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Gasull-Molinera V, Khan KS, Núñez Núñez M, Kouiti M. The impact of loneliness on mental and physical health outcomes: An umbrella review. Semergen 2024; 50:102261. [PMID: 38824784 DOI: 10.1016/j.semerg.2024.102261] [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] [Accepted: 03/28/2024] [Indexed: 06/04/2024]
Abstract
Loneliness and related constructs associated with isolation are public health problems with increasing prevalence. The aim of this umbrella was to collate and grade evidence analyzing actual and subjective loneliness as a health risk factor. Following prospective registration, a systematic search was conducted in Pubmed, Embase, Scopus, Web of Sciences, psycoINFO and Cochrane Library until August 2023. Systematic reviews assessing the association between actual and subjective loneliness with adverse health outcomes were selected. Risk of bias was evaluated using AMSTAR-2 tool. Data were tabulated and synthesis was narrative. A total of 13 systematic reviews was selected (four included meta-analysis). The methodological quality was critically low in 10 reviews (76.92%) and low in 3 (23.08%). Results showed that loneliness was related to poor well-being and increase the risk of negative mental and physical health. The available data suggested but did not allow the confirmation of a causal association. Most constructs of loneliness seem to be related to mental and physical health conditions. A preventive strategy ought to be recommended, especially for vulnerable populations.
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Affiliation(s)
| | - K S Khan
- Universidad de Granada, Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Consorcio Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain
| | - M Núñez Núñez
- Consorcio Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Biosanitary Research Institute (Ibs. Granada), 18012 Granada, Spain
| | - M Kouiti
- Universidad de Granada, Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco.
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2
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McDonald B, Reiter AMF, Kanske P. Theater-based interventions as a means of reducing social isolation and loneliness, facilitating successful aging, and strengthening social cognition in older adults. Front Psychol 2024; 15:1364509. [PMID: 39006549 PMCID: PMC11240220 DOI: 10.3389/fpsyg.2024.1364509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/20/2024] [Indexed: 07/16/2024] Open
Affiliation(s)
- Brennan McDonald
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Saxony, Germany
| | - Andrea M F Reiter
- German Center of Prevention Research on Mental Health, Würzburg, Bavaria, Germany
- Department of Psychology, Faculty of Medicine, University of Würzburg, Würzburg, Germany
- Clinic and Polyclinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Bavaria, Germany
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Saxony, Germany
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Wilson SJ, Marini CM. Older Adults' Social Profiles and Links to Functional and Biological Aging in the United States and Mexico. Psychosom Med 2024; 86:387-397. [PMID: 37678359 DOI: 10.1097/psy.0000000000001248] [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] [Indexed: 09/09/2023]
Abstract
OBJECTIVE Social stress-loneliness, isolation, and low relationship quality-increase risks of aging-related diseases. However, the ways in which they intersect to undermine healthy aging remain poorly understood. We used latent class analysis to identify groups of older adults based on their social stress in both the United States and Mexico. Thereafter, we examined their cross-sectional associations with markers of functional and biological aging. METHOD Participants in the Health and Retirement Study (HRS; N = 8316) and Mexican Health and Aging Study (MHAS; N = 15,001) reported their loneliness, isolation (i.e., living alone), and relationship quality with spouse, children, and friends. Outcomes included C-reactive protein, functional limitations, self-rated health, comorbidities, gait speed, and grip strength. Models controlled for demographics, health behaviors, and body mass index. RESULTS In both countries, five classes emerged, a supported group and four with elevated social stress: a) strained, b) isolated, c) spousal ambivalence, and d) unhappily married. Compared with the others, strained participants in both samples had greater functional limitations, poorer self-rated health, and more comorbidities, as well as slower gait in HRS and weaker grip in MHAS. Generally, supported participants fared better than the other groups. In HRS, C-reactive protein levels differed between the strained group and others, but these associations were explained by health behaviors and body mass index. CONCLUSIONS Older adults in both countries with strained relationships fared worst in their aging-related outcomes, revealing new insights about the links between toxic social stress and unhealthy aging.
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Affiliation(s)
- Stephanie J Wilson
- From the Department of Psychology (Wilson), Southern Methodist University, Dallas, Texas; and Gordon F. Derner School of Psychology (Marini), Adelphi University, Garden City, New York
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Ghanei M, Philip KEJ, Moghadam MRS, Hosseini H, Babaie A, Roustanezhad M, Hopkinson NS. Pulmonary rehabilitation in Iranian outpatients with mustard gas lung disease: a randomised controlled trial. BMJ Open 2024; 14:e083085. [PMID: 38806414 PMCID: PMC11138312 DOI: 10.1136/bmjopen-2023-083085] [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: 12/11/2023] [Accepted: 05/15/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVE People with mustard gas lung disease experience cough, sputum, breathlessness and exercise limitation. We hypothesised that pulmonary rehabilitation (PR) would be beneficial in this condition. DESIGN An assessor-blind, two-armed, parallel-design randomised controlled clinical trial. SETTING Secondary care clinics in Iran. PARTICIPANTS 60 men with breathlessness due to respiratory disease caused by documented mustard gas exposure, mean (SD) age 52.7 (4.36) years, MRC dyspnoea score 3.5 (0.7), St. George's Respiratory Questionnaire (SGRQ) 72.3 (15.2). INTERVENTIONS Participants were allocated either to a 6-week course of thrice-weekly PR (n=31) or to usual care (n=29), with 6-week data for 28 and 26, respectively. OUTCOME MEASURES Primary endpoint was change in cycle endurance time at 70% baseline exercise capacity at 6 weeks. Secondary endpoints included 6 min walk distance, quadriceps strength and bulk, body composition and health status. For logistical reasons, blood tests that had been originally planned were not performed and 12-month follow-up was available for only a small proportion. RESULTS At 6 weeks, cycle endurance time increased from 377 (140) s to 787 (343) s with PR vs 495 (171) s to 479 (159) s for usual care, effect size +383 (231) s (p<0.001). PR also improved 6 min walk distance+103.2 m (63.6-142.9) (p<0.001), MRC dyspnoea score -0.36 (-0.65 to -0.07) (p=0.016) and quality of life; SGRQ -8.43 (-13.38 to -3.48) p<0.001, as well as quadriceps strength+9.28 Nm (1.89 to 16.66) p=0.015. CONCLUSION These data suggest that PR can improve exercise capacity and quality of life in people with breathlessness due to mustard gas lung disease and support the wider provision of this form of care. TRIAL REGISTRATION NUMBER IRCT2016051127848N1.
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Affiliation(s)
- Mostafa Ghanei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Keir E J Philip
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Hamed Hosseini
- Clinical Trial Center, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Aliakbar Babaie
- Janbazan Medical and Engineering Research Center, Tehran, Iran (the Islamic Republic of)
| | - Mohammad Roustanezhad
- Janbazan Medical and Engineering Research Center, Tehran, Iran (the Islamic Republic of)
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5
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Philip KEJ, Buttery SC, Bowen S, Lewis A, Jeffery E, Alghamdi SM, Williams P, Alasmari AM, Alsulayyim AS, Orton CM, Conway F, Chan L, Vijayakumar B, Tana A, Tonkin J, Perkins A, Garner JL, Srikanthan K, Sadaka A, Pavitt MJ, Banya W, Lound A, Elkin S, Polkey MI, Man WDC, Lewis K, Cave P, Fancourt D, Hopkinson NS. Singing for lung health in COPD: a multicentre randomised controlled trial of online delivery. BMJ Open Respir Res 2024; 11:e002365. [PMID: 38697677 PMCID: PMC11086531 DOI: 10.1136/bmjresp-2024-002365] [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: 02/08/2024] [Accepted: 03/25/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Singing for lung health (SLH) is an arts-based breathing control and movement intervention for people with long-term respiratory conditions, intended to improve symptoms and quality of life. Online, remotely delivered programmes might improve accessibility; however, no previous studies have assessed the effectiveness of this approach. METHODS We conducted an assessor-blind randomised controlled trial comparing the impact of 12 weeks of once-weekly online SLH sessions against usual care on health-related quality of life, assessed using the RAND 36-Item Short Form Health Survey (SF-36) Mental Health Composite (MHC) and Physical Health Composite (PHC) scores. RESULTS We enrolled 115 people with stable chronic obstructive pulmonary disease (COPD), median (IQR) age 69 (62-74), 56.5% females, 80% prior pulmonary rehabilitation, Medical Research Council dyspnoea scale 4 (3-4), forced expiratory volume in 1 s % predicted 49 (35-63). 50 participants in each arm completed the study. The intervention arm experienced improvements in physical but not mental health components of RAND SF-36; PHC (regression coefficient (95% CI): 1.77 (95% CI 0.11 to 3.44); p=0.037), but not MHC (0.86 (95% CI -1.68 to 3.40); p=0.504). A prespecified responder analysis based on achieving a 10% improvement from baseline demonstrated a response rate for PHC of 32% in the SLH arm and 12.7% for usual care (p=0.024). A between-group difference in responder rate was not found in relation to the MHC (19.3% vs 25.9%; p=0.403). DISCUSSION AND CONCLUSION A 12-week online SLH programme can improve the physical component of quality of life for people with COPD, but the overall effect is relatively modest compared with the impact seen in research using face-to-face group sessions. Further work on the content, duration and dose of online interventions may be useful. TRIAL REGISTRATION NUMBER NCT04034212.
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Affiliation(s)
- Keir E J Philip
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Sara C Buttery
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Sarah Bowen
- Hywel Dda University Health Board, Carmarthen, UK
| | - Adam Lewis
- Department of Health Sciences, Brunel University London, Uxbridge, UK
| | - Edmund Jeffery
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Saeed M Alghamdi
- National Heart and Lung Institute, Imperial College London, London, UK
- Clinical Technology Department, Faculty of Applied Medical Sciences, Umm Al-Qura University College of Applied Medical Science, Makkah, Saudi Arabia
| | - Parris Williams
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Ali M Alasmari
- National Heart and Lung Institute, Imperial College London, London, UK
- Department of Respiratory Therapy, College of Medical Rehabilitation, Taibah University, Madinah, Al Madinah, Saudi Arabia
| | - Abdullah S Alsulayyim
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Christopher M Orton
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Francesca Conway
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Ley Chan
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Bavithra Vijayakumar
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Anand Tana
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - James Tonkin
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Alexis Perkins
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Justin L Garner
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Karthikan Srikanthan
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Ahmed Sadaka
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Matthew J Pavitt
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Winston Banya
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Adam Lound
- Patient Experience Research Centre, Imperial College, London, UK
| | - Sarah Elkin
- Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Michael I Polkey
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - William D-C Man
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Keir Lewis
- Hywel Dda University Health Board, Carmarthen, UK
| | - Phoene Cave
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, London, UK
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
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Williams PJ, Buttery SC, Laverty AA, Hopkinson NS. Lung Disease and Social Justice: Chronic Obstructive Pulmonary Disease as a Manifestation of Structural Violence. Am J Respir Crit Care Med 2024; 209:938-946. [PMID: 38300144 DOI: 10.1164/rccm.202309-1650ci] [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: 09/20/2023] [Accepted: 02/01/2024] [Indexed: 02/02/2024] Open
Abstract
Lung health, the development of lung disease, and how well a person with lung disease is able to live all depend on a wide range of societal factors. These systemic factors that adversely affect people and cause injustice can be thought of as "structural violence." To make the causal processes relating to chronic obstructive pulmonary disease (COPD) more apparent, and the responsibility to interrupt or alleviate them clearer, we have developed a taxonomy to describe this. It contains five domains: 1) avoidable lung harms (processes impacting lung development, processes that disadvantage lung health in particular groups across the life course), 2) diagnostic delay (healthcare factors; norms and attitudes that mean COPD is not diagnosed in a timely way, denying people with COPD effective treatment), 3) inadequate COPD care (ways in which the provision of care for people with COPD falls short of what is needed to ensure they are able to enjoy the best possible health, considered as healthcare resource allocation and norms and attitudes influencing clinical practice), 4) low status of COPD (ways COPD as a condition and people with COPD are held in less regard and considered less of a priority than other comparable health problems), and 5) lack of support (factors that make living with COPD more difficult than it should be, i.e., socioenvironmental factors and factors that promote social isolation). This model has relevance for policymakers, healthcare professionals, and the public as an educational resource to change clinical practices and priorities and stimulate advocacy and activism with the goal of the elimination of COPD.
