Social needs of older people: a systematic literature review

Prioritizing Protecting Oneself Over the COVID-19 Virus Versus Other Health and Social Needs Among Older Adults Living Alone: A Qualitative Study

BACKGROUND AND OBJECTIVES

People aged 65 and older, deemed most "vulnerable" by public health, were targeted by the coronavirus disease 2019 protection measures, which sought to minimize physical contact and social activities. Older adults living alone were particularly affected by these measures. However, such measures meant to protect the older population may not have necessarily reflected older adults' individual prioritization choices. This study therefore aimed to understand how protecting oneself over the virus was considered in the prioritization of other health and social needs of older adults living alone during the pandemic.

RESEARCH DESIGN AND METHODS

This study adopted a qualitative design. A total of 17 semistructured interviews were conducted between May 2021 and June 2022 with older adults living alone. All interviews were audio-recorded and transcribed verbatim. A reflexive thematic analysis as defined by Braun and Clarke was performed.

RESULTS

Our analysis showed 2 forms of prioritization across 2 themes. This first theme focused on participants who reported prioritizing protecting themselves over the virus by limiting in-person contact and activities. The second theme showed that although several participants reported that protecting themselves over the virus was important to them, the prioritization of this need was not shared by all and, in some cases, evolved over the course of the pandemic.

DISCUSSION AND IMPLICATIONS

Our study demonstrated heterogeneity in the prioritization of older adults needs. Future public health recommendations should consider these variations in the needs and priorities of older adults when determining public health measures.

The Role of the Built Environment in Supporting Older Adults' Engagement: A Narrative Literature Review

OBJECTIVE

This literature review aimed to summarize the existing knowledge surrounding the role of the built environment in supporting older adults' physical and social engagement and identify opportunities for future research and design that facilitates older adults' engagement at multiple environmental scales: from interior spaces to neighborhoods.

BACKGROUND

Physical environments can support or impede older adults' physical and social engagement: willful, motivated involvement in meaningful activity or occupation. Research shows that engagement is a core component of health and well-being and relates to positive health outcomes, including reduced disease risk, better mental health, and improved physical and cognitive function. Thus, designing supportive built environments for engagement can yield significant, positive health and well-being impacts.

METHODS

A systematized search of five databases, a hand search, and an iterative screening process identified 55 studies for inclusion in this review. Through inductive thematic analysis, this review summarizes findings regarding the built environment's role in physical and social engagement in older age and design strategies to facilitate engagement and support health and well-being.

RESULTS

Evidence indicates that built environment characteristics can influence older people's physical and social engagement in homes, neighborhoods, and care settings. The thematic analysis of the included studies identified three key themes concerning the relationships of built environment characteristics to older adults' engagement across multiple environmental scales: connection, access, and security.

CONCLUSIONS

Built environments influence older people's physical and social engagement, significantly affecting their health, well-being, abilities, and longevity. Numerous design strategies can support older adults' engagement, but more research is needed.

Understanding loneliness in late life

Loneliness in late adulthood is a public health issue. Thus, understanding the etiology of loneliness is of critical importance. Here, we conceptualize the development of loneliness in late life as dynamic interactions between individual and contextual processes. Specifically, we suggest that loneliness arises if the existing social relationships are unable to meet a set of social expectations. These expectations are fulfilled by three different layers of the social structure: 1) close confidants; 2) broader social networks; and 3) involvement in the community. Although older adults experience losses in their broader network and engage less in the community, they may avoid loneliness by focusing on close confidants. However, these adaptations may make it more difficult for older adults to overcome loneliness.

Men's Social Connectedness in Later Life: A Qualitative Study with Older Men

This qualitative study aimed to understand men's social connectedness in later life in Portugal focusing on their perceptions, obstacles, strategies, and impact on well-being. The sample included 104 older Portuguese men over 65 years of age (Mage = 70.76 years). The qualitative data were the direct transcriptions of the answers given by participants to the electronic interview using thematic analysis. Findings revealed six overarching themes encompassing 18 subcategories: definitions of social connectedness (social support, community identity, mental health promotion, use of community structures), difficulties/obstacles in maintaining social connectedness (ageism, lack of initiative, physical limitations, psychological traits, resources), strategies/actions or resources to establish social connections (use of technology, use of community groups, leisure and sport activities, church/religion), negative impact of difficulties in establishing relevant social connections (mental health, physical health, relationships), positive actions from being socially connected (positive prescriptions to promote social connectedness), and concerns from being socially disconnected (health risks). These findings indicate that the lack of social connectedness creates social vulnerability in later life, and social support is needed to ensure safer aging among older men.

Development of Older Adults' Perceptions on Community-based Connectedness with People Scale: Reliability and validity evaluation

AIM

We developed a self-assessment scale-Older Adults' Perceptions of Community-based Connectedness with People-to assess older adults' comprehensive perceptions of their connectedness with others in the community. A specific aim of this study is to evaluate the reliability and validity of this scale.

METHODS

Participants consisted of 1000 men and women aged 65 years or older, living in Sapporo, Hokkaido, Japan. Factorial validity was assessed using exploratory and confirmatory factor analysis, while concurrent validity was assessed using correlation analysis. Reliability was confirmed by Cronbach's α coefficient using the internal consistency method, and the stability coefficient was confirmed using the test-retest method.

RESULTS

Responses were received from 380 participants, and 358 participants who responded to all items were included in the analysis. The developed scale comprised 22 items with three factors: "Perception of Inclusion" (α = .947), "Perception of Reciprocity through Reception" (α = .937), and "Perception of Reciprocity through Provision" (α = .910). Correlation analyses indicated that concurrent scales were positively correlated with Ikigai and negatively correlated with loneliness on the total scale. The model fit was comparative fit index = 0.933, goodness-of-fit index = 0.854, adjusted goodness-of-fit index = 0.818, and root mean square of approximation = 0.081. The stability coefficient of the total scale scores was 0.875 (95% CI: [0.830, 0.908]).

CONCLUSIONS

The developed scale had adequate reliability and validity. The perceptions of connectedness measured using this scale can be used by public health and nursing care professionals to prevent loneliness and isolation among older adults living in the community.

Effects of combat sports on cognitive function in older people: a systematic review

INTRODUCTION

This systematic review aimed to analyze the available body of published peer-reviewed studies on the effects of combat sports compared with active/passive control on cognitive function and electrophysiological markers of brain activity in older people.

EVIDENCE ACQUISITION

The studies were searched in Scopus, Web of Science, PubMed, MEDLINE, and PsycINFO databases from deadline to June 2023. The PRISMA, TESTEX, RoB, and GRADE scales assessed the evidence's methodological quality and certainty of evidence. The protocol was registered in PROSPERO (code: CRD42022361695).

EVIDENCE SYNTHESIS

After reviewing 3768 studies, seven combat sports interventions (score ≥60% in methodological quality) were selected, composed of 381 older people (63% female), with a mean age of 66 years. In the selected studies, interventions based on judo, karate, and taekwondo were carried out, where it was not possible to verify the benefits of combat sports in cognitive function and electrophysiological markers of brain activity regarding active/passive control groups, although the individual results of the analyzed studies indicate that the practice of combat sports favor selective attention, divided attention, executive function, visual perception, and cognitive processing speed in older people.

