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Tang VFY, Jiang D, Kwok JYY, Qian M, Yeung DYL, Chow EOW, Choi NG, Chou KL. Study protocol of a sequential, multiple assignment, randomised trial using an adaptive intervention to reduce loneliness among Chinese older adults in Hong Kong. BMJ Open 2024; 14:e087245. [PMID: 39153786 PMCID: PMC11331834 DOI: 10.1136/bmjopen-2024-087245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/29/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Loneliness is a prevalent and alarming issue among older adults that requires effective interventions. While randomised controlled trials have been commonly undertaken to explore reduction in loneliness, there is a growing recognition that a comprehensive treatment strategy involving multiple interventions may yield better outcomes. Therefore, this study aims to develop and identify a two-stage adaptive intervention that combines telephone-delivered behavioural activation (Tele-BA) and mindfulness techniques (Tele-MF) to reduce loneliness in older adults in Hong Kong. METHODS A Sequential, Multiple Assignment, Randomised Trial (SMART) design will be adopted. 244 lonely older adults will be recruited from the community and randomly assigned to either one of the 4-week two-stage, embedded adaptive interventions involving different sequences and dosages of Tele-BA and Tele-MF (eg, 4 weeks of Tele-BA followed by booster sessions for responders or 4 weeks of Tele-BA followed by 4 weeks of Tele-BA with motivational component or 4 weeks of Tele-MF for non-responders) based on a set of decision rules. The primary outcome will be loneliness measured by the Revised University of California Los Angeles (UCLA) Loneliness Scale. Secondary outcomes, such as De Jong Gierveld Loneliness Scale, perceived stress, sleep quality and depressive and anxiety symptoms, will be assessed. Adhering to the intention-to-treat principles, the data will be analysed using linear mixed models. The findings may have implications for the development of psychosocial adaptive interventions involving BA and MF to reduce loneliness and improve well-being among older adults in Hong Kong using the SMART design. ETHICS AND DISSEMINATION Ethical approval was obtained by the Human Research Ethics Committee at The Education University of Hong Kong (reference: 2022-2023-0117). The findings from this study will be presented in academic conferences and submitted for publication. TRIAL REGISTRATION NUMBER ChiCTR2300077472.
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Affiliation(s)
- Vivien Foong Yee Tang
- Department of Social Sciences and Policy Studies, The Education University of Hong Kong, Hong Kong, Hong Kong
| | - Da Jiang
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, Hong Kong
| | - Jojo Yan Yan Kwok
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong
| | - Min Qian
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Dannii Yuen-lan Yeung
- Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong, Hong Kong, Hong Kong
| | - Esther Oi Wah Chow
- Department of Social Work, Hong Kong Shue Yan University, Hong Kong, Hong Kong
| | - Namkee G Choi
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, USA
| | - Kee Lee Chou
- Department of Social Sciences and Policy Studies, The Education University of Hong Kong, Hong Kong, Hong Kong
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Hajek A, Sutin AR, Posi G, Stephan Y, Peltzer K, Terracciano A, Luchetti M, König HH. Chronic loneliness and chronic social isolation among older adults. A systematic review, meta-analysis and meta-regression. Aging Ment Health 2024:1-16. [PMID: 39126212 DOI: 10.1080/13607863.2024.2385448] [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: 04/03/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVES We performed a systematic review and meta-analysis to examine the prevalence and antecedents/consequences of chronic loneliness and social isolation (i.e. enduring or persistent experience that extends over a certain period of time) among older adults. Moreover, we conducted a meta-regression to explore sources of heterogeneity. METHOD A search was conducted in four electronic databases. We included observational studies that reported prevalence and, where available, antecedents/consequences of chronic loneliness or chronic social isolation amongst older adults. Key characteristics of the studies were extracted. RESULTS Across 17 studies included in the meta-analysis, the estimated prevalence of chronic loneliness was 20.8% (95% CI: 16.1-25.5%), including 21.7% among women (95% CI: 16.1-27.4%) and 16.3% among men (95% CI: 10.6-21.9%). One study reported chronic social isolation (13.4%) and found that chronic social isolation predicted higher depression scores. Meta-regressions indicated that loneliness was less prevalent when assessed with single-item measures. Regarding antecedents/consequences, spousal loss can contribute to chronic loneliness which in turn may contribute to adverse health-related outcomes. CONCLUSION About one in five older adults experiences chronic loneliness reflecting the need to address chronic loneliness. More longitudinal research is needed on chronic loneliness and social isolation, particularly from low and middle-income countries.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Angelina R Sutin
- College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Giuliana Posi
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | | | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | | | - Martina Luchetti
- College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Pan C. Bidirectional and Dynamic Relationships Between Social Isolation and Loneliness Among Older Adults in China. J Am Med Dir Assoc 2024; 25:105003. [PMID: 38670171 DOI: 10.1016/j.jamda.2024.03.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES This study aimed to investigate the bidirectional associations and temporal dynamics between social isolation (SI) and loneliness among older adults. DESIGN This is a prospective cohort study. SETTING AND PARTICIPANTS With the global phenomenon of population aging, there has been a significant increase in the prevalence of SI and loneliness among older adults. These factors exert substantial impacts on the health and well-being of this population. Consequently, it is imperative to implement more effective interventions targeting SI and combating loneliness in order to enhance the overall health and well-being of older adults. METHODS Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were analyzed, focusing on individuals aged 65 and older. Generalized Cross-Lagged Modeling (GCLM) was used to assess these associations. RESULTS The findings reveal significant cross-lagged effects between SI and loneliness over the course of 16 years. Higher levels of SI at 1 time point predict increased loneliness scores in subsequent periods, and greater levels of loneliness at 1 time point predict higher SI scores in future periods. Notably, the impact of SI on loneliness is found to be larger and more enduring compared to the influence of loneliness on SI. These cross-lagged effects persist over an extended period, indicating a long-term reciprocal relationship between SI and loneliness among older adults. CONCLUSIONS AND IMPLICATIONS This study provides valuable insights into the bidirectional associations between SI and loneliness among older adults. Given that the effect of SI dominates, the findings suggest that public health strategies aimed at promoting health and well-being should prioritize interventions that enrich older adults' social networks. Emphasizing early interventions aimed at enhancing social networks is essential for promoting healthy aging and overall well-being.
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Affiliation(s)
- Chaoping Pan
- College of Medical Humanities and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Neupert SD, Graham EK, Ogle D, Ali S, Zavala DV, Kincaid R, Hughes ML, Hu RX, Antonucci T, Suitor JJ, Gilligan M, Ajrouch KJ, Scott SB. A Coordinated Data Analysis of Four Studies Exploring Age Differences in Social Interactions and Loneliness During a Global Pandemic. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae086. [PMID: 38761103 PMCID: PMC11247406 DOI: 10.1093/geronb/gbae086] [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: 12/01/2023] [Indexed: 05/20/2024] Open
Abstract
OBJECTIVES Examining loneliness and social isolation during population-wide historical events may shed light on important theoretical questions about age differences, including whether these differences hold across different regions and the time course of the unfolding event. We used a systematic, preregistered approach of coordinated data analysis (CDA) of 4 studies (total N = 1,307; total observations = 18,492) that varied in design (intensive repeated-measures and cross-sectional), region, timing, and timescale during the first year of the coronavirus disease 2019 pandemic. METHODS We harmonized our data sets to a common period within 2020-2021 and created a common set of variables. We used a combination of ordinary least squares regression and multilevel modeling to address the extent to which there was within- and between-person variation in the associations between social isolation and loneliness, and whether these associations varied as a function of age. RESULTS Within- and between-person effects of social interactions were negatively associated with loneliness in 1 study; in follow-up sensitivity analyses, these patterns held across early and later pandemic periods. Across all data sets, there was no evidence of age differences in the within-person or between-person associations of social interactions and loneliness. DISCUSSION Applying the CDA methodological framework allowed us to detect common and divergent patterns of social interactions and loneliness across samples, ages, regions, periods, and study designs.
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Affiliation(s)
- Shevaun D Neupert
- Department of Psychology, North Carolina State University, Raleigh, North Carolina, USA
| | - Eileen K Graham
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Destiny Ogle
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
| | - Sumbleen Ali
- Department of Human Ecology, SUNY Oneonta, Oneonta, New York, USA
| | - Daisy V Zavala
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Reilly Kincaid
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
| | - MacKenzie L Hughes
- School of Psychology, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Rita X Hu
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Toni Antonucci
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - J Jill Suitor
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
| | - Megan Gilligan
- Department of Human Development and Family Science, University of Missouri, Columbia, Missouri, USA
| | - Kristine J Ajrouch
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
- Department of Sociology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Stacey B Scott
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
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Pica MG, Grullon JR, Wong R. Correlates of Loneliness and Social Isolation among Older Adults during the COVID-19 Outbreak: A Comprehensive Assessment from a National United States Sample. Geriatrics (Basel) 2024; 9:96. [PMID: 39051260 PMCID: PMC11270347 DOI: 10.3390/geriatrics9040096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 07/08/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024] Open
Abstract
This study examined the correlates of loneliness and social isolation among older adults in the United States (U.S.) during the COVID-19 outbreak. We analyzed data from the 2020 National Health and Aging Trends Study, a nationally representative sample of 3257 U.S. older adults aged 65 years and older. We analyzed and identified the sociodemographic, health, social support, and community correlates of loneliness, higher loneliness during versus before the COVID-19 outbreak, and social isolation using weighted multiple logistic regression models. About 35.2% of U.S. older adults reported loneliness during the COVID-19 outbreak, 21.9% reported higher loneliness compared to before the COVID-19 outbreak, and 32.8% were socially isolated during the outbreak. Correlates for increased odds of loneliness included female gender, higher education, physical activity, depression, anxiety, functional limitations, and virtual communication access (only for higher loneliness during COVID-19 outbreak). Correlates for increased odds of social isolation included higher age, non-Hispanic Black, Hispanic, higher number of household children, and metropolitan residence. Our findings provide insights into evidence-based approaches to address social disconnection among U.S. older adults. The wide range of sociodemographic, health, social support, and community correlates identified in this study warrants multifaceted interventions that traverse individual, community, and societal levels to address the loneliness and social isolation epidemic.
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Affiliation(s)
- Miguel G. Pica
- Department of Public Health and Preventive Medicine, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Jason R. Grullon
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Roger Wong
- Department of Public Health and Preventive Medicine, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Department of Geriatrics, SUNY Upstate Medical University, Syracuse, NY 13210, USA
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Patil U, Braun KL. Interventions for loneliness in older adults: a systematic review of reviews. Front Public Health 2024; 12:1427605. [PMID: 39091527 PMCID: PMC11291379 DOI: 10.3389/fpubh.2024.1427605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 07/05/2024] [Indexed: 08/04/2024] Open
Abstract
Loneliness in older persons is a major risk factor for adverse health outcomes. Before the COVID-19 pandemic led to unprecedented isolation and hampered programs aimed at preventing or reducing loneliness, many interventions were developed and evaluated. However, previous reviews provide limited or conflicting summaries of intervention effectiveness. This systematic review aimed to assess previous review quality and bias, as well as to summarize key findings into an overarching narrative on intervention efficacy. The authors searched nine electronic databases and indices to identify systematic reviews of interventions to reduce loneliness in older people prior to the COVID-19 pandemic; 6,925 records were found initially. Of these, 19 reviews met inclusion criteria; these encompassed 101 unique primary intervention studies that varied in research design, sample size, intervention setting, and measures of loneliness across 21 nations. While 42% of reviews had minimal risk of bias, only 8% of primary studies appraised similarly. Among the 101 unique articles reviewed, 63% of tested interventions were deemed by article author(s) as effective or partially effective. Generally, interventions that included animals, psychological therapies, and skill-building activities were more successful than interventions focused on social facilitation or health promotion. However, interventions that targeted multiple objectives aimed at reducing loneliness (e.g., improving social skills, enhancing social support, increasing social opportunities, and changing maladaptive social cognition) were more effective than single-objective interventions. Future programs should incorporate multiple approaches, and these interventions should be rigorously tested.