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Affiliation(s)
| | | | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
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Shimada H, Doi T, Tsutsumimoto K, Makino K, Harada K, Tomida K, Morikawa M, Arai H. Combined impact of physical frailty and social isolation on use of long-term care insurance in Japan: A longitudinal observational study. Maturitas 2024; 182:107921. [PMID: 38295504 DOI: 10.1016/j.maturitas.2024.107921] [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: 07/20/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES The combined effect of physical frailty and social isolation on the need to make use of long-term care insurance (LTCI) among older adults remains unknown. Thus this study investigates the association between physical frailty, social isolation, and the use of LTCI among older adults in Japan. STUDY DESIGN This is a prospective observational study. MAIN OUTCOME MEASURES Physical frailty is defined as limitations in strength, mobility, and physical activity, as well as exhaustion and weight loss. People with one or two indicators were categorized as pre-frail. Participants with a score of 1 point or more on the social isolation scale were defined as being socially isolated. Participants were followed up monthly for two years to check whether incident certification of care had been required. RESULTS Data on 4576 community-dwelling independent older adults (mean age, 73.9 ± 5.5 years, 2032 men, 2544 women) were analyzed. A time-dependent Cox proportional hazards regression model showed that individuals with pre-frailty without social isolation (hazard ratio [HR] 2.02, 95 % confidence interval [CI] 1.40-2.91), pre-frailty with social isolation (HR 2.36, 95 % CI 1.62-3.43), frailty without social isolation (HR 2.98, 95 % CI 1.83-4.85), and frailty with social isolation (HR 3.19, 95 % CI 2.07-4.91) had significantly higher risks of needing to make use of LTCI than those with no frailty and without social isolation. This higher risk was non-significant among individuals with no frailty and social isolation (HR 1.28, 95 % CI 0.78-2.10). CONCLUSION Combined frailty and social isolation among older adults should be addressed to prevent adverse health outcomes, including use of LTCI.
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Affiliation(s)
- Hiroyuki Shimada
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan.
| | - Takehiko Doi
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Kouki Tomida
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Hidenori Arai
- Centre for Gerontology and Social Science, National Centre for Geriatrics and Gerontology, Obu, Japan
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Parpucu Tİ, Keskin T, Başkurt Z, Başkurt F. Effect of Physical Performance Levels of Elderly Living in Urban and Rural Areas on Social Participation, Social Functioning, and Quality of Life: A Cross-sectional Study from the Mediterranean Region of Turkey. Niger J Clin Pract 2024; 27:297-303. [PMID: 38528348 DOI: 10.4103/njcp.njcp_854_22] [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: 12/05/2022] [Accepted: 01/21/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Social interaction is a very important subject for the elderly, especially in the context of active aging. AIM This study aims to investigate the effect of physical performance levels of the elderly living in rural and urban areas on social participation, social functioning, and quality of life. METHODS A total of 418 volunteer elderly aged 65 and over, living in rural (42.3%) and urban (57.7%) areas, participated in this study. The Mini-Mental State Examination, Short Physical Performance Battery, the World Health Organization Quality of Life Scale for Older Adults, Social Functioning Scale, and the Community Integration Questionnaire were applied to participants. RESULTS The scores of social functioning (P = 0.027) and the social network subscale of social participation (P = 0.001) were significantly higher among participants living in urban areas compared to those living in rural areas. Physical performance was positively correlated with social participation (r = 0.404) and social functioning (r = 0.324) at a moderate level (P = 0.000), and with quality of life at a low level (r = 0.158) (P = 0.001). Social participation was positively correlated with social functioning at a high level (r = 0.572) and with quality of life at a moderate level (r = 0.300) (P = 0.000). Social functioning was positively correlated with quality of life at a low level (r = 0.234) (P < 0.01). CONCLUSION To increase social participation, social functioning, and quality of life among the elderly, it is necessary to keep physical performance levels higher. In addition, in the planning of social participation, it is crucial to take into account where the elderly live in.
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Affiliation(s)
- T İ Parpucu
- Physical Therapy and Rehabilitation Department, Faculty of Health Sciences, Süleyman Demirel University Isparta, Turkey
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Barutcu CD, Damar HT. Determining the predictors associated with the difficulty of adaptation to ageing of hospitalized older adults. Difficulty of older adult to aging. Saudi Med J 2024; 45:317-321. [PMID: 38438217 PMCID: PMC11115399 DOI: 10.15537/smj.2024.45.3.20230267] [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: 10/04/2023] [Accepted: 12/17/2023] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVES To determine the predictors associated with the difficulty of adaptation to ageing of hospitalized older adults. METHODS This descriptive cross-sectional study was carried out in a university hospital between October 2019 and March 2020. The sample consisted of 247 older adults. Research data were collected using a Visual Analogue Scale (VAS), the Falls Efficacy Scale (FES) International, Hospital Anxiety and Depression Scale, and Assessment Scale of Adaptation Difficulty for the Elderly (ASADE). RESULTS The average age of the patients was 73.90 ± 7.38 years, 22.3% of the patients had a fall history in the last year, and 74.5% had a high fear of falling. The mean FES score of the older adult patients was 35.60 ± 11.09, and the mean VAS score was 1.40 ± 1.36. The mean scores for anxiety was 9.30 ± 2.32 and depression was 10.08 ± 1.96. The mean ASADE total score was 16.56 ± 10.7, role and the self-actualization mode score was 9.05 ± 4.66, interdependence mode score was 2.02 ± 1.02, physiological mode score was 3.00 ± 2.03 and self-concept score was 2.47 ± 2.07. CONCLUSION The findings revealed that using walking aids, being single, pain, fear of falling, and anxiety affect adaptation difficulties to aging. Anxiety was found to have an effect on all sub-dimensions of adaptation difficulty to aging. There is a need for further studies to determine the correlation between anxiety and the adaptation difficulties experienced by older adults.
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Affiliation(s)
- Canan D. Barutcu
- From the Department of Internal Medicine Nursing (Barutcu), Faculty of Health Sciences, Mehmet Akif Ersoy University; from the Elderly Care Program (Damar), Health Services Vocational School, Izmir Democracy University, Burdur, Turkey.
| | - Hale T. Damar
- From the Department of Internal Medicine Nursing (Barutcu), Faculty of Health Sciences, Mehmet Akif Ersoy University; from the Elderly Care Program (Damar), Health Services Vocational School, Izmir Democracy University, Burdur, Turkey.
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MacAulay RK, Timblin HR, Tallman MD. How Loneliness Gets Under the Skin: Inflammation Mediates the Relationship Between Loneliness and Gait Speed. Psychosom Med 2024; 86:99-106. [PMID: 37982542 DOI: 10.1097/psy.0000000000001268] [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] [Indexed: 11/21/2023]
Abstract
OBJECTIVE Loneliness is linked to interleukin 6 (IL-6), a marker of systemic inflammation, which chronically has deleterious effects on physical and mental health across the adult life span. This study investigated cross-sectional relationships among loneliness, IL-6, demographics, multimorbidity, depression, obesity, friendship quantity, and slowed gait. METHODS Data from the Midlife Development in the United States Biomarker Project, a national adult sample ( N = 822; age range, 26-78 years) was used for this study. The PROCESS macro tested the hypothesis that IL-6 would mediate the relationship between loneliness and gait, after adjusting for demographic and health risk factors. RESULTS Age ( β = 0.292, p < .001), sex ( β = 0.197, p < .001), body mass index (BMI, β = 0.374, p < .001), waist-hip ratio ( β = 0.242, p < .001), and loneliness ( β = 0.089, p = .025) but not multimorbidity ( β = 0.043, p = .20), depression history ( β = 0.022, p = .47), depression symptoms ( β = 0.036, p = .28), and number of friends ( β = 0.022, p = .46) contributed to the variance in IL-6. Serial mediation analyses supported the chained effect of loneliness on walking time through BMI and IL-6. Results also showed specific indirect effects of BMI and IL-6 on walking time, suggesting more than one pathway by which loneliness influences health. CONCLUSIONS These results suggest that loneliness may increase the risk of systemic inflammation, leading to slowed gait and adverse health outcomes. Psychosocial interventions that address loneliness may provide an optimal treatment target for reducing inflammation and preventing declines in health.
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Alasmari AM, Alsulayyim AS, Alghamdi SM, Philip KEJ, Buttery SC, Banya WAS, Polkey MI, Armstrong PC, Rickman MJ, Warner TD, Mitchell JA, Hopkinson NS. Oral nitrate supplementation improves cardiovascular risk markers in COPD: ON-BC, a randomised controlled trial. Eur Respir J 2024; 63:2202353. [PMID: 38123239 PMCID: PMC10831142 DOI: 10.1183/13993003.02353-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 11/06/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Short-term studies suggest that dietary nitrate (NO3 -) supplementation may improve the cardiovascular risk profile, lowering blood pressure (BP) and enhancing endothelial function. It is not clear if these beneficial effects are sustained and whether they apply in people with COPD, who have a worse cardiovascular profile than those without COPD. Nitrate-rich beetroot juice (NR-BRJ) is a convenient dietary source of nitrate. METHODS The ON-BC trial was a randomised, double-blind, placebo-controlled parallel group study in stable COPD patients with home systolic BP (SBP) measurement ≥130 mmHg. Participants were randomly allocated (1:1) using computer-generated, block randomisation to either 70 mL NR-BRJ (400 mg NO3 -) (n=40) or an otherwise identical nitrate-depleted placebo juice (0 mg NO3 -) (n=41), once daily for 12 weeks. The primary end-point was between-group change in home SBP measurement. Secondary outcomes included change in 6-min walk distance (6MWD) and measures of endothelial function (reactive hyperaemia index (RHI) and augmentation index normalised to a heart rate of 75 beats·min-1 (AIx75)) using an EndoPAT device. Plasma nitrate and platelet function were also measured. RESULTS Compared with placebo, active treatment lowered SBP (Hodges-Lehmann treatment effect -4.5 (95% CI -5.9- -3.0) mmHg), and improved 6MWD (30.0 (95% CI 15.7-44.2) m; p<0.001), RHI (0.34 (95% CI 0.03-0.63); p=0.03) and AIx75 (-7.61% (95% CI -14.3- -0.95%); p=0.026). CONCLUSIONS In people with COPD, prolonged dietary nitrate supplementation in the form of beetroot juice produces a sustained reduction in BP, associated with an improvement in endothelial function and exercise capacity.
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Affiliation(s)
- Ali M Alasmari
- National Heart and Lung Institute, Royal Brompton Campus, Imperial College London, London, UK
- Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia
| | - Abdullah S Alsulayyim
- National Heart and Lung Institute, Royal Brompton Campus, Imperial College London, London, UK
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Saeed M Alghamdi
- Clinical Technology Department, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Keir E J Philip
- National Heart and Lung Institute, Royal Brompton Campus, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Sara C Buttery
- National Heart and Lung Institute, Royal Brompton Campus, Imperial College London, London, UK
| | - Winston A S Banya
- National Heart and Lung Institute, Royal Brompton Campus, Imperial College London, London, UK
| | - Michael I Polkey
- National Heart and Lung Institute, Royal Brompton Campus, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Paul C Armstrong
- Centre for Immunobiology, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Matthew J Rickman
- National Heart and Lung Institute, Cardiothoracic Pharmacology, Vascular Biology, Imperial College London, London, UK
| | - Timothy D Warner
- Centre for Immunobiology, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jane A Mitchell
- National Heart and Lung Institute, Cardiothoracic Pharmacology, Vascular Biology, Imperial College London, London, UK
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Royal Brompton Campus, Imperial College London, London, UK
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12
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Negrey JD, Frye BM, Craft S, Register TC, Baxter MG, Jorgensen MJ, Shively CA. Executive function mediates age-related variation in social integration in female vervet monkeys (Chlorocebus sabaeus). GeroScience 2024; 46:841-852. [PMID: 37217631 PMCID: PMC10828467 DOI: 10.1007/s11357-023-00820-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
In humans, social participation and integration wane with advanced age, a pattern hypothesized to stem from cognitive or physical decrements. Similar age-related decreases in social participation have been observed in several nonhuman primate species. Here, we investigated cross-sectional age-related associations between social interactions, activity patterns, and cognitive function in 25 group-living female vervets (a.k.a. African green monkeys, Chlorocebus sabaeus) aged 8-29 years. Time spent in affiliative behavior decreased with age, and time spent alone correspondingly increased. Furthermore, time spent grooming others decreased with age, but the amount of grooming received did not. The number of social partners to whom individuals directed grooming also decreased with age. Grooming patterns mirrored physical activity levels, which also decreased with age. The relationship between age and grooming time was mediated, in part, by cognitive performance. Specifically, executive function significantly mediated age's effect on time spent in grooming interactions. In contrast, we did not find evidence that physical performance mediated age-related variation in social participation. Taken together, our results suggest that aging female vervets were not socially excluded but decreasingly engaged in social behavior, and that cognitive deficits may underlie this relationship.
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Affiliation(s)
- Jacob D Negrey
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157-1040, USA
| | - Brett M Frye
- Department of Biology, Emory and Henry College, Emory, VA, USA
- Wake Forest Alzheimer's Disease Research Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Internal Medicine/Gerontology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Suzanne Craft
- Wake Forest Alzheimer's Disease Research Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Internal Medicine/Gerontology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Thomas C Register
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157-1040, USA
- Wake Forest Alzheimer's Disease Research Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Mark G Baxter
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157-1040, USA
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Matthew J Jorgensen
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157-1040, USA
| | - Carol A Shively
- Department of Pathology/Comparative Medicine, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157-1040, USA.