CONCLUSIONS

The available evidence does not allow a definite recommendation regarding combat sports as an effective cognitive function intervention in older people.

Older people's connectedness with people in the community in contemporary contexts: A concept analysis

AIM

This study aimed to clarify the concept of older people's connectedness with people in the community within the literature.

METHODS

This study was based on Walker and Avant's concept analysis method. We used PubMed, MEDLINE, CINAHL, and Web of Science databases and included peer-reviewed articles that were published in English between January 2010 and April 2023. After assessing eligibility and applying exclusion criteria, 25 articles were analyzed.

RESULTS

Attributes included sense of belonging to the community achieved through interactions and feeling of togetherness through interrelationships, which consequently led to the maintenance of healthy physical and mental states and independent living, the acquisition of the ability to overcome difficulties, and the creation of a sense of meaning in life through coexistence.

CONCLUSION

We identified the concept of older people's connectedness with people in the community in a contemporary context. Connectedness is a useful concept to consider in nursing care because it seems to evolve into comprehensive health, including the physical and psychosocial health of older adults.

Improved Mental Health, Social Connections and Sense of Self: A Mixed Methods Systematic Review Exploring the Impact and Experience of Community Reminiscence Programs

Older people can experience health and social challenges such as loneliness, depression, and lack of social connectedness. One initiative that has been trialed to address these challenges is reminiscence programs. These programs can include music, art, photographs, sports, and general discussion to stimulate memories. This review aimed to systematically search for literature that explored the impact and experience of reminiscence programs for older people living in the community for the purposes of informing community programming. The PICOS framework was used to develop the review parameters and search strategy. Qualitative and quantitative research focused on community-based reminiscence programs were included. Commercially produced databases and grey literature were searched. The Critical Appraisal Skills Program qualitative critical appraisal tool and McMaster quantitative critical appraisal tool were used to assess the methodological quality of the included studies. Quantitative data were descriptively synthesized, and qualitative data were thematically analyzed, with each reported separately. Twenty-seven studies were included in the review. All quantitative studies (n = 17) provided clear information regarding the purpose, sample size, and justification. The measures adopted were reliable and valid. All studies reported clear data collection/analysis information and statistically significant findings. All qualitative studies (n = 10) clearly articulated a purpose with nine clearly describing recruitment, data collection, and researcher relationship. Synthesis of quantitative data demonstrated positive findings through a reduction in depression, anxiety, and loneliness and improvements in quality of life and mastery. These findings were supported and broadened by qualitative findings with three key themes identified: program processes, program ingredients, and program benefits. Providing opportunities for older adults to come together to tell stories about their past experiences may positively contribute to social outcomes. As reminiscence programs gain popularity, their implementation in practice should be underpinned by clear and reproducible practices.

Active aging and urban policies: the space as an instrument for an inclusive and sustainable city

Aging is one of the most important challenges of our times. As stated by United Nations' report on 1983, "Policies to meet the challenge of a growing, healthier and more active seniors population -based on the view of the ageing of society as an opportunity to be utilized -automatically benefit the individual ageing person, materially and otherwise. Similarly, any effort to ameliorate the quality of life for the seniors, and to meet their diverse social and cultural needs, enhances their capacity to continue interacting with society". Aging society provides not only a new context, but a new opportunity to rethink our traditional views of age. The growing number of seniors people will soon make the majority of overall population. As noticed by reports of international organizations, cities will play a more important role in dealing with these quantitative and cultural changes, mostly because it is expected that a quarter of the population over 60 will be concentrating in the central areas of compact cities. In brief, cities are at once growing and aging at an incredible speed. Although aging process represents a fundamental and structural phenomenon with very deep consequences at economic, social and political level, and with an impact on the individual one as on the society as whole, our cities should deal with this process and respond, in terms of public health and social care, to needs of older people, also those that will experience a loss of autonomy. It is important to note that there are a greater heterogeneity within older population in terms of conditions and demands, which depend on their specific personal, social and familial context. Urban space - in its complex differentiation between public space, third space, and private space - represents both a tool and a strategic factor in pursuing the objective of ensuring high levels of widespread well-being and, from a political perspective, fully shaping the right to the city for seniors individuals.

Understanding joy amongst older people: A scoping review

To date there has been little focus on the concept of joy amongst older people in the literature. The objective of this scoping review was to understand the extent and type of evidence about joy and older people. Searches were run in ten databases in January 2022 (re-run January 2023). Eligible studies included people aged 65 and over living in their usual place of residence and described the experience or evaluation of joy. Screening was conducted independently by two reviewers and data were extracted by one reviewer and checked by a second. We included 11 papers reporting both qualitative (n = 5) and quantitative (n = 6) studies involving 1,487 participants with a mean age of 81.6 years. Seven of the studies were based in care or nursing homes with four in community settings. Five studies reported the experience of joy, three reported on the assessment of joy, and three examined the association between joy and other factors. Social connections and participation in activities that are meaningful to the individual are important sources of joy. Joy amongst older people has received little attention in the literature despite it being highlighted as being important to older people themselves in relation to their health and wellbeing.

Household Need and Unmet Need for Caregivers of Older Persons in Thailand

The need for caregivers is a crucial issue in Thailand. This research examined levels and trends of household needs and unmet needs for caregivers of older persons and explored potential factors associated with these needs. The analysis utilized data from the Survey of Older Persons in Thailand 2007, 2011, 2014, and 2017. The household need for a caregiver of older persons was defined as a household with one or more older people who needed a caregiver to help them perform basic activities of daily living. The unmet need for a caregiver referred to households where at least one older person in the household needed care but did not receive it. Findings illustrated the increasing levels and trends of household needs as well as unmet needs over time. In terms of potential determinants, older person households in Bangkok and households with higher socioeconomic status were more likely to be the household need for caregivers. In contrast, those households in the Northeastern, the poorest region, were more likely to be the unmet need household. These findings are indicative of the rising demand for long-term care services in Thailand. However, it is vital to consider unmet household needs, especially in the worse-off area, when designing national policies.

Predictors of Psychological Distress among Post-Operative Cardiac Patients: A Narrative Review

Following surgery, over 50% of cardiac surgery patients report anxiety, stress and/or depression, with at least 10% meeting clinical diagnoses, which can persist for more than a year. Psychological distress predicts post-surgery health outcomes for cardiac patients. Therefore, post-operative distress represents a critical recovery challenge affecting both physical and psychological health. Despite some research identifying key personal, social, and health service correlates of patient distress, a review or synthesis of this evidence remains unavailable. Understanding these factors can facilitate the identification of high-risk patients, develop tailored support resources and interventions to support optimum recovery. This narrative review synthesises evidence from 39 studies that investigate personal, social, and health service predictors of post-surgery psychological distress among cardiac patients. The following factors predicted lower post-operative distress: participation in pre-operative education, cardiac rehabilitation, having a partner, happier marriages, increased physical activity, and greater social interaction. Conversely, increased pain and functional impairment predicted greater distress. The role of age, and sex in predicting distress is inconclusive. Understanding several factors is limited by the inability to carry out experimental manipulations for ethical reasons (e.g., pain). Future research would profit from addressing key methodological limitations and exploring the role of self-efficacy, pre-operative distress, and pre-operative physical activity. It is recommended that cardiac patients be educated pre-surgery and attend cardiac rehabilitation to decrease distress.