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Affiliation(s)
- Uday Patil
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaiʻi at Mānoa, Honolulu, HI, United States
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Miura KW, Kudo T, Otake-Matsuura M. Web-Based Group Conversational Intervention on Cognitive Function and Comprehensive Functional Status Among Japanese Older Adults: Protocol for a 6-Month Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e56608. [PMID: 38990615 PMCID: PMC11273076 DOI: 10.2196/56608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Social communication is a key factor in maintaining cognitive function and contributes to well-being in later life. OBJECTIVE This study will examine the effects of "Photo-Integrated Conversation Moderated by Application version 2" (PICMOA-2), which is a web-based conversational intervention, on cognitive performance, frailty, and social and psychological indicators among community-dwelling older adults. METHODS This study is a randomized controlled trial with an open-label, 2-parallel group trial and 1:1 allocation design. Community dwellers aged 65 years and older were enrolled in the trial and divided into the intervention and control groups. The intervention group receives the PICMOA-2 program, a web-based group conversation, once every 2 weeks for 6 months. The primary outcome is verbal fluency, including phonemic and semantic fluency. The secondary outcomes are other neuropsychiatric batteries, including the Mini-Mental State Examination, Logical Memory (immediate and delay), verbal paired associates, and comprehensive functional status evaluated by questionnaires, including frailty, social status, and well-being. The effect of the intervention will be examined using a mixed linear model. As a secondary aim, we will test whether the intervention effects vary with the covariates at baseline to examine the effective target attributes. RESULTS Recruitment was completed in July 2023. A total of 66 participants were randomly allocated to intervention or control groups. As of January 1, 2024, the intervention is ongoing. Participants are expected to complete the intervention at the end of February 2024, and the postintervention evaluation will be conducted in March 2024. CONCLUSIONS This protocol outlines the randomized controlled trial study design evaluating the effect of a 6-month intervention with PICMOA-2. This study will provide evidence on the effectiveness of social interventions on cognitive function and identify effective target images for remote social intervention. TRIAL REGISTRATION UMIN Clinical Trials UMIN000050877; https://tinyurl.com/5eahsy66. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56608.
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Affiliation(s)
- Kumi Watanabe Miura
- Center for Advanced Intelligence Project, RIKEN, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takashi Kudo
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
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Li K, Tang F, Albert SM, Rauktis ME, Ohmer ML. Social Isolation, Loneliness, and Depressive Symptoms Among Older Adults: The Moderating Effect of Resilience. THE GERONTOLOGIST 2024; 64:gnae056. [PMID: 38785377 DOI: 10.1093/geront/gnae056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Social isolation has been recognized as a social problem with negative health consequences. Using data from 3 waves of the Health and Retirement Study, this study aimed to examine the long-term impact of social isolation on loneliness and depressive symptoms and to explore the moderating effect of resilience. RESEARCH DESIGN AND METHODS This study comprised 3,681 U.S. adults aged 60 and older at the baseline wave. Social isolation index was constructed using 5 indicators, including not married or cohabitating with a partner, no social participation, and less than monthly contacts with children, family members, or friends. Loneliness was measured by the University of California Los Angeles (UCLA) Loneliness Scale and depressive symptoms were measured by the Center for Epidemiological Studies-Depression scale. The moderator of resilience was assessed by the simplified resilience score. Latent growth curve models with robust standard errors were estimated. RESULTS The results of latent growth curve models showed that social isolation was significantly associated with more initial loneliness and depressive symptoms. However, social isolation was associated with a slower increasing rate of loneliness, but no significant relationship with the change rate of depressive symptoms. Furthermore, resilience significantly buffered the negative effect of social isolation on the initial level of depressive symptoms. DISCUSSION AND IMPLICATIONS The findings underscore the importance of enacting strategies and interventions targeting resilience to address social isolation and its negative consequences among older adults.
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Affiliation(s)
- Ke Li
- Department of Social Work, College of Health and Human Services, University of New Hampshire, Durham, New Hampshire, USA
| | - Fengyan Tang
- School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Steven M Albert
- Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary E Rauktis
- School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary L Ohmer
- School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Liu T, Wang YH, Ng ZLY, Zhang W, Wong SMY, Wong GHY, Lum TYS. Comparison of networks of loneliness, depressive symptoms, and anxiety symptoms in at-risk community-dwelling older adults before and during COVID-19. Sci Rep 2024; 14:14737. [PMID: 38926445 PMCID: PMC11208589 DOI: 10.1038/s41598-024-65533-z] [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: 10/20/2023] [Accepted: 06/20/2024] [Indexed: 06/28/2024] Open
Abstract
Network analysis provides an innovative approach to examining symptom-to-symptom interactions in mental health, and adverse external conditions may change the network structures. This study compared the networks of common risk factors and mental health problems (loneliness, depressive symptoms, and anxiety symptoms) in community-dwelling older people before and during COVID-19. Older adults (aged ≥ 60) at risk for depression were recruited through non-governmental organizations. Loneliness, depressive symptoms and anxiety symptoms were measured using the three-item Loneliness Scale (UCLA-3), nine-item Patient Health Questionnaire (PHQ-9), and seven-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Data from 2549 (before) and 3506 (during COVID-19) respondents were included using propensity score matching. Being restless (GAD-7-item5) was most central, indicated by Expected Influence, in both pre and during COVID-19 networks despite low severity (mean score). The network during COVID-19 had higher global strength and edge variability than the pre-pandemic network, suggesting easier symptom spread and potentially more complex symptom presentation. In addition, feeling isolated from others (UCLA-3-item3) had stronger connections with feeling worthless/guilty (PHQ-9-item6) and anticipatory anxiety (GAD-7-item7) during COVID-19 than before. These findings may enhance our knowledge of the symptom structure of common mental health problems and the impacts of the pandemic. Targeting central symptoms may offer novel preventive strategies for older people.
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Affiliation(s)
- Tianyin Liu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
| | - Yun-Han Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Zuna Loong Yee Ng
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Wen Zhang
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Stephanie Ming Yin Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Gloria Hoi-Yan Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Terry Yat-Sang Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
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Sayed L, Alanazi M, Ajrouch KJ. Intergenerational Relations and Well-being Among Older Middle Eastern/Arab American Immigrants During the COVID-19 Pandemic. Res Aging 2024:1640275241256990. [PMID: 38898773 DOI: 10.1177/01640275241256990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
This study aimed to examine the consequences of COVID-19 socialization restrictions on familial and social support systems of older Middle Eastern/Arab immigrants in Michigan, home to the largest, most visible concentration of Middle Eastern/Arab Americans in the United States. Six focus group (N = 45) interviews were conducted with Middle Eastern/Arab American immigrants aged 60 and older to assess difficulties faced during the pandemic as it related to familial, social, and medical care. Inductive analysis identified two major themes to advance meanings of intergenerational relations among older immigrants (a) the breakdown of family relations, which describes a shift in both the experience and expectations of intergenerational relations in Middle Eastern/Arab families; and (b) cultural sources of increased stress, illustrating how the pandemic interfered with valued family interactions to affect well-being. These findings indicated social and cultural sources of heightened stress linked to shifts in intergenerational relations among Middle Eastern/Arab American older immigrants.
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Affiliation(s)
- Linda Sayed
- James Madison College, Michigan State University, East Lansing, MI, USA
| | - Mohammed Alanazi
- Department of Nursing, College of Applied Medicine, University of Bisha, Bisha, Saudi Arabia
| | - Kristine J Ajrouch
- Department of Sociology, Anthropology and Criminology, Eastern Michigan University, Ypsilanti, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Kwok JYY, Jiang D, Yeung DYL, Choi NG, Ho RTH, Warner LM, Chou KL. Layperson-Delivered Telephone-Based Behavioral Activation Among Low-Income Older Adults During the COVID-19 Pandemic: The HEAL-HOA Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2416767. [PMID: 38888923 PMCID: PMC11185980 DOI: 10.1001/jamanetworkopen.2024.16767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/15/2024] [Indexed: 06/20/2024] Open
Abstract
Importance Older adults are particularly vulnerable to loneliness and its physical and psychosocial sequelae, but scalable interventions are lacking, especially during disasters such as pandemics. Objective To compare the effects of layperson-delivered, telephone-based behavioral activation and mindfulness interventions vs telephone-based befriending on loneliness among at-risk older adults. Design, Setting, and Participants This assessor-blinded, 3-arm randomized clinical trial screened Chinese older adults through household visits and community referrals from April 1, 2021, to April 30, 2023, in Hong Kong. Eligible participants (≥65 years of age) who were lonely, digitally excluded, living alone, and living below the poverty line and provided consent to participate were randomized into behavioral activation, mindfulness, and befriending groups. Assessments were conducted at baseline, 1 month, and 3 months. Intervention As part of the Helping Alleviate Loneliness in Hong Kong Older Adults (HEAL-HOA) dual randomized clinical trial, 148 older laypersons were trained to deliver a twice-weekly 30-minute intervention via telephone for 4 weeks. Main Outcomes and Measures The primary outcome was loneliness measured by the UCLA Loneliness Scale (range, 20-80) and the De Jong Gierveld Loneliness Scale (range, 0-6), with higher scores on both scales indicating greater loneliness. Secondary outcomes were depression, perceived stress, life satisfaction, psychological well-being, sleep quality, perceived social support, and social network. Results A total of 1151 participants (mean [SD] age, 76.6 [7.8] years; 843 [73.2%] female) were randomized to the behavioral activation (n = 335), mindfulness (n = 460) or befriending (n = 356) group. Most were widowed or divorced (932 [81.0%]), had primary education or below (782 [67.9%]), and had 3 or more chronic diseases (505 [43.9%]). Following intention-to-treat principles, linear mixed-effects regression model analyses showed that loneliness measured by the UCLA Loneliness Scale was significantly reduced in the behavioral activation group (mean difference [MD], -1.96 [95% CI, -3.16 to -0.77] points; P < .001]) and in the mindfulness group (MD, -1.49 [95% CI, -2.60 to -0.37] points; P = .004) at 3 months compared with befriending. Loneliness measured by the De Jong Gierveld Loneliness Scale was not significantly reduced at 3 months in the behavioral activation group (MD, -0.06 [95% CI, -0.26 to 0.13] points; P > .99]) but was in the mindfulness group (MD, 0.22 [95% CI, 0.03 to 0.40] points; P = .01) at 3 months compared with befriending. In the behavioral activation and mindfulness groups, sleep quality improved compared with befriending, but perceived stress increased. Psychological well-being and perceived social support improved in the behavioral activation group. No statistically significant between-group differences were observed in depression, life satisfaction, or social network. Conclusion and Relevance In this randomized clinical trial, scalable psychosocial interventions delivered remotely by older laypersons appeared promising in reducing later life loneliness and addressing the pressing mental health challenges faced by aging populations and professional geriatric mental health workforce shortages. Further research should explore ways to maximize the clinical relevance and cost-effectiveness of these interventions. Trial Registration Chinese Clinical Trial Registry Identifier: ChiCTR2300072909.
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Affiliation(s)
- Jojo Yan Yan Kwok
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
- Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong
| | - Da Jiang
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Dannii Yuen-lan Yeung
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas
| | - Rainbow Tin Hung Ho
- Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong
- Department of Social Work & Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Lisa Marie Warner
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Kee-Lee Chou
- Department of Social Sciences and Policy Studies, The Education University of Hong Kong, Tai Po, Hong Kong
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Robinson E, Dickins M, Lad L, Beard S, McGill D, Hayes J, Fabri AM, Wade H, Meyer C, Lowthian JA. Adaptation and Implementation of a Volunteer-Delivered, Telephone-Based, Social Support Program HOW-R-U? During the COVID-19 Pandemic: A Pragmatic Study. THE GERONTOLOGIST 2024; 64:gnae034. [PMID: 38656333 DOI: 10.1093/geront/gnae034] [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: 06/01/2023] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Public health concerns surrounding social isolation and loneliness heightened during the coronavirus disease 2019 (COVID-19) pandemic, as infection prevention measures led to increased feelings of loneliness and depression. Our objective was to evaluate the implementation of the HOW-R-U? program, during the pandemic (March 2020-December 2021). HOW-R-U? is a weekly volunteer-delivered telephone program designed to facilitate social connection and ease feelings of social isolation, loneliness, and depression in older people. RESEARCH DESIGN AND METHODS This pragmatic study used the Implementation Framework for Aged Care to adapt and implement HOW-R-U? in an Australian aged and community care organization and a tertiary health service in Melbourne. The evaluation involved analysis of program data, semistructured interviews, and surveys with program recipients, volunteers, and referrers. A process evaluation was conducted alongside an assessment of outcomes including pre- and post-symptoms of isolation, depression, and loneliness. RESULTS The implementation evaluation indicated that codesigned systems and processes effectively supported the ongoing implementation of HOW-R-U? with transition into business as usual across both organizations. Recipients reported that telephone calls had a positive impact on their lives, whereas volunteers reported enjoyment of supporting others. Several challenges were identified, namely in program reach and fidelity. DISCUSSION AND IMPLICATIONS HOW-R-U? was well regarded by all involved, and evaluation learnings have informed implementation into business as usual by both organizations.
