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Song Y, Yuan Q, Liu H, Gu K, Liu Y. Machine learning algorithms to predict mild cognitive impairment in older adults in China: A cross-sectional study. J Affect Disord 2024; 368:117-126. [PMID: 39271065 DOI: 10.1016/j.jad.2024.09.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 08/29/2024] [Accepted: 09/10/2024] [Indexed: 09/15/2024]
Abstract
OBJECTIVE This study aimed to explore the predictive value of machine learning (ML) in mild cognitive impairment (MCI) among older adults in China and to identify important factors causing MCI. METHODS In this study, 6434 older adults were selected based on the data of the China Health and Elderly Care Longitudinal Survey (CHARLS) in 2020, and the dataset was subsequently divided into the training set and the test set, with a ratio of 6:4. To construct a prediction model for MCI in older adults, six ML algorithms were used, including logistic regression, KNN, SVM, decision tree (DT), LightGBM, and random forest (RF). The Delong test was used to compare the differences of ROC curves of different models, while decision curve analysis (DCA) was used to evaluate the model performance. The important contributions of the prediction results were then used to explain the model by the SHAP value.The Matthews correlation coefficient (MCC) was calculated to evaluate the performance of the models on imbalanced datasets. Additionally, causal analysis and counterfactual analysis were conducted to understand the feature importance and variable effects. RESULTS The area under the ROC curve of each model range from 0.71 to 0.77, indicating significant difference (P < 0.01). The DCA results show that the net benefits of LightGBM is the largest within various probability thresholds. Among all the models, the LightGBM model demonstrated the highest performance and stability. The five most important characteristics for predicting MCI were educational level, social events, gender, relationship with children, and age. Causal analysis revealed that these variables had a significant impact on MCI, with an average treatment effect of -0.144. Counterfactual analysis further validated these findings by simulating different scenarios, such as improving educational level, increasing age, and increasing social events. CONCLUSION The ML algorithm can effectively predict the MCI of older adults in China and identify the important factors causing MCI.
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Affiliation(s)
- Yanliqing Song
- College of Sports, Nanjing Tech University, Nanjing, China
| | - Quan Yuan
- College of Sports, Nanjing Tech University, Nanjing, China
| | - Haoqiang Liu
- College of Sports, Nanjing Tech University, Nanjing, China
| | - KeNan Gu
- College of Sports, Nanjing Tech University, Nanjing, China
| | - Yue Liu
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China.
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2
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Yu Q, Ren Y, Wu J. Loneliness shapes disparities in healthy life expectancy: a multi-state analysis from China. BMC Public Health 2024; 24:1492. [PMID: 38834967 DOI: 10.1186/s12889-024-18975-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 05/27/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVES To assess the influence of loneliness on the healthy life expectancy of older adults in China and its gender disparities across different health indicators, in order to provide insights for enhancing the health status and subjective well-being of the older population. METHOD We conducted a cohort analysis using four waves of weighted samples (2008, 2011, 2014, and 2018) from the Chinese Longitudinal Healthy Longevity Survey, encompassing 15,507 respondents aged 65-99. Physical and subjective health were assessed through activity of daily living (ADL) and self-rated health (SRH), respectively. Utilizing loneliness status as a time-variant variable, we employed the multi-state interpolated Markov Chain to explore the associations between loneliness and age-specific life expectancy (LE), healthy life expectancy (HLE), and the proportion of healthy life expectancy in life expectancy (HLE/LE). RESULTS Compared to the non-lonely population, both LE and HLE were lower among lonely individuals. Regarding gender differences, the HLE/LE for females in the lonely population was consistently lower than that for males. The impact of loneliness on the health of older adults varied by measurement indicators and gender. Specifically, based on ADL results, the decline in HLE/LE was greater for females, with a decline of 53.6% for lonely females compared to 51.7% for non-lonely females between the ages of 65 and 99. For males, the decline was 51.4% for lonely males and 51.5% for non-lonely males. According to SRH, the gender difference in the decline of HLE/LE due to loneliness was less apparent. For males, the change in HLE/LE for non-lonely individuals was 3.4%, compared to 4.2% for lonely individuals, whereas for females, the change was 3.7% for non-lonely individuals and 4.4% for lonely individuals. CONCLUSION Loneliness exerts varied effects on health across different measurement indicators and gender demographics. Targeted health promotion interventions are imperative to mitigate these negative impacts, particularly emphasizing the enhancement of subjective well-being and physical functioning, especially among older adult females.
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Affiliation(s)
- Qi Yu
- Institute of Population Research, Peking University, Beijing, China
| | - Yiting Ren
- Department of Mathematics, University College London, London, UK
| | - Jilei Wu
- Institute of Population Research, Peking University, Beijing, China.
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Xu J, Liu G, Li H, Jiang X, Zhou S, Wang J, Pang M, Li S, Kong F. Association between social integration and loneliness among the female migrant older adults with children: the mediating effect of social support. BMC Geriatr 2024; 24:4. [PMID: 38172722 PMCID: PMC10763376 DOI: 10.1186/s12877-023-04569-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The number of migrant older adults with children (MOAC) in China has been increasing in recent years, and most of them are women. This study aimed to explore the mediating effect of social support between social integration and loneliness among the female MOAC in Jinan, China. METHODS In this study, 418 female MOAC were selected using multi-stage cluster random sampling in Jinan, Shandong Province, China. Loneliness was measured by the eight-item version of the University of California Los Angeles Loneliness Scale (ULS-8), and social support was measured by The Social Support Rating Scale (SSRS). Descriptive analyses, t-tests, ANOVA, and structural equation modeling (SEM) were used to illustrate the relationship between social integration, social support, and loneliness. RESULTS The average scores of ULS-8 and SSRS were 12.9 ± 4.0 and 39.4 ± 5.9 among female MOAC in this study. Social integration and social support were found to be negatively related to loneliness, and the standardized direct effect was -0.20 [95% CI: -0.343 to -0.068] and -0.39 [95% CI: -0.230 to -0.033], respectively. Social support mediated the relationship between social integration and loneliness, and the indirect effect was -0.16 [95% CI: -0.252 to -0.100]. CONCLUSION The female MOAC's loneliness was at a relatively lower level in this study. It was found that social integration was negatively associated with loneliness, and social support mediated the relationship between them. Helping female MOAC integrate into the inflow city and improving their social support could be beneficial for alleviating their loneliness.
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Affiliation(s)
- Jing Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Department of Medical Administration, The First Affiliated Hospital of Anhui Medical University, Hefei, 230000, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Guangwen Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Hexian Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Xiaoxu Jiang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Shengyu Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Mingli Pang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
- Institute of Health and Elderly Care, Shandong University, Jinan, China.
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Nicolaisen M, Thorsen K. Gender Differences in Loneliness Over Time: A 15-Year Longitudinal Study of Men and Women in the Second Part of Life. Int J Aging Hum Dev 2024; 98:103-132. [PMID: 37563853 DOI: 10.1177/00914150231194243] [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] [Indexed: 08/12/2023]
Abstract
Evidence suggests that in old age, women are lonelier than men. Gender differences in loneliness are often explained by gender differences in longevity, social status and loss, health, and mobility-well-established predictors that may influence loneliness differently in "younger" (40-59 years) and "older" (60-80 years) groups of men and women in the second part of life. This study explores loneliness in men and women ages 40 to 80 years at baseline over a 15-year period using panel data from three waves of the Norwegian Life Course, Ageing and Generation Study (N = 2,315). Our analyses show that women were more lonely than men also in adjusted analyses. Logistic regression analyses indicated that loss of a partner and poor mental health are prospectively related to loneliness among men and women, whereas other factors like becoming a partner, stable singlehood, and poor physical health were related to loneliness among women but not men.