Experienced barriers in the use of ICT for social interaction in older adults ageing in place: a qualitative systematic review protocol (SYSR-D-22-00848)

BACKGROUND

Several information and communication technologies (ICT) have been developed to enhance social connectedness of older adults aging in place, although they are not accessible for all. Barriers in using ICT might for example relate to health issues, sensory loss, lack of technical skills, or reluctance to use technologies. Though knowledge on these barriers is crucial for the development and implementation of ICT for older adults, no systematic review was found on this subject. The proposed qualitative systematic review aims to explore barriers experienced by older adults aging in place in using ICT for social interaction.

METHODS

The review will be conducted in accordance with the JBI methodology. Databases for search will include MEDLINE (via PubMed), CINAHL (via EBSCO), and Web of Science (ISI), among others. Included studies focus on older adults ageing in place 60 years or older. Pairs of authors will independently, by following agreed guidelines, assess the eligibility of studies, and extract data. The testing of eligibility criteria and screening of titles, abstracts, and full texts will be performed. The findings will describe for example populations, context, culture, and the phenomena of interest. Qualitative research findings will, where possible, be pooled by using JBI SUMARI for the meta-aggregation approach.

DISCUSSION

The mapping of published studies has the potential to identify research gaps in the existing literature, which again may inform developers and stakeholders in designing more user-friendly and adaptive ICT solutions for older people ageing in place.

SYSTEMATIC REVIEW REGISTRATION

CRD42022370044.

The Risks of Experiencing Severe Loneliness Across Middle and Late Adulthood

OBJECTIVES

From a theoretical point of view, older adults may not necessarily face a greater risk of becoming lonely than middle-aged adults but are more likely at a disadvantage in fighting loneliness. Therefore, in this study, we differentiate between the risk of becoming lonely and the risk of remaining lonely.

METHODS

A large longitudinal data set representative of the German noninstitutionalized population from 40 to 85 years of age (N = 15,408; 49% female participants) was used in the analysis. Lagged logistic regression models were estimated to investigate the effect of earlier experiences of severe loneliness on the risk of being lonely after three years across middle age and late adulthood. Individual differences in health, views on aging, and social activities were taken into account to explore their role in age differences in the risk of remaining lonely.

RESULTS

The analysis revealed marginal age differences in the risk of becoming lonely but a marked age gradient regarding the risk of remaining lonely. Lonely older adults who were older than 75 years of age were more likely to remain lonely after three years than lonely middle-aged adults. Controlling for individual differences in health, views on aging as social loss, and social activities accounted for this age difference.

DISCUSSION

Interventions against loneliness may prioritize older age groups because losses in capacities, shifts in motivations, and a degraded opportunity structure render it increasingly less likely that older adults leave a state of loneliness on their own accord.

Testing a model of biopsychosocial successful aging based on socioemotional selectivity theory in the second half of life

OBJECTIVES

We first tested a successful aging model, which included biomedical and psychosocial indicators. Next, we tested the assumptions on the social network characteristics of the socioemotional selectivity theory in a model where the outcome variable is successful aging.

DESIGN

Cross-sectional study.

SETTING

The study was carried out in municipal centers and nursing homes.

PARTICIPANTS

A total of 478 adults (Mean age = 72.11, SD = 10.43) were enrolled.

MEASUREMENTS

Psychological Well-being Scale, Life Satisfaction Scale, Future Time Perspective, Katz Index of Independence in Activities of Daily Living Scale, Lawton Instrumental Activities of Daily Living Scale, and Mini-Mental State Examination Test were completed.

RESULTS

The structural equation modeling analyses indicated that higher social satisfaction mediated the association of the future time perspective with successful aging. Furthermore, there was another significant indirect sequential path from the future time perspective to successful aging. The path was first via the number of close social partners and second, social satisfaction.

CONCLUSIONS

The findings highlight the importance of social satisfaction in the process of successful aging and provide novel evidence that the socioemotional selectivity theory can be considered as a biopsychosocial model of successful aging in future studies.

Effects of a biopsychosocial-spiritual group therapy on quality of life among institutionalized older adults with disabilities: A randomized controlled trial

The traditional biomedical care approach has been unsatisfactory to meet the complex needs of seniors with long-term multimorbidity and irreversible disability, particularly for those living in residential LTC facilities. This study aimed to develop and evaluate the effectiveness of an 8-week biopsychosocial-spiritual (BPS-S) group intervention with the attempt to enhance quality of life (QoL) and meaning in life among senior residents with disability. This single-blind randomized controlled trail was conducted in eight residential LTC facilities. The primary outcome, 'participants' overall and subdomain QoL', and the secondary outcome, 'meaning in life', were repeatedly assessed, including four time points: before, mid- and post-intervention, and at a 1-month follow-up. A generalized linear mixed model (GLMM) was used to assess between-group differences over time. The post-intervention differences indicated significant higher improvement on senior residents' overall and all 4 domains of QoL, as well as their meaning in life, between the baseline and both times of post-intervention and 1-month follow-up. On the other hand, participants' family QoL have improved immediately in the midst of intervention. This study provides preliminary evidence to support the feasibility and effectiveness of an 8-week BPS-S group therapy. We recommend the BPS-S be integrated into routine institutional care activities to help maximize senior residents' own capacity for self-healing, achieve a state of harmonious balance between body, mind, social and spiritual relationships; and in turn, enhance holistic health of this group.

The relative importance of friendship to happiness increases with age

Happiness is predicted by social relationships in general and contact frequency in particular. This study aims to examine if the relative importance of social contacts with the closest family/relative, friend, and neighbor in happiness changes with advancing age. We used data for all participants aged 19 years and older (n = 229,099) in the 2019 Community Health Survey, which measured the frequency of contact with the closest relative/family, neighbor, and friend among a representative sample of Koreans between August 16 and October 31, 2019. The Shapley value decomposition method was used to measure the relative importance of each predictor of happiness. Overall, contact frequency was positively associated with happiness (p<0.001). The relative importance value of contact with the closest family, neighbor, and friend to happiness increased from 4.70%, 3.98%, and 7.35%, respectively, in the 19-29 years group to 8.09%, 4.44%, and 11.00%, respectively, in the 60 years and older group. Frequent interactions with the closest friend could have a greater impact on happiness in old age than those with the closest family and neighbor.

