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Liang J, Aranda MP, Jang Y, Wilber K. The Role of Social Isolation on Mediating Depression and Anxiety among Primary Family Caregivers of Older Adults: A Two-Wave Mediation Analysis. Int J Behav Med 2024; 31:445-458. [PMID: 37878186 PMCID: PMC11043211 DOI: 10.1007/s12529-023-10227-5] [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] [Accepted: 10/04/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Primary family caregivers of older people with chronic care conditions are highly vulnerable to social isolation and psychological strains such as depression and anxiety due to their demanding responsibilities. This study examines how social isolation mediates the relationship between caregiving stress and mental health symptoms of primary family caregivers. METHODS The analytic sample included 881 primary caregivers of older adults from the 2015 and 2017 National Study of Caregiving (NSOC). Social isolation was measured using a composite structure that includes objective social disconnectedness and subjective loneliness. Two-wave mediation models were estimated to examine longitudinally if social isolation mediated the relationship between caregiving stress (subjective & objective stress) and mental health symptoms (depression & anxiety) of primary caregivers. RESULTS The study findings indicate that both subjective (β = 0.32, p < 0.001) and objective stress (β = 0.21, p = 0.003) have direct effects on depression among primary caregivers. Social isolation was found to only mediate the relationship between objective stress and depression (β = 0.18, p < 0.001). In contrast, no significant direct and indirect pathway was found in the anxiety model. CONCLUSIONS The study demonstrates the internal mechanism where objective strains of caregiving make family caregivers socially isolated, which in turn leads to increased symptoms of depression. Future interventions and practices aimed at improving the psychological well-being of family caregivers should prioritize strategies aimed at increasing social engagement, particularly for those with heavy caregiver burdens.
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Affiliation(s)
- Jiaming Liang
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA.
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, USA.
| | - Maria P Aranda
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, USA
| | - Yuri Jang
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, USA
- Department of Social Welfare, Ewha Womans University, Seoul, Republic of Korea
| | - Kathleen Wilber
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, USA
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Campbell C, Walker J. Informal caregiving and the risk of material hardship in the United States. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1701-e1710. [PMID: 34617649 DOI: 10.1111/hsc.13597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/19/2021] [Accepted: 09/26/2021] [Indexed: 06/13/2023]
Abstract
Millions of people in the United States provide unpaid care to family and friends with long-term illnesses and disabilities. Research shows that informal caregiving can be beneficial for recipients of care, but taxing for those providing care. Studies have not explored associations between informal caregiving and the risk of experiencing different forms of material hardship. In this study, we use data from the Survey of Income and Program Participation (N = 31,633) to address this gap in the literature. The sample was drawn from a multistage-stratified sample of the civilian, non-institutionalised population of the United States. We analyse data that were collected in 2011 and find that providing informal care to others is associated with an increased risk of experiencing healthcare hardship, bill-paying hardship and food insecurity. Moreover, we find that household financial resources mediate the association between caregiving and material hardship. As a result, while caregiving households face a higher risk of experiencing material hardships at all income levels, the disparity is largest at low incomes and smallest at high incomes. The findings highlight the need for a stronger safety net for informal caregivers.