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Affiliation(s)
- Magnhild Nicolaisen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Kirsten Thorsen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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Zhang P, Abudukelimu N, Sali A, Chen JX, Li M, Mao YY, Zhu Y, Zhu QX. Sociodemographic features associated with the MoCA, SPPB, and GDS scores in a community-dwelling elderly population. BMC Geriatr 2023; 23:557. [PMID: 37704972 PMCID: PMC10500811 DOI: 10.1186/s12877-023-04162-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 07/11/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND An accurate evaluation of cognitive function, physical health, and psychological health is fundamental for assessing health problems in the elderly population, and it is important to identify the necessity of early therapeutic intervention. The objective of this study was to evaluate the states of mental and physical functions and to investigate the relationships between sociodemographic features and these functions in a community-dwelling elderly population. METHODS This community-based cross-sectional study was conducted in a suburban district of Shanghai, China. A total of 1025 participants aged 60-89 years underwent investigations of demographic and lifestyle features and a multidimensional geriatric evaluation comprising the Montreal Cognitive Assessment (MoCA), Short Physical Performance Battery (SPPB), and Geriatric Depression Scale (GDS). RESULTS The results of the multivariate linear regression models demonstrated that the MoCA and SPPB scores decreased with advancing age (all P < 0.01). However, the GDS score did not exhibit an age-related decrease (P = 0.09). Both sex and living alone influenced the MoCA score (P < 0.01 and P = 0.04, respectively), SPPB score (P < 0.01 and P = 0.04, respectively), and GDS score (P < 0.01 and P < 0.01, respectively). A higher education level was related to better MoCA and SPPB scores (all P < 0.01). Furthermore, age and sex had interactive effects on the MoCA score (P = 0.03) and SPPB score (P < 0.01). The kernel-weighted local polynomial smoothing curves exhibited similar trends. CONCLUSIONS It is imperative to develop a more sensitive evaluation of physical function, and to encourage various intellectually and emotionally stimulating social activity strategies to promote healthy aging, especially in elderly women and those living alone who have a low education level.
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Affiliation(s)
- Peng Zhang
- School of Management, Hainan Medical University, Haikou, Hainan, 571199, China
| | - Nazhakaiti Abudukelimu
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Ayijiamal Sali
- Department of Medicine, Kashgar Vocational and Technical College, Kashgar, Xinjiang Uygur Autonomous Region, 844099, China
| | - Jin-Xia Chen
- Emergency Department, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China
| | - Min Li
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Yan-Yan Mao
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China
| | - Yi Zhu
- Emergency Department, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212000, China.
- School of Clinical Medicine, Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China.
| | - Qian-Xi Zhu
- Shanghai-MOST Key Laboratory of Health and Disease Genomics, NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China.
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Akgül H, Güven AZ, Güven S, Ceylan M. Loneliness, Social Support, Social Trust, and Subjective Wellness in Low-Income Children: A Longitudinal Approach. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1433. [PMID: 37761396 PMCID: PMC10529055 DOI: 10.3390/children10091433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023]
Abstract
The progress and development of society in every sense is possible by raising healthy individuals. To do so, it is necessary to ensure the physical and mental development of children in a healthy way. There are many variables that affect the physical and mental development of children. These variables are affected by individual factors, social structure, social interactions and cultural values. In addition, when these factors interact with each other, their effect on behavior and well-being may increase. Undoubtedly, one of the primary factors negatively affecting a child's physical and psychological development is the adverse economic conditions and hardships experienced by his/her family and consequently, by the child. Increasing poverty hinders children's access to resources, and thus negatively affects their mental health as well as their physical development. Furthermore, positive economic conditions pave the way for an improved environment, better nutrition, higher-quality education, elevated social status, more friends, reduced feelings of loneliness, and increased social support and trust and all of these positively contribute to psychological well-being. Therefore, based on the conviction that early interventions can be protective and screening is needed to determine the proper intervention, this study aims to investigate the relationship between psychological well-being, loneliness, social support and social trust, all of which affect the psychological health of children living in economically disadvantaged families. To this end, answers to the following questions were sought. Is there a significant relationship between the loneliness, social support, social trust and psychological well-being of the children from low-income families? Do the feelings of loneliness, social support and social trust of the children from low-income families significantly predict their psychological well-being?
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Affiliation(s)
- Hanife Akgül
- Faculty of Education, Çanakkale Onsekiz Mart University, Çanakkale 17100, Türkiye; (H.A.); (S.G.)
| | - Ahmet Zeki Güven
- Faculty of Education, Department of Turkish Language Education, Akdeniz University, Antalya 07070, Türkiye
| | - Sibel Güven
- Faculty of Education, Çanakkale Onsekiz Mart University, Çanakkale 17100, Türkiye; (H.A.); (S.G.)
| | - Müyesser Ceylan
- Faculty of Education, Anadolu University, Eskisehir 26470, Türkiye;
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7
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Narendran M, Manjunath R, Murthy MRN. Loneliness, social support networks, mood, and well-being among the community-dwelling elderly, Mysore. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2023. [DOI: 10.4103/injms.injms_94_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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8
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Nicolaisen M, Pripp AH, Thorsen K. Why Not Lonely? A Longitudinal Study of Factors Related to Loneliness and Non-Loneliness in Different Age Groups Among People in the Second Part of Life. Int J Aging Hum Dev 2022:914150221112292. [PMID: 35861808 DOI: 10.1177/00914150221112292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Age-related changes and losses may lead to loneliness. However, some people do not become lonelier, even after negative life events. This study examines the development of loneliness based on Norwegian panel data (N = 2,315), age 40-80 years at baseline, and the impacts of partnership and health measured in 2002, 2007, and 2017. We ask: How does loneliness develop over time, and who resists becoming lonely? In the total group, loneliness decreased from 2002 to 2007 and then leveled off. In the eldest age group, 70-80 years at baseline, loneliness increased but only in the last period, from 2007 to 2017. In all age groups and at all three times, those who were not lonely more often had a partner and were more often in good health compared to those who were lonely. Period effects, cohort, and age-related changes influencing the development in loneliness over time are discussed.
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Affiliation(s)
- Magnhild Nicolaisen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Are Hugo Pripp
- Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Kirsten Thorsen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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Zhang X, Dong S. The relationships between social support and loneliness: A meta-analysis and review. Acta Psychol (Amst) 2022; 227:103616. [PMID: 35576818 DOI: 10.1016/j.actpsy.2022.103616] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 11/26/2022] Open
Abstract
The loneliness of modern people is becoming more and more prominent, and has brought profoundly negative effects on mental health. Social support is an important predictor of loneliness. However, the size of the correlation reported by studies on the relation between social support and loneliness varies greatly. The aim of this meta-analysis is to determine the relation between social support and loneliness. One hundred and seventy-seven articles (N = 113,427) were identified, and robust variance estimation with random effects were used. As expected, higher levels of social support were negatively correlated with loneliness (r = -0.39). The association between social support and loneliness were also moderated by several variables. Specifically, the negative relationship between loneliness and social support among rural populations is stronger than that of urban populations in Chinese samples, the effect of perceived social support (r = -0.45) on loneliness is greater than that of other social supports (r = -0.36), and the friend support (r = -0.48) played a more important role in reducing loneliness than that of two other supports (family support: r = -0.34; significant other support: r = -0.40). The current results support robust links between social support and loneliness, emphasizing the important role of social support in reducing levels of loneliness, this may have some implications for future research and loneliness treatments.
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Yang C, Sun X, Duan W. Widowhood and Life Satisfaction Among Chinese Elderly Adults: The Influences of Lifestyles and Number of Children. Front Public Health 2022; 9:754681. [PMID: 35155332 PMCID: PMC8826226 DOI: 10.3389/fpubh.2021.754681] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022] Open
Abstract
Our study examined how lifestyle and number of children influence the relationship between widowhood and life satisfaction based on self-regulation theory. A sample of 2,968 elderly respondents (male = 1,515, female = 1,453, mean age = 69.12 years, SD = 7.24) participated in Chinese General Social Survey. Our findings suggest that lifestyle is positively related to life satisfaction, and number of children is positively associated with life satisfaction but negatively related to lifestyle. The moderated mediation model demonstrated that lifestyle partly mediated the relationship between widowhood and life satisfaction. Moreover, number of children moderated the relationship between widowhood and lifestyle and between lifestyle and satisfaction with life. Widowed elderly individuals who have more children are likely to show a higher level of satisfaction with life. The present study has significance in practice because it provides empirical implications obtained from a national survey on the universal two-child policy in China as two children might decrease the negative impacts of widowhood on life satisfaction.