- Wake Forest Alzheimer's Disease Research Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
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Kaczorowska A, Kaczorowska A, Kowalska J. Associations Between Physical Fitness, Cognitive Function, and Depression in Nursing Homes Residents Between 60-100 Years of Age in South-Western Poland. Med Sci Monit 2024; 30:e942729. [PMID: 38185903 PMCID: PMC10785523 DOI: 10.12659/msm.942729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/26/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Healthy aging depends on physical fitness, cognitive function, and emotional well-being. Reduced physical activity in the elderly impacts daily activities, increasing morbidity risk. Cognitive decline affects learning, attention, and independence. Depression, prevalent among the elderly, correlates with loneliness and affects overall health. Physical fitness positively influences cognitive health and mood. This study examines these associations in Polish nursing homes residents. MATERIAL AND METHODS We assessed 93 people aged 60-100 years living in nursing homes. The Short Physical Performance Battery (SPPB) test was used to assess physical fitness. The Abbreviated Mental Test Score (AMTS) was used to assess cognitive functions. The Geriatric Depression Scale (GDS) was used to assess depression. RESULTS In the SPPB test, the mean score was 4.85 points, indicating moderate limitations. On the AMTS, 55% of subjects had cognitive impairment. On the GDS scale, 44% of respondents had depressive symptoms. Seniors without mood disorders were characterized by faster gait compared to those with suspected depressive disorders (P=0.036). Men performed significantly better in the whole SPPB test (P=0.024) and in the standing up from a chair and gait speed tests (P=0.046, P<0.001) compared to women. We found a negative correlation between the AMTS test scores and the SPPB gait test scores and age (P<0.05) and a positive correlation between the SPPB gait test scores and the GDS scores (P<0.05). CONCLUSIONS Older nursing homes' residents in better emotional and cognitive state tended to have faster gait. Men tended to have a higher level of physical fitness compared to women. Older age was associated with worse cognitive state of the examined seniors.
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Affiliation(s)
- Agnieszka Kaczorowska
- Faculty of Physiotherapy, Wrocław University of Health and Sport Sciences, Wrocław, Poland
| | | | - Joanna Kowalska
- Faculty of Physiotherapy, Wrocław University of Health and Sport Sciences, Wrocław, Poland
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14
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Lewis A, Turner LA, Fryer S, Smith R, Dillarstone H, Patrick YW, Bevan-Smith E. The acceptability, practicality, implementation and efficacy of a physical and social activity intervention 'BreatheHappy' for people with long-term respiratory conditions: A feasibility study. Chron Respir Dis 2024; 21:14799731241238435. [PMID: 38553857 PMCID: PMC10981237 DOI: 10.1177/14799731241238435] [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: 06/30/2023] [Revised: 02/24/2024] [Accepted: 02/19/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES This study aimed to determine the feasibility of a group-based pilot programme of low-to-moderate physical activity training, education and social activities, by investigating acceptability, practicality, implementation and efficacy testing. We offer suggestions on programme adaptions for future study. METHODS People with a range of chronic respiratory diseases were invited to participate in a pilot 12 week group activity programme. Activities included outdoor walking, tai-chi, education and a range of social activities. Acceptability was determined by participant experiences determined during interviews. Practicality was determined by programme and outcome measure completion, cost and adverse events. Implementation was determined according to whether the programme ran as planned. Efficacy was determined by statistical analyses of outcomes including hand grip strength, timed up and go test, COPD Helplessness Index, COPD Assessment Test, and measures of physical activity via accelerometry. RESULTS Thematic analysis indicated that the "BreatheHappy" programme was acceptable. Seven of nine participants completed eight out of 10 sessions and the majority completed all outcome measures. "BreatheHappy" was therefore considered practical. The programme was not implemented as planned, with only 10 sessions running rather than the 12 intended. There was a significant increase in daily step counts (MD: 1284 95% CI: 240-2329 p: 0.024 effect size: 0.988), stepping time (MD: 16 min 95% CI: 5-27 min p: 0.011 effect size: 1.36) and daily minutes completing light physical activity (MD: 23 95% CI: 6-38 p: 0.006 effect size: 1.6). However, time spent sitting for ≥30 min but ≤60 min significantly increased (MD: 26 95% CI: 0.2-52 min p: 0.049 effect size: 0.931), showing signs of efficacy and changing physical activity behaviour patterns. DISCUSSION A 10-week programme of low-moderate physical activity training, education and social activities shows signs of feasibility for future research. Suggested adaptions for future study include using physical activity measures such as daily step count or light physical activity for a primary outcome, and mental health and social health related outcome measures relatable to participant's beneficial experiences of the programme. Recruitment in future studies will try and reach both those less socially active and possibly those who have completed pulmonary rehabilitation (PR). Venues should be close to efficient transport links whilst different frequencies and durations of programme delivery should be trialled. Adequate funding should be provided for both staff running the programme and blinded research staff for outcome measurement.
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Affiliation(s)
- A Lewis
- Department of Health Sciences, Brunel University London, Uxbridge, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - LA Turner
- School of Education and Science, University of Gloucestershire, Cheltenham, UK
| | - S Fryer
- School of Education and Science, University of Gloucestershire, Cheltenham, UK
| | - R Smith
- Department of Geography, University College London, London, UK
| | - H Dillarstone
- Institute for Global Health, University College London, London, UK
| | - YW Patrick
- Department of Health and Social Care, University of Gloucestershire, Cheltenham, UK
| | - E Bevan-Smith
- Department of Health and Social Care, University of Gloucestershire, Cheltenham, UK
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15
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Morikawa M, Lee S, Makino K, Harada K, Katayama O, Tomida K, Yamaguchi R, Nishijima C, Fujii K, Misu Y, Shimada H. Social isolation and risk of disability in older adults: Effect modification of metabolic syndrome. Arch Gerontol Geriatr 2024; 116:105209. [PMID: 37782966 DOI: 10.1016/j.archger.2023.105209] [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: 02/17/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE Delaying the onset of disabilities is a social challenge, especially in an aging society. Social isolation (SI) and metabolic syndrome (MetS) can coexist and pose the risks of disability onset. However, their interaction is not proven in older adults. Therefore, this study investigated whether SI combined with MetS exacerbates disability onset in older adults. MATERIALS AND METHODS A total of 3,738 community-dwelling older adults underwent a health check-up. After baseline assessments, we followed them up to assess disability incidence for five years. SI was defined as a condition in which two or more of the following measures were met: domestic isolation, less social contact, and social disengagement. MetS was defined according to the criteria of the International Diabetes Federation. We used Cox proportional hazard regression used to identify the interaction effect of SI and MetS on the risk of disability onset after adjusting for potential confounding factors. RESULTS Multivariate Cox proportional hazard regression showed a significant interaction effect of SI and MetS on disability onset. In the subgroup analysis stratified by MetS status, SI was identified as a risk factor for disability onset only in the MetS group, but not in the non-MetS group. CONCLUSIONS This five-year longitudinal study showed that the co-occurrence of SI and MetS increased the risk of disability onset in older adults. This indicates that the assessment of MetS in socially isolated older adults is important for healthcare providers to delay the onset of disabilities.
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Affiliation(s)
- Masanori Morikawa
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Sangyoon Lee
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Keitaro Makino
- 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
| | - Osamu Katayama
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Kouki Tomida
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Ryo Yamaguchi
- 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
| | - Kazuya Fujii
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Yuka Misu
- 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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16
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Nakajima C, Tomida K, Shimoda T, Kawakami A, Shimada H. Association between willingness to participate in physical and social activities and loneliness in older adults: A stratified analysis by social isolation status. Arch Gerontol Geriatr 2024; 116:105216. [PMID: 37782967 DOI: 10.1016/j.archger.2023.105216] [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: 07/27/2023] [Revised: 09/19/2023] [Accepted: 09/25/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND This study aimed to examine the relationship between willingness to participate in physical activity (PA) and social activity (SA) and loneliness among community-dwelling older adults and to identify differences depending on whether or not they were socially isolated. METHOD This study included 4,590 participants aged 65 years or older. The study used the UCLA Loneliness Scale and a questionnaire to assess the willingness to participate in PA/SA. Social isolation was defined as the presence of two or more of the following conditions: domestic isolation, less social contact, and social disengagement. A binomial logistic regression analysis was conducted with loneliness as the dependent variable and willingness to participate in PA/SA as the independent variable, stratified by social isolation. RESULTS Those who experienced loneliness (n=1,595, 34.7%) were significantly more unwilling to participate in PA/SA than those who did not (p<0.05). For those in social isolation (n=321, 7.0%), there was no association between willingness to participate in PA/SA and loneliness [odds ratio (95% confidence interval); PA, 0.89 (0.41-1.92); SA, 0.52 (0.22-1.20)]. Those without social isolation showed no association between willingness to participate in PA and loneliness; however, there was a significant association with willingness to participate in SA [PA, 1.05 (0.81-1.36); SA, 0.54 (0.41-0.72)]. CONCLUSION Among people without social isolation, the willingness to participate in SA was associated with reduced loneliness. However, the results suggest that environmental factors may limit activity and increase loneliness among people with social isolation, even when willing to participate in PA/SA.
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Affiliation(s)
- Chika Nakajima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Medical Science Division, Department of Medical Sciences, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Nagano, Japan.
| | - Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Takahiro Shimoda
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Ayuka Kawakami
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Misu Y, Katayama O, Lee S, Makino K, Harada K, Tomida K, Morikawa M, Yamaguchi R, Nishijima C, Fujii K, Shimada H. Reciprocal relationship between physical and social frailty among community-dwelling older adults. Arch Gerontol Geriatr 2023; 114:105066. [PMID: 37245490 DOI: 10.1016/j.archger.2023.105066] [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: 03/13/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Both physical and social frailty are risk factors for major adverse health-related outcomes and influence each other. However, the longitudinal causal relationship between physical and social frailty has not been clarified. This study aimed to determine the reciprocal relationship between physical and social frailty by age group. METHODS This study analyzed longitudinal data from a cohort study of older adults aged 65 years or older living in Obu City, Aichi Prefecture, Japan. The study included 2568 participants who participated in both a baseline assessment in 2011 and a follow-up assessment four years later. Participants participated in assessments of physical and cognitive function. Physical frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria. Social frailty was assessed with five questions about daily social activities, social roles, and social relationships. A total frailty score was calculated for each frailty type and used in the cross-lagged panel analysis. The reciprocal relationship between physical and social frailty status was analyzed using a cross-lagged panel model in each of the young-old (n = 2006) and old-old (n = 562) groups. RESULTS In the old-old group, baseline physical frailty status predicted social frailty status four years later, and social frailty status at baseline predicted physical frailty status four years later. In the young-old group, the effect of social frailty status at baseline on physical frailty at four years was significant; however, the cross-lag effect from baseline physical frailty status to social frailty status at four years was insignificant, indicating that social frailty preceded physical frailty. CONCLUSION The reciprocal relationship between physical and social frailty differed by age group. The results of this study suggest the importance of considering age when planning strategies to prevent frailty. Although a causal relationship between both physical and social frailty was observed in old-old, social frailty preceded physical frailty in the young-old, suggesting that early prevention of social frailty is important for the prevention of physical frailty.
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Affiliation(s)
- Yuka Misu
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan.
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Ryo Yamaguchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Obu, Aichi 474-8511, Japan
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Chuang ST, Lin MH, Hsu H, Chi CM, Lee YR, Yen YH. Epidemic-Prevention Measures and Health Management in a Nursing Home during the Coronavirus Disease 2019 Pandemic. Healthcare (Basel) 2023; 11:2535. [PMID: 37761732 PMCID: PMC10531124 DOI: 10.3390/healthcare11182535] [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: 07/27/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
This study aimed to investigate the impact of epidemic prevention and isolation policies on residents' health and well-being and assess the effectiveness of implementing intervention measures to maintain their quality of life. This mixed-methods research study involved a retrospective record review of residents' daily life diaries and descriptive statistical analysis. Data were collected between March 2021 and June 2022, and epidemic-prevention measures were implemented using Taiwan's Centers for Disease Control guidelines. Three interventions were developed to address residents' health, social, and rehabilitation needs. Despite an overall infection rate of 10% at various times between 2021 and 2022, there were no reported outbreaks of nosocomial infections. The concept of reablement proved effective in helping residents maintain their independence and physical function, with a maintenance rate of 66.6%, thereby improving their quality of life. By implementing epidemic-prevention measures, we found that proper hand washing and the use of surgical masks were effective in controlling infections. Furthermore, the decline in physical function is a continuous and gradual process for older adults. Even under the restriction of social interaction, it is essential to incorporate rehabilitation plans into residents' daily activities and encourage their active participation, as this promotes improved physical function and enhances their overall quality of life.
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Affiliation(s)
- Shu-Ting Chuang
- Department of Nursing, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan;
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien 970046, Taiwan
- Taichung Tzu Chi Nursing Home, Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan; (C.-M.C.); (Y.-R.L.)
| | - Mei-Hui Lin
- Department of Accounting Information, Da-Yeh University, Changhua 515006, Taiwan;
| | - Honda Hsu
- Division of Plastic Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi City 622007, Taiwan;
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
| | - Chia-Ming Chi
- Taichung Tzu Chi Nursing Home, Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan; (C.-M.C.); (Y.-R.L.)