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Affiliation(s)
- Colin Campbell
- Department of Sociology, East Carolina University, Greenville, North Carolina, USA
| | - Jasmine Walker
- Department of Sociology, East Carolina University, Greenville, North Carolina, USA
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Hajek A, Brettschneider C, Mallon T, Kaduszkiewicz H, Oey A, Wiese B, Weyerer S, Werle J, Pentzek M, Fuchs A, Conrad I, Luppa M, Weeg D, Mösch E, Kleineidam L, Wagner M, Scherer M, Maier W, Riedel-Heller SG, König HH. Social support and health-related quality of life among the oldest old - longitudinal evidence from the multicenter prospective AgeCoDe-AgeQualiDe study. Qual Life Res 2021; 31:1667-1676. [PMID: 34939147 PMCID: PMC9098616 DOI: 10.1007/s11136-021-03070-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to examine the longitudinal within-association between social support and health-related quality of life among the oldest old. METHODS Longitudinal data (follow-up waves 7 to 9) were used from the multicenter prospective cohort study "Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85 +)" (AgeQualiDe). n = 648 individuals were included in the analytical sample. At FU wave 7, mean age was 88.8 years (SD: 2.9 years, from 85 to 99 years). Social support was quantified using the Lubben Social Network Scale (6-item version). Health-related quality of life was assessed using the EQ-5D-3L including problems in five health dimensions, and its visual analogue scale (EQ VAS). It was adjusted for several covariates in conditional logistic and linear fixed effects regressions. RESULTS Intraindividual decreases in social support were associated with an increased likelihood of developing problems in 'self-care', 'usual activities', 'pain/discomfort' and 'anxiety/depression' (within individuals over time). In contrast, intraindividual changes in social support were not associated with intraindividual changes in the EQ VAS score. CONCLUSION Findings indicate a longitudinal intraindividual association between social support and problems, but only in some health dimensions. Further research in this area based on longitudinal studies among the oldest old (from different countries) is required.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tina Mallon
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hanna Kaduszkiewicz
- Institute of General Practice, Faculty of Medicine, Kiel University, Kiel, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Siegfried Weyerer
- Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kataria G, Dhyani K, Patel D, Srinivasan K, Malwade S, Syed Abdul S. The smart pill sticker: Introducing a smart pill management system based on touch-point technology. Health Informatics J 2021; 27:14604582211052848. [PMID: 34894833 DOI: 10.1177/14604582211052848] [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
Older adults tend to suffer from multi-morbidity, requiring complex treatment methodologies demanding poly-pharmacy. The increasing medication usage can tend towards the mismanagement of prescriptions and irregular or faulty administration. Thus, there arises an urgent need for a proper pill management system for these prescribed medicines. To tackle this grave concern, we propose a mobile, cost-effective, robust, and easy to use solution involving the extension to the human body-smartphones and conductive stickers. The technology utilizes a unique combination of touch-points on the smartphone screen to recognize the medication and give information regarding the proper usage and dosage and gives a reminder of the intake of the medicine. Our tool is comprised of two components-(1) the conductive ink stickers containing a unique combination of conductive inks to be applied to the pill container and (2) the mobile application utilizing touch-points generated by the conductive ink sticker to give information of the corresponding medicine. The following functionalities could be performed by the application-detection of pill container: providing essential information about pill container and dosage; keeping a count of pills already taken, to be taken and remaining pills; reordering the medication and reminding about the medicine intake at the correct designated time.
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Affiliation(s)
- Garvit Kataria
- School of Information Technology and Engineering, 30026Vellore Institute of Technology (VIT), Vellore, India
| | - Kshitij Dhyani
- School of Information Technology and Engineering, 30026Vellore Institute of Technology (VIT), Vellore, India
| | - Darsh Patel
- School of Computer Science and Engineering, 30026Vellore Institute of Technology (VIT), Vellore, India
| | - Kathiravan Srinivasan
- School of Computer Science and Engineering, 30026Vellore Institute of Technology (VIT), Vellore, India
| | - Shwetambara Malwade
- International Center for Health Information Technology (ICHIT), College of Medical Science and Technology, 38032Taipei Medical University, Taipei, Taiwan
| | - Shabbir Syed Abdul
- International Center for Health Information Technology (ICHIT), College of Medical Science and Technology, 38032Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Biomedical Informatics, College of Medical Sciences and Technology, 38032Taipei Medical University, Taipei, Taiwan.,School of Gerontology Health Management, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
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Wettstein M, Werner-Wahl H, Spuling SM. Nine-year changes in self-reported problems with vision and hearing among older adults: do subjective age views matter? Aging Ment Health 2021; 25:2200-2212. [PMID: 32985229 DOI: 10.1080/13607863.2020.1822290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES So far, little is known about linkages between subjective age views and long-term changes in vision and hearing. METHOD We examined the predictive role of two key measures of subjective age views (attitude toward own aging [ATOA]; aging-related cognitions comprising continuous growth, social loss, and physical decline) for changes in self-reported problems with vision and hearing over a period of up to 9 years. A subsample of the German Ageing Survey was used, consisting of 2,499 older adults. RESULTS Controlling for socio-demographic characteristics, self-rated health, and depressive symptoms, we found that with increasing age, more favorable ATOA scores, as well as higher scores on continuous growth and lower scores on physical decline, were associated with fewer self-reported vision problems at baseline. With advancing age, more favorable ATOA scores were also related with fewer hearing problems at baseline. However, among individuals with an older baseline age, more favorable ATOA scores were associated with a steeper increase in vision problems. Higher scores on continuous growth were related with less increase in hearing problems, independent of age. CONCLUSION Our findings suggest that subjective age views predict individuals' self-reported vision and hearing problems.
