The aims were to determine loneliness and its social and emotional components in a sample of elderly people and to assess its prevalence and associations with sociodemographic variables. METHODS Analytical, cross-sectional, observational research was carried out based on a population over 60 years of age in Valencia (Spain). Loneliness was assessed with the De Jong-Gierveld Loneliness Scale. RESULTS Five-hundred and thirty community-dwelling individuals participated. The mean age of the sample was 72.7 years (84.2% women); 36.2% suffered from moderate loneliness and 6.6% suffered from extreme loneliness. The sociodemographic variables most significantly related to loneliness were being single, separated, or divorced (p < 0.01). Among widowers, loneliness was inversely associated with years of widowhood (p < 0.01). Having sons/daughters was a significant protective factor (p < 0.05), while having grandchildren or siblings did not have a significant influence. The ability to walk and smartphone and video call use were not associated with loneliness. CONCLUSIONS There is a high prevalence of unwanted loneliness in community-dwelling individuals, and some social factors play an important role. Interventions against loneliness among older people are a priority for welfare and public health.
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Affiliation(s)
- Vanessa Ibáñez-del Valle
- Frailty Research Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
| | - Silvia Corchón
- Frailty Research Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
| | - Georgiana Zaharia
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
| | - Omar Cauli
- Frailty Research Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
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Chen H, Wei D, Janszky I, Dahlström U, Rostila M, László KD. Bereavement and Prognosis in Heart Failure: A Swedish Cohort Study. JACC. HEART FAILURE 2022; 10:753-764. [PMID: 36175061 DOI: 10.1016/j.jchf.2022.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The role of stress in the prognosis of heart failure (HF) is unclear. This study investigated whether the death of a close family member, a severe source of stress, is associated with mortality in HF. OBJECTIVES This study assessed whether the death of a close family member is associated with mortality in HF. METHODS Patients from the Swedish Heart Failure Registry during 2000-2018 and/or in the Swedish Patient Register with a primary diagnosis of HF during 1987-2018 (N = 490,527) were included in this study. Information was obtained on death of family members (children, partner, grandchildren, siblings, and parents), mortality, sociodemographic variables, and health-related factors from several population-based registers. The association between bereavement and mortality was analyzed by using Poisson regression. RESULTS Loss of a family member was associated with an increased risk of dying (adjusted relative risk: 1.29; 95% CI: 1.27-1.30). The association was present not only in case of the family member's cardiovascular deaths and other natural deaths but also in case of unnatural deaths. The risk was higher for 2 losses than for 1 loss and highest in the first week after the loss. The association between bereavement and an increased mortality risk was observed for the death of a child, spouse/partner, grandchild, and sibling but not of a parent. CONCLUSIONS Death of a family member was associated with an increased risk of mortality among patients with HF. Further studies are needed to investigate whether less severe sources of stress can also contribute to poor prognosis in HF and to explore the mechanisms underlying this association.
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Affiliation(s)
- Hua Chen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Dang Wei
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Imre Janszky
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Department of Public Health and Nursing, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulf Dahlström
- Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mikael Rostila
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Krisztina D László
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Merritt SH, Krouse M, Alogaily RS, Zak PJ. Continuous Neurophysiologic Data Accurately Predict Mood and Energy in the Elderly. Brain Sci 2022; 12:brainsci12091240. [PMID: 36138976 PMCID: PMC9497070 DOI: 10.3390/brainsci12091240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/01/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
The elderly have an elevated risk of clinical depression because of isolation from family and friends and a reticence to report their emotional states. The present study explored whether data from a commercial neuroscience platform could predict low mood and low energy in members of a retirement community. Neurophysiologic data were collected continuously for three weeks at 1Hz and averaged into hourly and daily measures, while mood and energy were captured with self-reports. Two neurophysiologic measures averaged over a day predicted low mood and low energy with 68% and 75% accuracy. Principal components analysis showed that neurologic variables were statistically associated with mood and energy two days in advance. Applying machine learning to hourly data classified low mood and low energy with 99% and 98% accuracy. Two-day lagged hourly neurophysiologic data predicted low mood and low energy with 98% and 96% accuracy. This study demonstrates that continuous measurement of neurophysiologic variables may be an effective way to reduce the incidence of mood disorders in vulnerable people by identifying when interventions are needed.