- Ph.D. Program in Healthcare Science, China Medical University, Taichung City 406040, Taiwan
| | - Yu-Ru Lee
- Taichung Tzu Chi Nursing Home, Buddhist Tzu Chi Medical Foundation, Taichung City 427213, Taiwan; (C.-M.C.); (Y.-R.L.)
| | - Ya-Hui Yen
- Department of Nursing, National Chi Nan University, Puli Township 545301, Taiwan
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Pollak C, Verghese J, Blumen H. Loneliness and Functional Decline in Aging: A Systematic Review. Res Gerontol Nurs 2023; 16:202-212. [PMID: 37159388 PMCID: PMC10926714 DOI: 10.3928/19404921-20230503-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Loneliness is prevalent in adults aged ≥65 years in the United States and is associated with functional decline. The purpose of the current review was to synthesize evidence on the relationship between loneliness and functional decline using Roy's Adaptation Model as a theoretical framework. A comprehensive review of PubMed, Medline, and Embase databases was performed. Inclusion criteria were samples including adults primarily aged >60 years, peer-reviewed, published in the English language, and included a measure for loneliness and function. A total of 47 studies were analyzed. Most studies examined correlates, risk factors, and predictors of loneliness, rather than the relationship between loneliness and function. Evidence suggests there is bidirectionality in the relationship between loneliness and functional decline. Loneliness is associated with functional decline in aging via multiple possible pathways. Further studies are needed to determine causality and biological mechanisms underlying the relationship. [Research in Gerontological Nursing, 16(4), 202-212.].
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Takahashi S, Naganuma T, Kurita N, Omae K, Ohnishi T, Yoshioka T, Ito F, Takeshima T, Fukuma S, Hamaguchi S, Fukuhara S. Social Isolation/Loneliness and Tooth Loss in Community-Dwelling Older Adults: The Sukagawa Study. Innov Aging 2023; 7:igad065. [PMID: 37497340 PMCID: PMC10368321 DOI: 10.1093/geroni/igad065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Indexed: 07/28/2023] Open
Abstract
Background and Objectives The relationship between social isolation/loneliness and oral health is unclear. This study investigated the association between social isolation/loneliness and tooth loss in older Japanese adults. Research Design and Methods This was a cross-sectional study of a population-based cohort (the Sukagawa Study); 5,490 cohort study participants aged ≥75 years and who were independent answered a self-administered questionnaire in 2018. Social isolation was defined based on the 6-item Japanese version of the Lubben Social Network Scale. Loneliness was measured by the 3-item Japanese version of the University of California, Los Angeles (UCLA) Loneliness Scale version 3. The primary outcome was tooth loss, defined as having fewer than 20 teeth. The secondary outcomes were decreased toothbrushing frequency and diminished ability to chew food. Prevalence ratios (PRs) were estimated using a modified Poisson regression analysis in 2 models-Model 1, which adjusted for age, gender, smoking status, alcohol consumption, low annual income, and short education period, and Model 2, which added history of depression, history of diabetes mellitus, history of stroke, and cognitive impairment to Model 1. Results The primary analysis included 4,645 participants. Adjusted PRs of social isolation and loneliness for tooth loss (Model 1) were 0.97 (95% confidence interval [CI] 0.92-1.01) and 1.06 (95% CI 1.01-1.12), respectively; those for decreased toothbrushing frequency were 1.13 (95% CI 0.95-1.36) and 1.56 (95% CI 1.26-1.92), respectively; and those for chewing difficulty were 1.61 (95% CI 1.06-2.43) and 2.94 (95% CI 1.91-4.53), respectively. The adjusted PRs in Model 2 demonstrated results similar to that of Model 1. Discussion and Implications Loneliness is associated with tooth loss among older adults, whereas social isolation is not. Our findings can inform plans for policymakers, professionals, and organizations to identify lonely older adults and provide social prescriptions to improve their access to oral health care services.
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Affiliation(s)
- Sei Takahashi
- Department of General Internal Medicine, Fukushima Medical University, Fukushima, Japan
- Futaba Emergency and General Medicine Support Center, Fukushima Medical University, Fukushima, Japan
| | - Toru Naganuma
- Department of General Internal Medicine, Fukushima Medical University, Fukushima, Japan
- Futaba Emergency and General Medicine Support Center, Fukushima Medical University, Fukushima, Japan
| | - Noriaki Kurita
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kenji Omae
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
| | - Tsuyoshi Ohnishi
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
- Department of Nephrology, Kasukabe Chuo General Hospital, Saitama, Japan
| | - Takashi Yoshioka
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Fumihito Ito
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
| | - Taro Takeshima
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
- Center for University-wide Education, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan
| | - Shingo Fukuma
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sugihiro Hamaguchi
- Department of General Internal Medicine, Fukushima Medical University, Fukushima, Japan
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
| | - Shunichi Fukuhara
- Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
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21
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Thomas S, Machuel P, Foubert J, Nafilyan V, Bannister N, Colvin H, Routen A, Morriss R, Khunti K, Farooqi A, Armstrong N, Gray L, Gordon A. Study protocol for the use of time series forecasting and risk analyses to investigate the effect of the COVID-19 pandemic on hospital admissions associated with new-onset disability and frailty in a national, linked electronic health data setting. BMJ Open 2023; 13:e067786. [PMID: 37208137 DOI: 10.1136/bmjopen-2022-067786] [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: 05/21/2023] Open
Abstract
INTRODUCTION Older people were at particular risk of morbidity and mortality during COVID-19. Consequently, they experienced formal (externally imposed) and informal (self-imposed) periods of social isolation and quarantine. This is hypothesised to have led to physical deconditioning, new-onset disability and frailty. Disability and frailty are not routinely collated at population level but are associated with increased risk of falls and fractures, which result in hospital admissions. First, we will examine incidence of falls and fractures during COVID-19 (January 2020-March 2022), focusing on differences between incidence over time against expected rates based on historical data, to determine whether there is evidence of new-onset disability and frailty. Second, we will examine whether those with reported SARS-CoV-2 were at higher risk of falls and fractures. METHODS AND ANALYSIS This study uses the Office for National Statistics (ONS) Public Health Data Asset, a linked population-level dataset combining administrative health records with sociodemographic data of the 2011 Census and National Immunisation Management System COVID-19 vaccination data for England. Administrative hospital records will be extracted based on specific fracture-centric International Classification of Diseases-10 codes in years preceding COVID-19 (2011-2020). Historical episode frequency will be used to predict expected admissions during pandemic years using time series modelling, if COVID-19 had not occurred. Those predicted admission figures will be compared with actual admissions to assess changes in hospital admissions due to public health measures comprising the pandemic response. Hospital admissions in prepandemic years will be stratified by age and geographical characteristics and averaged, then compared with pandemic year admissions to assess more granular changes. Risk modelling will assess risk of experiencing a fall, fracture or frail fall and fracture, if they have reported a positive case of COVID-19. The combination of these techniques will provide insight into changes in hospital admissions from the COVID-19 pandemic. ETHICS AND DISSEMINATION This study has approval from the National Statistician's Data Ethics Advisory Committee (NSDEC(20)12). Results will be made available to other researchers via academic publication and shared via the ONS website.
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Affiliation(s)
| | | | | | - Vahe Nafilyan
- Office for National Statistics, Newport, UK
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Ash Routen
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Applied Research Collaboration-East Midlands (ARC-EM), Leicester, UK
| | - Richard Morriss
- NIHR Applied Research Collaboration-East Midlands (ARC-EM), Leicester, UK
- Psychiatry, University of Nottingham, Nottingham, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Applied Research Collaboration-East Midlands (ARC-EM), Leicester, UK
| | - Azhar Farooqi
- NIHR Applied Research Collaboration-East Midlands (ARC-EM), Leicester, UK
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Natalie Armstrong
- NIHR Applied Research Collaboration-East Midlands (ARC-EM), Leicester, UK
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Laura Gray
- NIHR Applied Research Collaboration-East Midlands (ARC-EM), Leicester, UK
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Adam Gordon
- NIHR Applied Research Collaboration-East Midlands (ARC-EM), Leicester, UK
- Academic Unit of Injury, Rehabilitation and Inflammation Sciences (IRIS), University of Nottingham, Nottingham, UK
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22
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Ito K, Suzumura S, Kanada Y, Narukawa R, Sakurai H, Makino I, Abiko T, Oi S, Kondo I. The use of a companion robot to improve depression symptoms in a community-dwelling older adult during the coronavirus disease 2019 state of emergency. FUJITA MEDICAL JOURNAL 2023; 9:47-51. [PMID: 36789127 PMCID: PMC9923449 DOI: 10.20407/fmj.2021-023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/09/2022] [Indexed: 02/16/2023]
Abstract
Objective We investigated the impact of using a companion robot on the mental state of a community-dwelling older adult who was receiving home-visit rehabilitation services during the state of emergency for coronavirus disease 2019 (COVID-19). Methods This case involved an 80-year-old woman with compression fractures of lumbar vertebrae 1 and 2. Her medical history included hypothyroidism, hypertension, dyslipidemia, and depression. The companion robot used was Smibi®, a healing baby robot that responds in various ways depending on how the user interacts with it. The patient interacted (e.g., hugging, conversing) with Smibi® for 30 minutes per day for 1 month, from April 2020 (immediately before the declaration of a state of emergency in Japan) to May 2020. The patient was evaluated with the Self-Rating Depression Scale (SDS) before and after using Smibi®. Results The SDS score decreased from 37 points to 26 points after the use of Smibi®. The items related to diurnal variation, sleep, despair about the future, and dissatisfaction decreased by 2-3 points. Conclusion Our findings suggest that interacting with Smibi® may improve depression in older adults who have been forced to refrain from going out due to the spread of COVID-19. Future studies with long-term follow-up and large sample sizes are required to confirm the effectiveness of companion robots in improving depression among community-dwelling older adults.
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Affiliation(s)
- Kei Ito
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Shota Suzumura
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan,Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Yoshikiyo Kanada
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Rie Narukawa
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hiroaki Sakurai
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | - Isao Makino
- Togo Seisakusyo Corporation, Togo, Aichi, Japan
| | | | - Shigeo Oi
- Togo Seisakusyo Corporation, Togo, Aichi, Japan
| | - Izumi Kondo
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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23
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A Systematic Literature Review of Loneliness in Community Dwelling Older Adults. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci12010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Research on loneliness is extensive. This paper presents a systematic review of intervention studies, outlining the antecedents to, and consequences of loneliness in community-dwelling older people. Using PRISMA methodology, a systematic literature review was conducted between January and August 2021 resulting in 49 useable articles. Papers were included if they: (a) investigated older people (+50); (b) were living in community dwellings; (c) had been published in English; (d) had titles or abstracts available and, (e) were published between 2016 and 2021. This study found the antecedents and consequences of social, emotional and existential loneliness differ, however, the vast majority of research has not examined the unique types of loneliness and instead kept loneliness as a generic term, despite the acceptance that various types of loneliness exist. In addition, the findings of intervention studies identified through this review have yielded mixed results. Those interventions focused on improving personal and psycho-social resources for older people fared better outcomes than those focused on technological and social connections alone. This paper reports important implications for the future of research conducted on loneliness and interventions accordingly.
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24
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Fraune MR, Komatsu T, Preusse HR, Langlois DK, Au RHY, Ling K, Suda S, Nakamura K, Tsui KM. Socially facilitative robots for older adults to alleviate social isolation: A participatory design workshop approach in the US and Japan. Front Psychol 2022; 13:904019. [PMID: 36337527 PMCID: PMC9629871 DOI: 10.3389/fpsyg.2022.904019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/16/2022] [Indexed: 06/29/2024] Open
Abstract
Social technology can improve the quality of older adults' social lives and mitigate negative mental and physical health outcomes associated with loneliness, but it should be designed collaboratively with this population. In this paper, we used participatory design (PD) methods to investigate how robots might be used as social facilitators for middle-aged and older adults (age 50+) in both the US and Japan. We conducted PD workshops in the US and Japan because both countries are concerned about the social isolation of these older adults due to their rapidly aging populations. We developed a novel approach to participatory design of future technologies that spends 2/3 of the PD session asking participants about their own life experiences as a foundation. This grounds the conversation in reality, creates rapport among the participants, and engages them in creative critical thinking. Then, we build upon this foundation, pose an abstract topic, and ask participants to brainstorm on the topic based on their previous discussion. In both countries, participants were eager to actively discuss design ideas for socially facilitative robots and imagine how they might improve their social lives. US participants suggested design ideas for telepresence robots, social distancing robots, and social skills artificial intelligence programs, while Japanese participants suggested ideas for pet robots, robots for sharing experiences, and easy-to-operate instructor robots. Comparing these two countries, we found that US participants saw robots as tools to help facilitate their social connections, while Japanese participants envisioned robots to function as surrogate companions for their parents and distract them from loneliness when they were unavailable. With this paper, we contribute to the literature in two main ways, presenting: (1) A novel approach to participatory design of future technologies that grounds participants in their everyday experience, and (2) Results of the study indicating how middle-aged and older adults from the US and Japan wanted technologies to improve their social lives. Although we conducted the workshops during the COVID-19 pandemic, many findings generalized to other situations related to social isolation, such as older adults living alone.