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Affiliation(s)
| | - Marissa Dickins
- Bolton Clarke Research Institute, Melbourne, Victoria, Australia
- Department of Psychiatry, Southern Synergy, Monash Health, Melbourne, Victoria, Australia
| | - Lina Lad
- Bolton Clarke, Melbourne, Victoria, Australia
| | | | | | | | | | - Henni Wade
- Northern Health, Melbourne, Victoria, Australia
| | - Claudia Meyer
- Bolton Clarke Research Institute, Melbourne, Victoria, Australia
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Judy A Lowthian
- Bolton Clarke Research Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Knauft K, Zilioli S, Tarraf W, Rorai V, Perry TE, Lichtenberg PA. Social connectedness in older Urban African-American adults during the COVID-19 pandemic: the roles of education and partnership. Aging Ment Health 2024; 28:874-881. [PMID: 37986033 PMCID: PMC11102929 DOI: 10.1080/13607863.2023.2282682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE This study examined education, partnership status, and the moderating role of the lockdown period on social connectedness during the COVID-19 pandemic in a sample of urban African-American older adults. METHODS Five hundred thirty-four African-American adults living in Detroit (91.0% female, Mage = 74.53) reported demographic information pre-pandemic and answered one social connectedness questionnaire between April and December 2020. RESULTS Participants interviewed after the lockdown (post-June 2020) reported more loneliness than those interviewed during the lockdown (April-June, 2020). Married/partnered participants reported less loneliness and social isolation. Loneliness did not differ between those with high education levels interviewed during the lockdown compared to post-lockdown. However, among individuals with low education levels, those interviewed after the lockdown reported more loneliness than those interviewed during the lockdown period. CONCLUSION Our findings suggest partnership status is associated with more social connectedness during the pandemic and education accentuates the effects of forced isolation related to loneliness among urban African-American older adults.
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Affiliation(s)
| | - Samuele Zilioli
- Department of Psychology, Wayne State University
- Department of Family Medicine and Public Health Sciences, Wayne State University
| | | | | | - Tam E. Perry
- Institute of Gerontology, Wayne State University
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14
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MacLeod A, Levesque J, Ward-Griffin C. Social Isolation of Older Adults, Family, and Formal Caregivers During the COVID-19 Pandemic: Stories and Solutions Through Participatory Action Research. Can J Aging 2024; 43:230-243. [PMID: 37721044 DOI: 10.1017/s071498082300048x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
This participatory action research (PAR) aimed to understand the health implications of guidelines impacting social isolation among frail community-dwelling older adults and their family and formal caregivers during the coronavirus disease (COVID-19) pandemic. Reflexive thematic analysis (RTA) of data collected from 10 policy/procedural documents revealed four themes: valuing principles, identifying problem(s), setting priorities, and making recommendations. Interviews with 31 participants from Peterborough, Ontario, also revealed four themes: sacrificing social health, diminishing physical health, draining mental health, and defining supports. Recommendations to decision makers were finalized at a knowledge exchange event involving participants and members of Age-friendly Peterborough. Key findings demonstrate the need for Canadian governments and health and social service agencies to enhance access to technology-based interventions, and educational and financial resources for caregivers. Meaningful communication and collaboration between older adults, caregivers, and decision makers are also needed to reduce the gap between policy and practice when addressing social isolation.
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Affiliation(s)
- Ann MacLeod
- Trent/Fleming School of Nursing, Peterborough, ON, Canada
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15
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Horgan S, Prorok J, Conn D, Checkland C, Saunders J, Watson-Borg B, Tinley L. Can 'What Is Known' about Social Isolation and Loneliness Interventions Sufficiently Inform the Clinical Practice of Health Care and Social Service Professionals Who Work with Older Adults? Exploring Knowledge-to-Practice Gaps. Healthcare (Basel) 2024; 12:1111. [PMID: 38891186 PMCID: PMC11171656 DOI: 10.3390/healthcare12111111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Establishing intervention effectiveness is an important component of a broader knowledge translation (KT) process. However, mobilizing the implementation of these interventions into practice is perhaps the most important aspect of the KT cycle. The purpose of the current study was to conduct an umbrella review to (a) identify promising interventions for SI&L in older adults, (b) interpret (translate) the findings to inform clinical knowledge and practice interventions in different settings and contexts, and (c) highlight research gaps that may hinder the uptake of these interventions in practice. The broader purpose of this study was to inform evidence-based clinical practice guidelines on SI&L for HCSSPs. In line with other reviews, our study noted variations in methods and intervention designs that prohibit definitive statements about intervention effectiveness. Perhaps, the most significant contribution of the current review was in identifying knowledge-to-practice gaps that inhibit the implementation of interventions into practice-based realities.
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Affiliation(s)
- Salinda Horgan
- Department of Psychiatry, School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Jeanette Prorok
- Department of Psychiatry, School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - David Conn
- Department of Psychiatry, Baycrest Centre, Toronto, ON M6A 2E1, Canada;
| | - Claire Checkland
- Canadian Coalition of Seniors’ Mental Health, Markham, ON L3R 9X9, Canada; (C.C.); (J.S.); (B.W.-B.); (L.T.)
| | - John Saunders
- Canadian Coalition of Seniors’ Mental Health, Markham, ON L3R 9X9, Canada; (C.C.); (J.S.); (B.W.-B.); (L.T.)
| | - Bette Watson-Borg
- Canadian Coalition of Seniors’ Mental Health, Markham, ON L3R 9X9, Canada; (C.C.); (J.S.); (B.W.-B.); (L.T.)
| | - Lisa Tinley
- Canadian Coalition of Seniors’ Mental Health, Markham, ON L3R 9X9, Canada; (C.C.); (J.S.); (B.W.-B.); (L.T.)
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Assor M, Lantermino L. [A post-Covid-19 approach to loneliness and isolation in old age]. SOINS. GERONTOLOGIE 2024; 29:29-32. [PMID: 38677808 DOI: 10.1016/j.sger.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
The Covid-19 pandemic has accentuated loneliness and isolation among the elderly, affecting their physical and mental health. The post-Covid-19 approach needs to strengthen early detection of loneliness and isolation while promoting social engagement.
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Affiliation(s)
- Magali Assor
- Association Les Petits Frères des pauvres, 19 cité Voltaire, 75011 Paris, France.
| | - Laura Lantermino
- Centre hospitalier universitaire de Nice, 4 avenue Reine Victoria, 06000 Nice, France
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17
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Su Y, Hamatani M, Yuki M, Ogawa N, Kawahara K. Frailty and social isolation before and during the coronavirus disease 2019 pandemic among older adults: A path analysis. J Adv Nurs 2024; 80:1902-1913. [PMID: 37994183 DOI: 10.1111/jan.15971] [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: 05/29/2023] [Revised: 10/09/2023] [Accepted: 11/07/2023] [Indexed: 11/24/2023]
Abstract
AIM To explore the prevalence of social isolation among Japanese community-dwelling older adults before and during the COVID-19 pandemic as well as determine how family and friend connections before and during the pandemic affected frail older adults during the pandemic. DESIGN A cross-sectional study. METHODS A total of 852 community-dwelling older adults in Hokkaido and Tokyo, Japan were surveyed conducted between April and November 2021 using convenience sampling. The Lubben social network scale-6, frailty screening index, and geriatric depression scale were used to assess social isolation, frailty and depression, respectively. A path analysis was conducted to evaluate the effect of social isolation on frailty. RESULTS Participants had a mean age of 76.8 ± 6.6 years. Overall, 46% and 59% of participants were socially isolated before and during the COVID-19 pandemic, respectively. Frailty was found in 19% of participants during the pandemic. Friends and family connectedness before the pandemic had no direct relationship with frailty; only friend connectedness affected frailty indirectly via depression. Family connectedness during the pandemic had a significant, negative and direct relationship with frailty. CONCLUSION The findings show that connectedness with family and friends is critical for older people's physical and mental health. IMPACT Nurses in the community should consider these findings to reduce mental health problems and physical decline among older adults. It is important to identify older adults who are socially isolated from their families or friends and provide resources to help them build relationships within their communities. PATIENT OR PUBLIC CONTRIBUTION Community centre staff and community volunteers assisted in data collection. The public was not involved in data analysis, interpretation or manuscript preparation.
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Affiliation(s)
- Ya Su
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Masako Hamatani
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Michiko Yuki
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Natsuka Ogawa
- Emergency and Critical Care Center, Tohoku University Hospital, Sendai, Japan
| | - Kayoko Kawahara
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
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18
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Morikawa M, Harada K, Kurita S, Fujii K, Nishijima C, Kakita D, Shimada H. Association of objectively measured physical activity with incidence disability in older adults with/without social isolation. Arch Gerontol Geriatr 2024; 120:105338. [PMID: 38295617 DOI: 10.1016/j.archger.2024.105338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE This study aimed to investigate association between objectively measured physical activities with incidence disability in older adults with and without social isolation. METHODS This 5-year longitudinal observational study used a population-based study from a sub-cohort of the National Center for Geriatrics and Gerontology Study of Geriatric Syndrome. In Japan, Incident disability is defined as a new case of public insurance certification for long-term care. As participants, we enrolled 5,257 community-dwelling older adults aged ≥ 70 years. The Participants on whom incomplete baseline physical activity assessments were performed; who required long-term care; had a history of dementia, Parkinson's disease, stroke, or depression; who lacked independence in basic ADL; who had Mini-Mental State Examination scores; or who had missing measurements; were excluded. Thus, 2,071 participants were included. RESULTS Of the participants, 1,183 non-socially isolated participants had 151 (4.3%) cases of disability, while socially isolated participants had 150 (13%) cases. Cox proportional-hazards regression analysis presented the adjusted hazard ratio (HR) and 95% confidence interval (95%CI) of daily steps and low-intensity and moderate-to-vigorous physical activities-0.62(0.43-0.89), 0.84(0.60-1.18), 0.62(0.43-0.89) in participants with social isolation, and 0.58(0.40-0.85), 0.86(0.60-1.24), 0.70(0.49-1.01) in those with social isolation. CONCLUSIONS Daily steps were significantly associated with a decreased risk of incidence disability, regardless of social isolation. These results suggest the greater importance of daily physical activity than its specific intensity in socially isolated older adults.
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Affiliation(s)
- Masanori Morikawa
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Kenji Harada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Satoshi Kurita
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Kazuya Fujii
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Chiharu Nishijima
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Daisuke Kakita
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
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19
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Dones I, Ciobanu RO. Older adults' experiences of wellbeing during the COVID-19 pandemic: a comparative qualitative study in Italy and Switzerland. FRONTIERS IN SOCIOLOGY 2024; 9:1243760. [PMID: 38751995 PMCID: PMC11094362 DOI: 10.3389/fsoc.2024.1243760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024]
Abstract
Background Particularly at the beginning of the pandemic, adults aged 65 and older were portrayed as a homogeneously vulnerable population due to the elevated health risks associated with contracting the COVID-19 disease. This portrayal, combined with travel restrictions, closures of economic sectors, country-wide lockdowns, and suggestions by governmental authorities to limit social contact, had important implications for the wellbeing of older individuals. However, older adults are a heterogeneous population who relies on different resources to cope with stressful periods, like the COVID-19 pandemic. Simultaneously, countries also employed different measures to contain the virus. Research thus far has focused on the short-term consequences of the pandemic, but studies have yet to address its long-term consequences. Objectives We explore older adults' lived experiences nearly 2 years after the pandemic onset. Moreover, we focus on the bordering countries of Switzerland and Italy, who employed contrasting containment measures. This paper analyzes (1) How the COVID-19 pandemic impacted the experiences of wellbeing of older adults in these regions and (2) How older adults coped with the stressors brought about by the pandemic, in particular social distancing. Methods The paper draws on 31 semi-structured interviews with 11 Swiss natives residing in Switzerland, 10 Italian migrants residing in Switzerland, and 10 Italian natives residing in Italy. Interviews were conducted from December 2021 to March 2022. Results Coping mechanisms of the three groups related to acceptance, hobbies, cognitive reframing, telephone use, vaccine use and social distancing. However, results show heterogeneous experiences of wellbeing, with Swiss natives sharing more positive narratives than the other two groups. Moreover, Italian migrants and Italian natives expressed the long-term negative consequences of the pandemic on their experienced wellbeing.