Understanding and Addressing Older Adults' Loneliness: The Social Relationship Expectations Framework

Loneliness is an experience resulting from a perceived discrepancy between expected and actual social relationships. Although this discrepancy is widely considered the "core mechanism" of loneliness, previous research and interventions have not sufficiently addressed what older adults specifically expect from their social relationships. To address this gap and to help situate research on older adults' loneliness within broader life span developmental theories, we propose a theoretical framework that outlines six key social relationship expectations of older adults based on research from psychology, gerontology, and anthropology: availability of social contacts, receiving care and support, intimacy and understanding, enjoyment and shared interests, generativity and contribution, and being respected and valued. We further argue that a complete understanding of loneliness across the life span requires attention to the powerful impacts of contextual factors (e.g., culture, functional limitations, social network changes) on the expression and fulfillment of older adults' universal and age-specific relationship expectations. The proposed Social Relationship Expectations Framework may fruitfully inform future loneliness research and interventions for a heterogeneous aging population.

Active aging needs from the perspectives of older adults and geriatric experts: a qualitative study

Introduction

With an increasing rate of population aging and its consequences, preparation for active aging based on older adults' needs is an unavoidable priority. Active aging needs must be identified to help strategic planning for older adults' health and wellbeing. This study aimed to explore the active aging needs from the perspectives of older adults and geriatric experts.

Methods

This exploratory-descriptive qualitative study was conducted in four provinces with the oldest populations in Iran. Semi-structured and focus group interviews were conducted with 41 participants (20 older adults and 21 geriatric experts), who were chosen through purposive and snowball sampling. Data were analyzed using the conventional content analysis.

Results

This study identified three themes and thirteen categories from the data: (1) basic individual needs with three categories of physiological, psycho-emotional, and spiritual needs; and (2) managerial needs with seven categories of political-legal, socio-economic, and cultural-spiritual infrastructures, academic strategies, an age-friendly environment; technological services, and provision of specialized services and daycare for older adults, and (3) educational needs with three categories of training self-care and self-efficacy, empowering the health care workers; and empowering the family.

Conclusion

The results revealed personal, managerial, and educational needs for active aging and could assist policymakers and geriatric experts to promote and meet active aging needs successfully.

Out-of-home life spaces valued by urban older adults with limited income

Background

Access to, and occupational performance in, out-of-home-life-spaces is linked to health, wellbeing and quality of life for older adults. There is little evidence of how this relates to older adults with limited resources in an African urban context.

Objectives

To describe the out-of-home-life-spaces accessed and valued by older adults with limited resources, living in an urban South African setting.

Method

An exploratory concurrent mixed methods study saw 84 rehabilitation clinicians conduct 393 face-to-face interviews with older adults. Clinicians produced reflective field notes and participated in focus groups. Quantitative data were analysed using descriptive statistics with SPSS Version X. Qualitative data were analysed through inductive content analysis.

Results

Older adults walked, used mini-bus taxis or private vehicles to get to places of worship, medical facilities, shops, family and friends and special interest gatherings on a weekly or monthly frequency. Lack of funds was the main barrier. Older adults aspired to travel, go on holiday and to visit out-of-town family homes.

Conclusion

Exploring the daily lived experience of older, urban South Africans with limited resources brought to light the value they attribute to participation in activities that contribute to the wellbeing of their families and communities. Such activities are found in a variety of life spaces.

Contribution

Results could inform policy makers and service providers in their planning of community mobility, transportation services and health care, for older adults with limited resources.

Loneliness and social networks of older adults in rural communities: a narrative synthesis systematic review

Introduction

Loneliness has significant impacts on the health of older adults. Social networks help to improve psychosocial and quality of life outcomes among older adults. A fifth of older adults live in rural communities, where geographic isolation poses challenges to health. The dynamics of social networks of older adults in rural communities has not been explored.

Objective

To synthesize the literature related to loneliness and social networks of older adults in rural settings.

Methods

A mixed-methods systematic review was conducted through searching six bibliographic databases to retrieve peer-reviewed literature with no time limits. We performed a methodological assessment of each study using a mixed method quality assessment tool. Findings are synthesized thematically.

Results

A total of 50 studies (32 quantitative, 15 qualitative, and 3 mixed methods) were included in this review. Studies were conducted in 17 different countries, the majority from China (n = 12), the UK (n = 9), and USA (n = 9). Findings revealed that social networks of older adults consist of family, friends and neighbors and continue to be developed through participation in various physical and social activities such as walking groups and participation in religious events. Social networks offer informational, functional, psychological and social support to older adults. Through their social networks, older adults feel socially connected and cared for. Successful interventions to improve social networks and address loneliness were those developed in groups or one-on-one with the older adults. The key ingredient to the positive impact of these interventions on reducing social isolation and loneliness was the formation of a social connection and regular engagement with the older adults. However, the review did not find any explicitly reported theory or model on which these interventions are based.

Conclusion

The prevalence of loneliness among older adults in rural areas needs urgent attention. Social network theory and methods can help in developing interventions to address social isolation and loneliness among older adults in rural communities.

Lessons Learned from Older Adults Fusing of an Augmented Reality, Assisted Living and Social Interaction Platform

The aging population and the subsequent changing societal structures are foreseen to bring both opportunities and challenges for the economy, services and society at large. Digital exclusion among older people may become less of an issue in the future, as those who have used the Internet in their working and social lives continue to do so as they reach old age. However, given the rapid pace of technological advances, older adults, may still experience some degree of digital exclusion. Technological advances may offer benefits for older adults, such as maintaining their independence and connection to society. Nevertheless, adopting new technologies like augmented reality (AR) may be difficult for older adults commonly due to the decline of cognitive and physical abilities and/or their lack of familiarity, apprehension and understanding on these new technologies. In this study, the GUIDed system is presented, an AR-operated app developed in this work, aiming to support the independence and quality of life of older people. Finally, the paper discusses lessons learned from the co-creation process, including the evaluation methods, paper prototypes, focus groups and living labs, and the results on the acceptance of the AR functionality and for improving the GUIDed system.

Health and social needs of older adults in slum communities in Ghana: a phenomenological approach used in 2021

Slum-dwellers lack several essential amenities (such as water, sanitation, and electricity) which make them more vulnerable than non-slum dwellers. As there is limited to no access to health and social care services in slums, the slum environment is expected to be an even more dangerous environment for older adults, negatively impacting their quality of life (QoL). To provide an overview of the perceived (unmet) health and social care needs and how it affects the QoL, this study aims to explore the self-perceived health and social needs of older adults in urban slums in Ghana. Using a phenomenological approach, 25 semi-structured interviews were conducted between May and June 2021, in the homes of older adults in two slums in Ghana. After coding and analysing the transcripts, five main themes emerged: (a) perception of health; (b) (de)motivators of health service use; (c) perception of social care, (d) social needs, and (e) influence of phenomena on QoL. It appeared that older adults believed that spiritual powers were causing illnesses and influenced their use of formal health services. Other factors such as expired insurance cards and the attitude of healthcare workers served as demotivators for using health services.Perceived health needs were mainly current disease conditions (arthritis, diabetes, hypertension, vision/hearing challenges), challenges with health insurance, the behaviour of some health professionals, the proximity of health facilities, and unnecessary queues at major health facilities. Unmet social needs identified by this study were a sense of neglect by family (need for companionship), requiring assistance with activities of daily living, and the need for financial support. Participants had more health needs than social needs. Health providers do not usually prioritize the care of slum-dwelling older adults. Most participants still have challenges with the National Health Insurance Scheme (NHIS). Their social needs were mainly related to financial difficulties and help with some activities of daily living. Participants expressed that they desired companionship (especially the widowed or divorced ones) and the lack of it made them feel lonely and neglected. Home visits by health professionals to older adults should be encouraged to monitor their health condition and advocate for family members to keep older adults company. Healthcare providers should exhibit positive attitudes and educate older patients on the advantages of formal health services use, as well as the need to seek early treatment as this will influence their QoL to a large extent.