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Hernández-Ascanio J, Ventura-Puertos PE, Rich-Ruiz M, Cantón-Habas V, Roldán-Villalobos AM, Pérula-de Torres LÁ. Conditions for Feasibility of a Multicomponent Intervention to Reduce Social Isolation and Loneliness in Noninstitutionalized Older Adults. Healthcare (Basel) 2022; 10:1104. [PMID: 35742155 PMCID: PMC9223082 DOI: 10.3390/healthcare10061104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/06/2022] [Accepted: 06/11/2022] [Indexed: 11/23/2022] Open
Abstract
AIMS To identify the factors conditioning the feasibility of an intervention to reduce social isolation and loneliness in noninstitutionalized older adults from the perspective of the intervention agents. DESIGN A Dimensional Grounded Theory study conducted from December 2019 to January 2020. METHODS Twelve participants were recruited from an experimental study developed in a health district of a southern Spanish city. Data were collected through focus group meetings, individual interviews, biograms, anecdote notebooks, and the field diaries of two participants not included in the other techniques. Transcripts were analyzed using thematic analysis. FINDINGS Findings were divided into three themes: (a) the elderly between the walls of loneliness, economic difficulties, losses, and the past; (b) intervention agents/volunteers between the walls of inexperience in the management of psychological/emotional processes, lack of moral authority, and difficulty in planning results adapted to the (elderly) person; and (c) intervention between the walls of (interest in) company and assistance at home, lack of involvement ("waiting for you to save them"), and withdrawal/"abandonment". CONCLUSION A profile of the specialized intervention agent, professionalized (or at least a mentored agent), with both technical and relational competencies; a clear understanding of the purposes of the intervention (empowerment, as opposed to having company or being helped with household chores) and the commitment to active participation by the elder; or adequate management of the completion of the intervention (flexibility, attachment management) are some of the main factors contributing to the feasibility of these approaches. IMPACT The findings have potential implications in the field of primary healthcare because primary and community healthcare services can implement corrections to the proposed intervention and ensure its effectiveness under feasible conditions. The nurse is shown as the most appropriate profile to conduct this intervention, although more research is needed to analyze the feasibility of this type of intervention in the daily practice of community nurses.
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Affiliation(s)
- Jose Hernández-Ascanio
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
| | - Pedro Emilio Ventura-Puertos
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
| | - Manuel Rich-Ruiz
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
- CIBER on Frailty and Healthy Ageing, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Vanesa Cantón-Habas
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
| | - Ana María Roldán-Villalobos
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
- Family and Community Medicine Unit of the Córdoba-Guadalquivir Health District, 14004 Cordoba, Spain
| | - Luis Ángel Pérula-de Torres
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
- Family and Community Medicine Unit of the Córdoba-Guadalquivir Health District, 14004 Cordoba, Spain
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LeBlanc RG, Chiodo L, Jacelon CS. Social relationship influence on self-care and health among older people living with long term conditions: A mixed-methods study. Int J Older People Nurs 2022; 17:e12450. [PMID: 35191193 DOI: 10.1111/opn.12450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Social relationships influence health, yet less is known on how social relationships influence self-care among older people living with multiple long-term conditions. OBJECTIVES The purpose of this study was to determine how social networks influence therapeutic self-care behaviours and health among community dwelling older people living with multiple long-term conditions. DESIGN Explanatory sequential mixed-methods. SETTING/SAMPLE Community dwelling older people living in the Northeast United States. METHODS A cross-sectional sample of eighty-nine people aged sixty-five and older participated in telephone surveys. A nested sample of twelve participants completed a follow-up open-ended interview. Descriptive statistics, bivariate correlations and regression statistics were used to examine the associations between social network features and functions with the dependent variables of therapeutic self-care behaviours and health. Qualities that emphasised the contexts of the relationships were integrated in the data analysis. RESULTS The strength of the social network and level of social support influenced the outcomes of therapeutic self-care and mental health. Thematic analysis expanded this explanation of self-care in relation to social network size, psycho-social support, activation of support, interaction frequency and type. CONCLUSION In supporting older people living with multiple long-term conditions, this nursing research offers new ways to understand close social relationships influence on self-care in developing systems of care at the community level. IMPLICATIONS FOR PRACTICE Designing care systems that include small trusted formal and informal caregivers that integrate social network members could improve health outcomes and improve access to supportive resources.