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Affiliation(s)
- Marlena R. Fraune
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Takanori Komatsu
- Department of Frontier Media Science, Meiji University, Tokyo, Japan
| | - Harrison R. Preusse
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Danielle K. Langlois
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Rachel H. Y. Au
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Katrina Ling
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | - Shogo Suda
- Department of Frontier Media Science, Meiji University, Tokyo, Japan
| | - Kiko Nakamura
- Department of Frontier Media Science, Meiji University, Tokyo, Japan
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25
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The oxytocin signalling gene pathway contributes to the association between loneliness and cardiometabolic health. Psychoneuroendocrinology 2022; 144:105875. [PMID: 35939863 DOI: 10.1016/j.psyneuen.2022.105875] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/23/2022]
Abstract
Increasing evidence has shown adverse effects of loneliness on cardiometabolic health. The neuromodulator and hormone oxytocin has traditionally been linked with social cognition and behaviour. However, recent implications of the oxytocin system in energy metabolism and the overrepresentation of metabolic issues in psychiatric illness suggests that oxytocin may represent a mechanism bridging mental and somatic traits. To clarify the role of the oxytocin signalling system in the link between cardiometabolic risk factors and loneliness, we calculated the contribution of single nucleotide polymorphisms (SNPs) in the oxytocin signalling pathway gene-set (154 genes) to the polygenic architecture of loneliness and body mass index (BMI). We investigated the associations of these oxytocin signalling pathway polygenic scores with body composition measured using body magnetic resonance imaging (MRI), bone mineral density (BMD), haematological markers, and blood pressure in a sample of just under half a million adults from the UK Biobank (BMD subsample n = 274,457; body MRI subsample n = 9796). Our analysis revealed significant associations of the oxytocin signalling pathway polygenic score for BMI with abdominal subcutaneous fat tissue, HDL cholesterol, lipoprotein(a), triglycerides, and BMD. We also found an association between the oxytocin signalling pathway polygenic score for loneliness and apolipoprotein A1, the major protein component of HDL. Altogether, these results provide additional evidence for the oxytocin signalling pathway's role in energy metabolism, lipid homoeostasis, and bone density, and support oxytocin's complex pleiotropic effects.
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26
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Liang N, Nejat G. A Meta-Analysis on Remote HRI and In-Person HRI: What Is a Socially Assistive Robot to Do? SENSORS (BASEL, SWITZERLAND) 2022; 22:7155. [PMID: 36236261 PMCID: PMC9570716 DOI: 10.3390/s22197155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/09/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Recently, due to the COVID-19 pandemic and the related social distancing measures, in-person activities have been significantly reduced to limit the spread of the virus, especially in healthcare settings. This has led to loneliness and social isolation for our most vulnerable populations. Socially assistive robots can play a crucial role in minimizing these negative affects. Namely, socially assistive robots can provide assistance with activities of daily living, and through cognitive and physical stimulation. The ongoing pandemic has also accelerated the exploration of remote presence ranging from workplaces to home and healthcare environments. Human-robot interaction (HRI) researchers have also explored the use of remote HRI to provide cognitive assistance in healthcare settings. Existing in-person and remote comparison studies have investigated the feasibility of these types of HRI on individual scenarios and tasks. However, no consensus on the specific differences between in-person HRI and remote HRI has been determined. Furthermore, to date, the exact outcomes for in-person HRI versus remote HRI both with a physical socially assistive robot have not been extensively compared and their influence on physical embodiment in remote conditions has not been addressed. In this paper, we investigate and compare in-person HRI versus remote HRI for robots that assist people with activities of daily living and cognitive interventions. We present the first comprehensive investigation and meta-analysis of these two types of robotic presence to determine how they influence HRI outcomes and impact user tasks. In particular, we address research questions regarding experience, perceptions and attitudes, and the efficacy of both humanoid and non-humanoid socially assistive robots with different populations and interaction modes. The use of remote HRI to provide assistance with daily activities and interventions is a promising emerging field for healthcare applications.
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Affiliation(s)
- Nan Liang
- Autonomous Systems and Biomechatronics Laboratory (ASBLab), Department of Mechanical and Industrial Engineering, University of Toronto, 5 King’s College Rd, Toronto, ON M5S 3G8, Canada
| | - Goldie Nejat
- Autonomous Systems and Biomechatronics Laboratory (ASBLab), Department of Mechanical and Industrial Engineering, University of Toronto, 5 King’s College Rd, Toronto, ON M5S 3G8, Canada
- KITE, Toronto Rehabilitation Institute, Toronto, ON M5G 2A2, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON M6A 2E1, Canada
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27
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Pai N, Vella SL. The physical and mental health consequences of social isolation and loneliness in the context of COVID-19. Curr Opin Psychiatry 2022; 35:305-310. [PMID: 35787541 DOI: 10.1097/yco.0000000000000806] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW Social isolation and loneliness are known contributors to all-cause mortality as well as a range of physical and mental health conditions. Therefore, this article reviews current literature pertaining to the effects of social isolation and loneliness on physical and mental health during the current COVID-19 pandemic. RECENT FINDINGS Social isolation and loneliness contribute to a myriad of physical and mental health conditions. Specifically social isolation and loneliness contribute to the development of cardiovascular disease, diabetes mellitus, and cancer. However, most research indicated that poor lifestyle factors explained most of the association. Social isolation and loneliness are also associated with cognitive problems including dementia, immune system problems, and mental health conditions. Further social isolation and loneliness also spur behavioral issues that significantly affect physical and mental health. SUMMARY Evidence suggests that social isolation and loneliness have significant consequences on the physical and mental health of the individual and that the move toward ending all protections against COVID-19 has significant implications for the vulnerable. Further the similarities between the effects of social isolation and loneliness are compared to some of the conditions evident in long-COVID.
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Affiliation(s)
- Nagesh Pai
- Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong
- Illawarra Health and Medical Research Institute
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Shae-Leigh Vella
- Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong
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28
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Clifton K, Gao F, Jabbari J, Van Aman M, Dulle P, Hanson J, Wildes TM. Loneliness, social isolation, and social support in older adults with active cancer during the COVID-19 pandemic. J Geriatr Oncol 2022; 13:1122-1131. [PMID: 36041993 PMCID: PMC9385725 DOI: 10.1016/j.jgo.2022.08.003] [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: 01/22/2022] [Revised: 06/09/2022] [Accepted: 08/09/2022] [Indexed: 11/29/2022]
Abstract
Introduction The COVID-19 pandemic has had a considerable impact on mental health. The social distancing and stay-at-home orders have likely also impacted loneliness, social isolation, and social support. Older adults, particularly those with comorbidities such as cancer, have a greater potential to be impacted. Here we assessed loneliness, social isolation, and social support in older adults undergoing active cancer treatment during the pandemic. Materials and methods A mixed methods study in which quantitative data and qualitative response items were collected in parallel was conducted in 100 older adults with cancer. Participants completed a survey by telephone with a series of validated questionnaires to assess the domains of loneliness, social isolation, and social support as well as several open-ended questions. Baseline demographics and geriatric assessments were summarized using descriptive statistics. Bivariate associations between social isolation and loneliness and social support and loneliness were described using Spearman correlation coefficients. Conventional content analysis was performed on the open-ended questions. Results In a population of older adults with cancer, 3% were noted to be severely lonely, although 27% percent screened positive as having at least one indicator of loneliness by the University of California, Los Angeles (UCLA) Three Item Loneliness Scale. There was a significant positive correlation between loneliness and social isolation (r = +0.52, p < 0.05) as well as significant negative correlation between loneliness and social support (r = −0.49, p < 0.05). There was also a significant negative correlation between loneliness and emotional support (r = −0.43, p < 0.05). There was no significant association between loneliness and markers of geriatric impairments, including comorbidities, G8 score or cognition. Discussion Reassuringly, in this cohort we found relatively low rates of loneliness and social isolation and high rates of social support. Consistent with prior studies, loneliness, social isolation, and social support were found to be interrelated domains; however, they were not significantly associated with markers of geriatric impairments. Future studies are needed to study if cancer diagnosis and treatment may mediate changes in loneliness, social isolation, and social support in the context of the pandemic as well as beyond.
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Affiliation(s)
- Katherine Clifton
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, United States of America.
| | - Feng Gao
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, United States of America
| | - JoAnn Jabbari
- Goldfarb School of Nursing at Barnes-Jewish College, Saint Louis, MO, United States of America
| | - Mary Van Aman
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, United States of America
| | - Patricia Dulle
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, United States of America
| | - Janice Hanson
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, United States of America
| | - Tanya M Wildes
- Division of Hematology/Oncology, University of Nebraska Medical Center/Nebraska Medicine, Omaha NE, United States of America
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29
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Physical activity and gender buffer the association of retirement with functional impairment in Ghana. Sci Rep 2022; 12:12832. [PMID: 35896681 PMCID: PMC9329384 DOI: 10.1038/s41598-022-17178-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022] Open
Abstract
Females on average live longer but with higher rates of functional impairment and lower physical and economic activities than men. However, research linking retirement to functional impairment and the modifying role of gender and physical activity (PA) is limited especially in low- and middle-income countries. This paper examines the association between retirement and functional impairment in Ghana and evaluates the effect modification of the association by gender and PA. The sample included 1201 adults aged ≥ 50 years from a population-based study. Functional impairment was assessed with the activities of daily living scale. Ordinary least squares regression models adjusted for confounding variables and estimated gender-wise and PA heterogeneity effect of retirement on functional impairment. Regressions showed that retirement predicted an increase in functional impairment score in the full sample (β = .76, p < .001) and in men (β = 1.96, p < .001), but not in women. Interestingly, retirement significantly increased functional impairment in ≥ 65 age cohort (full sample: β = .71, p < .005; men: β = 1.86, p < .001) although not in women. However, the effect was significantly moderated by PA such that retirement × PA predicted a decrease in functional impairment in the full sample (β = −.81, p < .005) and the ≥ 65 age group (β = −.43, p < .005). Functional impairment risk of retirement is gender-specific, but PA buffers the relationship. Retirement is generally commonplace, but these findings imply that promoting PA may hold promise for addressing functional impairment in old age. Attending to the physical health needs of men during retirement should be a social policy priority.
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30
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Zanon M, Peruch M, Concato M, Moreschi C, Pizzolitto S, Radaelli D, D’Errico S. Spread of COVID-19 Infection in Long-Term Care Facilities of Trieste (Italy) during the Pre-Vaccination Era, Integrating Findings of 41 Forensic Autopsies with Geriatric Comorbidity Index as a Valid Option for the Assessment of Strength of Causation. Vaccines (Basel) 2022; 10:774. [PMID: 35632530 PMCID: PMC9146610 DOI: 10.3390/vaccines10050774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/02/2022] [Accepted: 05/11/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND in 2020, a new form of coronavirus spread around the world starting from China. The older people were the population most affected by the virus worldwide, in particular in Italy where more than 90% of deaths were people over 65 years. In these people, the definition of the cause of death is tricky due to the presence of numerous comorbidities. OBJECTIVE to determine whether COVID-19 was the cause of death in a series of older adults residents of nursing care homes. METHODS 41 autopsies were performed from May to June 2020. External examination, swabs, and macroscopic and microscopic examination were performed. RESULTS the case series consisted of nursing home guests; 15 men and 26 women, with a mean age of 87 years. The average number of comorbidities was 4. Based only on the autopsy results, the defined cause of death was acute respiratory failure due to diffuse alveolar damage (8%) or (31%) bronchopneumonia with one or more positive swabs for SARS-CoV-2. Acute cardiac failure with one or more positive swabs for SARS-CoV-2 was indicated as the cause of death in in symptomatic (37%) and asymptomatic (10%) patients. Few patients died for septic shock (three cases), malignant neoplastic diseases (two cases), and massive digestive bleeding (one case). CONCLUSIONS Data from post-mortem investigation were integrated with previously generated Geriatric Index of Comorbidity (GIC), resulting in four different degrees of probabilities: high (12%), intermediate (10%), low (59%), and none (19%), which define the level of strength of causation and the role of COVID-19 disease in determining death.
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Affiliation(s)
- Martina Zanon
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.Z.); (M.P.); (M.C.); (D.R.)
| | - Michela Peruch
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.Z.); (M.P.); (M.C.); (D.R.)
| | - Monica Concato
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.Z.); (M.P.); (M.C.); (D.R.)
| | - Carlo Moreschi
- Department of Medicine, Forensic Medicine University of Udine, 33100 Udine, Italy;
| | - Stefano Pizzolitto
- Department of Pathology, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy;
| | - Davide Radaelli
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.Z.); (M.P.); (M.C.); (D.R.)
| | - Stefano D’Errico
- Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; (M.Z.); (M.P.); (M.C.); (D.R.)