Perceptions and experiences of eating alone among community-living retired Swedes: Loss, routine and independence

The practice of eating together, commensality, is often considered as something positive in later life, particularly regarding peoples' nutritional status and psychosocial well-being. Eating alone, in contrast, is treated as a risk factor, although literature indicates that it is not necessarily something negative. Still, analyses that specifically target older peoples' varied experiences and notions of eating alone are scarce. This study has explored perceptions and experiences of eating alone among older people in Sweden, a country considered highly individualistic, yet with relatively low levels of loneliness in the older population. Semi-structured interviews were conducted with 20 community-living and retired Swedes, 70-90 years of age. A thematic analysis identified three themes: i) 'Eating alone as a manifestation of loss'; ii) 'Eating alone as an everyday routine'; and iii) 'Eating alone as independence and contentment'. General perceptions of eating alone were often related to the current living situation (e.g., cohabiting or single-living). One key finding was an identified tension between the idea of eating alone as something problematic among those living and eating with a partner and the practical experience of an uncomplicated routine among those living and eating alone. Eating together is discussed as a possible social need for many, but perhaps not for all. Some can feel content with eating alone or even enjoy it. Future studies should approach potential disadvantages of eating alone among older people as an open empirical question that is likely to depend on both the individual and the cultural context.

Older Adults' Views on Social Interactions and Online Socializing Games - A Qualitative Study

Age-related difficulties and quarantine restrictions impede the possibilities to maintain contact with one's social network. Maintaining these contacts may be supported by digital games. To develop effective and feasible digital tools to foster social interaction, we aimed to explore what older adults find important in social contact and what barriers and enablers they foresee in digital gaming interventions as network support aids. Two focus groups and 20 semi-structured interviews (N = 29) with older adults (aged 55-87) were held to explore the research questions. Furthermore, a questionnaire was administered (N = 29) containing measures of loneliness, frailty, and social network size. Participants found 'reciprocity', 'in-person contact', and 'personal connection' important in contact with strong ties. Online games were not used much for socializing but may be used in the future, particularly by less mobile older adults. Future social gaming interventions should be challenging, user-friendly, and offer the possibility to communicate. Digital co-designed interventions that are feasible, challenging, intuitive, and trigger meaningful communication may strengthen social interactions in older adults. They may be a relevant social support tool in periods of interaction limitations due to functional impairment or social isolation.

Social relations and exclusion among people facing death

In line with current policies and service developments related to palliative care, more people are dying at home. This situation has provoked discussions about the importance of non-medical issues related to death. The process of dying is often long, with many phases, and the social aspect is a major part of it. Our focus in this article is on dying as a social process. Social relationships are significant and play a meaningful role in enhancing the well-being of older adults approaching the end of life. Meaningful social relationships tend to change over time; however, and the process of dying may exacerbate such changes in and challenge these relationships. The aim of our study was to examine how social relationships are experienced and (re)constructed among older adults (70-83 years old) during the process of dying, in a Finnish context. We were interested in the nature and type of these relationships, and in the possible new forms of expression that may emerge during this process. Our empirical data were based on interviews with seven older adults who were close to death. The analysis revealed processes of exclusion from existing relations. At the same time, we observed new and unexpected relations being initiated, which sometimes became meaningful and supportive. The results highlighted the role of expectations and importance of analysing exclusion from a life-course perspective.

The Effects of Public Open Space on Older People's Well-Being: From Neighborhood Social Cohesion to Place Dependence

This quantitative study examines the effects of Public Open Space (POS) on older people's well-being and examines the roles of neighborhood social cohesion (NSC) and place dependence (PD) as series buffers. A questionnaire survey of 501 people aged 65 and over was conducted in various communities of Hong Kong. Structural equation modelling (SEM) was used to analyze the pathways connecting POS and well-being. A multigroup analysis examined differences in the POS-well-being associations between the young-old (aged 65 to 75, n = 166) and old-old group (aged 76 to 95, n = 166). Results show that the association between POS and emotional well-being was stronger than social and psychological well-being. POS promotes three facets of well-being through developing NSC and, subsequently, PD. Multigroup analysis results suggest that the pathway from POS to emotional well-being via NSC is stronger for the old-old group; POS is more important for psychological well-being for the young-old group. This study highlights that the quality of POS, including attractive natural elements, various amenities, and sufficient space for social interactions, is essential for making relationship-rich and health-promotive urban environments.

State containment measures, living arrangements, and mental health of U.S. older adults during the COVID-19 pandemic

OBJECTIVES

Early in the coronavirus pandemic, U.S. states implemented several different types of containment measures to slow the disease's spread. Early evidence indicates containment measures were associated with changes in individuals' mental health. This study explores the associations between U.S. state containment measures and older adults' mental health and importantly, whether the associations vary by living arrangement and gender.

METHODS

The study analyzed national sample of adults aged 50 or older from 12 waves (April-July 2020) of the U.S. Household Pulse Survey (N = 394,934). State fixed-effects models linked four state containment measures (stay-at-home order, restaurant closure, bar closure, and movie theater closure) to levels of depression and anxiety across different types of living arrangements, net of controls. Men and women were analyzed separately.

RESULTS

Stay-at-home order and restaurant and bar closure, but not movie theater closure, were associated with higher levels of depression and anxiety in older adults. Living arrangements moderated the associations for women but not men. For women, compared to living alone, living with a spouse or intergenerational family was associated with higher levels of anxiety and depression during stay-at-home order and restaurant closure.

CONCLUSION

The associations between containment measures and mental health vary by type of living arrangement and were gendered, likely because household situations create different demands and supports that men and woman experience differently. Although containment measures are necessary to protect public health, paying attention to these underlying dynamics can inform policymakers' efforts to implement policies that balance harms and benefits for older adults.