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Affiliation(s)
- Caiyun Yang
- School of Philosophy and Law & Political Science, Shanghai Normal University, Shanghai, China
| | - Xixi Sun
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - Wenjie Duan
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
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11
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Solé-Padullés C, Macià D, Andersson M, Stiernstedt M, Pudas S, Düzel S, Zsoldos E, Ebmeier KP, Binnewies J, Drevon CA, Brandmaier AM, Mowinckel AM, Fjell AM, Madsen KS, Baaré WFC, Lindenberger U, Nyberg L, Walhovd KB, Bartrés-Faz D. No Association Between Loneliness, Episodic Memory and Hippocampal Volume Change in Young and Healthy Older Adults: A Longitudinal European Multicenter Study. Front Aging Neurosci 2022; 14:795764. [PMID: 35283753 PMCID: PMC8905540 DOI: 10.3389/fnagi.2022.795764] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background Loneliness is most prevalent during adolescence and late life and has been associated with mental health disorders as well as with cognitive decline during aging. Associations between longitudinal measures of loneliness and verbal episodic memory and brain structure should thus be investigated. Methods We sought to determine associations between loneliness and verbal episodic memory as well as loneliness and hippocampal volume trajectories across three longitudinal cohorts within the Lifebrain Consortium, including children, adolescents (N = 69, age range 10-15 at baseline examination) and older adults (N = 1468 over 60). We also explored putative loneliness correlates of cortical thinning across the entire cortical mantle. Results Loneliness was associated with worsening of verbal episodic memory in one cohort of older adults. Specifically, reporting medium to high levels of loneliness over time was related to significantly increased memory loss at follow-up examinations. The significance of the loneliness-memory change association was lost when eight participants were excluded after having developed dementia in any of the subsequent follow-up assessments. No significant structural brain correlates of loneliness were found, neither hippocampal volume change nor cortical thinning. Conclusion In the present longitudinal European multicenter study, the association between loneliness and episodic memory was mainly driven by individuals exhibiting progressive cognitive decline, which reinforces previous findings associating loneliness with cognitive impairment and dementia.
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Affiliation(s)
- Cristina Solé-Padullés
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain,*Correspondence: Cristina Solé-Padullés,
| | - Dídac Macià
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain,ISGlobal, Hospital Clínic – University of Barcelona, Barcelona, Spain
| | - Micael Andersson
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden,Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - Mikael Stiernstedt
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden,Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - Sara Pudas
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden,Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - Sandra Düzel
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany,Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany
| | - Enikő Zsoldos
- Department of Psychiatry, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Klaus P. Ebmeier
- Department of Psychiatry, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Julia Binnewies
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Christian A. Drevon
- Vitas Ltd., Oslo, Norway,Department of Nutrition, Institute of Basic Medical Sciences, Faculty Medicine, University of Oslo, Oslo, Norway
| | - Andreas M. Brandmaier
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany,Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany
| | - Athanasia M. Mowinckel
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway,Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Anders M. Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway,Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Kathrine Skak Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark,Radiography, Department of Technology, University College Copenhagen, Copenhagen, Denmark
| | - William F. C. Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Ulman Lindenberger
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany,Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany
| | - Lars Nyberg
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden,Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden,Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Kristine B. Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway,Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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Wei K, Yang J, Yang B, Jiang L, Jiang J, Cao X, Li C. Living Preference Modifies the Associations of Living Arrangements With Loneliness Among Community-Dwelling Older Adults. Front Public Health 2022; 9:794141. [PMID: 35127625 PMCID: PMC8814323 DOI: 10.3389/fpubh.2021.794141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
ObjectivesLiving arrangement has been reported to have a significant influence on feelings of loneliness in older adults, but their living preferences may confound the association. This study aimed to investigate whether the associations of living arrangements with loneliness differ in community-dwelling older adults according to different living preferences.MethodsIn the 2008/2009 (baseline) and 2011/2012 (follow-up) waves of the Chinese Longitudinal Healthy Longevity Survey, living arrangements [living with children mainly (LWC), living with spouse only (LWS), and living alone (LA)], living preferences [preferring living with children (PreLWC) and preferring living alone/only with spouse (PreLA)], and feelings of loneliness were assessed. The effect modifications of living preferences in the associations of living arrangements with loneliness were estimated using logistic regression models, and corresponding odds ratios (ORs) were calculated.ResultsLiving preferences significantly modified the associations of living arrangements with loneliness at baseline (p for interaction = 0.009 for LWS and = 0.015 for LA). Compared with LWC, LWS was protective for loneliness only in the PreLA older adults at baseline (OR = 0.53, 95% CI = 0.45–0.64, p < 0.001), and LA was significantly associated with loneliness especially in the PreLWC older adults, compared with their PreLA counterparts (at baseline, ORs = 2.89 vs. 2.15; at follow-up, ORs = 1.68 vs. 1.51).ConclusionLiving preference modifies the associations of living arrangements with loneliness, and those who prefer living with children but live alone are more likely to feel lonely. It is recommended that living preferences should be considered when managing loneliness in community-dwelling older adults.
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Affiliation(s)
- Kai Wei
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, China
| | - Junjie Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bixi Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijuan Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiangling Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyi Cao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Clinical Neurocognitive Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Xinyi Cao
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, China
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Chunbo Li
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Westwood S, Hafford-Letchfield T, Toze M. Physical and mental well-being, risk and protective factors among older lesbians /gay women in the United Kingdom during the initial COVID-19 2020 lockdown. J Women Aging 2021; 34:501-522. [PMID: 34486952 DOI: 10.1080/08952841.2021.1965456] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This article reports on a subset of findings from a recent UK survey of the impact of COVID-19 on older LGBT+ people in the UK. It considers the responses of 149 lesbian/gay women (137 cisgender, 12 trans) to questions relating to physical and mental health and wellbeing. Findings indicate that those women - in couples and singles - who were happy with their living circumstances pre-COVID showed stoicism, adaptability, and determined positivity in response to the pandemic and associated lockdown. Some even reported an improved quality of life, better personal relationships and increased neighborly support. By contrast, those women who were very unhappy with their circumstances prior to COVID-19 - generally women who lived alone and experienced a mismatch between their actual and desired social network - either remained unhappy or became more unhappy, due to its impact on fragile support systems. For trans women, formal support from trans/LGBT+ specific networks - online during COVID lockdown - were central to their wellbeing. Having access to, and being able to use, online technologies were essential to good mental health during lockdown. These findings reaffirm the diversity among older lesbians/gay women as well as highlighting how COVID-19 has acted as a magnifier to their preexisting circumstances. The narratives of those doing well - generally better-networked, intentionally positive and engaged in practices which promote their well-being - may offer insights for supporting those who find their lives more challenging, both during a public health crisis and more generally.
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Çam C, Atay E, Aygar H, Öcal EE, Önsüz MF, Işıklı B, Metintaş S. Elderly people's quality of life in rural areas of Turkey and its relationship with loneliness and sociodemographic characteristics. Psychogeriatrics 2021; 21:795-804. [PMID: 34235795 DOI: 10.1111/psyg.12741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/18/2021] [Accepted: 06/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of the present study was to examine the relationships between loneliness, quality of life and the factors that may be related to the quality of life in individuals ≥65 years old living in rural areas of Turkey. METHODS The World Health Organization Quality of Life Instrument Older Adults Module (WHOQOL OLD) and Loneliness Scale for the Elderly (LSE) was administered to 427 elderly participants. Multiple linear regression was used to determine the variables that affected QOL. RESULTS The results of the multivariate linear regression analyses indicated that gender, marital status, education level, family income status, general health condition, living arrangement, and loneliness level for subdomains were within the predictors. Loneliness level had the strongest negative impact on the four WHOQOL OLD subdomains and total WHOQOL OLD score. It was the most important predictor for autonomy, past present future activities, social participation, death-and-dying, and intimacy subdomains and for the total QOL. CONCLUSIONS Remarkably, a sense of loneliness in the elderly was determined to be the most important factor for predicting their QOL. Loneliness should be considered in attempts to improve QOL for the elderly, interventions to reduce loneliness should specifically target this group, and activities with the potential to increase QOL should be encouraged.