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Affiliation(s)
| | - Lisa Chiodo
- University of Massachusetts, Amherst, Massachusetts, USA
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Wolff JL, Benge JF, Cassel CK, Monin JK, Reuben DB. Emerging topics in dementia care and services. J Am Geriatr Soc 2021; 69:1763-1773. [PMID: 34245585 DOI: 10.1111/jgs.17341] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/16/2021] [Accepted: 05/19/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND The National Institute on Aging (NIA), in conjunction with the Department of Health and Human Services as part of the National Alzheimer's Project Act (NAPA), convened a 2020 Dementia Care, Caregiving, and Services Research Summit Virtual Meeting Series. This review article summarizes three areas of emerging science that are likely to grow in importance given advances in measurement, technologies, and diagnostic tests that were presented at the Summit. RESULTS Dr. Cassel discussed novel ethical considerations that have resulted from scientific advances that have enabled early diagnosis of pre-clinical dementia. Dr. Monin then summarized issues regarding emotional experiences in persons with dementia and their caregivers and care partners, including the protective impact of positive emotion and heterogeneity of differences in emotion by dementia type and individual characteristics that affect emotional processes with disease progression. Finally, Dr. Jared Benge provided an overview of the role of technologies in buffering the impact of cognitive change on real-world functioning and their utility in safety and monitoring of function and treatment adherence, facilitating communication and transportation, and increasing access to specialists in underserved or remote areas. CONCLUSIONS National policy initiatives, supported by strong advocacy and increased federal investments, have accelerated the pace of scientific inquiry and innovation related to dementia care and services but have raised some new concerns regarding ethics, disparities, and attending to individual needs, capabilities, and preferences.
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Affiliation(s)
- Jennifer L Wolff
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jared F Benge
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Christine K Cassel
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Joan K Monin
- Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - David B Reuben
- Department of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Abstract
Abstract
While having social support can contribute to better health, those in poor health may be limited in their capacity to receive social support. We studied the health factors associated with social support among community-dwelling older adults in Singapore. We used data from the third follow-up interviews (2014–2016) of 16,943 participants of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese. Participants were interviewed at a mean age of 73 years (range 61–96 years) using the Duke Social Support Scale (DUSOCS). We first applied ordinary least squares regression to DUSOCS scores and found that those with instrumental limitations, poor self-rated health, cognitive impairment and depression had lower social support scores. We then applied latent class analysis to DUSOCS answer patterns and revealed four groups of older adults based on the source and amount of social support. Among them, compared to the ‘overall supported’ group (17%) with the highest social support scores and broad support from family members and non-family individuals, the ‘family restricted’ (50%) group had the lowest social support scores and only received support from children. Health factors associated with being ‘family restricted’ were instrumental limitations (odds ratio (OR) = 1.33, 95% confidence interval (CI) = 1.19–1.49), poor self-rated health (OR = 1.40, 95% CI = 1.28–1.53), cognitive impairment (OR = 1.19, 95% CI = 1.04–1.37) and depression (OR = 2.50, 95% CI = 2.22–2.82). We found that while older adults in poor health have lower social support scores, they were more likely to receive a lot of support from children. Our results showed that lower social support scores among Singaporean older adults in poor health may not indicate lack of social support, but rather that social support is restricted in scope and intensified around children. These results may apply to other Asian societies where family plays a central role in elder-care.
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13
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Casey ANS, Liu Z, Kochan NA, Sachdev PS, Brodaty H. Cross-Lagged Modeling of Cognition and Social Network Size in the Sydney Memory and Ageing Study. J Gerontol B Psychol Sci Soc Sci 2020; 76:1716-1725. [DOI: 10.1093/geronb/gbaa193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Indexed: 12/26/2022] Open
Abstract
Abstract
Objectives
This study assessed whether reciprocal relationships exist between cognitive function and the social network size of older adults, controlling for age, sex, education, medical conditions, and depressive symptoms.
Methods
Data were collected at biennial follow-ups over 6 years in the Sydney Memory and Ageing Study, a longitudinal cohort study including 1,037 community-based Sydney residents aged 70–90 years without dementia at baseline. We used random intercept cross-lagged panel models to investigate reciprocal associations between social network size and scores in each of 7 cognitive domains including a global score.
Results
Standardized models indicated that within-person deviation in expected language score predicted deviation in expected network size. Within-person deviation in prior expected social network size predicted deviation in expected executive function at year 6. Cross-lagged effects in models of both global cognition and memory, respectively, could not be attributed solely to within-person change.
Discussion
Findings support a co-constitutive view of cognitive function and social relationships in older age. Although both cognition and network size declined over time, slower than expected decline in language ability predicted less than expected contraction in social networks. A similar influence of network size on executive functioning indicated that relationships with friends and family outside of the home contributed significantly to the maintenance of higher order cognitive abilities in older late life. Diverse patterns of influence between cognitive domains and social network size over 6 years underscore the importance of assessing the complex and nuanced interplay between brain health and social relationships in older age.
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Affiliation(s)
- Anne-Nicole S Casey
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, UNSW Sydney, Australia
| | | | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, UNSW Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, UNSW Sydney, Australia
- Neuropsychiatric Institute (NPI), Prince of Wales Hospital, Randwick, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, UNSW Sydney, Australia
- Dementia Centre for Research Collaboration (DCRC), School of Psychiatry, UNSW Sydney, Australia
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