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Kang JW, Oremus M, Dubin J, Tyas SL, Oga-Omenka C, Golberg M. Exploring the differential impacts of social isolation, loneliness, and their combination on the memory of an aging population: A 6-year longitudinal study of the CLSA. Arch Gerontol Geriatr 2024; 125:105483. [PMID: 38788370 DOI: 10.1016/j.archger.2024.105483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024]
Abstract
Memory plays a crucial role in cognitive health. Social isolation (SI) and loneliness (LON) are recognized risk factors for global cognition, although their combined effects on memory have been understudied in the literature. This study used three waves of data over six years from the Canadian Longitudinal Study on Aging to examine whether SI and LON are individually and jointly associated with memory in community-dwelling middle-aged and older adults (n = 14,208). LON was assessed with the question: "In the last week, how often did you feel lonely?". SI was measured using an index based on marital/cohabiting status, retirement status, social activity participation, and social network contacts. Memory was evaluated with combined z-scores from two administrations of the Rey Auditory Verbal Learning Test (immediate-recall, delayed-recall). We conducted our analyses using all available data across the three timepoints and retained participants with missing covariate data. Linear mixed models were used to regress combined memory scores onto SI and LON, adjusting for sociodemographic, health, functional ability, and lifestyle variables. Experiencing both SI and LON had the greatest inverse effect on memory (least-squares mean: -0.80 [95 % confidence-interval: -1.22, -0.39]), followed by LON alone (-0.73 [-1.13, -0.34]), then SI alone (-0.69 [-1.09, -0.29]), and lastly by being neither lonely nor isolated (-0.65 [-1.05, -0.25]). Sensitivity analyses confirmed this hierarchy of effects. Policies developed to enhance memory in middle-aged and older adults might achieve greater benefits when targeting the alleviation of both SI and LON rather than one or the other individually.
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Affiliation(s)
- Ji Won Kang
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Mark Oremus
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Joel Dubin
- Statistics and Actuarial Science, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Suzanne L Tyas
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Charity Oga-Omenka
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Meira Golberg
- Statistics and Actuarial Science, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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McVeigh KS, Mehl MR, Polsinelli AJ, Moseley SA, Sbarra DA, Glisky EL, Grilli MD. Loneliness and social isolation are not associated with executive functioning in a cross-sectional study of cognitively healthy older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:777-794. [PMID: 37865921 DOI: 10.1080/13825585.2023.2270208] [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: 12/16/2022] [Accepted: 10/06/2023] [Indexed: 10/24/2023]
Abstract
The literature on the relationship between social interaction and executive functions (EF) in older age is mixed, perhaps stemming from differences in EF measures and the conceptualization/measurement of social interaction. We investigated the relationship between social interaction and EF in 102 cognitively unimpaired older adults (ages 65-90). Participants received an EF battery to measure working memory, inhibition, shifting, and global EF. We measured loneliness subjectively through survey and social isolation objectively through naturalistic observation. Loneliness was not significantly related to any EF measure (p-values = .13-.65), nor was social isolation (p-values = .11-.69). Bayes factors indicated moderate to extremely strong evidence (BF01 = 8.70 to BF01 = 119.49) in support of no relationship.. Overall, these findings suggest that, among cognitively healthy older adults, there may not be a robust cross-sectional relationship between EF and subjective loneliness or objective social isolation.
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Affiliation(s)
- Katelyn S McVeigh
- Human Memory Lab, Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Matthias R Mehl
- Naturalistic Observation of Social Interaction Laboratory, Department of Psychology, Tucson, AZ, USA
| | - Angelina J Polsinelli
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - David A Sbarra
- Laboratory for Social Connectedness and Health, Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Elizabeth L Glisky
- Aging and Cognition Laboratory, Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Matthew D Grilli
- Human Memory Lab, Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Neurology, University of Arizona, Tucson, AZ, USA
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Hungerford C, Bernoth M, Channell P, Blanchard D. Overcoming Loneliness: Is There a Role for Mental Health Nurses? Issues Ment Health Nurs 2024:1-4. [PMID: 38901006 DOI: 10.1080/01612840.2024.2357156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Affiliation(s)
- Catherine Hungerford
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Maree Bernoth
- Faculty of Science and Health, Charles Sturt University, NSW, Australia
| | - Patricia Channell
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Sunshine Coast, QLD, Australia, Australia
| | - Denise Blanchard
- School of Nursing and Midwifery, University of Newcastle, Gosford, NSW, Australia
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Ohta R, Yakabe T, Adachi H, Sano C. Linking Agricultural Activity Frequency to Loneliness in Rural Hospital Patients: A Cross-Sectional Study. Cureus 2024; 16:e59909. [PMID: 38854219 PMCID: PMC11161130 DOI: 10.7759/cureus.59909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction Agriculture is deeply woven into the fabric of rural life, influencing the economy, and the social and health dynamics of rural communities. While it offers physical and mental health benefits through regular physical activity and interaction with nature, the solitary nature of farming activities may also lead to social isolation. This study explores the complex relationship between the frequency of agricultural engagement and feelings of loneliness among rural inhabitants with chronic diseases, addressing a gap in the literature concerning the impact of agricultural practices on social well-being. Method A cross-sectional analysis was conducted among patients over 40 who frequented the general medicine department in Unnan City, a rural area of Japan. The study utilized the Japanese version of the University of California, Los Angeles (UCLA) Loneliness Scale to assess loneliness and collected data on agricultural activity frequency through questionnaires. Multivariate logistic regression analyses examined the association between agricultural activities and loneliness, controlling for demographic and health-related variables. Results Among 647 participants, higher frequencies of agricultural activities were significantly associated with increased loneliness, especially for individuals engaging in agriculture four to five times weekly or daily. Engaging in agricultural activities four to five times weekly and daily significantly increased the likelihood of higher loneliness levels, with odds ratios (OR) of 1.80 (p = 0.039) and 2.47 (p < 0.01), respectively, when compared to engagement less than once a week. Age emerged as an influential factor, with individuals aged 75 and older showing increased odds of experiencing higher loneliness (OR 1.56, p = 0.025). Conclusion The study underscores the dual nature of agricultural engagement in rural communities, highlighting its role in both supporting physical health and contributing to social isolation. These findings advocate for developing targeted interventions that mitigate loneliness among rural populations, suggesting the need for a balanced approach that encompasses social and healthcare strategies to enhance the overall well-being of individuals engaged in agriculture.