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Affiliation(s)
- Cüneyt Çam
- Department of Public Health, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Emrah Atay
- Department of Public Health, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Hatice Aygar
- Department of Public Health, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Ece E Öcal
- Department of Public Health, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Muhammed F Önsüz
- Department of Public Health, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Burhanettin Işıklı
- Department of Public Health, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Selma Metintaş
- Department of Public Health, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
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15
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Alam MZ. Women outweighed men at life expectancy in Bangladesh: does it mean a better quality of life? Heliyon 2021; 7:e07618. [PMID: 34368483 PMCID: PMC8326742 DOI: 10.1016/j.heliyon.2021.e07618] [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: 12/22/2020] [Revised: 04/22/2021] [Accepted: 07/15/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction Men had a higher life expectancy than women until 2000 in Bangladesh. After 2000, statistics showed that women had a higher life expectancy than men. We aimed to address whether higher life expectancy is a gain or burden (Failures of Success) for older women. Methods We utilised data from Bangladesh Demographic and Health Survey-2011, Health and Morbidity Status Survey-2014, Population and Housing Census-2011, Household Income and Expenditure Survey-2010, and primary data. We calculated and estimated gender-specific different aspects of quality of life. Findings Findings showed that the mean age at marriage was 5.8 years lower for women, while life expectancy was three years higher than men; thus, women were expected to live for 8.8 years alone. Both disabilities and morbidities were higher among women than men; hence they had lower healthy life expectancy. About 53% of women could work daily activities while 8% higher for men. Only 2.4% of women earned while almost 58% for men. Depression and loneliness were also higher among women than men. The value of the active ageing index and quality of life were also lower for women than men. Conclusion This study overall found that there were the Failures of Success especially for older women in Bangladesh, as increasing life expectancies led them to extra years of chronic illness, economic insolvency, more anxiety and depression, and increasing misery. Therefore, sex and gender and their inherent differences should inform decision making to promote gender equity in health. The government and policymakers may intervene for quality of life, especially for women, through reducing gender stereotypes and increasing community engagement. Without considering the quality of life, healthy ageing cannot be ensured.
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Affiliation(s)
- Md Zakiul Alam
- Department of Population Sciences, University of Dhaka, Dhaka 1000, Bangladesh
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16
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Wetzel B, Pryss R, Baumeister H, Edler JS, Gonçalves ASO, Cohrdes C. "How Come You Don't Call Me?" Smartphone Communication App Usage as an Indicator of Loneliness and Social Well-Being across the Adult Lifespan during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6212. [PMID: 34201322 PMCID: PMC8227237 DOI: 10.3390/ijerph18126212] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023]
Abstract
Loneliness and lack of social well-being are associated with adverse health outcomes and have increased during the COVID-19 pandemic. Smartphone communication data have been suggested to help monitor loneliness, but this requires further evidence. We investigated the informative value of smartphone communication app data for predicting subjective loneliness and social well-being in a sample of 364 participants ranging from 18 to 78 years of age (52.2% female; mean age = 42.54, SD = 13.22) derived from the CORONA HEALTH APP study from July to December 2020 in Germany. The participants experienced relatively high levels of loneliness and low social well-being during the time period characterized by the COVID-19 pandemic. Apart from positive associations with phone call use times, smartphone communication app use was associated with social well-being and loneliness only when considering the age of participants. Younger participants with higher use times tended to report less social well-being and higher loneliness, while the opposite association was found for older adults. Thus, the informative value of smartphone communication use time was rather small and became evident only in consideration of age. The results highlight the need for further investigations and the need to address several limitations in order to draw conclusions at the population level.
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Affiliation(s)
- Britta Wetzel
- Mental Health Research Unit, Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (B.W.); (J.-S.E.)
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-University of Würzburg, 97080 Würzburg, Germany;
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, 89081 Ulm, Germany;
| | - Johanna-Sophie Edler
- Mental Health Research Unit, Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (B.W.); (J.-S.E.)
| | | | - Caroline Cohrdes
- Mental Health Research Unit, Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (B.W.); (J.-S.E.)
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Staats K, Grov EK, Husebø BS, Tranvåg O. Dignity of older home-dwelling women nearing end-of-life: Informal caregivers' perception. Nurs Ethics 2021; 28:444-456. [PMID: 33111614 PMCID: PMC8151564 DOI: 10.1177/0969733020956372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Most older people wish to live in the familiar surroundings of their own home until they die. Knowledge concerning dignity and dignity loss of home-dwelling older women living with incurable cancer should be a foundation for quality of care within municipal healthcare services. The informal caregivers of these women can help increase the understanding of sources related to dignity and dignity loss. AIM The aim of this study was to explore informal caregivers' perceptions of sources related to dignity and dignity loss in end-of-life of older home-dwelling women with incurable cancer. RESEARCH DESIGN AND METHOD The study was founded upon Gadamer's philosophical hermeneutics. In-depth interviews with 13 informal caregivers were carried out, and four participant observations were performed during home meetings. ETHICAL CONSIDERATION The study was based on voluntary participation, informed consent, confidentiality and the opportunity to withdraw at any time. The Norwegian Social Science Data Services approved the study. RESULTS Three main sources important in preserving the older women's dignity were identified: maintaining one's self-concept, remaining hopeful and sustaining freedom of choice. We also identified three main sources that lead to dignity loss: Sensing loss of human value, experiencing absence of gentleness and feelings of being treated as an object. DISCUSSION AND FINAL CONSIDERATIONS On the individual level, the opportunity to maintain one's self-concept and control in life, preserved dignity, while feelings of existential loneliness led to dignity loss. On the relational level, being confirmed as worthy human beings promoted the women's dignity, whereas dignity loss was related to uncaring behaviours from healthcare professionals. On the societal level, individual decisions concerning travel situations and the place to stay when nearing end-of-life were of crucial importance. Constituting these women's living space, these perspectives should be emphasized in healthcare professionals' educational training and in the municipal end-of-life care of these patients.
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Affiliation(s)
| | | | | | - Oscar Tranvåg
- 1657Western Norway University of Applied Sciences, Norway; Oslo University Hospital, Norway
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18
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Abstract
Abstract
The amount of financial debt held by older adults has grown substantially over the past two decades in Europe. This study examines the association of objective and subjective debt burden with social and emotional loneliness among 1,606 older adults in the Netherlands. Objective debt burden is based on financial terms, such as debt-to-income ratio; whereas subjective debt burden measures the psychological distress caused by financial debt. Data are from the 2015/2016 wave of the Longitudinal Aging Study Amsterdam. First, we use means-comparison tests to examine whether older adults who experience social and emotional loneliness differ from older adults who do not experience loneliness regarding their subjective and objective debt burdens. Subsequently, using linear regression models we address two questions: whether social loneliness and emotional loneliness are associated with objective and subjective debt burden; and whether social participation, social network size, anxiety and depression mediate these relationships. We find that subjective debt burden (i.e. the worry related to debt) is a significant predictor of social loneliness, above and beyond the role of social and psychological measures. Objective debt burden, in contrast, is unrelated to social and emotional loneliness. Social participation, social network size, anxiety and depression do not mediate the debt-burden-to-loneliness relationships. The results point to the importance of subjective debt burden in understanding social loneliness and designing interventions.
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Shapiro E, Levine L, Kay A. A Jerusalem Synagogue Coping During the Coronavirus Pandemic: Challenges and Opportunities. JOURNAL OF RELIGION AND HEALTH 2021; 60:81-98. [PMID: 33389438 PMCID: PMC7778493 DOI: 10.1007/s10943-020-01131-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 05/22/2023]
Abstract
A diverse Modern Orthodox synagogue in Jerusalem continued to serve its congregants and maintain community despite closures and restrictions during the coronavirus pandemic. Members were surveyed in April 2020. There were minorities of members who were experiencing mental health issues, especially those less acculturated and no one surveyed received any professional mental health help. About a quarter of the members said that regular check-ins were important but some said they were not receiving enough of them. Synagogues can potentially serve as coping resources for congregants both during periods of crisis as well as during regular periods of operation.