The Impact of a Canadian Model of Aging in Place on Community Dwelling Older Adults' Experience of Physical Distancing during the COVID-19 Pandemic

Naturally occurring retirement communities (NORCs) are unplanned communities with a high proportion of residents aged 65 years and older. Oasis is a Canadian aging in place model that combines health and supportive community services for adults aged 65 years and older within NORCs. The aims of this study were to explore how physical distancing restrictions during the COVID-19 pandemic impacted older adults living in a NORC (Oasis members) and to investigate whether Oasis served as a context for social connection and well-being during the COVID-19 pandemic. An interpretive description methodology guided this study. Semi-structured interviews were conducted with nine Oasis members (aged 66-77 years) and two Oasis site coordinators. The Oasis members also completed a social network mapping activity guided by the hierarchical mapping technique. Three overarching themes related to the impact of physical distancing on Oasis members during the COVID-19 pandemic were identified: (1) unintended consequences of physical distancing restrictions on participants' wellbeing; (2) face-to-face interactions are important for social connection; and (3) family, friend, healthcare provider, and community support mitigated the impact of physical distancing restrictions during the COVID-19 pandemic. In addition, two of Oasis' core pillars were found to support participants: strengthening social connectivity and connection to pre-existing community services. Findings illustrate that community programs like Oasis acted as a source of resilience during the COVID-19 pandemic and advance our understanding of the impact of aging in place models on community dwelling older adults' experience of the COVID-19 pandemic.

Everyday Experiences of People Living with Mild Cognitive Impairment or Dementia: A Scoping Review

Increasing attention has been paid to the 'voice' of people living with mild cognitive impairment (MCI) or dementia, but there is a lack of clarity about how everyday life is perceived from this insider's perspective. This study aimed to explore the everyday life experiences, challenges and facilitators of individuals with MCI and dementia living at home. A scoping review of qualitative studies, guided by the Joanna Briggs Institute Reviewers Manual, was conducted. Eight databases were searched, resulting in 6345 records, of which 58 papers published between 2011 and 2021 were included. Analysis was carried out by descriptive content analysis. Findings were categorized into seven spheres of everyday life: experiences related to the condition, self, relationships, activities, environment, health and social care and public opinions. The results show many disruptions and losses in everyday life and how people try to accommodate these changes. In all areas of everyday life, people show a deep desire to have reciprocal relationships, stay engaged through participation in activities and have a sense of belonging in the community. However, more research is needed on the factors that promote and impede the sense of reciprocity and belonging.

The effects of changes in daily life due to the COVID-19 pandemic on the depressive symptoms among community-dwelling older adults in Korea

This study aims to identify the effects of daily life changes due to the coronavirus disease 2019 pandemic on the depressive symptoms among community-dwelling older adults. This cross-sectional and secondary data analysis study collected and analysed the data of 72 335 older adults aged older than 65 who participated in the 2020 Korean Community Health Survey. Changes in daily life due to the coronavirus disease 2019 pandemic were measured by changes in physical activity, sleep duration, consumption of instant foods or soda drinks, alcohol consumption, smoking, and social contact compared to before the pandemic as perceived by the participants. The Patient Health Questionnaire-9 was used to assess depressive symptoms, and multiple logistic regression analysis was conducted to explore the relationship between the two. After adjusting for socio-demographic and health-related factors, changes in daily life due to the coronavirus disease 2019 pandemic that affected depressive symptoms in older adults living in the community were observed. This study confirmed that changes in daily life due to the coronavirus disease 2019 pandemic negatively affected the mental health of older adults. Thus, there is a need to improve social support and care systems, by including non-face-to-face programmes using remote communication technology. It will allow older adults to maintain their daily lives and mental health during the COVID-19 pandemic.

Community-based responses to loneliness in older people: A systematic review of qualitative studies

In many countries across the world, older people are one of the groups most vulnerable to loneliness. Community-based responses are well placed to support and enhance pre-existing coping strategies in older people. However, the evidence base of these responses remain scattered and obscured, particularly in relation to their design and reasons behind their success. In this systematic review, we focus on qualitative studies on community-based responses to loneliness among older people to learn how these responses work in practice with in-depth details. At the end of a systematic searching and screening process, 17 studies conducted in five countries (Australia, Canada, New Zealand, Spain and the UK) published in English were selected and reviewed initially in October 2020 and then updated at the end of August 2021. Three themes were identified as being most valuable to addressing loneliness in a specific community, namely, autonomy, new social connections, and belonging. These interventions were also employed according to three primary considerations: what the community lacked, how that community experienced loneliness, or a combination of both. Several implications for policymakers and future research emerged, urging future interventions to take a more contextual approach that encompasses community-level considerations before establishing a user-led and tailored setting that facilitates social engagement.

"We see each other from a distance": Neighbourhood social relationships during the COVID-19 pandemic matter for older adults' social connectedness

Introduction

We extend previous research to illustrate how individual, interpersonal and neighbourhood factors in a high-density urban setting in Vancouver, Canada, shape social connectedness experiences of community-dwelling older adults during the first wave of the COVID-19 pandemic.

Methods

We conducted 31 semi-structured interviews and collected objective measures of loneliness and social connectedness (surveys).

Results

Three dimensions of the neighbourhood environment influenced social connectedness: (i) interactions with neighbours, (ii) involvement with neighbourhood-based organizations, and (ii) outdoor pedestrian spaces. Seventy-one percent of participants felt a strong sense of belonging to their local community, while 39% were classified as high or extremely lonely.

Summary

Many participants leveraged pre-existing social ties to maintain connections during the pandemic. However, volunteer outreach was vital for more isolated older adults. Although many participants felt lonely and isolated at times, the relative ease and accessibility with which they could connect with others in their neighbourhood environment, may have helped mitigate persistent loneliness.

Conclusion

Strategies that foster social connectedness over the longer term, need to prioritize the needs of older adults who face multiple barriers to equitable social participation.

Women's Expressed Motivational Factors for Participation in Aquarobics Classes

Leisure provides a vehicle for women to develop friendships in later life, yet few studies have explored older women’s experiences of social and emotional connections with leisure. This article provides insights into the perceived benefits a group of older women state they gain from participation in aquarobics for leisure. The main themes to emerge from the focus group interview data (n = 19 women, x¯ age = 75 years), illustrating the key motivational factor for participation in the classes, included an individual desire to improve one’s overall fitness. Participants also expressed a strong sense of belonging from being able to socialize after the activity, and highly valued the welcoming atmosphere and feeling of comradery involved. The aquarobics instructor was noted as performing a very important role in ensuring delivery of an enjoyable class experience where participants experienced variety, had fun, and felt happy taking part. For this group of women, aquarobics forms a health promoting leisure context offering an important space for gaining subjective wellbeing, building social connectedness and resisting the dominant ideology of aging.

Social Inclusion and Communality of Volunteering: A Focus Group Study of Older People’s Experiences

The aim of this qualitative study was to describe the factors that motivate older people to volunteer and how volunteering influences their social inclusion and communality. Data were collected using focus group interviews in 2020–2021 from older people aged 65–81 years (n = 38) who had experience of volunteering in the community. The data were analyzed using inductive content analysis. Based on the results, the experiences described by older people who participate in volunteering consisted of factors encouraging older people to volunteer and depended on the activation, support, and motivation of volunteer operators. The support provided by the health care services and volunteer action organization for volunteers was a key factor in encouraging older people to participate in volunteering. Moreover, volunteering impacted the communality of volunteers in several ways, influencing social capital. The sense of communality was enhanced by the way in which volunteering was carried out, including collaboration with health care services and associations. In order to strengthen the importance of volunteering in society, there is a need for close collaboration between voluntary organizations and health care service providers to develop volunteering because health care organizations cannot respond to all of the challenges faced by the ageing population.