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Affiliation(s)
- Iuna Dones
- Faculty of Social Sciences, University of Geneva, Geneva, Switzerland
- Swiss Center of Expertise in Life Course Research (LIVES), Geneva, Switzerland
- Faculty of Social Work, University of Applied Sciences and Arts Western Switzerland (HETSL/HES-SO), Lausanne, Switzerland
| | - Ruxandra Oana Ciobanu
- Swiss Center of Expertise in Life Course Research (LIVES), Geneva, Switzerland
- Faculty of Social Work, University of Applied Sciences and Arts Western Switzerland (HETSL/HES-SO), Lausanne, Switzerland
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Ding L, Liu J, Yang Y, Cui Z, Du G. Chronically socially isolated mice exhibit depressive-like behavior regulated by the gut microbiota. Heliyon 2024; 10:e29791. [PMID: 38681644 PMCID: PMC11046198 DOI: 10.1016/j.heliyon.2024.e29791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 04/04/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024] Open
Abstract
Objectives Chronic loneliness is a widespread issue, and the gut-brain axis is known to be crucial in facilitating communication between the gut and brain. However, the precise mechanism by which chronic loneliness affects the gut-brain axis remains uncertain. Methods Fourteen 55-week-old Balb/c mice were used in the experiment, with seven mice being randomly assigned to the chronic social isolation (CSI) group. The CSI group mice underwent 12 weeks of isolation to simulate the psychiatric state of a population in prolonged social isolation. The mental state of the CSI mice was assessed through animal behavior analysis, while plasma cytokines were measured using ELISA. Additionally, the composition of the gut microbiota was analyzed using 16S rRNA sequencing, and the metabolite composition of the intestinal contents was examined using nontargeted metabolomics. The Student-T test was used to determine significant mean differences. Results Mice that were exposed to the CSI exhibited increased immobility time lengths in forced swimming and hanging tail experiments, and decreased movement lengths and number of times traversing the intermediate region, compared to control mice. Additionally, CSI decreased the abundance of the probiotics Ruminococcaceae, Akkermansiaceae, and Christensenellaceae. Additionally, CSI reduced the production of the metabolites oleamide and tryptophan. Furthermore, IL-1β, IL-4, and IL-6 were significantly increased, while TNF-α was significantly decreased. Conclusion CSI induces a dysbiotic gut microbiota and the production of neurorelated metabolites, which in turn increase inflammatory responses and result in depressive behaviors in CSI mice. Therefore, these findings suggest that the gut microbiota may serve as a target for the treatment of long-term social isolation-induced mental disorders.
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Affiliation(s)
- Linwei Ding
- Biotechnology Laboratory, Hainan Medical University, Haikou, China
| | - Jiaqi Liu
- Biotechnology Laboratory, Hainan Medical University, Haikou, China
- Biotechnology Major, Hainan Medical University, Haikou, China
| | - Yunjia Yang
- Biotechnology Laboratory, Hainan Medical University, Haikou, China
- School of Public Health, Hainan Medical University, Haikou, China
| | - Zeying Cui
- Biotechnology Laboratory, Hainan Medical University, Haikou, China
| | - Guankui Du
- Biotechnology Laboratory, Hainan Medical University, Haikou, China
- Biotechnology Major, Hainan Medical University, Haikou, China
- Department of Biochemistry and Molecular Biology, Hainan Medical University, Haikou, China
- Department of Breast Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
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Wong ELY, Qiu H, Sun KS, Mo PKH, Lai AHY, Yam CHK, Miao HY, Cheung AWL, Yeoh EK. Social Support, Resilience, and Mental Health Among Three High-Risk Groups in Hong Kong: A Mediation Analysis. Int J Public Health 2024; 69:1606828. [PMID: 38681117 PMCID: PMC11045880 DOI: 10.3389/ijph.2024.1606828] [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] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/01/2024] [Indexed: 05/01/2024] Open
Abstract
Objectives To compare the prevalence of anxiety/depression, resilience, and social support among nurses, foreign domestic helpers (FDHs), and residents living in subdivided units (SDUs), and to examine their associations in these high-risk groups in Hong Kong during Omicron waves. Methods We recruited 1,014 nurses, 621 FDHs, and 651 SDU residents from December 2021 to May 2022 in this cross-sectional survey. The depression, anxiety, social support, and resilience levels were measured by the validated scales. The multivariate binary logistic regression and causal mediation analysis were applied to examine the associations. Results We observed a prevalence of 17.7% in anxiety and 21.6% in depression which were the highest in SDU residents, followed by FDHs, and lowest in nurses. Social support was associated with increased resilience levels and decreased risks of anxiety/depression. The association of social support with mental disorders was partly mediated by resilience, accounting for 30.9% and 20.9% of the total effect of social support on anxiety and depression, respectively. Conclusion Public health strategies should target improving social support and providing resilience-promoting interventions to help reduce mental disorders in vulnerable groups.
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Affiliation(s)
- Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Hong Qiu
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Kai-Sing Sun
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Phoenix Kit-Han Mo
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Angel Hor-Yan Lai
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Carrie Ho-Kwan Yam
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ho-Yee Miao
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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Geng T, Li Y, Peng Y, Chen X, Xu X, Wang J, Sun L, Gao X. Social isolation and the risk of Parkinson disease in the UK biobank study. NPJ Parkinsons Dis 2024; 10:79. [PMID: 38589402 PMCID: PMC11001945 DOI: 10.1038/s41531-024-00700-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 04/02/2024] [Indexed: 04/10/2024] Open
Abstract
Parkinson disease (PD) has become one of the most rapidly growing causes of disability among the older population and social isolation is a major concern in the PD community. However, the relationship between social isolation and future risk of PD remains unclear. This study included 192,340 participants aged 60 or older who were free of dementia and PD at baseline from the UK Biobank study. Social isolation was measured using a composite score derived from three questions on number in household, frequency of friend/family visits, and leisure/social activities. Incident PD cases were identified through electronic health records. Multivariable-adjusted Cox regression models were used to compute the hazard ratio (HR) and 95% confidence interval (CI). Among the 192,340 participants (mean [standard deviation] age, 64.2 [2.9] years; 103,253 [53.7%] women), 89,075 (46.3%) participants were in the least isolated group and 26,161 (13.6%) were in the most isolated group. Over a median follow-up of 12.5 years, 2048 incident PD cases were documented. Compared to the least isolated group, the multivariable-adjusted HRs (95% CIs) for PD were 1.00 (0.91-1.10) for the moderately isolated group and 1.19 (1.05-1.36) for the most isolated group (P-trend = 0.04). The observed association was independent of the genetic susceptibility to PD and consistent in subgroup analyses. Social isolation was associated with a higher risk of PD regardless of genetic risk. Our findings highlighted the importance of developing screening and intervention strategies for social isolation among older adults to reduce the risk of PD.
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Affiliation(s)
- Tingting Geng
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
| | - Yaqi Li
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Yinshun Peng
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Xiao Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Xinming Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Jian Wang
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Liang Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
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Almidani L, Miller R, Varadaraj V, Mihailovic A, Swenor BK, Ramulu PY. Vision Impairment and Psychosocial Function in US Adults. JAMA Ophthalmol 2024; 142:283-291. [PMID: 38386343 PMCID: PMC10884944 DOI: 10.1001/jamaophthalmol.2023.6943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/15/2023] [Indexed: 02/23/2024]
Abstract
Importance Vision impairment and psychosocial function, including symptoms of depression and anxiety and social isolation, are a major cause of morbidity in the US. However, there is a lack of nationally representative studies assessing associations between both objective and subjective vision impairment with psychosocial function following the COVID-19 pandemic. Objective To provide updated national estimates on the associations of vision impairment with depressive and anxiety symptoms and social isolation in US adults 65 years and older. Design, Setting, and Participants This was a cross-sectional analysis of the National Health and Aging Trends Study round 9 (2019) and 11 (2021), a nationally representative sample of Medicare beneficiaries aged 65 years and older. Binocular distance visual acuity, near visual acuity, and contrast sensitivity were tested. Objectively measured vision impairment was defined as having vision impairment in either distance visual acuity (worse than 20/40), near visual acuity (worse than 20/40), or contrast sensitivity (worse than 1.55 logCS). Self-reported vision impairment was defined based on participants' report on their vision status. Data were analyzed in May 2023. Main Outcomes and Measures Depressive and anxiety symptoms assessed via the Patient Health Questionnaire. Social isolation was defined based on living arrangement, communication frequency, and activity participation responses. Results Among 2822 community-dwelling adults sampled from a population of 26 182 090, the mean (SD) age was 78.5 (5.6) years; 1605 individuals (54.7%) were female; 1077 (32.3%) had objectively measured vision impairment, and 203 (6.4%) had self-reported vision impairment. In adjusted models, all outcomes were significantly associated with objectively measured vision impairment, including depressive symptoms (odds ratio [OR], 1.81; 95% CI, 1.26-2.58), anxiety symptoms (OR, 1.74; 95% CI, 1.13-2.67), and severe social isolation (OR, 2.01; 95% CI, 1.05-3.87). Similarly, depressive symptoms (OR, 2.37; 95% CI, 1.44-3.88) and anxiety symptoms (OR, 2.10; 95% CI, 1.09-4.05) but not severe social isolation symptoms (OR, 2.07; 95% CI, 0.78-5.49) were significantly associated with self-reported vision impairment. Conclusions and Relevance In this study, vision impairment was associated with several psychosocial outcomes, including symptoms of depression and anxiety and social isolation. These findings provide evidence to support prioritizing research aimed at enhancing the health and inclusion of people with vision impairment.
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Affiliation(s)
- Louay Almidani
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rhonda Miller
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Varshini Varadaraj
- Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing, Baltimore, Maryland
| | - Aleksandra Mihailovic
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bonnielin K. Swenor
- Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing, Baltimore, Maryland
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Pradeep Y. Ramulu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Thomas S, Littleboy K, Foubert J, Nafilyan V, Bannister N, Routen A, Morriss R, Khunti K, Armstrong N, Gray LJ, Gordon AL. Impact of the COVID-19 pandemic on hospital episodes for falls and fractures associated with new-onset disability and frailty in England: a national cohort study. Age Ageing 2024; 53:afae071. [PMID: 38582747 PMCID: PMC10998734 DOI: 10.1093/ageing/afae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Older people with frailty are at risk of harm from immobility or isolation, yet data about how COVID-19 lockdowns affected them are limited. Falls and fractures are easily measurable adverse outcomes correlated with frailty. We investigated whether English hospital admission rates for falls and fractures varied from the expected trajectory during the COVID-19 pandemic, and how these varied by frailty status. METHODS NHS England Hospital Episode Statistics Admitted Patient Care data were analysed for observed versus predicted outcome rates for 24 January 2020 to 31 December 2021. An auto-regressive integrated moving average time-series model was trained using falls and fracture incidence data from 2013 to 2018 and validated using data from 2019. Models included national and age-, sex- and region-stratified forecasts. Outcome measures were hospital admissions for falls, fractures, and falls and fractures combined. Frailty was defined using the Hospital Frailty Risk Score. RESULTS 144,148,915 pre-pandemic hospital admissions were compared with 42,267,318 admissions after pandemic onset. For the whole population, falls and fracture rates were below predicted for the first period of national lockdown, followed by a rapid return to rates close to predicted. Thereafter, rates followed expected trends. For people living with frailty, however, falls and fractures increased above expected rates during periods of national lockdown and remained elevated throughout the study period. Effects of frailty were independent of age. CONCLUSIONS People living with frailty experienced increased fall and fracture rates above expected during and following periods of national lockdown. These remained persistently elevated throughout the study period.
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Affiliation(s)
- Seth Thomas
- Data and Analysis for Social Care and Health, Health Analysis and Pandemic Insights, Office for National Statistics, Newport, UK
| | - Kathryn Littleboy
- Data and Analysis for Social Care and Health, Health Analysis and Pandemic Insights, Office for National Statistics, Newport, UK
| | - Josephine Foubert
- Data and Analysis for Social Care and Health, Health Analysis and Pandemic Insights, Office for National Statistics, Newport, UK
| | - Vahe Nafilyan
- Data and Analysis for Social Care and Health, Health Analysis and Pandemic Insights, Office for National Statistics, Newport, UK
| | - Neil Bannister
- Data and Analysis for Social Care and Health, Health Analysis and Pandemic Insights, Office for National Statistics, Newport, UK
| | - Ash Routen
- NIHR Applied Research Collaboration East Midlands, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Richard Morriss
- NIHR Applied Research Collaboration East Midlands, Leicester, UK
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Kamlesh Khunti
- NIHR Applied Research Collaboration East Midlands, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Natalie Armstrong
- NIHR Applied Research Collaboration East Midlands, Leicester, UK
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Laura J Gray
- NIHR Applied Research Collaboration East Midlands, Leicester, UK
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Adam L Gordon
- NIHR Applied Research Collaboration East Midlands, Leicester, UK
- Academic Unit of Injury, Recovery and Inflammation Sciences (IRIS), School of Medicine, University of Nottingham, Nottingham, UK
- Department of Medicine for the Elderly, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
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Shillington KJ, Vanderloo LM, Burke SM, Ng V, Tucker P, Irwin JD. Factors that contributed to Ontario adults' mental health during the first 16 months of the COVID-19 pandemic: a decision tree analysis. PeerJ 2024; 12:e17193. [PMID: 38563002 PMCID: PMC10984169 DOI: 10.7717/peerj.17193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024] Open
Abstract
The COVID-19 pandemic has negatively impacted the mental health of individuals globally. However, less is known about the characteristics that contributed to some people having mental health problems during the pandemic, while others did not. Mental health problems can be understood on a continuum, ranging from acute (e.g., depression following a stressful event) to severe (e.g., chronic conditions that disrupt everyday functioning). Therefore, the purpose of this article was to generate profiles of adults who were more or less at risk for the development of mental health problems, in general, during the first 16-months of the COVID-19 pandemic in Ontario, Canada. Data were collected via online surveys at two time points: April-July 2020 and July-August 2021; 2,188 adults (Mage = 43.15 years; SD = 8.82) participated. Surveys included a demographic questionnaire and four previously validated tools to measure participants' mental health, subjective wellbeing, physical activity and sedentary behaviour, and sleep. A decision tree was generated at each time point for those with mental health problems, and those with no mental health problems. Results showed that subjective wellbeing was the biggest contributor to mental health status. Characteristics associated with no mental health problems among adults included having good wellbeing, being a good sleeper (quantity, quality, and patterns of sleep), and being over the age of 42. Characteristics associated with mental health problems included having poor wellbeing and being a poor sleeper. Findings revealed that specific characteristics interacted to contribute to adults' mental health status during the first 16 months of the COVID-19 pandemic. Given that wellbeing was the biggest contributor to mental health, researchers should focus on targeting adults' wellbeing to improve their mental health during future health crises.