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Affiliation(s)
- Ephraim Shapiro
- Department of Health Systems Management, Ariel University, 4 Kiryat Hamada, 40700, Ariel, Israel.
| | - Livia Levine
- Department of Business Management, Jerusalem College of Technology, Jerusalem, Israel
| | - Avi Kay
- Department of Business Management, Jerusalem College of Technology, Jerusalem, Israel
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Srivastava S, Ramanathan M, Dhillon P, Maurya C, Singh SK. Gender Differentials in Prevalence of Loneliness among Older Adults in India: an Analysis from WHO Study on Global AGEing and Adult Health. AGEING INTERNATIONAL 2020. [DOI: 10.1007/s12126-020-09394-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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21
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Motsoeneng M, Modise MA. Grieving widows’ lived experiences in a rural South African setting. JOURNAL OF PSYCHOLOGY IN AFRICA 2020. [DOI: 10.1080/14330237.2020.1767935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Molefi Motsoeneng
- Department of Education and Professional Studies, Central University of Technology, Bloemfontein, South Africa
| | - Motalenyane Alfred Modise
- Department of Education and Professional Studies, Central University of Technology, Bloemfontein, South Africa
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22
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Rochon PA, Mason R, Gurwitz JH. Increasing the visibility of older women in clinical research. Lancet 2020; 395:1530-1532. [PMID: 32416775 DOI: 10.1016/s0140-6736(20)30849-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/01/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Paula A Rochon
- Women's College Research Institute, Women's College Hospital, Toronto, ON M5S 1B2, Canada; Department of Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
| | - Robin Mason
- Women's College Research Institute, Women's College Hospital, Toronto, ON M5S 1B2, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jerry H Gurwitz
- Division of Geriatric Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
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Kojima G, Walters K, Iliffe S, Taniguchi Y, Tamiya N. Marital Status and Risk of Physical Frailty: A Systematic Review and Meta-analysis. J Am Med Dir Assoc 2019; 21:322-330. [PMID: 31740150 DOI: 10.1016/j.jamda.2019.09.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/19/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Community-dwelling older people with mean age ≥60 years. METHODS Systematic literature search using 5 databases was conducted in February 2019 to identify longitudinal and cross-sectional studies examining associations between marital status and Fried's phenotype-based frailty status. Additional studies were searched for by reviewing the reference lists of relevant articles and conducting forward citation tracking of included articles. Odds ratio (OR) of marital status and frailty was pooled using a random-effects meta-analysis. Subgroup analysis and analyses stratified by gender and marital status (married, widowed, divorced or separated, and never married) were completed. RESULTS A total of 1565 studies were found, from which 3 studies with longitudinal data and 35 studies with cross-sectional data were included. Although longitudinal studies suggested that married men had lower frailty risks than unmarried men while married women had higher frailty risks than widowed women, meta-analysis was not possible because of different methodologies. Meta-analyses of cross-sectional data from 35 studies including 80,754 individuals showed that unmarried individuals were almost twice more likely to be frail than married individuals (pooled odds ratio = 1.88, 95% confidence interval = 1.70-2.07). A high degree of heterogeneity was observed (I2 = 69%) and was partially explained by reasons for not being married and study location. Stratified analyses showed that pooled risks of frailty in the unmarried compared with the married were not statistically different between women and women (P for difference = .62). CONCLUSIONS AND IMPLICATIONS Three and 35 studies, respectively, were found providing longitudinal and cross-sectional data regarding associations between marital status and frailty among community-dwelling older people. A meta-analysis of cross-sectional data showed almost twice higher frailty risk in unmarried individuals compared with married individuals. Marital status should be recognized as an important factor, and more longitudinal studies controlling for potential confounding factors are needed.
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Affiliation(s)
- Gotaro Kojima
- Videbimus Toranomon Clinic, Tokyo, Japan; Department of Primary Care and Population Health, University College London, London, UK; Health Services Research & Development Center, University of Tsukuba, Tsukuba, Japan.
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, London, UK
| | - Steve Iliffe
- Department of Primary Care and Population Health, University College London, London, UK
| | - Yu Taniguchi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan
| | - Nanako Tamiya
- Health Services Research & Development Center, University of Tsukuba, Tsukuba, Japan
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Franconi F, Campesi I, Colombo D, Antonini P. Sex-Gender Variable: Methodological Recommendations for Increasing Scientific Value of Clinical Studies. Cells 2019; 8:E476. [PMID: 31109006 PMCID: PMC6562815 DOI: 10.3390/cells8050476] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 02/08/2023] Open
Abstract
There is a clear sex-gender gap in the prevention and occurrence of diseases, and in the outcomes and treatments, which is relevant to women in the majority of cases. Attitudes concerning the enrollment of women in randomized clinical trials have changed over recent years. Despite this change, a gap still exists. This gap is linked to biological factors (sex) and psycho-social, cultural, and environmental factors (gender). These multidimensional, entangled, and interactive factors may influence the pharmacological response. Despite the fact that regulatory authorities recognize the importance of sex and gender, there is a paucity of research focusing on the racial/ethnic, socio-economic, psycho-social, and environmental factors that perpetuate disparities. Research and clinical practice must incorporate all of these factors to arrive at an intersectional and system-scenario perspective. We advocate for scientifically rigorous evaluations of the interplay between sex and gender as key factors in performing clinical trials, which are more adherent to real-life. This review proposes a set of 12 rules to improve clinical research for integrating sex-gender into clinical trials.
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Affiliation(s)
- Flavia Franconi
- Laboratory of Sex-gender Medicine, National Institute of Biostructures and Biosystems, 07100 Sassari, Italy.
| | - Ilaria Campesi
- Laboratory of Sex-gender Medicine, National Institute of Biostructures and Biosystems, 07100 Sassari, Italy.
- Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, 07100 Sassari, Italy.
| | - Delia Colombo
- Value and Access Head, Novartis Italia, 21040 Origgio, Italy.
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Nyqvist F, Nygård M, Scharf T. Loneliness amongst older people in Europe: a comparative study of welfare regimes. Eur J Ageing 2018; 16:133-143. [PMID: 31139028 DOI: 10.1007/s10433-018-0487-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Previous research implies that the extent of welfare state regime provision plays an important indirect role in the prevalence of loneliness in later life. The aim of this study was therefore to assess the association between quality of living conditions and level of social integration indicators and the absence of loneliness in five different welfare regimes. By incorporating welfare state regimes as a proxy for societal-level features, we expanded the micro-level model of loneliness suggesting that besides individual characteristics, welfare state characteristics are also important protective factors against loneliness. The data source was from the European Social Survey round 7, 2014, from which we analysed 11,389 individuals aged 60 and over from 20 countries. The association between quality of living conditions, level of social integration variables and the absence of loneliness was analysed using multivariate logistic regression treating the welfare regime variable as a fixed effect. Our study revealed that the absence of loneliness was strongly associated with individual characteristics of older adults, including self-rated health, household size, feeling of safety, marital status, frequency of being social, as well as number of confidants. Further, the Nordic as well as Anglo-Saxon and Continental welfare regimes performed better than the Southern and Eastern regimes when it comes to the absence of loneliness. Our findings showed that different individual resources were connected to the absence of loneliness in the welfare regimes in different ways. We conclude that older people in the Nordic regime, characterised as a more socially enabling regime, are less dependent on individual resources for loneliness compared to regimes where loneliness is to a greater extent conditioned by family and other social ties.
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Affiliation(s)
- Fredrica Nyqvist
- 1Åbo Akademi University, Faculty of Education and Welfare Studies, Social Policy, Vaasa, Finland
| | - Mikael Nygård
- 1Åbo Akademi University, Faculty of Education and Welfare Studies, Social Policy, Vaasa, Finland
| | - Thomas Scharf
- 2Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
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Bennett KM, Chao Q, Roper L, Lowers V. "The deceased has left; the alive has to move on": Experiences of Chinese Widows in the UK. DEATH STUDIES 2018; 42:498-507. [PMID: 29173041 DOI: 10.1080/07481187.2017.1387617] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Relatively little is known about the experiences of Chinese widows, especially those living outside China. This qualitative study examines the experiences of eight Chinese or Hong Kong-born widows living in the UK. Using a semistructured approach to interviewing, participants were asked about their lives before, during, and after their spousal bereavement. Five major themes emerged: (1) complexity of marital lives; (2) experiences around the time of the death including fate; (3) loneliness and isolation; (4) the challenges of practical tasks; and finally, (5) current life. The implications of the findings for social policy and practice are briefly discussed.