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Jackson T, Flinn F, Rafferty L, Ehrlich E, Fletcher M. Exploring the experiences of older adults living with asthma in the United Kingdom: a co-produced qualitative study. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2022.100079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Morikawa M, Lee S, Makino K, Bae S, Chiba I, Harada K, Tomida K, Katayama O, Shimada H. Association of social isolation and smartphone use on cognitive functions. Arch Gerontol Geriatr 2022; 101:104706. [PMID: 35490476 PMCID: PMC9399736 DOI: 10.1016/j.archger.2022.104706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/05/2022] [Accepted: 04/13/2022] [Indexed: 11/19/2022]
Abstract
Background The number of socially isolated older adults has increased owing to the coronavirus disease pandemic, thus leading to a decrease in cognitive functions among this group. Smartphone use is expected to be a reasonable preventive measure against cognitive decline in this social context. Thus, this study aimed to investigate the influence of social isolation and smartphone use on cognitive functions in community-dwelling older adults. Methods We divided 4,601 community-dwelling older adults into four groups based on their levels of social isolation and smartphone use. Then, we conducted cognitive functions tests including a word list memory task, trail-making test, and symbol digit substitution task. Social isolation was defined when participants met two or more of the following measures: domestic isolation, less social contact, and social disengagement. We used an analysis of covariance adjusted by background information to measure between-group differences in levels of cognitive functions and social isolation. A linear regression model was used to analyze the association of standardized scores of cognitive function tests with smartphone use. Results Smartphone users’ scores of the symbol digit substitution task were superior compared with both non-users with social isolation and without. All cognitive functions were associated with smartphone use among non-socially and socially isolated participants. Socially isolated older adults showed an association only between trail making test- part A and smartphone use. Conclusions Smartphone use was associated with cognitive functions (memory, attentional function, executive function, and processing speed) even in socially isolated community-dwelling 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.
| | - Sangyoon Lee
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Keitaro Makino
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo 102-0083, Japan
| | - Seongryu Bae
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Ippei Chiba
- 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
| | - Kouki Tomida
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Osamu Katayama
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo 102-0083, Japan
| | - Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
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Gyasi RM, Peprah P, Abass K, Pokua Siaw L, Dodzi Ami Adjakloe Y, Kofi Garsonu E, Phillips DR. Loneliness and physical function impairment: Perceived health status as an effect modifier in community-dwelling older adults in Ghana. Prev Med Rep 2022; 26:101721. [PMID: 35141124 PMCID: PMC8814641 DOI: 10.1016/j.pmedr.2022.101721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/03/2022] [Accepted: 01/23/2022] [Indexed: 11/01/2022] Open
Abstract
Background Methods Results Conclusions
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Sakalle A, Tomar P, Bhardwaj H, Alim MA. A Modified LSTM Framework for Analyzing COVID-19 Effect on Emotion and Mental Health during Pandemic Using the EEG Signals. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:8412430. [PMID: 35281542 PMCID: PMC8915925 DOI: 10.1155/2022/8412430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/01/2022] [Indexed: 11/17/2022]
Abstract
COVID-19, a WHO-declared public health emergency of worldwide concern, is quickly spreading over the world, posing a physical and mental health hazard. The COVID-19 has resulted in one of the world's most significant worldwide lockdowns, affecting human mental health. In this research work, a modified Long Short-Term Memory (MLSTM)-based Deep Learning model framework is proposed for analyzing COVID-19 effect on emotion and mental health during the pandemic using electroencephalogram (EEG) signals. The participants of this study were volunteers that recovered from COVID-19. The EEG dataset of 40 people is collected to predict emotion and mental health. The results of the MLSTM model are also compared with the other literature classifiers. With an accuracy of 91.26%, the MLSTM beats existing classifiers when using the 70-30 partitioning technique.
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Affiliation(s)
- Aditi Sakalle
- CSE Department, Gautam Buddha University, Greater Noida, India
| | - Pradeep Tomar
- CSE Department, Gautam Buddha University, Greater Noida, India
| | | | - Md. Abdul Alim
- Department of Mathematics and Provost, Bangladesh University of Engineering and Technology, Dhaka, Bangladesh
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Use of Digital Tools, Social Isolation, and Lockdown in People 80 Years and Older Living at Home. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052908. [PMID: 35270600 PMCID: PMC8910393 DOI: 10.3390/ijerph19052908] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 02/01/2023]
Abstract
The COVID-19 crisis and associated lockdowns have exposed the extent of social isolation among older adults (OAs). Currently, the French government and medical, social, and charitable organizations are working to find means of limiting the multiple psychological and physical consequences of social isolation on the health of OAs. One proposal is to help the elderly become more comfortable using digital tools (DTs). However, the ability of DTs to reduce social isolation is disputed in the literature. This study aimed to collect the views of OAs on social isolation; to identify the determinants of the use or not of DTs, in particular in the context of a lockdown; and the role of DTs in the strategy to reduce social isolation. This qualitative study was based on 27 semi-structured individual interviews with OAs ≥ 80 years, in Côte-d’Or and Haute-Marne (French departments), from March to May 2021. A total of 96.3% of participants had already owned one or more DTs (mobile phone, tablet, or computer) for several years. The lockdown had not prompted the population to equip themselves more. The most common reason for using DTs was to maintain contact with relatives, and 63% of the participants said that DTs have a positive impact in reducing social isolation. However, there is a significant need for assistance and training in their use, especially since many services are now offered online. The participants suggested that the key to minimizing social isolation remained the maintenance of social contacts. In conclusion, DTs appear to be useful for helping the elderly maintain social links with relatives and, therefore, have a strategic place in the reduction of social isolation. However, these tools should not replace in-person interactions.
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Philip KEJ, Bu F, Polkey MI, Brown J, Steptoe A, Hopkinson NS, Fancourt D. Relationship of smoking with current and future social isolation and loneliness: 12-year follow-up of older adults in England. THE LANCET REGIONAL HEALTH. EUROPE 2022; 14:100302. [PMID: 35036984 PMCID: PMC8743222 DOI: 10.1016/j.lanepe.2021.100302] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Smoking is often colloquially considered "social". However, the actual relationship of smoking with current and future social isolation and loneliness is unclear. We therefore examined these relationships over a 12-year follow-up. METHODS In this cohort study, we used a nationally representative sample of community dwelling adults aged 50 years and over from the English Longitudinal Study of Ageing (N=8780) (45% male, mean(SD) age 67(10) years. We examined associations of self-reported smoking status at baseline assessment, with social isolation (low social contact, social disengagement, domestic isolation), and loneliness (3-item UCLA loneliness scale), measured at baseline, and follow-up at 4, 8 and 12 years, using ordinary least squares regression models. FINDINGS At baseline, smokers were more likely to be lonely (coef.=0·111, 95% CI 0·025 - 0·196) and socially isolated than non-smokers, having less frequent social interactions with family and friends (coef.= 0·297, 95%CI 0·148 - 0·446), less frequent engagement with community and cultural activities (coef.= 0·534, 95%CI 0·421 - 0·654), and being more likely to live alone (Odds Ratio =1·400, 95%CI 1·209 - 1·618). Smoking at baseline was associated with larger reductions in social contact (coef.=0·205, 95%CI 0·053 - 0·356, to 0·297, 95%CI 0·140 - 0·455), increases in social disengagement (coef.=0·168, 95%CI 0·066 - 0·270, to coef.=0·197, 95%CI 0·087 - 0·307), and increases in loneliness (coef.=0·105, 95%CI 0·003 - 0·207), at 4-year follow-up) over time. No association was found between smoking and changes in cohabitation status. Findings were independent of all identified confounders, including age, sex, social class and the presence of physical and mental health diagnoses. INTERPRETATION Smoking is associated with the development of increasing social isolation and loneliness in older adults, suggesting smoking is detrimental to aspects of psychosocial health. The idea that smoking might be prosocial appears a misconception. FUNDING UK Economic and Social Research Council & Imperial College London.
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Affiliation(s)
- Keir EJ Philip
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
- NIHR Imperial Biomedical Research Centre, London, United Kingdom
- Respiratory Medicine, Royal Brompton Business Group, Guys and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Feifei Bu
- Tobacco and Alcohol Research Group, University College London, United Kingdom
| | - Michael I Polkey
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Respiratory Medicine, Royal Brompton Business Group, Guys and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Jamie Brown
- Tobacco and Alcohol Research Group, University College London, United Kingdom
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Nicholas S Hopkinson
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
- NIHR Imperial Biomedical Research Centre, London, United Kingdom
- Respiratory Medicine, Royal Brompton Business Group, Guys and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Bloom I, Zhang J, Hammond J, Bevilacqua G, Lawrence W, Ward KA, Cooper C, Dennison EM. Impact of the COVID-19 pandemic on community-dwelling older adults: A longitudinal qualitative study of participants from the Hertfordshire Cohort Study. PLoS One 2022; 17:e0275486. [PMID: 36240147 PMCID: PMC9565385 DOI: 10.1371/journal.pone.0275486] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/18/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Older adults have been especially vulnerable to adverse effects from the COVID-19 pandemic including higher mortality and more severe disease complications. At the same time, social isolation, malnutrition and physical inactivity are serious concerns among older adults. The pandemic and associated restrictions may serve to exacerbate these issues, presenting increased risks to physical and mental health. The aims of this qualitative study were: i) to explore how community-living older people in the UK experienced the first wave of the COVID-19 pandemic, specifically how it impacted their well-being and associated health behaviours; ii) to explore how older people's experiences and behaviours changed over time throughout the first wave. METHODS Qualitative data were collected by conducting serial telephone interviews, with an interval of approximately three months. Participants were from the Hertfordshire Cohort Study, all aged over 80 years. Discussions were audio-recorded, information related to the COVID-19 pandemic was transcribed verbatim and transcripts analysed thematically. Interviews were conducted from March to October 2020. RESULTS Data for twelve participants (7 men and 5 women) from a total of 35 interviews were used, comprising two or three timepoints per participant. Analysis identified five overarching themes: 1) shopping strategies and food accessibility, 2) limitations on activities and going out, 3) disruption to healthcare, 4) social and psychological repercussions, and 5) coping strategies. Findings highlight challenges associated with accessing shops, healthcare, and usual activities due to pandemic-related restrictions. Longitudinal findings showed that for some, the ongoing pandemic and related restrictions appeared to aggravate mental health issues (low mood, anxiety) over time, as well as greater feelings of isolation or loneliness, reduced activity and functional limitations; this was despite some relaxation of restrictions later on. Coping strategies used by participants included finding ways to keep busy and to do physical activity safely, maintaining social contact remotely, and having an optimistic or positive outlook, a 'do what you can' attitude. CONCLUSIONS Interventions are likely to be needed in the wake of the COVID-19 pandemic to support health behaviours, such as increasing physical activity, social engagement and improving mental health among community-living older adults.
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Affiliation(s)
- Ilse Bloom
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- * E-mail:
| | - Jean Zhang
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Julia Hammond
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Gregorio Bevilacqua
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
| | - Wendy Lawrence
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Kate A. Ward
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, United Kingdom
| | - Elaine M. Dennison
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom
- Victoria University of Wellington, Wellington, New Zealand
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Reilly CC, Bristowe K, Roach A, Maddocks M, Higginson IJ. "You can do it yourself and you can do it at your convenience": internet accessibility and willingness of people with chronic breathlessness to use an internet-based breathlessness self-management intervention during the COVID-19 pandemic. ERJ Open Res 2022; 8:00557-2021. [PMID: 35198627 PMCID: PMC8859502 DOI: 10.1183/23120541.00557-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/23/2021] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION The burden of chronic breathlessness on individuals, family, society and health systems is significant, and set to increase exponentially with population ageing, complex multimorbidity and coronavirus disease 2019 (COVID-19)-related disability. Breathlessness support services are effective; however, reach and access are limited. Delivering online breathlessness interventions may build capacity and resilience within health systems to tackle chronic breathlessness through supported self-management. The aim of this study was to explore accessibility and willingness of patients with chronic breathlessness to use an internet-based breathlessness self-management intervention (SELF-BREATHE). METHODS Semi-structured telephone interviews were conducted with adults living with advanced malignant and non-malignant disease and chronic breathlessness (July to November 2020). Interviews were analysed using conventional and summative content analysis. RESULTS 25 patients (COPD: n=13; lung cancer: n=8; interstitial lung disease (ILD): n=3; bronchiectasis: n=1) were interviewed: 17 male, median (range) age 70 (47-86) years and Medical Research Council dyspnoea score 3 (2-5). 21 patients had internet access. Participants described greater use, acceptance and normalisation of the internet since the advent of the COVID-19 pandemic. They described multifaceted internet use: functional, self-investment (improving health and wellbeing) and social. The concept of SELF-BREATHE was highly valued, and most participants with internet access were willing to use it. In addition to technical limitations, personal choice and perceived value of the internet were important factors that underpinned readiness to use online resources. CONCLUSION These findings suggest that patients living with chronic breathlessness that have access to the internet would have the potential to benefit from the online SELF-BREATHE intervention, if given the opportunity.
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Affiliation(s)
- Charles C. Reilly
- Dept of Physiotherapy, King's College Hospital, London, UK
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Katherine Bristowe
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Anna Roach
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Irene J. Higginson
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
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Hartley P, Monaghan A, Donoghue OA, Kenny RA, Romero-Ortuno R. Exploring bi-directional temporal associations between timed-up-and-go and cognitive domains in the Irish longitudinal study on ageing (TILDA). Arch Gerontol Geriatr 2021; 99:104611. [PMID: 34998129 DOI: 10.1016/j.archger.2021.104611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The bi-directional longitudinal associations between mobility and cognition in older adults are poorly understood. Our objective was to study the temporal associations between timed-up-and-go (TUG) and five cognitive function domains: global cognition, processing speed, verbal fluency, executive function, and sustained attention. METHODS We designed two longitudinal samples: A (for cognition as predictor of mobility), and B (for mobility as predictor of cognition). To examine the associations between the five cognitive domains at wave 1 and change in TUG times up to wave 5 (eight years), five linear mixed-effect models were fitted. To examine the associations between TUG times at wave 1 and change in the five cognitive domains between waves 1 and 3 (four years), five linear-regression models were fitted. RESULTS After removing participants with missing data, sample A numbered 4913 participants (mean age 62), and sample B 3675 (mean age 61). Baseline cognitive domains were all significant predictors of future change in TUG times. Baseline TUG time was also a significant predictor of future change in all five cognitive domains. In both cases, poorer performance at baseline predicted greater future loss of function. CONCLUSION There was evidence of bi-directional temporal relationships between cognition and mobility. In both directions, the effect of the explanatory variable was small, though cognition as predictor of future mobility may have greater clinical relevance than vice versa. Our findings underscore the importance for clinicians of considering the bi-directional associations between cognition and mobility when observing subtle changes in either, especially as impairments emerge.