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Affiliation(s)
- Katie J Shillington
- Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Neurobiology, University of California San Diego, San Diego, California, United States
- Center for Empathy and Social Justice in Human Health, T. Denny Sanford Institute for Empathy and Compassion, University of California San Diego, San Diego, California, United States
| | - Leigh M Vanderloo
- Child Health Evaluative Science, The Hospital for Sick Children, Toronto, Ontario, Canada
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Shauna M Burke
- Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
| | - Victor Ng
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Division of Professional Development and Practice Support, College of Family Physicians of Canada, Mississauga, Ontario, Canada
| | - Patricia Tucker
- Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
- School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
| | - Jennifer D Irwin
- Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
- School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
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Stegen H, Duppen D, Savieri P, Stas L, Pan H, Aartsen M, Callewaert H, Dierckx E, De Donder L. Loneliness prevalence of community-dwelling older adults and the impact of the mode of measurement, data collection, and country: A systematic review and meta-analysis. Int Psychogeriatr 2024:1-15. [PMID: 38525677 DOI: 10.1017/s1041610224000425] [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] [Indexed: 03/26/2024]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis is to assess the prevalence of loneliness in many countries worldwide which have different ways of assessing it. DESIGN Systematic review and meta-analysis. SETTING We searched seven electronic databases for English peer-reviewed studies published between 1992 and 2021. PARTICIPANTS We selected English-language peer-reviewed articles, with data from non-clinical populations of community-dwelling older adults (>60 years), and with "loneliness" or "lonely" in the title. MEASUREMENTS A multilevel random-effects meta-analysis was used to estimate the prevalence of loneliness across studies and to pool prevalence rates for different measurement instruments, data collection methods, and countries. RESULTS Our initial search identified 2,021 studies of which 45 (k = 101 prevalence rates) were included in the final meta-analysis. The estimated pooled prevalence rate was 31.6% (n = 168,473). Measurement instrument was a statistically significant moderator of the overall prevalence of loneliness. Loneliness prevalence was lowest for single-item questions and highest for the 20-item University of California-Los Angeles Loneliness Scale. Also, differences between modes of data collection were significant: the loneliness prevalence was significantly the highest for face-to-face data collection and the lowest for telephone and CATI data collection. Our moderator analysis to look at the country effect indicated that four of the six dimensions of Hofstede also caused a significant increase (Power Distance Index, Uncertainty Avoidance Index, Indulgence) or decrease (Individualism) in loneliness prevalence. CONCLUSIONS This study suggests that there is high variability in loneliness prevalence rates among community-dwelling older adults, influenced by measurement instrument used, mode of data collection, and country.
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Affiliation(s)
- Hannelore Stegen
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Daan Duppen
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Perseverence Savieri
- Core facility - Support for Quantitative and Qualitative Research (SQUARE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Lara Stas
- Core facility - Support for Quantitative and Qualitative Research (SQUARE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Honghui Pan
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Brussels Interdisciplinary Research centre on Migration and Minorities (BIRMM), Brussels, Belgium
| | - Marja Aartsen
- Norwegian Social Research, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Hannelore Callewaert
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Eva Dierckx
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Alexianen Zorggroep Tienen, Psychiatric Clinic, Tienen, Belgium
| | - Liesbeth De Donder
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Imamura K, Kawai H, Ejiri M, Sasai H, Hirano H, Fujiwara Y, Ihara K, Obuchi S. Social isolation, regardless of living alone, is associated with mortality: the Otassha study. Front Public Health 2024; 12:1365943. [PMID: 38560448 PMCID: PMC10978664 DOI: 10.3389/fpubh.2024.1365943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Social isolation has been recognized as a contributing factor to negative health outcomes. Although living alone is associated with health-related outcomes, existing findings are inconsistent. It is not the act of living alone that may predict poor health, but rather social isolation that can lead to increased mortality risk. This study investigated the combined associations of social isolation and living alone with mortality among community-dwelling older adults. Methods We included older adults from Itabashi ward, Tokyo, who participated in comprehensive health checkups. Participants were categorized into four groups based on their social isolation status and living alone. The primary outcome was all-cause mortality, analyzed using Cox proportional hazards models. Results Of the 1,106 participants (mean age 73, 42% male), 4.5% experienced both social isolation and living alone. This combination was associated with a worse prognosis regarding all-cause mortality (hazard ratio (HR): 2.08 [95% confidence interval (CI), 1.08-4. 00]). Those who were socially isolated but not living alone also showed a trend towards higher mortality risk (HR: 1.41 [95% CI, 0.90-2.20]). Contrastingly, those who were not socially isolated and lived alone did not show an increased mortality risk (HR: 0.81 [95% CI, 0.44-1.49]). Discussion and conclusion Living alone is not inherently associated with a poor prognosis in older adults; however, social isolation was associated with a higher mortality risk. Healthcare providers should focus on enhancing social interactions and support for older adults because of their effects on health rather than solely addressing living arrangements to prevent adverse health events.
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Affiliation(s)
- Keigo Imamura
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Manami Ejiri
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroyuki Sasai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | | | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Kim C, Chun J. "Meaning in Life" Mediates the Relationship between Loneliness and Depressive Symptoms among Older Adults during the COVID-19 Pandemic. Healthcare (Basel) 2024; 12:584. [PMID: 38470695 PMCID: PMC10930687 DOI: 10.3390/healthcare12050584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Loneliness was found to be a commonly experienced feeling among older adults during the COVID-19 pandemic and is considered to be a high-risk factor for depressive symptoms. Maintaining meaning in life has been found to be a protective resource for mental health among older adults. The purpose of this study was to examine the mediating effects of an individual's meaning in life in the relationship between loneliness and depressive symptoms among older Korean adults. METHODS The data were obtained from a sample of 213 community-dwelling older adults aged over 65. The instruments were the UCLA Loneliness Scale, the Center for Epidemiologic Studies Depression Scale, and the Meaning in Life Questionnaire. RESULTS Loneliness was positively associated with depressive symptoms and negatively associated with the presence of and search for meaning among older adults. The presence of meaning mediated the relationship between loneliness and depressive symptoms but the search for meaning did not. The search for meaning mediated the relationship between loneliness and depressive symptoms through the presence of meaning. CONCLUSIONS Our study findings suggest that efforts to reduce loneliness and improve meaning in life should be undertaken to prevent depressive symptoms among older adults.
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Affiliation(s)
- Chanhee Kim
- Department of Nursing, Changwon National University, 20 Changwondaehak-ro, Uichang-gu, Changwon-si 51140, Gyeongsangnam-do, Republic of Korea;
| | - Jiyoung Chun
- College of Nursing, Sahmyook University, Seoul 01795, Republic of Korea
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Williams-Farrelly MM, Schroeder MW, Li C, Perkins AJ, Bakas T, Head KJ, Boustani M, Fowler NR. Loneliness in older primary care patients and its relationship to physical and mental health-related quality of life. J Am Geriatr Soc 2024; 72:811-821. [PMID: 38240340 PMCID: PMC10947914 DOI: 10.1111/jgs.18762] [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: 06/15/2023] [Revised: 11/09/2023] [Accepted: 12/03/2023] [Indexed: 03/19/2024]
Abstract
BACKGROUND Loneliness is a significant public health challenge in the United States, especially among older adults. The epidemiology of loneliness among older adults in primary care is lacking, and specific research is needed on how loneliness impacts older primary patients' physical, mental, and cognitive health. A large sample of older primary care patients were recruited for a trial during the COVID-19 pandemic to measure the relationship between loneliness and physical and mental quality of life (QOL). METHODS Baseline data come from the Caregiver Outcomes of Alzheimer's Disease Screening (COADS) study, an ongoing randomized controlled trial evaluating benefits and risks of Alzheimer's disease and related dementias screening among primary care patients ages 65 and older, collected April 2020 to September 2021. Loneliness was measured with the 5-item, Loneliness Fixed Form Ages 18+ from The NIH Toolbox Emotion Battery, physical and mental health-related QOL was measured with the SF-36v2, and depression and anxiety severity were measured with the PHQ-9 and GAD-7, respectively. RESULTS Spearman correlation analyses revealed that loneliness was moderately correlated with mental health QOL (r[601] = -0.43, p < 0.001), anxiety severity (r[601] = 0.44, p < 0.001), and depression severity (r[601] = 0.42, p < 0.001), while weakly correlated with physical health QOL (r[601] = -0.15, p < 0.001). After conducting unadjusted and adjusted linear regression models, we found that loneliness was significantly associated with both lower mental (p < 0.001) and physical (p < 0.001) QOL. Furthermore, loneliness remained significantly associated with worse mental QOL after adjusting for age, gender, race, ethnicity, educational level, perceived income status, neighborhood disadvantage, severity of comorbidities, and comorbid depression and anxiety. CONCLUSION Primary care providers should discuss loneliness with their older adult patients and provide resources to help patients develop and maintain meaningful social relationships.
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Affiliation(s)
- Monica M. Williams-Farrelly
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Indianapolis, IN, 46202, USA
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Indiana University Center for Aging Research, Indianapolis, IN, 46202, USA
- Regenstrief Institute, Inc., Indianapolis, IN, 46202, USA
| | - Matthew W. Schroeder
- Indiana University Center for Aging Research, Indianapolis, IN, 46202, USA
- Regenstrief Institute, Inc., Indianapolis, IN, 46202, USA
| | - Claudia Li
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Anthony J. Perkins
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Biostatistics and Health Data Science, Indianapolis, IN, 46202, USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH, 45219, USA
| | - Katharine J. Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, 46202, USA
| | - Malaz Boustani
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Indianapolis, IN, 46202, USA
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Indiana University Center for Aging Research, Indianapolis, IN, 46202, USA
- Regenstrief Institute, Inc., Indianapolis, IN, 46202, USA
| | - Nicole R. Fowler
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Indianapolis, IN, 46202, USA
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Indiana University Center for Aging Research, Indianapolis, IN, 46202, USA
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Zvolensky MJ, Bakhshaie J, Redmond BY, Smit T, Nikčević AV, Spada MM, Distaso W. Coronavirus Anxiety, COVID Anxiety Syndrome and Mental Health: A Test Among Six Countries During March 2021. Clin Psychol Psychother 2024; 31:e2988. [PMID: 38654488 PMCID: PMC11200194 DOI: 10.1002/cpp.2988] [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: 02/21/2024] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
The negative impact of the COVID-19 pandemic on mental health outcomes is widely documented. Specifically, individuals experiencing greater degrees of severity in coronavirus anxiety have demonstrated higher levels of generalized anxiety, depression and psychological distress. Yet the pathways in which coronavirus anxiety confers vulnerability are not well known. The present investigation sought to address this gap in the scientific literature by testing the indirect effect of the COVID-19 anxiety syndrome, which centres on the function of detecting and managing the environmental threat of virus exposure and its sequalae. Data were collected during the height of the pandemic (March 2021) and included 5297 adults across six countries. Structural equation modelling techniques revealed that the COVID-19 anxiety syndrome evidenced a statistically significant indirect effect between coronavirus anxiety and generalized anxiety, depression and work/social adjustment. Overall, results suggest there could be public health merit to targeting anxiety related to virus exposure to improve behavioural health for those who are struggling with excessive fear and worry.