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Affiliation(s)
| | - Qiuling Chao
- b Department of International Cooperation and Exchange , Xi'an Jiaotong University , Xi'an , China
| | - Louise Roper
- a School of Psychology , University of Liverpool , Liverpool , UK
| | - Victoria Lowers
- a School of Psychology , University of Liverpool , Liverpool , UK
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27
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Accepting, active and in control: older women's experiences of ageing with peripheral arterial disease. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x1800065x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThe population of Australia is ageing, with women being the primary beneficiaries of this increase in longevity. Increasingly older individuals are being diagnosed with different chronic illnesses such as peripheral arterial disease (PAD) which causes blockages of the blood vessels in the legs resulting in pain, non-healing ulcers, immobility and the potential amputation of the threatened limb. PAD has been traditionally thought to affect men more than women. Resultingly, women have been under-represented in clinical trials of PAD and under-diagnosed in the health-care setting. However, it has recently been acknowledged that women are indeedmorelikely to suffer from PAD than men due to increased presence of disease and survival advantage. As such, very little is known about women's understanding of and the meaning they create of their experiences of PAD. Therefore, how older women with PAD experience the ageing process is the focus of this qualitative research project. Interviews were conducted with 11 women from Sydney, Australia aged over 65 years who had been diagnosed with PAD. The interviews were analysed using an inductive thematic analysis. Three manifest themes were constructed: independence and control, active and involved, and the acceptance of ageing. These findings emphasised the idea that despite the presence of a chronic illness and increased age, remaining independent and engaged with life was vital to these women's wellbeing. Their subjective experiences of ageing reflect the fact that by adapting to the physical, mental and social changes that come with growing older, the focus does not need to be on loss and decline but rather can be about the continuation of life that can be both positive and meaningful.
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Kitzmüller G, Clancy A, Vaismoradi M, Wegener C, Bondas T. "Trapped in an Empty Waiting Room"-The Existential Human Core of Loneliness in Old Age: A Meta-Synthesis. QUALITATIVE HEALTH RESEARCH 2018; 28:213-230. [PMID: 29235943 DOI: 10.1177/1049732317735079] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Loneliness in old age has a negative influence on quality of life, health, and survival. To understand the phenomenon of loneliness in old age, the voices of lonely older adults should be heard. Therefore, the purpose of this meta-synthesis was to synthesize scientific studies of older adults' experiences of loneliness. Eleven qualitative articles that met the inclusion criteria were analyzed and synthesized according to Noblit and Hare's meta-ethnographic approach. The analysis revealed the overriding meaning of the existential human core of loneliness in old age expressed through the metaphor "trapped in an empty waiting room." Four interwoven themes were found: (a) the negative emotions of loneliness, (b) the loss of meaningful interpersonal relationships, (c) the influence of loneliness on self-perception, and (d) the older adults' endeavors to deal with loneliness. The joint contribution of family members, health care providers, and volunteers is necessary to break the vicious circle of loneliness.
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Affiliation(s)
| | - Anne Clancy
- 2 UiT, The Arctic University of Norway, Harstad, Norway
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The mediating effects of hope and loneliness on the relationship between social support and social well-being in the elderly. ACTA PSYCHOLOGICA SINICA 2018. [DOI: 10.3724/sp.j.1041.2018.01151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Impact of the disability trajectory on the mortality risk of older adults in China. Arch Gerontol Geriatr 2017; 74:174-183. [PMID: 29126080 DOI: 10.1016/j.archger.2017.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 08/27/2017] [Accepted: 10/20/2017] [Indexed: 11/22/2022]
Abstract
Using data from the Chinese Longitudinal Health Longevity Survey of 2005, 2008 and 2011, the authors compared the difference in the disability trajectory (DT) of survivor, decedent and dropped-out survey respondents and examined gender differences in DT using a group-based trajectory model, gender differences in the impact of DT on mortality risk (MR) among older adults, and mediating effects of resources and health status during late life through survival analysis. This analysis shows that the DTs of the survivors, decedents and dropped-out respondents differ remarkably. The trajectories of the decedents generally begin higher and increase more rapidly. Three types of DT exist for both genders: Type 1, the "independent type"; Type 2, the "low start, rapidly increasing in late life type"; and Type 3, the "high start, rapid development type". Women are more likely to experience a DT of functional impairment. Men who experience the Type 3 trajectory suffer the highest MR, followed by those of the Type 1 and Type 2 trajectories. Women who experience the Type 3 trajectory suffer the highest MR, followed by those of the Type 2 and Type 1 trajectories. In addition, economic status, medical treatment, daily care by the family and chronic diseases mediate the impact of DT on MR for both genders, while the mediating effect of emotional support from children was only observed for women.
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Siniscarco MT, Love-Williams C, Burnett-Wolle S. Video Conferencing: An Intervention for Emotional Loneliness in Long-Term Care. ACTIVITIES ADAPTATION & AGING 2017. [DOI: 10.1080/01924788.2017.1326763] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Invisible Voices: An Intersectional Exploration of Quality of Life for Elderly South Asian Immigrant Women in a Canadian Sample. J Cross Cult Gerontol 2017; 32:147-170. [PMID: 28497244 DOI: 10.1007/s10823-017-9315-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kim JI, Son HM. Experiences of Depression in Low Income Elderly Women. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2016; 22:241-253. [PMID: 37684873 DOI: 10.4069/kjwhn.2016.22.4.241] [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: 09/08/2016] [Revised: 11/18/2016] [Accepted: 11/28/2016] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this qualitative research was to understand the meaning of the depression in low income elderly women. METHODS Participants were 15 elderly women, aged between 60 and 80 who were registered in two senior welfare centers in Seoul. Data were collected from June to December, 2012 after having obtained consent from participants. In-depth interviews were done with open-ended questions about their depression experiences, which were audio-taped and transcribed with verbatim. Data were analyzed using qualitative content analysis to discover the categories considering their relationships and abstractness. RESULTS Depressions of aged women were a part of the their life throughout their long lived hardship and was implied unhealed wounds within the relationship. Participants did not know how to manage with depression symptoms that they tried to overcome individually but due to decreased activities and interpersonal relationships, their depressions were tended to continue. They have tried to get out from depressive symptoms, but it still remains unseen shadow of mind. CONCLUSION This results suppose that social support and aged welfare policy included reliving the economical difficulty and improving relationships will be provided to manage the depression for low income elderly women.
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Affiliation(s)
- Jeung Im Kim
- School of Nursing, Soonchunhyang University, Chonan, Korea
| | - Haeng Mi Son
- School of Nursing, Soonchunhyang University, Chonan, Korea
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Shen HW, Perry T. Interdependence between the Social and Material Convoy: Links between Volunteering, Widowhood, and Housing Transitions. SOCIAL WORK RESEARCH 2016; 40:71-82. [PMID: 27257361 PMCID: PMC4886269 DOI: 10.1093/swr/svw002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 07/20/2015] [Accepted: 07/23/2015] [Indexed: 06/05/2023]
Abstract
Relocation in older adulthood may occur due to triggering events, such as widowhood. Guided by Kahn and Antonucci's convoy model, this study explores the influence of volunteering on decision to relocate following the death of a spouse. Using three waves of data from the Health and Retirement Study (2006, 2008, and 2010), 5,146 community-dwelling married older individuals who were 65 years or older in 2008 were included. Findings from two multinomial logistic regression models showed that widows and widowers who were not volunteering in 2008 were more likely to move out of area in 2010 than their married counterparts, whereas the relationship between widowhood and relocation was not detected among those involved in volunteering. This article emphasizes the interdependency of social relationships and residences, a fundamental of one's material convoy, for older adults. Volunteering experiences may not only affect instrumental and emotional support after the loss of a key anchor in one's social convoy, but may also facilitate a widowed older adult to age in place rather than relocate.