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Affiliation(s)
- Peter Hartley
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland; Department of Public Health and Primary Care, University of Cambridge, United Kingdom.
| | - Ann Monaghan
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Orna A Donoghue
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland; Global Brain Health Institute, Trinity College Dublin, Ireland
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Byrne KA, Anaraky RG, Dye C, Ross LA, Chalil Madathil K, Knijnenburg B, Levkoff S. Examining Rural and Racial Disparities in the Relationship Between Loneliness and Social Technology Use Among Older Adults. Front Public Health 2021; 9:723925. [PMID: 34532308 PMCID: PMC8438168 DOI: 10.3389/fpubh.2021.723925] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/09/2021] [Indexed: 12/25/2022] Open
Abstract
Loneliness, the subjective negative experience derived from a lack of meaningful companionship, is associated with heightened vulnerability to adverse health outcomes among older adults. Social technology affords an opportunity to cultivate social connectedness and mitigate loneliness. However, research examining potential inequalities in loneliness is limited. This study investigates racial and rural-urban differences in the relationship between social technology use and loneliness in adults aged 50 and older using data from the 2016 wave of the Health and Retirement Study (N = 4,315). Social technology use was operationalized as the self-reported frequency of communication through Skype, Facebook, or other social media with family and friends. Loneliness was assessed using the UCLA Loneliness scale, and rural-urban differences were based on Beale rural-urban continuum codes. Examinations of race focused on differences between Black/African-American and White/Caucasian groups. A path model analysis was performed to assess whether race and rurality moderated the relationship between social technology use and loneliness, adjusting for living arrangements, age, general computer usage. Social engagement and frequency of social contact with family and friends were included as mediators. The primary study results demonstrated that the association between social technology use and loneliness differed by rurality, but not race. Rural older adults who use social technology less frequently experience greater loneliness than urban older adults. This relationship between social technology and loneliness was mediated by social engagement and frequency of social contact. Furthermore, racial and rural-urban differences in social technology use demonstrated that social technology use is less prevalent among rural older adults than urban and suburban-dwelling older adults; no such racial differences were observed. However, Black older adults report greater levels of perceived social negativity in their relationships compared to White older adults. Interventions seeking to address loneliness using social technology should consider rural and racial disparities.
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Affiliation(s)
- Kaileigh A. Byrne
- Department of Psychology, Clemson University, Clemson, SC, United States
| | - Reza Ghaiumy Anaraky
- Department of Human-Centered Computing, Clemson University, Clemson, SC, United States
| | - Cheryl Dye
- Department of Psychology, Clemson University, Clemson, SC, United States
| | - Lesley A. Ross
- Department of Psychology, Clemson University, Clemson, SC, United States
| | - Kapil Chalil Madathil
- Department of Civil Engineering, Clemson University, Clemson, SC, United States
- Department of Industrial Engineering, Clemson University, Clemson, SC, United States
| | - Bart Knijnenburg
- Department of Human-Centered Computing, Clemson University, Clemson, SC, United States
| | - Sue Levkoff
- College of Social Work, University of South Carolina, Columbia, SC, United States
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Salman D, Beaney T, E Robb C, de Jager Loots CA, Giannakopoulou P, Udeh-Momoh CT, Ahmadi-Abhari S, Majeed A, Middleton LT, McGregor AH. Impact of social restrictions during the COVID-19 pandemic on the physical activity levels of adults aged 50-92 years: a baseline survey of the CHARIOT COVID-19 Rapid Response prospective cohort study. BMJ Open 2021; 11:e050680. [PMID: 34433606 PMCID: PMC8390149 DOI: 10.1136/bmjopen-2021-050680] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Physical inactivity is more common in older adults, is associated with social isolation and loneliness and contributes to increased morbidity and mortality. We examined the effect of social restrictions to reduce COVID-19 transmission in the UK (lockdown), on physical activity (PA) levels of older adults and the social predictors of any change. DESIGN Baseline analysis of a survey-based prospective cohort study. SETTING Adults enrolled in the Cognitive Health in Ageing Register for Investigational and Observational Trials cohort from general practitioner practices in North West London were invited to participate from April to July 2020. PARTICIPANTS 6219 cognitively healthy adults aged 50-92 years completed the survey. MAIN OUTCOME MEASURES Self-reported PA before and after the introduction of lockdown, as measured by metabolic equivalent of task (MET) minutes. Associations of PA with demographic, lifestyle and social factors, mood and frailty. RESULTS Mean PA was significantly lower following the introduction of lockdown from 3519 to 3185 MET min/week (p<0.001). After adjustment for confounders and prelockdown PA, lower levels of PA after the introduction of lockdown were found in those who were over 85 years old (640 (95% CI 246 to 1034) MET min/week less); were divorced or single (240 (95% CI 120 to 360) MET min/week less); living alone (277 (95% CI 152 to 402) MET min/week less); reported feeling lonely often (306 (95% CI 60 to 552) MET min/week less); and showed symptoms of depression (1007 (95% CI 612 to 1401) MET min/week less) compared with those aged 50-64 years, married, cohabiting and not reporting loneliness or depression, respectively. CONCLUSIONS AND IMPLICATIONS Markers of social isolation, loneliness and depression were associated with lower PA following the introduction of lockdown in the UK. Targeted interventions to increase PA in these groups should be considered.
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Affiliation(s)
- David Salman
- Department of Primary Care and Public Health, Imperial College London, London, UK
- MSk Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Thomas Beaney
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Catherine E Robb
- Ageing Epidemiology Research Unit (AGE), Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Celeste A de Jager Loots
- Ageing Epidemiology Research Unit (AGE), Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Parthenia Giannakopoulou
- Ageing Epidemiology Research Unit (AGE), Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Chinedu T Udeh-Momoh
- Ageing Epidemiology Research Unit (AGE), Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Sara Ahmadi-Abhari
- Ageing Epidemiology Research Unit (AGE), Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Public Health Directorate, Imperial College Healthcare NHS Trust, London, UK
| | - Lefkos T Middleton
- Ageing Epidemiology Research Unit (AGE), Faculty of Medicine, School of Public Health, Imperial College London, London, UK
- Public Health Directorate, Imperial College Healthcare NHS Trust, London, UK
| | - Alison H McGregor
- MSk Lab, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
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Del Pozo Cruz B, Perales F, Alfonso-Rosa RM, Del Pozo-Cruz J. Impact of Social Isolation on Physical Functioning Among Older Adults: A 9-Year Longitudinal Study of a U.S.-Representative Sample. Am J Prev Med 2021; 61:158-164. [PMID: 33849775 DOI: 10.1016/j.amepre.2021.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Social isolation among older adults is associated with poor health and premature mortality, but its impact on physical functioning is not fully understood. Previous studies have typically relied on community samples, cross-sectional data, and suboptimal prospective designs. This study generates more robust evidence by investigating the longitudinal associations between social isolation and physical functioning in a large panel of older adults. METHODS Analyses were based on 9 waves of data (2011-2019) from a sample of adults aged ≥65 years from the U.S. National Health and Aging Trends Study (N=12,427 individuals; 54,860 person-year observations) and within-individual fixed-effect panel regression models. Analyses were conducted in 2020. Social isolation was measured using the Social Isolation Index, and physical functioning was measured through the Short Physical Performance Battery. RESULTS In fully adjusted fixed-effect regression models, each 1-unit increase in the Social Isolation Index resulted in an average decrease of 0.27 units in the Short Physical Performance Battery (95% CI= -0.31, -0.24). This relationship was moderated by age, with the Social Isolation Index bearing a significantly and substantially stronger influence on the Short Physical Performance Battery at older ages than at younger ages. CONCLUSIONS This study confirms that social isolation is associated with deficits in physical functioning among older adults in the U.S. using more robust data and methods than earlier studies. These findings highlight the importance of incorporating strategies to reduce social isolation in policies aimed at promoting successful aging.
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Affiliation(s)
- Borja Del Pozo Cruz
- Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Epidemiology of Physical Activity and Fitness Across the Lifespan Research Group, Faculty of Education, University of Seville, Seville, Spain.
| | - Francisco Perales
- School of Social Science, The University of Queensland, Brisbane, Australia
| | - Rosa M Alfonso-Rosa
- Epidemiology of Physical Activity and Fitness Across the Lifespan Research Group, Faculty of Education, University of Seville, Seville, Spain; Department of Human Motricity and Sport Performance, University of Seville, Seville, Spain
| | - Jesus Del Pozo-Cruz
- Epidemiology of Physical Activity and Fitness Across the Lifespan Research Group, Faculty of Education, University of Seville, Seville, Spain; Department of Physical Education and Sport, Faculty of Education, University of Seville, Seville, Spain
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43
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McKinlay AR, Fancourt D, Burton A. A qualitative study about the mental health and wellbeing of older adults in the UK during the COVID-19 pandemic. BMC Geriatr 2021; 21:439. [PMID: 34311710 PMCID: PMC8312210 DOI: 10.1186/s12877-021-02367-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 06/29/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES The objective of this study was to examine factors that threatened and protected the wellbeing of older adults living in the UK during social distancing restrictions due to the COVID-19 pandemic. METHODS Semi-structured telephone or video interviews with 20 adults aged over 70. Purposive sampling methods were used to increase diversity within the group. Transcripts were analysed using reflexive thematic analysis. RESULTS Participants described potential threats to their wellbeing during the pandemic, including fears for mortality, grieving normal life, and concerns for the future. Participants also described activities and behaviours that helped to protect their mental health, including adopting a slower pace of life, maintaining routine, socialising, and using past coping skills. Many participants drew on their resilience and life experience to self-manage fear and uncertainty associated with the pandemic, using their time during lockdown to reflect or organise end-of-life affairs. DISCUSSION This study provides UK-based evidence that while some older adults experienced challenges during the first wave of COVID-19, many were resilient throughout social distancing restrictions despite early reported concerns of mental health consequences among the older adult population. Our findings highlight the importance of maintaining access to essentials to promote feelings of normality and use of social support to help reduce uncertainty in times of pandemics.
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Affiliation(s)
- A R McKinlay
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - D Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - A Burton
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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44
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Hampshire A, Hellyer PJ, Soreq E, Mehta MA, Ioannidis K, Trender W, Grant JE, Chamberlain SR. Associations between dimensions of behaviour, personality traits, and mental-health during the COVID-19 pandemic in the United Kingdom. Nat Commun 2021; 12:4111. [PMID: 34272365 PMCID: PMC8285408 DOI: 10.1038/s41467-021-24365-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 06/09/2021] [Indexed: 12/20/2022] Open
Abstract
The COVID-19 pandemic (including lockdown) is likely to have had profound but diverse implications for mental health and well-being, yet little is known about individual experiences of the pandemic (positive and negative) and how this relates to mental health and well-being, as well as other important contextual variables. Here, we analyse data sampled in a large-scale manner from 379,875 people in the United Kingdom (UK) during 2020 to identify population variables associated with mood and mental health during the COVID-19 pandemic, and to investigate self-perceived pandemic impact in relation to those variables. We report that while there are relatively small population-level differences in mood assessment scores pre- to peak-UK lockdown, the size of the differences is larger for people from specific groups, e.g. older adults and people with lower incomes. Multiple dimensions underlie peoples’ perceptions, both positive and negative, of the pandemic’s impact on daily life. These dimensions explain variance in mental health and can be statistically predicted from age, demographics, home and work circumstances, pre-existing conditions, maladaptive technology use and personality traits (e.g., compulsivity). We conclude that a holistic view, incorporating the broad range of relevant population factors, can better characterise people whose mental health is most at risk during the COVID-19 pandemic. The COVID-19 pandemic has affected people’s health and well-being. Here, the authors characterize self-reported impact of the pandemic (positive and negative) at a large scale in the United Kingdom, and show variance among individual circumstances.
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Affiliation(s)
| | - Peter J Hellyer
- Imperial College London, London, UK.,King's College London, London, UK
| | | | | | - Konstantinos Ioannidis
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.,Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Jon E Grant
- Department of Psychiatry, University of Chicago, Chicago, IL, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Southampton, Southampton, UK.,Southern Health NHS Foundation Trust, Southampton, UK
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45
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di Cola FS, Caratozzolo S, Di Cesare M, Liberini P, Rao R, Padovani A. MIGRAINE MONITORING IN THE TIME OF COVID-19: TRIGGERS AND PROTECTORS DURING A PANDEMIC. PAIN MEDICINE 2021; 22:2728-2738. [PMID: 34181002 DOI: 10.1093/pm/pnab202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Aim of the present observational study was to assess the impact of COVID-19 quarantine on migraine and evaluate potential influencing factors. Previous studies reported mixed results regarding clinical outcome during quarantine in patients with migraine. In particular, data from areas strongly affetcted by COVID-19 pandemic are missing. METHODS One-hundred and seventy patients, previously assessed at the Headache Centre - ASST Spedali Civili Brescia, underwent a telephonic interview regarding migraine features and clinical, occupational and lifestyle variables. RESULTS Compared to baseline, during quarantine, we found a significant overall reduction in migraine days (14.7±0.6 vs 12.3±0.7, p <0.001), with 47.1% patients reporting a clinical improvement. Outdoor living spaces (OR 2.3, 95% CI 1.7-3.07, p = 0.009), a positive attitude throughout quarantine (OR 4.12, 95% CI 2.3-7.1, p = 0.03), working full-time (OR 1.03, 95% CI 0.5-1.9, p < 0.001) and a baseline diagnosis of chronic migraine (OR 1.4, 95% CI 1.1-2.02, p = 0.002) were associated with an increased chance of migraine improvement. Being single (OR 1.5, 95% CI 1.1-2.01, p = 0.05) and physical inactivity (OR 1.3, 95% CI 1.1-1.6, p = 0.02) were associated with an increased risk of worsening. CONCLUSIONS Quarantine had an overall positive impact on migraine. Based on our results, we hypothesize the reduction of daily hassles and challenges might be the main reason for such improvement.