An Audit of Mental Health Care Plans in Community Mental Health Services for Older Persons in Rural Communities in a State in Australia

Mental health care planning is an important part of holistic, patient-centred care provision. Rural older adults represent a vulnerable population with unique and complex care needs requiring robust care planning approaches. This study's aim was to audit care plan documentation for rural older Australians against quality standards. A retrospective review of the care plans from electronic case records was performed for all patients who were 65 years or older and managed by rural community mental health teams over a 12-month period. 72.1% of patients had a care plan available. Multiple assessment areas were sparsely documented, such as cognition (32%), self-harm risk assessments (29.8%), visual impairment (5.5%), hearing issues (5%) and Advance Care Directives (35.4%). This study highlighted the need for the development and implementation of a care plan template specific to rural older patients. Further research into care planning processes and barriers to implementation is also required for this population.

Social relationship influence on self-care and health among older people living with long term conditions: A mixed-methods study

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.

Does laughing with others lower the risk of functional disability among older Japanese adults? The JAGES prospective cohort study

While laughter is evoked mainly in social contexts, the potential link between laughter in daily life and health benefits is unclear. This study aimed to examine the association between laughter in daily life and the onset of functional disability among older adults in Japan. Data were obtained from a 6-year follow-up cohort of 12,571 participants (46.1% male) in the Japan Gerontological Evaluation Study, aged ≥65 years, who could independently perform daily activities. We evaluated their laughter in daily life from three perspectives: the types of situations in which people laugh, the number of situations in which people laugh with others, and the persons with whom people laugh. Using the Cox proportional hazards model, the risk of functional disability was estimated. A total of 1420 functional disabilities were observed during follow-up. After adjusting for potential confounders, participants who laughed with others (e.g., during conversations with friends) were at a reduced risk of functional disability (hazard ratio, 0.77; 95% confidence interval, 0.65-0.92) than those who laughed alone (e.g., during watching television). Similarly, the number of situations to laugh with others was inversely associated with the risk of functional disability (P_trend < 0.001). Laughing in a conversation with friends reduced the risk of functional disability by approximately 30% compared to laughing alone. Overall, laughing with others was associated with a reduced risk of functional disability. Having more situations to laugh with others or at least the situation to laugh with friends might contribute to reducing the risk of functional disability later in life.

Positive health during the COVID-19 pandemic: a survey among community-dwelling older individuals in the Netherlands

Background

Coronavirus Disease 2019 (COVID-19) reached the Netherlands in February 2020. To minimize the spread of the virus, the Dutch government announced an “intelligent lockdown”. Older individuals were urged to socially isolate completely, because they are at risk of a severe disease course. Although isolation reduces the medical impact of the virus, the non-medical impact should also be considered.

Aim

To investigate the impact of COVID-19 pandemic and associated restrictive measures on the six dimensions of Positive Health in community-dwelling older individuals living in the Netherlands, and to identify differences within subgroups.

Methods

In May/June 2020, community-dwelling older individuals aged ≥ 65 years completed an online survey based on Huber’s model of Positive Health. Positive Health was measured regarding the appreciation of the six dimensions (categorized as poor/satisfactory/excellent) and a comparison with a year before (categorized as decreased/unchanged/increased) using frequencies (%) and a chi-square test.

Results

834 older individuals participated (51% women, 38% aged ≥ 76 years, 35% living alone, 16% self-rated poor health). Most respondents assessed their bodily functions, mental well-being and daily functioning as satisfactory, their meaningfulness and quality of life (QoL) as excellent, and their social participation as poor. 12% of the respondents reported a deterioration of 4–6 dimensions and 73% in 1–3 dimensions, compared to the past year. Deterioration was most frequently experienced in the dimension social participation (73%), the dimension mental well-being was most frequently improved (37%) and quality of life was in 71% rated as unchanged. Women more often observed a deterioration of 4–6 dimensions than men (15% vs. 8%, p = 0.001), and individuals with self-rated poor health more often than individuals with self-rated good health (22% vs. 10%, p < 0.001). Older individuals living alone experienced more frequently a decrease in meaningfulness compared to older individuals living together.

Conclusion

The COVID-19 pandemic and associated restrictive measures had a substantial impact on all six dimensions of Positive Health in community-dwelling older individuals, especially in women, respondents living alone and respondents with self-rated poor general health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02737-2.

Virtual and augmented reality applications to improve older adults' quality of life: A systematic mapping review and future directions

Objective

The use of virtual reality and augmented reality to improve older adults' quality of life has rapidly increased in recent years. This systematic mapping review aimed to provide a comprehensive overview of existing research that identifies and classifies current virtual reality and augmented reality applications that enhance the quality of life of older adults to increase the understanding of the impact of these technologies.

Methods

To reach this objective, a systematic mapping review was conducted of the studies published between 2009 and 2020 in major scientific databases, such as IEEE Xplore, Web of Science, Scopus, and PubMed. A total of 57 studies were analyzed and classified into four main quality of life domains: physical, cognitive, psychological, and social well-being.

Results

The findings showed that virtual reality and augmented reality have found their places in many quality of life studies of older adults. Although virtual reality and augmented reality applications are notably growing in the physical and cognitive well-being domains in training and rehabilitation settings, they are still in the early stages of development in psychological and social well-being research as well as healthcare settings. Our findings also revealed that virtual reality games, particularly motion-based exergames, and 3D augmented reality systems are the most common virtual reality and augmented reality types among the reviewed studies. Moreover, balance and attention were the most prevalent physical and cognitive functions when using motion-based and immersive virtual reality exergames and augmented reality systems and games, respectively, while confidence and interaction were the most dominant psychological and social functions.

Conclusion

This mapping review provides a comprehensive overview of potential areas for further research in this field, thereby assisting researchers, technologists, and health practitioners in expanding this field of research.

Long-Term Effects on Loneliness of a Computer-Tailored Intervention for Older Adults With Chronic Diseases: A Randomized Controlled Trial

Objectives: This study explores the effects of the Active Plus intervention aiming to decrease loneliness among older adults (>65 years) with chronic diseases. Methods: A randomized controlled trial (RCT) was performed (N = 585; age: M = 74.5 years, SD = 6.4), assessing loneliness at baseline, 6 months and 12 months. Outcome measures in the multilevel linear regression analyses were total, social and emotional loneliness. Results: At 12 months, significant decreases in total (B = -.37, p = .01) and social loneliness (B = -.24, p = .02) were found. Age was a significant moderator for total and social loneliness; however, the intervention was effective only for participants aged 80 years and older. Discussion: The Active Plus intervention showed a significant decrease in total and social loneliness and was especially beneficial for the vulnerable age group of 80 years and older. A more comprehensive tool for measuring social activity and mobility impairments, and using a longer time frame to detect loneliness changes, may form interesting future research.