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Affiliation(s)
| | - Hans- Werner-Wahl
- Department of Psychological Ageing Research, Institute of Psychology, Heidelberg University, Heidelberg, Germany
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Informal Caregiving, Loneliness and Social Isolation: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212101. [PMID: 34831857 PMCID: PMC8618455 DOI: 10.3390/ijerph182212101] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/22/2022]
Abstract
Background: Several empirical studies have shown an association between informal caregiving for adults and loneliness or social isolation. Nevertheless, a systematic review is lacking synthesizing studies which have investigated these aforementioned associations. Therefore, our purpose was to give an overview of the existing evidence from observational studies. Materials and Methods: Three electronic databases (Medline, PsycINFO, CINAHL) were searched in June 2021. Observational studies investigating the association between informal caregiving for adults and loneliness or social isolation were included. In contrast, studies examining grandchild care or private care for chronically ill children were excluded. Data extractions covered study design, assessment of informal caregiving, loneliness and social isolation, the characteristics of the sample, the analytical approach and key findings. Study quality was assessed based on the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Each step (study selection, data extraction and evaluation of study quality) was conducted by two reviewers. Results: In sum, twelve studies were included in our review (seven cross-sectional studies and five longitudinal studies)—all included studies were either from North America or Europe. The studies mainly showed an association between providing informal care and higher loneliness levels. The overall study quality was fair to good. Conclusion: Our systematic review mainly identified associations between providing informal care and higher loneliness levels. This is of great importance in assisting informal caregivers in avoiding loneliness, since it is associated with subsequent morbidity and mortality. Moreover, high loneliness levels of informal caregivers may have adverse consequences for informal care recipients.
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Saad O, Zysberg L, Heinik J, Ben-Itzhak R, Zisberg A. A conceptual model for achieving well-being in adults with mild cognitive impairment. Geriatr Nurs 2021; 42:1467-1473. [PMID: 34670178 DOI: 10.1016/j.gerinurse.2021.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Low well-being is common among people with Mild Cognitive Impairment (MCI). We propose a model to examine how different types of resources work together to maintain well-being in people with MCI. METHODS Participants included 121 community dwelling adults over the age of 60 who were diagnosed with MCI. Structural equation modeling assessed suggested relationships between resources and well-being. RESULTS Emotional intelligence, general mental ability, morbidity, economic status, basic activities of daily living, and age were correlated to well-being in a triple mediation process through cognitive function, instrumental activities of daily living, and social support. Model fit was excellent (RMSEA-0.04; IFI-.96; CFI-.96; CMIN/DF-1.23), CONCLUSION: Achieving well-being when coping with MCI requires a combination of objective resources and subjective evaluation of the situation. Ultimately, social support determines an individual's level of well-being. Findings suggest the need to understand what kind of social support is required by those coping with MCI.
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Affiliation(s)
- Odelyah Saad
- JCT-Jerusalem College of Technology-Lev Academic Center Israel; The Cheryl Spencer Department of Nursing Faculty of Social Welfare and Health Science, University of Haifa, Israel, Haifa, Israel.
| | | | - Jeremia Heinik
- Academic Center for Continuing Medical Education, Sackler Faculty of Medicine, Tel Aviv University
| | - Ron Ben-Itzhak
- Geriatric Service, Sorasky Medical Center, Ichilov Israel
| | - Anna Zisberg
- The Cheryl Spencer Department of Nursing Faculty of Social Welfare and Health Science, University of Haifa, Israel, Haifa, Israel
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