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Affiliation(s)
- Francesca Schiano di Cola
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Salvatore Caratozzolo
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Marco Di Cesare
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Paolo Liberini
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Renata Rao
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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46
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Amore S, Puppo E, Melara J, Terracciano E, Gentili S, Liotta G. Impact of COVID-19 on older adults and role of long-term care facilities during early stages of epidemic in Italy. Sci Rep 2021; 11:12530. [PMID: 34131216 PMCID: PMC8206111 DOI: 10.1038/s41598-021-91992-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/07/2021] [Indexed: 12/23/2022] Open
Abstract
Older adults are the main victims of the novel COVID-19 coronavirus outbreak and elderly in Long Term Care Facilities (LTCFs) are severely hit in terms of mortality. This paper presents a quantitative study of the impact of COVID-19 outbreak in Italy during first stages of the epidemic, focusing on the effects on mortality increase among older adults over 80 and its correlation with LTCFs. The study of growth patterns shows a power-law scaling regime for the first stage of the pandemic with an uneven behaviour among different regions as well as for the overall mortality increase according to the different impact of COVID-19. However, COVID-19 incidence rate does not fully explain the differences of mortality impact in older adults among different regions. We define a quantitative correlation between mortality in older adults and the number of people in LTCFs confirming the tremendous impact of COVID-19 on LTCFs. In addition a correlation between LTCFs and undiagnosed cases as well as effects of health system dysfunction is also observed. Our results confirm that LTCFs did not play a protective role on older adults during the pandemic, but the higher the number of elderly people living in LTCFs the greater the increase of both general and COVID-19 related mortality. We also observed that the handling of the crises in LTCFs hampered an efficient tracing of COVID-19 spread and promoted the increase of deaths not directly attributed to SARS-CoV-2.
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Affiliation(s)
- Stefano Amore
- Community of Sant'Egidio, Piazza della Nunziata 4, 16124, Genova, Italy.
| | - Emanuela Puppo
- Community of Sant'Egidio, Piazza della Nunziata 4, 16124, Genova, Italy
| | - Josué Melara
- Community of Sant'Egidio, Piazza della Nunziata 4, 16124, Genova, Italy
| | - Elisa Terracciano
- Biomedicine and Prevention Department, University of Rome "Tor Vergata", Rome, Italy
| | - Susanna Gentili
- School of Doctorate in Nursing Science and Public Health, University of Rome "Tor Vergata", Rome, Italy
| | - Giuseppe Liotta
- Biomedicine and Prevention Department, University of Rome "Tor Vergata", Rome, Italy
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47
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Frykholm E, Gephine S, Saey D, Lemson A, Klijn P, Bij de Vaate E, Maltais F, van Hees H, Nyberg A. Isotonic quadriceps endurance is better associated with daily physical activity than quadriceps strength and power in COPD: an international multicentre cross-sectional trial. Sci Rep 2021; 11:11557. [PMID: 34078960 PMCID: PMC8172909 DOI: 10.1038/s41598-021-90758-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/12/2021] [Indexed: 11/24/2022] Open
Abstract
Knowledge about modifiable determinants of daily physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is crucial to design effective PA interventions. The present study aimed to determine the contribution of quadriceps strength, power and endurance to daily PA in COPD. Additionally, for quadriceps endurance, we also aimed to determine to what extent the association varies according to the mode of movement (isotonic, isometric, or isokinetic). Using a multicentre cross-sectional trial design we determined the contribution of quadriceps function to daily PA (steps, sedentary time and time spent doing moderate-to-very-vigorous physical activity [MVPA]) using bivariate and partial Pearson correlation analysis (r) and multiple linear regression models (ΔR2). Pre-determined controlling factors were sex, age, body mass index (BMI), COPD-assessment test, forced expiratory volume in one second in percent of the predicted value (FEV1pred), and distance walked on the 6-minute walk test. Eighty-one patients with COPD (mean ± SD: age 67 ± 8 years, FEV1pred 57 ± 19%, daily steps 4968 ± 3319, daily sedentary time 1016 ± 305 min, and MVPA time 83 ± 45 min) were included. Small to moderate bivariate correlations (r = .225 to .452, p < .05) were found between quadriceps function and measures of PA. The best multiple linear regression models explained 38–49% of the variance in the data. Isotonic endurance was the only muscle contributor that improved all PA models; daily steps (ΔR2 = .04 [relative improvement 13%] p = .026), daily sedentary time (ΔR2 = .07 [23%], p = .005) and MVPA-minutes (ΔR2 = .08 [20%], p = .001). Isotonic endurance was also independently associated with most PA variables, even when controlling for strength, power or isometric-isokinetic endurance properties of the muscle (r = .246 to .384, p < .05). In contrast, neither strength, power, isometric-or isokinetic endurance properties of the muscle was independently associated with PA measures when controlling for isotonic endurance (r = .037 to .219, p > .05). To conclude, strength, power, and endurance properties of the quadriceps were low to moderately associated with PA in patients with COPD. Isotonic quadriceps endurance was the only quadriceps property that was independently associated with the different measures of PA after controlling for a basic set of known determinants of PA, quadriceps strength or power, or isometric or isokinetic quadriceps endurance. Future longitudinal studies should investigate its potential as a modifiable determinant of PA.
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Affiliation(s)
- Erik Frykholm
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University , Umeå, Sweden.
| | - Sarah Gephine
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada.,Univ. Lille, Univ. Artois, Univ. Littoral Côte D'opale, ULR 7369-Urepsss, Lille, France
| | - Didier Saey
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada
| | - Arthur Lemson
- Department of Pulmonary Diseases, Radboud UMC, Nijmegen, The Netherlands
| | - Peter Klijn
- Department of Pulmonary Rehabilitation, Merem Medical Rehabilitation, Hilversum, The Netherlands.,Department of Pulmonary Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Eline Bij de Vaate
- Department of Pulmonary Rehabilitation, Merem Medical Rehabilitation, Hilversum, The Netherlands
| | - François Maltais
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Quebec, Canada
| | | | - André Nyberg
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University , Umeå, Sweden
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Sialino LD, Schaap LA, van Oostrom SH, Picavet HSJ, Twisk JWR, Verschuren WMM, Visser M, Wijnhoven HAH. The sex difference in gait speed among older adults: how do sociodemographic, lifestyle, social and health determinants contribute? BMC Geriatr 2021; 21:340. [PMID: 34078276 PMCID: PMC8173843 DOI: 10.1186/s12877-021-02279-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/04/2021] [Indexed: 12/25/2022] Open
Abstract
Background This study explores whether a sex difference in sensitivity to (strength of the association) and/or in exposure to (prevalence) determinants of gait speed contributes to the observed lower gait speed among older women compared to men. Methods Data from the Longitudinal Aging Study Amsterdam (LASA) were used. In total 2407 men and women aged 55–81 years were included, with baseline measurements in 1992/2002 and follow-up measurements every 3–4 years for 15/25 years. Multivariable mixed model analysis was used to investigate sex differences in sensitivity (interaction term with sex) and in exposure to (change of the sex difference when adjusted) socio-demographic, lifestyle, social and health determinants of gait speed. Results Women had a 0.054 m/s (95 % CI: 0.076 − 0.033, adjusted for height and age) lower mean gait speed compared to men. In general, men and women had similar determinants of gait speed. However, higher BMI and lower physical activity were more strongly associated with lower gait speed in women compared to men (i.e. higher sensitivity). More often having a lower educational level, living alone and having more chronic diseases, pain and depressive symptoms among women compared to men also contributed to observed lower gait speed in women (i.e. higher exposure). In contrast, men more often being a smoker, having a lower physical activity and a smaller personal network size compared to women contributed to a lower gait speed among men (i.e. higher exposure). Conclusions Both a higher sensitivity and higher exposure to determinants of gait speed among women compared to men contributes to the observed lower gait speed among older women. The identified (modifiable) contributing factors should be taken into account when developing prevention and/or treatment strategies aimed to enhance healthy physical aging. This might require a sex-specific approach in both research and clinical practice, which is currently often lacking. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02279-7.
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Affiliation(s)
- Lena D Sialino
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sandra H van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - H Susan J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Johannes W R Twisk
- Department of Clinical Epidemiology and Biostatistics, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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49
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Pourriyahi H, Saghazadeh A, Rezaei N. Altered immunoemotional regulatory system in COVID-19: From the origins to opportunities. J Neuroimmunol 2021; 356:577578. [PMID: 33933818 PMCID: PMC8050399 DOI: 10.1016/j.jneuroim.2021.577578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/19/2021] [Accepted: 04/13/2021] [Indexed: 10/26/2022]
Abstract
The emergence of the novel coronavirus (SARS-CoV-2) and the worldwide spread of the coronavirus disease (COVID-19) have led to social regulations that caused substantial changes in manners of daily life. The subsequent loneliness and concerns of the pandemic during social distancing, quarantine, and lockdown are psychosocial stressors that negatively affect the immune system. These effects occur through mechanisms controlled by the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenocortical (HPA) axis that alter immune regulation, namely the conserved transcriptional response to adversity (CTRA), which promotes inflammation and diminishes antiviral responses, leading to inadequate protection against viral disease. Unhealthy eating habits, physical inactivity, sleep disturbances, and mental health consequences of COVID-19 add on to the pathological effects of loneliness, making immunity against this ferocious virus an even tougher fight. Therefore, social isolation, with its unintended consequences, has inherently paradoxical effects on immunity in relation to viral disease. Though this paradox can present a challenge, its acknowledgment can serve as an opportunity to address the associated issues and find ways to mitigate the adverse effects. In this review, we aim to explore, in detail, the pathological effects of the new social norms on immunity and present suggested methods to improve our physical, psychological, and healthcare abilities to fight viral infection in the context of the COVID-19 pandemic.
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Affiliation(s)
- Homa Pourriyahi
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amene Saghazadeh
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; MetaCognition Interest Group (MCIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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50
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Del Pozo Cruz B, Perales F, Alfonso-Rosa RM, Del Pozo-Cruz J. Bidirectional and dynamic relationships between social isolation and physical functioning among older adults: A cross-lagged panel model of US national survey data. J Gerontol A Biol Sci Med Sci 2021; 76:1977-1980. [PMID: 33839792 DOI: 10.1093/gerona/glab110] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies examining unidirectional relationships between social isolation and physical functioning amongst older adults may be biased due to reverse causality. This study leveraged data from a US national sample of older adults and a novel estimation method to identify bidirectional associations between these two phenomena and their associated temporal dynamics. METHODS The analyses were based on nine waves of panel data from a sample of adults aged 65+ years from the US National Health and Aging Trends Study (n=12,427 individuals) and a cross-lagged panel model. Social isolation was measured using the Social Isolation Index (SII) and physical functioning through the Short Physical Performance Battery (SPPB). RESULTS One SD increase in the SPPB was associated with a -0.013 SD decrease (95% CI: -0.023, -0.004) in the SII a year later, whereas one SD increase in the SII was associated with a larger -0.058 SD decrease (95% CI: -0.069, -0.046) in the SPPB a year later. The SII→SPPB effect lasted for ~5 years, whereas the SPPB→SII lasted for ~3 years. CONCLUSIONS This study confirmed the existence of statistically significant bidirectional associations between social isolation and physical functioning amongst older adults in the US, net of reverse causation. Since the effect of social isolation dominates, the findings indicate that public-health strategies to promote successful aging should prioritise interventions that enrich older adults' social networks. Further, the effect time horizons yielded by the model point to the optimal timing for the re-delivery of interventions.
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Affiliation(s)
- Borja Del Pozo Cruz
- Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Epidemiology of Physical Activity and Fitness Across the Lifespan (EPAFit) Research Group, Faculty of Education, University of Seville, Seville, Spain
| | - Francisco Perales
- School of Social Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Rosa M Alfonso-Rosa
- Epidemiology of Physical Activity and Fitness Across the Lifespan (EPAFit) Research Group, Faculty of Education, University of Seville, Seville, Spain.,Department of Human Motricity and Sport Performance, University of Seville, Seville, Spain
| | - Jesus Del Pozo-Cruz
- Epidemiology of Physical Activity and Fitness Across the Lifespan (EPAFit) Research Group, Faculty of Education, University of Seville, Seville, Spain.,Department of Physical Education and Sport, Faculty of Education, University of Seville, Seville, Spain
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