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
| | - Jafar Bakhshaie
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Brooke Y. Redmond
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Ana V. Nikčević
- Department of Psychology, Kingston University, Kingston upon Thames, UK
| | | | - Walter Distaso
- Imperial College Business School, Imperial College London, London, UK
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Lin Y, Zhu T, Zhang X, Zeng Z. Trends in the prevalence of social isolation among middle and older adults in China from 2011 to 2018: the China Health and Retirement Longitudinal Study. BMC Public Health 2024; 24:339. [PMID: 38302982 PMCID: PMC10832184 DOI: 10.1186/s12889-024-17734-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Epidemiological studies have shown that social isolation, which is prevalent in older adults, is associated with a range of adverse health outcomes, but the prevalence of and trends in regard to social isolation remain ambiguous in China. The aim of this study was to elucidate the trends regarding the prevalence of social isolation among middle-aged and older adults in China from 2011 to 2018 and to further identify associated risk factors. METHODS A repeated cross-sectional study, The data were derived from panel sample data of four waves conducted from May 2011 to August 2018 in the nationally representative China Health and Retirement Longitudinal Study (CHARLS) using multistage probability sampling. Social isolation was ascertained by the five item Steptoe Social Isolation Index. The potential covariates were demographic characteristics, lifestyle factors, and health status. Linear-by-linear association was used to assess the trends in regard to social isolation over time under the influence of the potential covariates. Linear-by-linear association and an age-period-cohort analysis were used to explore the trends, and two-level (time, individual) generalized estimating equation models (GEE) linked multivariate binary logistic regression were performed to identify risk factors. RESULTS A high prevalence of social isolation and a moderate upward trend from 2013 to 2018 were observed among a U-shaped trend prevalence of social isolation from 2011 to 2018 across China, with rates of 38.09% (95% CI = 36.73-39.45) in 2011, 33.66% (32.32-35.00) in 2013, 39.13% (37.59-40.67) in 2015, and 39.95% (38.59-41.31) in 2018 (p < 0.001). The prevalence of social isolation increased with age and educational attainment. Females had a higher prevalence than males. The prevalence of social isolation was found to be significantly lower in pensioners than in non-pensioners between 2011 and 2018 (p < 0.001). The prevalence of social isolation was 38.9%, 34.9%, 38.5%, and 44.08% about three times higher among those who doid not use the Internet and 13.44%, 11.64%, 12.93%, and 16.73% than among those who doid in 2011, 2013, 2015 and 2018 respectively. The participants with short (0-5 h) and long sleep (9 or more hours), and poor self-rated health had a higher prevalence of social isolation than the others. Older age, lower educational attainment, living in a rural region, lack of medical insurance or pension, lack of internet use and poor health were risk factors (p < 0.05). CONCLUSIONS We found a U-shaped prevalence of social isolation trends from 2011 to 2018 and revealed increasing trends from 2013 to 2018 among middle-aged and older adults in China. The findings of the study highlight the urgent need for interventions to reduce social isolation including improving sleep quality and internet skills. Disadvantaged groups in terms of age, economic status, and health status should be the focus of such interventions, especially in the era of COVID-19.
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Affiliation(s)
- Yanwei Lin
- Department of Social Medicine and Health Management, School of Public Health, Guangdong Medical University, Dongguan, China
- Institute of Public Health and Wellness, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, Guangdong, 523808, China
- Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, WC2A2AE, UK
| | - Tingting Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
- Institute of Public Health and Wellness, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, Guangdong, 523808, China
| | - Xiaoyan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
- Institute of Public Health and Wellness, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, Guangdong, 523808, China
| | - Zhirong Zeng
- Institute of Public Health and Wellness, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, Guangdong, 523808, China.
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Ballesteros O, Mark S, Block A, Mackin L, Paul S, Cooper B, Abbott M, Chang S, Hammer MJ, Levine J, Pozzar R, Snowberg K, Tsai K, Van Blarigan E, Van Loon K, Miaskowski CA. COVID-19 pandemic stress and cancer symptom burden. BMJ Support Palliat Care 2024; 13:e1351-e1362. [PMID: 37541779 DOI: 10.1136/spcare-2023-004319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/25/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES In a sample of patients with cancer (n=1145) who were assessed during the height of the COVID-19 pandemic, latent profile analysis was used to identify subgroups of patients with distinct stress profiles and to evaluate for differences in demographic and clinical characteristics and symptom severity scores among these subgroups. METHODS Patients completed measures of cancer-specific and COVID-19 stress, global stress, social isolation, loneliness, depression, state and trait anxiety, morning and evening fatigue, morning and evening energy, sleep disturbance, cognitive function, and pain. Latent profile analysis was used to identify subgroups of patients with distinct stress profiles. Differences among the subgroups in study measures were evaluated using parametric and non-parametric tests. RESULTS Using clinically meaningful cut-off scores for the stress measures, four distinct stress profiles were identified (ie, none class (51.3%); low stress and moderate loneliness class (24.4%), high stress and moderate loneliness class (14.0%), and very high stress and moderately high loneliness class (high, 10.3%)). Risk factors associated with membership in the high class included: younger age, lower annual household income, lower functional status and higher comorbidity burden. The two worst stress profiles reported clinically meaningful levels of all of the common symptoms associated with cancer and its treatments. CONCLUSION Findings from this study, obtained prior to the availability of COVID-19 vaccines and anti-viral medications, provide important 'benchmark data' to evaluate for changes in stress and symptom burden in patients with cancer in the postvaccine era and in patients with long COVID-19.
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Affiliation(s)
- Olivia Ballesteros
- Department of Physiological Nursing, School of Nursing, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Sueann Mark
- Department of Physiological Nursing, School of Nursing, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Astrid Block
- Department of Physiological Nursing, School of Nursing, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Lynda Mackin
- Department of Physiological Nursing, School of Nursing, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Steven Paul
- Department of Physiological Nursing, School of Nursing, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Bruce Cooper
- Department of Physiological Nursing, School of Nursing, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Maura Abbott
- Department of Nursing, Columbia University Medical Center, New York, New York, USA
| | - Susan Chang
- Department of Medicine, School of Medicine, UCSF, San Francisco, CA, USA
| | - Marilyn J Hammer
- Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jon Levine
- Department of Medicine, School of Medicine, UCSF, San Francisco, CA, USA
| | - Rachel Pozzar
- Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Karin Snowberg
- Department of Physiological Nursing, School of Nursing, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Katy Tsai
- Department of Medicine, School of Medicine, UCSF, San Francisco, CA, USA
| | - Erin Van Blarigan
- Department of Epidemiology and Biostatistics, School of Medicine, UCSF, San Francisco, California, USA
| | - Katherine Van Loon
- Department of Medicine, School of Medicine, UCSF, San Francisco, CA, USA
| | - Christine A Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California San Francisco (UCSF), San Francisco, California, USA
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Al-Jadidi S, Alharrasi M, Al-Shukaili A, Alkalbani A, Muthukrishnan A. Psychological Symptoms of COVID-19 Pandemic Among Community-Dwelling Older People in Oman and Associated Risk Factors. SAGE Open Nurs 2024; 10:23779608231226102. [PMID: 38250457 PMCID: PMC10798079 DOI: 10.1177/23779608231226102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 11/29/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction The COVID-19 pandemic has led to a dramatic loss of human lives worldwide. Objective This study aimed to investigate the psychological factors of the COVID-19 pandemic in the community-dwelling older population. Method This was a cross-sectional study of older people aged ≥60 years with no mental or psychological illnesses. A total of 193 participants were recruited. The study questionnaire included anxiety- and depression-related questions tailored for the COVID-19 pandemic. The questionnaire was developed through a literature review and expert review. Data was collected from December 2020 to January 2022. Results The psychological symptoms of COVID-19 were high in this sample (mean 29.18 ± 3.57). Gender (female) was found to have a strong positive relationship with the psychological symptoms of COVID-19 score (p = 0.003). Chronic illnesses (β = 0.19, p < 0.001), living alone (β = 0.39, p < 0.001), and having a family member or a friend with COVID-19 (β = 0.15, p < 0.001) were also found to have a strong positive relationship with the psychological symptoms of COVID-19 score. Conclusion The negative psychological effects of COVID-19 were high among the older population in Oman. In this study, female gender, chronic illnesses, living alone, and having a family member or a friend with COVID-19 were associated with worse COVID-19 psychological symptoms. Older women were affected by COVID-19 more than older men. In addition, those who had chronic illnesses, lived alone, or had a family member or a friend with COVID-19 were more psychologically burdened by the pandemic than those without those characteristics. Particular attention should be given to older adults who have chronic illnesses, live alone, or have a family member or a friend with COVID-19. Support groups and psychological counseling programs are essential for older people during a pandemic.
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Affiliation(s)
| | | | | | - Ali Alkalbani
- Intensive Care Unit, Sultan Qaboos University Hospital, Muscat, Oman
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Ho AHY, Ma SHX, Tan MKB, Bajpai R, Goh SSN, Yeo G, Teng A, Yang Y, Galéry K, Beauchet O. Effects of participatory 'A'rt-Based Activity On 'Health' of Older Community-Dwellers: results from a randomized control trial of the Singapore A-Health Intervention. Front Med (Lausanne) 2023; 10:1238562. [PMID: 38188333 PMCID: PMC10768056 DOI: 10.3389/fmed.2023.1238562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/23/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction The practice of participatory art has been found to support the promotion, prevention, and management of health across the lifespan. However, clinical trials investigating the benefits of creative activities curated with and conducted in museums among older adults in East Asia remains limited. Methods The current research utilized a single-site, open-label randomized control trial (RCT) to evaluate a standardized Participatory 'A'rt-Based Activity On 'Health' of Older Community-Dwellers - the Singapore A-Health Intervention. Outcome measures include frailty as assessed by the Centre of Excellence on Longevity Self-administered Questionnaire, wellbeing as assessed by the Warwick-Edinburgh Mental Wellbeing Scales, and quality of life as assessed by the EuroQol-5D. 112 participants aged 60 and above were randomized into the intervention group (n = 56) or an inactive control group (n = 56). Participants completed four standardized online self-administered assessments at baseline, 5-week, 9-week and 12-week follow-up during the intervention period. Results Linear mixed model analyses revealed no statistically significant differences between the intervention group and control group for all outcome measures. However, within the intervention group, a consistent significant reduction in frailty was observed across time from baseline to 9 weeks (MD -0.44, 95% CI -0.85 to -0.039, p = 0.032), 5-weeks to 9-weeks (MD -0.64, 95% CI -1.03 to -0.24, p = 0.002), and 5-weeks to 12-weeks (MD -0.51, 95% CI -0.91 to -0.10, p = 0.014). Moreover, the post-test mean wellbeing score in the intervention group significantly improved over time at 9-weeks (MD 1.65, 95% CI 0.09 to 3.22, p = 0.039) and 12-week (MD 2.42, 95% CI 0.67 to 4.16, p = 0.006) as compared to baseline scores. Discussion The findings demonstrate the potential of a structured art and museum-based intervention as a resource for promoting health among aging populations. Such benefits transcend social, cultural, and societal contexts. Clinical trial registration ClinicalTrial.gov, NCT05945589.