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Affiliation(s)
- Huei-Wern Shen
- is assistant professor of social work and gerontology, School of Social Work, University of Missouri-St. Louis, 121 Bellerive Hall, One University Boulevard, St. Louis, MO 63121; is assistant professor, School of Social Work, Wayne State University, Detroit
| | - Tam Perry
- is assistant professor of social work and gerontology, School of Social Work, University of Missouri-St. Louis, 121 Bellerive Hall, One University Boulevard, St. Louis, MO 63121; is assistant professor, School of Social Work, Wayne State University, Detroit
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Abstract
More and more old people live alone, and living alone is reported to be a key risk factor for experiencing loneliness and developing poor health. The purpose of this qualitative study was to explore the experiences of living alone for older men. Systematic text condensation and hermeneutic interpretation were used in analysis of the data. Four themes emerged: lonely at times, missing and longing for a shared life, keeping active, and some kind of freedom. The findings revealed that inner and outer resources come into play and have influence on the processes of managing and solving the situation of living alone. The findings are in accordance with theoretical perspectives on loneliness, aloneness, and solitude. The findings offer nurses in any clinical context valuable information to allow them to address the core emotional and potential mental health issues old men face in coping with the situation of living alone.
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Affiliation(s)
| | - Bodil Tveit
- a VID Specialized University , Faculty of Nursing and Health , Oslo , Norway
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DiGiacomo M, Green A, Rodrigues E, Mulligan K, Davidson PM. Developing a gender-based approach to chronic conditions and women's health: a qualitative investigation of community-dwelling women and service provider perspectives. BMC WOMENS HEALTH 2015; 15:105. [PMID: 26590558 PMCID: PMC4655079 DOI: 10.1186/s12905-015-0264-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 11/18/2015] [Indexed: 11/24/2022]
Abstract
Background Chronic conditions contribute to over 70 % of Australia’s total disease burden, and this is set to increase to 80 % by 2020. Women’s greater longevity means that they are more likely than men to live with disability and have unique health concerns related to their gender based roles in society. Cultural and social issues can impact on women's health and are important to consider in health services planning and research. In this study, we aimed to identify barriers and facilitators to providing a gender-based approach to chronic conditions and women's health in an eastern metropolitan region of Australia. Methods Focus groups were used to engage both community-dwelling women who had chronic conditions and relevant professional stakeholders in the target area. Recorded proceedings underwent thematic analysis. Results Five focus groups were conducted with professional stakeholders and women community members in February and March 2014. Resultant themes included: women’s disempowerment through interactions with health systems; social and economic constraints and caregiving roles act to exclude women from participating in self-care and society; and empowerment can be achieved through integrated models of care that facilitate voice and enable communication and engagement. Conclusions This study underscores the importance of including perspectives of sex and gender in health care services planning. Tailoring services to socio-demographic and cultural groups is critical in promoting access to health care services. Unique epidemiological trends, particularly the ageing of women and new migrant groups, require particular attention.
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Affiliation(s)
- Michelle DiGiacomo
- Faculty of Health, Centre for Cardiovascular and Chronic Care, Broadway, University of Technology Sydney, Sydney, NSW, 2007, Australia.
| | - Anna Green
- Faculty of Health, Centre for Cardiovascular and Chronic Care, Broadway, University of Technology Sydney, Sydney, NSW, 2007, Australia.
| | - Emma Rodrigues
- Illawarra Shoalhaven Local Health District, Women's Health Service, Warrawong, 2502, NSW, Australia.
| | - Kathryn Mulligan
- Illawarra Shoalhaven Local Health District, Women's Health Service, Warrawong, 2502, NSW, Australia.
| | - Patricia M Davidson
- Faculty of Health, Centre for Cardiovascular and Chronic Care, Broadway, University of Technology Sydney, Sydney, NSW, 2007, Australia. .,School of Nursing, Johns Hopkins University, Baltimore, MD, 21205, USA.
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White K, Mackenzie L. Strategies used by older women with intellectual disability to create and maintain their social networks: An exploratory qualitative study. Br J Occup Ther 2015. [DOI: 10.1177/0308022615586419] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Social networks are important to health and wellbeing, and enhancing social networks are key occupations for older people. This is relevant for older people with intellectual disability, particularly older women, who face challenges in building social networks, and their social networks are vulnerable to loss as they age. This study aimed to investigate how older women with intellectual disability create and maintain their social networks. Method This exploratory qualitative study involved conducting in-depth interviews with five women with mild to moderate intellectual disability (as defined by their service organisation) aged over 50 years and living in the community, using the Support Interview Guide, that has previously been used with younger adults with intellectual disability. Participants could communicate in spoken English. Data were coded line by line and analysed using a thematic analysis. Results Participants created social networks independently and through others. Strategies used included communicating, sharing activities, celebrating special occasions, organising activities, supporting each other, having a routine, being out and about and using formal assistance. Barriers and facilitators were also identified. Conclusion As older women with intellectual disability age, occupational therapists and support organisations need to focus on assisting this group to build and maintain their social networks.
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Affiliation(s)
- Katharine White
- Occupational Therapist, Department of Ageing, Disability and Home Care, Burwood, New South Wales, Australia
| | - Lynette Mackenzie
- Associate Professor, The University of Sydney, Lidcombe, New South Wales, Australia
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Chen Y, Hicks A, While AE. Loneliness and social support of older people living alone in a county of Shanghai, China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2014; 22:429-438. [PMID: 24621394 DOI: 10.1111/hsc.12099] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/05/2013] [Indexed: 06/03/2023]
Abstract
China has an ageing population with the number of older people living alone increasing. Living alone may increase the risk of loneliness of older people, especially for those in China where collectivism and filial piety are emphasised. Social support may fill the need for social contacts, thereby alleviating loneliness. However, little is known about loneliness and social support of older people living alone in China. This study investigated loneliness and social support of older people living alone, by conducting a cross-sectional questionnaire survey with a stratified random cluster sample of 521 community-dwelling older people living alone in a county of Shanghai. Data were collected from November 2011 to March 2012. The instruments used included the UCLA Loneliness Scale version 3 and the Social Support Rate Scale. The participants reported a moderate level of loneliness. Their overall social support level was low compared with the Chinese norm. Children were the major source of objective and subjective support. Of the participants, 53.9% (n = 281) and 47.6% (n = 248) asked for help and confided when they were in trouble, but 84.1% (n = 438) never or rarely attended social activities. The level of loneliness and social support differed among the participants with different sociodemographic characteristics. There were negative correlations between loneliness and overall social support and its three dimensions. The findings suggest that there is a need to provide more social support to older people living alone to decrease their feelings of loneliness. Potential interventions include encouraging more frequent contacts from children, the development of one-to-one 'befriending' and group activity programmes together with identification of vulnerable subgroups.
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Affiliation(s)
- Yu Chen
- School of Nursing, Fudan University, Shanghai, China
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Chen Y, Hicks A, While AE. Loneliness and social support of older people in China: a systematic literature review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2014; 22:113-123. [PMID: 23714357 DOI: 10.1111/hsc.12051] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/05/2013] [Indexed: 06/02/2023]
Abstract
Loneliness is a serious problem for older people, which can be alleviated by social support. The dramatic population ageing together with social and economic change in China increases the likelihood of loneliness and the availability of different sources of social support of older people. The aim of this review was to identify the prevalence of loneliness and its related factors and sources of social support of older people in China. Electronic literature searches were conducted in September 2011 using Web of Science, PsycINFO, MEDLINE, PubMed, CINAHL, China Academic Journal and VIP Database for Chinese Technical Periodicals. Twenty-six papers were identified and reviewed. The prevalence of loneliness varied across the studies, reflecting the different measurements and samples. Marital status, gender, age, educational level, economic level, living arrangements, health status and social support were significant factors related to loneliness. The family was the most important source of social support followed by friends. The receipt of family support improved subjective well-being and mental health, but the effects of support from friends were inconsistent. Chinese older people received relatively little support from neighbours, governmental or other social organisations. Further well-designed studies are needed to identify additional factors related to loneliness and to understand the support from friends, neighbours, formal organisations and other sources.