Friendship and Cognitive Functioning among Married and Widowed Chinese Older Adults

OBJECTIVES

Guided by the social convoy model, this study investigated the association between friendship and cognitive functioning among older Chinese adults, as well as the moderating effect of marital status (married vs. widowed). We also explored whether depression might account for the link between friendship and cognitive functioning.

METHOD

We used data from the China Longitudinal Aging Social Survey in 2014 (N = 8,482). Cognitive functioning was measured with the Mini-Mental State Examination instrument and friendship was assessed with a three-item Lubben Social Network Scale. Linear regression and path analyses within a structural equation modeling framework were performed to examine the hypotheses.

RESULTS

Results indicated that friendship was significantly related to better cognitive functioning among older Chinese adults (β = 0.083, p <.001) and marital status moderated this association (β = -0.058, p <.01). In addition, depression partially mediated the relationship between friendship and cognitive functioning (β = 0.015, p <.001).

DISCUSSION

The results implied that friendship is important for maintaining cognitive functioning in later life and widowed older Chinese adults may benefit more from friendship in its relationship to cognitive functioning than married older Chinese adults. Further, one potential pathway linking friendship to cognitive functioning may be through depression; however, more research is needed to support this finding. Intervention programs aimed at building friendship opportunities may be one way to achieve better cognitive aging.

Comprehending socio-relational factors of mental wellbeing in the oldest old within Nordic and Mediterranean countries

Socio-relational aspects are essential for mental wellbeing (MWB), especially in the oldest old age. Our study aims to explore the socio-relational aspects related to MWB in accordance with the experiences of the oldest old of four European countries; and to examine how these differ between Mediterranean and Nordic people. A total of 117 participants aged 80+ years old were recruited, and 23 focus groups were performed. Qualitative content analysis identified five main themes. Family seemed to be the most important driver of the MWB of the oldest old, followed by relationships with close friends. Participants felt better when they had a sense of being needed, cared for, and connected. Loneliness and isolation negatively affected MWB, although solitude was appreciated. Differences appeared between Mediterranean and Nordic regions. Initiatives to promote positive interactions with family and friends, as well as social activities within the community, may contribute to strengthening MWB in the oldest old.

Aging, Social Distancing, and COVID-19 Risk: Who is more Vulnerable and Why?

Perceived social support represents an important predictor of healthy aging. The global COVID-19 pandemic has dramatically changed the face of social relationships and revealed elderly to be particularly vulnerable to the effects of social isolation. Social distancing may represent a double-edged sword for older adults, protecting them against COVID-19 infection while also sacrificing personal interaction and attention at a critical time. Here, we consider the moderating role of social relationships as a potential influence on stress resilience, allostatic load, and vulnerability to infection and adverse health outcomes in the elderly population. Understanding the mechanisms how social support enhances resilience to stress and promotes mental and physical health into old age will enable new preventive strategies. Targeted social interventions may provide effective relief from the impact of COVID-19-related isolation and loneliness. In this regard, a pandemic may also offer a window of opportunity for raising awareness and mobilizing resources for new strategies that help build resilience in our aging population and future generations.

The structure and functional correlates of social support networks of people in advanced old age living in chosen urban and rural areas in Poland: a cross-sectional study

The purpose of the study was to identify the different types of social support networks (SSNs) among community-dwelling people aged 75+ years in selected areas of Poland, and to evaluate any associations between the network type and demographic and health variables of the population studied. The two most prevalent SSN types identified using the Practitioner Assessment of Network Type were “family dependent” (35.8%) and “locally integrated” (32.2%). “Local self-contained” (6.4%), “wider community focused” (2.8%) and “private restricted” (5.6%) SSNs were observed less frequently. In 17.2% of cases, it was not possible to identify the type of network unequivocally. Older people with a locally integrated SSN, in contrast to the family dependent type, were generally younger, living alone, and less likely to be homebound, rate their health as poor, suffer from depression or dementia, and had lower levels of functional disability. Locally integrated SSNs are recognized in the literature as being the most robust in terms of facilitating well-being and providing sufficient support to help maintain the older person in the community. This may reflect the higher levels of independence of older people able to sustain these support networks, which are then transformed into family-dependent types as their health deteriorates, but confirmation of this would require prospective studies. An improved understanding of the prevalence of different types of social networks among older people in Poland would help to guide a systematic approach to recognizing unmet needs in this population and provide crucial information in the planning of formal services.

The impact of social network change and health decline: a qualitative study on experiences of older adults who are ageing in place

Background

Older adults prefer to age in place. Social network change and health decline challenge ageing in place, as stressors that make age-related advantages disappear. The aim of this study was to explore social network change and health decline and its impact on older adults who are ageing in place.

Method

In-depth interviews (n = 16) were conducted with older adults who were ageing in place and who were experiencing health decline and social network change. Procedures for grounded theory building were followed to analyse the interviews with respondents who were discharged from the hospital less than 4 months ago (n = 7). Narrative analysis was conducted to reach a deeper understanding of the expected complexity of experiences of this targeted sample.

Results

Results encompass a typology with four types of impact: A. Sneak preview of old age, B. Disruptive transition into old age, C. Drastically ageing, and D. Steadily ageing. Additionally, indications were found that older adults should be able to move along the four types of impact and ideally could end up in quartile D, experiencing little or no impact at all (anymore).

Conclusion

The results present an optimistic view on the possibilities of older adults to continue ageing in place despite experiencing unavoidable and uncontrollable stressors in life. Also, the results provide leads for practice, to develop an action perspective for home care nurses and gerontological social workers to determine and reduce the impact of social network change and health decline on older adults who are ageing in place. Suggestions for further research would be to unravel how to detect temporal setbacks in successful ageing in place.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02385-6.

Older adults in virtual communities: understanding the antecedents of knowledge contribution and knowledge seeking through the lens of socioemotional selectivity and social cognitive theories

Purpose

As older adults are increasingly active in virtual communities (VCs), these platforms for knowledge exchange present opportunities for companies to use elder human capital. The purpose of this study is to understand the antecedent factors that motivate older adults’ knowledge contribution and knowledge seeking (KS) behaviors in VCs.

Design/methodology/approach

Rooted in socio-emotional selectivity and social cognitive theories, this study included five key variables and developed models for older adults’ knowledge contributing (KC)/KS behaviors. This paper tested the hypotheses using data from a sample of 204 older adults in 3 VCs in China.

Findings

The results provide support for most of the hypotheses and show that while other members’ participation (MP) acts as a substitute for meaning in life and attitude toward aging, it acts as a complement for outcome expectations (OE) focused on others and OE focused on oneself in their impacts on KC/KS activities.

Practical implications

The study provides practical insights for developing elder human resources via VCs to avoid knowledge loss.

Originality/value

This study described older adults’ unique characteristics when modeling their information and communication technologies-related behaviors and built two models to explain their KC/KS behaviors. It confirmed that the same factor has different levels of impact on older adults’ KC/KS behaviors in VCs. In addition, it confirmed and reinforced the complementary and substitutive effects of other MP as an environmental factor on these behaviors.