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Affiliation(s)
- Andy Hau Yan Ho
- Action Research for Community Health Laboratory, Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Palliative Care Centre for Excellence in Research and Education, Singapore, Singapore
| | - Stephanie Hilary Xinyi Ma
- Action Research for Community Health Laboratory, Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Michael Koon Boon Tan
- Lab4Living, Culture and Creativity Research Institute, Sheffield Hallam University, Sheffield, United Kingdom
| | - Ram Bajpai
- School of Medicine, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Shannon Shuet Ning Goh
- Action Research for Community Health Laboratory, Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Gabriellia Yeo
- Action Research for Community Health Laboratory, Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Alicia Teng
- National Gallery Singapore, Community and Access, Singapore, Singapore
| | - Yilin Yang
- National Gallery Singapore, Community and Access, Singapore, Singapore
| | - Kévin Galéry
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
| | - Olivier Beauchet
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
- Departments of Medicine and Geriatrics, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
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Hajek A, Volkmar A, König HH. Prevalence and correlates of loneliness and social isolation in the oldest old: a systematic review, meta-analysis and meta-regression. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02602-0. [PMID: 38102477 DOI: 10.1007/s00127-023-02602-0] [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: 05/24/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Conducting a systematic review, meta-analysis and meta-regression regarding the prevalence and correlates of loneliness and social isolation amongst the community-dwelling and institutionalised oldest old (80 years and over). METHODS Three electronic databases (PsycINFO, CINAHL and Medline) were searched, including studies from inception to January 5, 2023. An additional hand search was conducted by checking included studies' references, and studies that cited included studies. We included observational studies describing the prevalence and (ideally) the correlates of loneliness, or social isolation, amongst individuals aged 80 years and over. Study design, operationalization of loneliness and social isolation, statistical analysis, characteristics of the sample and key findings were extracted. A random-effects meta-analysis was conducted. RESULTS We included 22 studies. The estimated prevalence of severe loneliness was 27.1% (95% CI: 23.7-30.4%). The estimated prevalence of moderate loneliness equalled 32.1% (95% CI: 15.8-48.4%). Moreover, the estimated prevalence of social isolation was 33.6% (95% CI: 28.9-38.2%). There was heterogeneity between the studies. Egger tests suggest the absence of potential publication bias. Meta-regressions showed that the heterogeneity could neither be attributed to the assessment of loneliness nor to the continent where the study was conducted. CONCLUSION Loneliness and social isolation are important problems in the oldest old. In this age group, studies are required, in particular from regions outside Europe. Additionally, longitudinal studies are required to investigate the determinants of loneliness and social isolation amongst individuals aged 80 years and over. Studies using more sophisticated tools to quantify loneliness and social isolation are required.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
| | - Alina Volkmar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Ferrante LE, Cohen AB. All the Lonely People: Social Isolation and Loneliness in Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 2023; 20:1703-1704. [PMID: 38038602 PMCID: PMC10704229 DOI: 10.1513/annalsats.202309-833ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Affiliation(s)
| | - Andrew B Cohen
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut; and
- VA Connecticut Healthcare System, West Haven, Connecticut
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Ruan J, Xu YM, Zhong BL. Loneliness in older Chinese adults amid the COVID-19 pandemic: Prevalence and associated factors. Asia Pac Psychiatry 2023; 15:e12543. [PMID: 37562972 DOI: 10.1111/appy.12543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/19/2023] [Accepted: 07/29/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Data on loneliness among older adults in China during the COVID-19 pandemic are still scarce. This study aimed to examine the prevalence of loneliness and identify its associated factors among older Chinese adults during the COVID-19 pandemic. METHODS During the COVID-19 pandemic, 1268 older Chinese adults (aged 50+ years) were recruited through snowball sampling. The Chinese version of the validated six-item De Jong Gierveld Loneliness Scale was used to assess participants' recent feelings of loneliness, and a cut-off score of two or more was used to indicate the presence of loneliness. RESULTS Loneliness was experienced by 37.9% of the participants in recent days. Factors significantly associated with loneliness included male sex (vs. female, OR: 1.62, p < .001), an education level of middle school and below (vs. college and above, OR: 1.50, p = .007), residing in the COVID-19 epicenter (vs. other provinces, OR: 1.48, p = .004), concern about contracting COVID-19 (OR: 1.68, p = .001), poor knowledge of COVID-19 (OR: 2.39, p = .012), and physical health problems (OR: 1.65, p < .001). DISCUSSION Loneliness is common among older Chinese adults amid the COVID-19 pandemic. Targeted intervention programs may be more effective in reducing loneliness among older adults who are worried about contracting COVID-19, have poor COVID-19 knowledge, and experience physical health problems.
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Affiliation(s)
- Juan Ruan
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Center for Psychological Consultation and Therapy, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yan-Min Xu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Center for Psychological Consultation and Therapy, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
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Hausmann LRM, Cohen AJ, Eliacin J, Gurewich DA, Lee RE, McCoy JL, Meterko M, Michaels Z, Moy EM, Procario GT, Russell LE, Schaefer JH. Developing a brief assessment of social risks for the Veterans Health Administration Survey of Healthcare Experiences of Patients. Health Serv Res 2023; 58:1209-1223. [PMID: 37674359 PMCID: PMC10622278 DOI: 10.1111/1475-6773.14220] [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] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVE To determine whether a 6- or 12-month look-back period affected rates of reported social risks in a social risk survey for use in the Veterans Health Administration and to assess associations of social risks with overall health and mental health. STUDY DESIGN Cross-sectional survey of respondents randomized to 6- or 12-month look-back period. DATA SOURCES AND STUDY SETTING Online survey with a convenience sample of Veterans in June and July 2021. DATA COLLECTION/EXTRACTION METHODS Veteran volunteers were recruited by email to complete a survey assessing social risks, including financial strain, adult caregiving, childcare, food insecurity, housing, transportation, internet access, loneliness/isolation, stress, discrimination, and legal issues. Outcomes included self-reported overall health and mental health. Chi-squared tests compared the prevalence of reported social risks between 6- and 12-month look-back periods. Spearman correlations assessed associations among social risks. Bivariate and multivariable logistic regression models estimated associations between social risks and fair/poor overall and mental health. PRINCIPAL FINDINGS Of 3418 Veterans contacted, 1063 (31.10%) responded (87.11% male; 85.61% non-Hispanic White; median age = 70, interquartile range [IQR] = 61-74). Prevalence of most reported social risks did not significantly differ by look-back period. Most social risks were weakly intercorrelated (median |r| = 0.24, IQR = 0.16-0.31). Except for legal issues, all social risks were associated with higher odds of fair/poor overall health and mental health in bivariate models. In models containing all significant social risks from bivariate models, adult caregiving and stress remained significant predictors of overall health; food insecurity, housing, loneliness/isolation, and stress remained significant for mental health. CONCLUSIONS Six- and 12-month look-back periods yielded similar rates of reported social risks. Although most individual social risks are associated with fair/poor overall and mental health, when examined together, only adult caregiving, stress, loneliness/isolation, food, and housing remain significant.
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Affiliation(s)
- Leslie R. M. Hausmann
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System (VAPHS); Department of MedicineUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Alicia J. Cohen
- Center of Innovation in Long Term Services and Supports, VA Providence Healthcare System; Department of Health Services, Policy, and Practice, Brown University School of Public HealthProvidenceRhode IslandUSA
| | - Johanne Eliacin
- National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System, Boston, Massachusetts; Department of General Internal Medicine and Geriatrics, Indiana University School of MedicineIndianapolisIndianaUSA
- Department of Health Services ResearchRegenstrief Institute, IncIndianapolisIndianaUSA
| | - Deborah A. Gurewich
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Section of General Internal Medicine, Boston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Richard E. Lee
- Veterans Rural Health Resource CenterWhite River JunctionVermontUSA
| | - Jennifer L. McCoy
- Center for Health Equity Research and Promotion and Office of Research and Development StatCore, VAPHSPittsburghPennsylvaniaUSA
| | - Mark Meterko
- Analytics and Performance Integration, Office of Quality and Patient SafetyDepartment of Veterans Affairs; Department of Health Law, Policy and Management, Boston University School of Public HealthBostonMassachusettsUSA
| | - Zachary Michaels
- Center for Health Equity Research and Promotion, VAPHSPittsburghPennsylvaniaUSA
| | - Ernest M. Moy
- Office of Health EquityVeterans Health AdministrationWashingtonDCUSA
| | - Gregory T. Procario
- Center for Health Equity Research and Promotion, VAPHSPittsburghPennsylvaniaUSA
| | - Lauren E. Russell
- Office of Health EquityVeterans Health AdministrationWashingtonDCUSA
| | - James H. Schaefer
- Analytics and Performance Integration, Office of Quality and Patient SafetyDepartment of Veterans AffairsDurhamNorth CarolinaUSA
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Xu YM, Wang MF, Zhong BL. Both people living in the COVID-19 epicenter and those who have recently left are at a higher risk of loneliness. Sci Rep 2023; 13:21145. [PMID: 38036534 PMCID: PMC10689773 DOI: 10.1038/s41598-023-47140-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/09/2023] [Indexed: 12/02/2023] Open
Abstract
There is little empirical data on the heightened risk of loneliness among individuals residing in the COVID-19 epicenter or those who have recently left. This study compared the risk of loneliness in individuals residing in Wuhan, the COVID-19 epicenter in China, and those who had recently left during the initial outbreak period to those living in non-epicenter regions. During the COVID-19 outbreak in China in 2020, three samples were obtained using snowball sampling. The samples included 2882 epicenter residents, 1028 left residents, and 2963 non-epicenter residents. Loneliness was assessed using the six-item De Jong Gierveld Loneliness Scale, with a score of two or more indicating the presence of loneliness. 53.5% and 55.2% of epicenter and recently left residents, respectively, experienced loneliness, which was significantly higher than the 43.9% observed in non-epicenter residents. After adjusting for covariates, the risk of loneliness remained statistically significant for both epicenter and left residents (OR = 1.35, P < 0.001 and OR = 1.20, P = 0.017, respectively), when compared to non-epicenter residents. Individuals residing in the COVID-19 epicenter, as well as those who have recently left, are at a heightened risk of loneliness during the outbreak. These individuals need psychosocial support to mitigate their risk of loneliness and promote their psychological wellbeing.
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Affiliation(s)
- Yan-Min Xu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei Province, China
- Center for Psychological Consultation and Therapy, Wuhan Hospital for Psychotherapy, Wuhan, Hubei Province, China
| | - Ming-Fang Wang
- Department of Clinical Nutrition, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei Province, China.
- Center for Psychological Consultation and Therapy, Wuhan Hospital for Psychotherapy, Wuhan, Hubei Province, China.
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Li H, Chen B, Chen Z, Chen L, Zhang D, Wen M, Li J, Li Y, Han X, Su D. Trust in COVID-19 Information from Different Media Types and Its Association with Preventive Measures Adoption in the U.S. JOURNAL OF HEALTH COMMUNICATION 2023; 28:633-647. [PMID: 37665096 DOI: 10.1080/10810730.2023.2245373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
This study compares and contrasts how key factors influence Americans' trust in different types of media (broadcast, print, and social) as COVID-19 information sources and how people's media trust is associated with their adoption of preventive measures. Our results from a national survey (sample = 2571) showed that age, political party affiliation, and race and ethnicity and income level were significantly associated with people's trust in different media types as COVID information sources. Elder adults trusted print and broadcast media more, while younger adults trusted social media more. Democrats and Lean Democrats had more trust in all three forms of media than Republicans and Lean Republicans. Asians had the highest levels of trust in all three media types, while Whites had the lowest level of trust in broadcast and social media. Trust in broadcast media was found to be associated with facial mask wearing, but trust in social media, however, did not contribute to the adoption of any COVID-19 preventive measures. This study contributes to a general understanding of media trust and mediated health communication and provides nuanced understanding of how demographic factors shape media trust and the consequence of media trust during a historical pandemic.
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Affiliation(s)
- Hongmei Li
- Strategic Communication Program, Department of Media, Journalism and Film, Miami University, Oxford, Ohio, USA
| | - Baojiang Chen
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Austin, Texas, USA
| | - Zhuo Chen
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California,USA
| | - Donglan Zhang
- Center for Population Health and Health Services Research, Department of Foundations of Medicine, NYU Grossman Long Island School of Medicine, Mineola, NY, USA
| | - Ming Wen
- Department of Sociology, The University of Hong Kong
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, California, USA
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Xusong Han
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Dejun Su
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Zhang H, Yang Y, Hao X, Qin Y, Li K. Effects of digital sleep interventions on sleep and psychological health during the COVID-19 pandemic: A systematic review and meta-analysis. Sleep Med 2023; 110:190-200. [PMID: 37625326 DOI: 10.1016/j.sleep.2023.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/10/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Various digital sleep interventions have been implemented to address sleep and psychological complications during the coronavirus disease 2019 (COVID-19) pandemic. However, the characteristics and effectiveness of digital sleep interventions on sleep and psychological outcomes for people with sleep problems during the COVID-19 pandemic are unknown. METHODS The protocol of this systematic review and meta-analysis was registered on PROSPERO (ID: CRD42022325662), seven databases were searched from December 2019 to June 2023. Reference lists from digital sleep reviews were also identified and selected. Two reviewers independently screened eligible articles and extracted data. Quality appraisal was undertaken by two independent reviewers using the Cochrane Risk-of-Bias Tools. Data synthesis was conducted using fixed- or random-effects model based on the results of the heterogeneity test. RESULTS A total of 20 studies were identified, including nine randomised controlled trials (RCTs) and 11 non-RCTs, involving 3860 participants. Meta-analyses showed that digital sleep interventions significantly improve sleep quality, insomnia, and depression during the COVID-19 pandemic. Subgroup analysis showed that interventions of more than four weeks, healthcare workers as participants, and relaxation therapies may have the advantage of improving sleep quality. Most non-RCTs supported the efficacy of digital sleep interventions on sleep and psychological health. CONCLUSION Digital sleep interventions during the COVID-19 pandemic had significant effectiveness in improving sleep and psychological outcomes for people with sleep problems. More structured and personalised digital sleep interventions should be designed, and other diverse digital technologies could be used to improve sleep and psychological disorders.