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Affiliation(s)
- Yu Chen
- Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
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Utz RL, Swenson KL, Caserta M, Lund D, deVries B. Feeling lonely versus being alone: loneliness and social support among recently bereaved persons. J Gerontol B Psychol Sci Soc Sci 2013; 69:85-94. [PMID: 24056690 DOI: 10.1093/geronb/gbt075] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES Despite increases in social support following widowhood, loneliness is among the most frequently reported challenges of bereavement. This analysis explores the dynamic relationship between social support and loneliness among recently bereaved older adults. METHODS Using longitudinal data from "Living After Loss" (n = 328), latent growth curve modeling was used to estimate changes in loneliness and social support during the first year and a half of bereavement among older adults aged 50+. RESULTS Both loneliness and social support declined over the first year and a half of bereavement. Greater social support was associated with lower levels of loneliness overall, but the receipt of social support did not modify one's expression of loneliness over time. Loneliness was more highly correlated with support from friends than family. Together, social support from both friends and family accounted for 36% of the total variance in loneliness. DISCUSSION There is conceptual and empirical overlap between the concepts of loneliness and social support, but results suggest that loneliness following widowhood cannot be remedied by interventions aimed only at increasing social support. Social support, especially that from friends, appears to be most effective if it is readily accessible and allows the newly bereaved an opportunity to express him/herself.
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Affiliation(s)
- Rebecca L Utz
- Correspondence should be addressed to Rebecca L. Utz, Department of Sociology, University of Utah, Room No. 301, 380 S 1530 E, Salt Lake City, UT 84112-0250. E-mail:
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Nikmat AW, Hawthorne G, Al-Mashoor SH. The comparison of quality of life among people with mild dementia in nursing home and home care—a preliminary report. DEMENTIA 2013; 14:114-25. [DOI: 10.1177/1471301213494509] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Living arrangements play an important role in determining the quality of life (QoL) of people with dementia. Although informal care (home-based) is favored, the transition to formal (institutional) care often becomes necessary, especially in the later stages of dementia. Nevertheless, there is currently no definitive evidence showing that informal or formal care provides a higher QoL for those with dementia. Objective To compare the QoL of people with dementia in the nursing home and home care, and identify factors that differentiate their QoL. Design and methods This was a cross-sectional survey. A total of 49 people with dementia ≥60 years old were recruited from government nursing homes and hospitals (home care). Consenting participants were assessed on cognitive severity, QoL, activities of daily living (ADLs), depression, and social isolation/connectedness by the Short Mini Mental State Examination (SMMSE), the WHO-8 (the EUROHIS-QOL), Short Assessment of Quality of Life (AQoL-8), Barthel Index (BI), Cornell Scale for Depression (CSDD), and Friendship Scale (FS). Results There were significant differences in QoL, HRQoLs, ADLs, and social connectedness among people with dementia in home care ( n = 19) and those in nursing homes ( n = 30) ( p < 0.01). No significant differences were found by socio-demographic factors, cognitive severity, or depression between the study cohorts. Conclusions Older adults with dementia who were living at home experienced higher QoL, ADLs, and social connectedness compared with those living in institutional care. Support should be provided enabling home care and empowering caregivers to provide better care for people with dementia.
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Lou VWQ, Ng JW. Chinese older adults' resilience to the loneliness of living alone: a qualitative study. Aging Ment Health 2013; 16:1039-46. [PMID: 22690832 DOI: 10.1080/13607863.2012.692764] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate resilience factors that help Chinese older adults living alone cope with senses of loneliness. METHOD Qualitative in-depth interviews were conducted on 13 older adults living alone in the community who did not show severe loneliness. Trained research assistants conducted interviews guided by semi-structured interview guidelines. The analysis followed a five-step interpretive approach. RESULTS The primary theme of resilience was found in cognitive competence, self and personality, and social relations. The secondary theme of resilience showed a family-oriented, relationship-focused resilience coping, which is in line with Chinese culture. CONCLUSION This study demonstrated that family-oriented and relationship-focused resilience at the cognitive, self and personality, and social relations levels played significant roles in helping the Chinese older adults overcome their high risk of loneliness. Developing and maintaining dynamic daily rhythms that can integrate family-oriented and relationship-focused coping strategies at the cognitive and social levels are recommended.
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Affiliation(s)
- Vivian W Q Lou
- Department of Social Work & Social administration, Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong.
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Losada A, Márquez-González M, García-Ortiz L, Gómez-Marcos MA, Fernández-Fernández V, Rodríguez-Sánchez E. Loneliness and Mental Health in a Representative Sample of Community-Dwelling Spanish Older Adults. THE JOURNAL OF PSYCHOLOGY 2012; 146:277-92. [DOI: 10.1080/00223980.2011.582523] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Ben-Zur H. Loneliness, Optimism, and Well-Being Among Married, Divorced, and Widowed Individuals. THE JOURNAL OF PSYCHOLOGY 2012; 146:23-36. [DOI: 10.1080/00223980.2010.548414] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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Davidson PM, DiGiacomo M, McGrath SJ. The Feminization of Aging: How Will This Impact on Health Outcomes and Services? Health Care Women Int 2011; 32:1031-45. [DOI: 10.1080/07399332.2011.610539] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Brownie S, Horstmanshof L. The management of loneliness in aged care residents: an important therapeutic target for gerontological nursing. Geriatr Nurs 2011; 32:318-25. [PMID: 21831481 DOI: 10.1016/j.gerinurse.2011.05.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 05/25/2011] [Accepted: 05/31/2011] [Indexed: 11/16/2022]
Abstract
Social engagement and meaningful relationships are critical determinants of the quality of life of older people. Human beings have an intrinsic need for social connections and an engagement with the social environment. Deficits in the quality of these social relationships lead to feelings of isolation and loneliness in older people. Loneliness can have serious physiological and health implications. It is well established that loneliness is a risk factor for poor physical and mental health, comparable in size to obesity, a sedentary lifestyle and possibly even smoking. The aim of this article is to present an argument for the management of loneliness in aged care residents as an important therapeutic target in gerontological nursing. To date little is known about the effectiveness of intervention strategies designed to alleviate loneliness in aged care residents. Nurses can address this deficit in our understanding by evaluating the impact of loneliness intervention strategies.
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Affiliation(s)
- Sonya Brownie
- ASLaRC Aged Services Unit, School of Health and Human Sciences, Southern Cross University, Lissmore, New South Wales, Australia
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Drageset J, Kirkevold M, Espehaug B. Loneliness and social support among nursing home residents without cognitive impairment: A questionnaire survey. Int J Nurs Stud 2011; 48:611-9. [DOI: 10.1016/j.ijnurstu.2010.09.008] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Revised: 09/08/2010] [Accepted: 09/11/2010] [Indexed: 10/19/2022]
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Golden J, Conroy RM, Bruce I, Denihan A, Greene E, Kirby M, Lawlor BA. Loneliness, social support networks, mood and wellbeing in community-dwelling elderly. Int J Geriatr Psychiatry 2009; 24:694-700. [PMID: 19274642 DOI: 10.1002/gps.2181] [Citation(s) in RCA: 327] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Both loneliness and social networks have been linked with mood and wellbeing. However, few studies have examined these factors simultaneously in community-dwelling participants. The aim of this study was to examine the relationship between social network, loneliness, depression, anxiety and quality of life in community dwelling older people living in Dublin. METHODS One thousand two hundred and ninety-nine people aged 65 and over, recruited through primary care practices, were interviewed in their own homes using the GMS-AGECAT. Social network was assessed using Wenger's typology. RESULTS 35% of participants were lonely, with 9% describing it as painful and 6% as intrusive. Similarly, 34% had a non-integrated social network. However, the two constructs were distinct: 32% of participants with an integrated social network reported being lonely. Loneliness was higher in women, the widowed and those with physical disability and increased with age, but when age-related variables were controlled for this association was non-significant. Wellbeing, depressed mood and hopelessness were all independently associated with both loneliness and non-integrated social network. In particular, loneliness explained the excess risk of depression in the widowed. The population attributable risk (PAR) associated with loneliness was 61%, compared with 19% for non-integrated social network. Taken together they had a PAR of 70% CONCLUSIONS Loneliness and social networks both independently affect mood and wellbeing in the elderly, underlying a very significant proportion of depressed mood.
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