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Affiliation(s)
- Huijing Zhang
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Yuhang Yang
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Xiaonan Hao
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Yuan Qin
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China
| | - Kun Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130012, China.
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Wang X, Zhang C, Luan W. Social isolation, depression, nutritional status and quality of life during COVID-19 among Chinese community-dwelling older adults: a cross-sectional study. BMJ Open 2023; 13:e072305. [PMID: 37723110 PMCID: PMC10510871 DOI: 10.1136/bmjopen-2023-072305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/30/2023] [Indexed: 09/20/2023] Open
Abstract
OBJECTIVE This survey investigated the relationship between social isolation, depression, nutritional status and quality of life among community-dwelling older adults during COVID-19. DESIGN This was a cross-sectional survey study. SETTING Communities in Pudong New Area, Shanghai, China that have contracted with Renji Hospital, affiliated with Shanghai Jiao Tong University School of Medicine. PARTICIPANTS From May to July 2022, 406 community-dwelling older adults were selected by convenience sampling in Shanghai, China. PRIMARY AND SECONDARY OUTCOME MEASURES The Lubben Social Network Scale, Geriatric Depression Scale, 36-item Short Form Health Survey Scale and risk assessment of malnutrition were used in older adults. Mediation models were constructed to determine the mediating role of depression and nutritional status on social isolation and quality of life among older adults. RESULTS The prevalence of social isolation among older adults in the community was 44.3%. The total social isolation score in community-dwelling older adults was positively associated with the total malnutrition risk and quality of life scores, and negatively associated with depression (p<0.01). Logistic regression demonstrated that living alone, loss of families or friends during COVID-19 and depression were risk factors for social isolation among community-dwelling older adults (p<0.05). Social isolation could directly affect the quality of life (β=0.306). In addition, depression (β=0.334) and nutritional status (β=0.058) had a significant mediating effect on the relationship between social isolation and quality of life. CONCLUSIONS Our findings showed that the prevalence of social isolation among older adults increased during COVID-19. Depression and nutritional status played parallel mediating roles on the effect of social isolation on quality of life. Community workers and healthcare providers should develop intervention plans to improve the status of social isolation in older adults, eliminating existing and ongoing adverse effects.
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Affiliation(s)
- Xinxin Wang
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, China
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Chengrui Zhang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Wei Luan
- Nursing Department, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, China
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Zhong BL, Yuan MD, Li F, Sun P. The Psychological Network of Loneliness Symptoms Among Chinese Residents During the COVID-19 Outbreak. Psychol Res Behav Manag 2023; 16:3767-3776. [PMID: 37705850 PMCID: PMC10497046 DOI: 10.2147/prbm.s424565] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/23/2023] [Indexed: 09/15/2023] Open
Abstract
Purpose Social distancing measures implemented during the COVID-19 pandemic have contributed to increased levels of loneliness, but the specific interactions between loneliness symptoms in the context of the pandemic remain unknown. This study characterized the psychological network of loneliness symptoms in residents during the initial wave of COVID-19 outbreak in China. Patients and Methods The study recruited 8472 Chinese residents (61.5% women, aged 33.0±10.6 years) through online snowball sampling. The Six-item De Jong Gierveld Loneliness Scale (DJGLS) was used to measure loneliness symptoms. Central symptoms of and bridge symptoms between emotional and social loneliness subscales were identified based on centrality and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedures. Results The nodes in the loneliness network were separated into two groups, corresponding to the social and emotional loneliness domains of the DJGLS. The strongest direction association was between "no reliable people" and "no trustworthy people" (edge weight=0.546). "No trustworthy people" has the highest node strength (1.047) in the loneliness network, followed by "emptiness sense" (0.767) and "no reliable people" (0.749). "Feeling of rejection" (1.672) and "no close people" (0.403) showed the first and second highest bridge strengths, respectively. Both the stability and accuracy tests supported robustness of the whole network. Conclusion Interventions targeting central symptoms "no trustworthy people" and "emptiness sense" and central bridge symptom "feeling of rejection" may be effective for alleviating the overall level of loneliness in pandemic-affected Chinese residents.
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Affiliation(s)
- Bao-Liang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei Province, People’s Republic of China
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, Hubei Province, People’s Republic of China
| | - Meng-Di Yuan
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, Hubei Province, People’s Republic of China
| | - Fang Li
- Department of Psychiatry, Huangpu District Mental Health Center, Shanghai, People’s Republic of China
| | - Peng Sun
- Department of Psychiatry, Huangpu District Mental Health Center, Shanghai, People’s Republic of China
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Schäfer SK, Lindner S, Kunzler AM, Meerpohl JJ, Lieb K. The mental health impact of the COVID-19 pandemic on older adults: a systematic review and meta-analysis. Age Ageing 2023; 52:afad170. [PMID: 37725975 DOI: 10.1093/ageing/afad170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Early in the COVID-19 pandemic, many experts pointed to potential adverse mental health effects for older adults. By contrast, many studies in young to middle-aged adults found older age to be associated with reduced mental burden. However, a systematic review on older adults is missing. OBJECTIVES To comprehensively assess the pandemic's mental health impact on older adults. DATA SOURCES We searched nine databases from December 2019 to April 2022. STUDY SELECTION We included longitudinal and repeated cross-sectional studies assessing pre- and/or peri-pandemic mental distress and/or positive mental health indicators (e.g. wellbeing) on at least two occasions. DATA SYNTHESIS We identified 108 studies comprising 102,136 participants (≥60 years). After removal of outliers, there was a small increase in mental distress from pre-to-peri-pandemic assessments, standardised mean difference (SMD) = 0.10, 95% confidence interval (CI) [0.01, 0.18]. Furthermore, a small peri-pandemic decrease in anxiety symptoms was observed, whereas other symptoms remained unchanged. For positive mental health indicators, wellbeing and quality of life showed an initial decrease, whereas overall positive mental health increased during the pandemic, SMD = 0.08, 95% CI [0.01, 0.15]. Being female was related to larger peri-pandemic increases in mental distress. CONCLUSIONS Based on many studies, this review demonstrated small decreases in mental health during early stages of the pandemic in older adults, with evidence for later recovery. These findings are similar to those for younger adults and correct earlier claims that older adults are at particular risk for negative mental health consequences. The results ask for further research into resilience and adaptation processes in older adults.
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Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology, Psychotherapy and Diagnostics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Saskia Lindner
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Angela M Kunzler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jörg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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45
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Rees J, Liu W, Ourselin S, Shi Y, Probst F, Antonelli M, Tinker A, Matcham F. Understanding the psychological experiences of loneliness in later life: qualitative protocol to inform technology development. BMJ Open 2023; 13:e072420. [PMID: 37336536 DOI: 10.1136/bmjopen-2023-072420] [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] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVES Loneliness is a public health issue impacting the health and well-being of older adults. This protocol focuses on understanding the psychological experiences of loneliness in later life to inform technology development as part of the 'Design for health ageing: a smart system to detect loneliness in older people' (DELONELINESS) study. METHODS AND ANALYSIS Data will be collected from semi-structured interviews with up to 60 people over the age of 65 on their experiences of loneliness and preferences for sensor-based technologies. The interviews will be audio-recorded, transcribed and analysed using a thematic codebook approach on NVivo software. ETHICS AND DISSEMINATION This study has received ethical approval by Research Ethics Committee's at King's College London (reference number: LRS/DP-21/22-33376) and the University of Sussex (reference number: ER/JH878/1). All participants will be required to provide informed consent. Results will be used to inform technology development within the DELONELINESS study and will be disseminated in peer-reviewed publications and conferences.
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Affiliation(s)
- Jessica Rees
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Wei Liu
- Department of Engineering, King's College London, London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Yu Shi
- School of Design, University of Leeds, Leeds, UK
| | - Freya Probst
- Department of Engineering, King's College London, London, UK
| | - Michela Antonelli
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Anthea Tinker
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Faith Matcham
- School of Psychology, University of Sussex, Falmer, UK
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46
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Taylor HO, Cudjoe TKM, Bu F, Lim MH. The state of loneliness and social isolation research: current knowledge and future directions. BMC Public Health 2023; 23:1049. [PMID: 37264355 DOI: 10.1186/s12889-023-15967-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/24/2023] [Indexed: 06/03/2023] Open
Abstract
In this editorial, we consider the current state of loneliness and social isolation research around the world, including knowledge gaps in the empirical literature.
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Affiliation(s)
- Harry Owen Taylor
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada.
| | - Thomas K M Cudjoe
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Feifei Bu
- Research Department of Behavioural Science and Health, Insititute of Epidemiology & Health Care, University College London, London, England
| | - Michelle H Lim
- Prevention Research Collaboration, Sydney School of Public Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Victoria, Australia
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47
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Li M, Rao W, Su Y, Sul Y, Caron G, D'Arcy C, Fleury MJ, Meng X. Psychological interventions for loneliness and social isolation among older adults during medical pandemics: a systematic review and meta-analysis. Age Ageing 2023; 52:7192245. [PMID: 37290121 DOI: 10.1093/ageing/afad076] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVES There is little research conducted to systematically synthesize the evidence on psychological interventions for social isolation and loneliness among older adults during medical pandemics. This systematic review aims to address this information gap and provides guidance for planning and implementing interventions to prevent and reduce loneliness and social isolation for older adults, especially during medical pandemics. METHODS Four electronic databases (EMBASE, PsychoInfo, Medline and Web of Science) and grey literature from 1 January 2000 to 13 September 2022 were searched for eligible studies on loneliness and social isolation. Data extraction and methodological quality assessment on key study characteristics were conducted independently by two researchers. Both qualitative synthesis and meta-analysis were used. RESULTS The initial search yielded 3,116 titles. Of the 215 full texts reviewed, 12 intervention articles targeting loneliness during the COVID-19 pandemic met the inclusion criteria. No studies were found concerning intervention with respect to social isolation. Overall, interventions targeting social skills and the elimination of negativities effectively alleviated the feelings of loneliness in the older population. However, they had only short-term effects. CONCLUSION This review systematically summarised the key characteristics and the effectiveness of existing interventions addressing loneliness in older adults during the COVID-19 pandemic. Future interventions should focus on social skills and eliminating negativities and be tailored to the needs and characteristics of older people. Repeated larger-scale randomized controlled trials and long-term effectiveness evaluations on this topic are warranted.
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Affiliation(s)
- Muzi Li
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec H3A1A1, Canada
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
| | - Wenwang Rao
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec H3A1A1, Canada
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Yingying Su
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec H3A1A1, Canada
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
| | - Youngjoo Sul
- Department of Anatomy & Cell Biology, McGill University, Montreal, Quebec H3A0G4, Canada
| | - Gabriel Caron
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
| | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan S7N5E5, Canada
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N5E5, Canada
| | - Marie-Josee Fleury
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec H3A1A1, Canada
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
| | - Xiangfei Meng
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec H3A1A1, Canada
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
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Durak M, Karakose S, Yow WQ. Editorial: Late-life psychopathology. Front Psychol 2023; 14:1204202. [PMID: 37303896 PMCID: PMC10249054 DOI: 10.3389/fpsyg.2023.1204202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/05/2023] [Indexed: 06/13/2023] Open
Affiliation(s)
- Mithat Durak
- Department of Psychology, Bolu Abant Izzet Baysal University, Bolu, Türkiye
| | - Selin Karakose
- College of Medicine, Florida State University, Tallahassee, FL, United States
| | - W. Quin Yow
- Humanities, Arts and Social Sciences, Singapore University of Technology and Design, Singapore, Singapore
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Hussain B, Mirza M, Baines R, Burns L, Stevens S, Asthana S, Chatterjee A. Loneliness and social networks of older adults in rural communities: a narrative synthesis systematic review. Front Public Health 2023; 11:1113864. [PMID: 37255758 PMCID: PMC10225733 DOI: 10.3389/fpubh.2023.1113864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/17/2023] [Indexed: 06/01/2023] Open
Abstract
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.
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Affiliation(s)
- Basharat Hussain
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Mahrukh Mirza
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Rebecca Baines
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Lorna Burns
- Peninsula School of Medicine, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | | | - Sheena Asthana
- Plymouth Institute of Health and Care Research (PIHR), Plymouth, United Kingdom
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- Centre for Coastal Communities, University of Plymouth, Plymouth, United Kingdom
| | - Arunangsu Chatterjee
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- School of Medicine, University of Leeds, Leeds, United Kingdom
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50
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Hajek A, König HH. Loneliness and social isolation in old age: A look at research during the COVID-19 pandemic and a look ahead. Arch Gerontol Geriatr 2023; 108:104958. [PMID: 36796141 PMCID: PMC9911977 DOI: 10.1016/j.archger.2023.104958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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