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Affiliation(s)
| | | | | | - Chiaki Sano
- Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN
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Liao X, Wang Z, Zeng Q, Zeng Y. Loneliness and social isolation among informal carers of individuals with dementia: A systematic review and meta-analysis. Int J Geriatr Psychiatry 2024; 39:e6101. [PMID: 38752797 DOI: 10.1002/gps.6101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/03/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. METHODS We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta-analysis. Subgroup analyses and meta-regression were employed to explore potential moderating variables and heterogeneity. RESULTS The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%-59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%-47.6%). Subgroup analyses and meta-regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. CONCLUSIONS This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population.
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Affiliation(s)
- Xinqi Liao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhong Wang
- Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Qinglin Zeng
- Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Yanli Zeng
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Yoo-Jeong M, Nguyen AL. Combined effects of social isolation and loneliness on patient-reported outcomes in older adults with HIV. AIDS Care 2024:1-8. [PMID: 38691674 DOI: 10.1080/09540121.2024.2339046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 03/26/2024] [Indexed: 05/03/2024]
Abstract
Social isolation exists when one has limited contact with others and is distinct from loneliness, an affective state on the perception of isolation. Less is known about the combined effects of social isolation and loneliness (SI/L) in older persons with HIV (OPWH). Using cross-sectional data on OPWH (age ≥50; N = 146), we assessed the overlap between SI/L and the separate and combined effects of SI/L on patient-reported outcomes (quality-of-life [QoL], HIV-related stigma, and depressive symptoms). Social isolation and loneliness were assessed using Social Network Index and the PROMIS-Social Isolation Scale, respectively, and based on each score, participants were grouped into four categories: "lonely only", "isolated only", "lonely+isolated", or "neither". Among participants (mean age = 56.53), 26.7% were considered "lonely only", 12.3% were "isolated only", 15.1% were "lonely+isolated", and 45.9% were "neither". Adjusted regression models showed that lonely+isolated group had more depressive symptoms and lower QoL than those considered "neither" or "isolated only" (p < .001) and that. The adjusted proportional odds model showed that the odds of stigma were 1.22 and 6.06 higher than those considered "neither" (p < .001) or "lonely only" (p = .016). Results demonstrate the combined effects of SI/L on patient-reported outcomes among OPWH. Findings highlight the need for approaches targeting OPWH who are lonely and isolated.
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Affiliation(s)
- Moka Yoo-Jeong
- Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, MA, USA
| | - Annie L Nguyen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
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Huijie Z, Haojun J, Zhiping Z, Zhaoyu Y. Association between residential environment and emotional wellbeing among older adults in China: the mediating effect of health lifestyle. Front Public Health 2024; 12:1338079. [PMID: 38699418 PMCID: PMC11063323 DOI: 10.3389/fpubh.2024.1338079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/13/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction The association between the residential environment and emotional wellbeing (EWB) in older adults has received extensive attention from gerontologists, especially during the COVID-19 pandemic; however, the mediating mechanism of how residential environment affects emotional wellbeing has not been fully explored. This study examined the effects of the residential environment on EWB and the mediating role of health lifestyle. Methods This study analyzed the survey data of 493 rural and 515 urban older adults from 2021 Chinese General Social Survey. General linear regression and structural equation models were used to examine the effects of residential environment and health lifestyle. Results Urban participants exhibited clear advantages in EWB, residential environment, and physical activity. Residential environment significantly affected the EWB of older adults, and health lifestyle played a mediating role in this relationship. The residential environment and health lifestyle did not significantly affect EWB in rural participants. Discussion This study revealed differences in the effects of health lifestyles and residential environments on EWB among older adults in rural and urban settings in China. This study provided empirical evidence of mental health disparities between older rural and urban Chinese residents.
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Affiliation(s)
- Zhu Huijie
- College of Humanities and Social Development, Nanjing Agricultural University, Nanjing, China
- Center for Social Research, Nanjing Agricultural University, Nanjing, China
- Jin Shanbao Institute for Agricultural and Rural Development Research Institute, Nanjing, China
| | - Jiang Haojun
- Tourism and Social Management College, Nanjing Xiaozhuang University, Nanjing, China
| | - Zhu Zhiping
- College of Humanities and Social Development, Nanjing Agricultural University, Nanjing, China
| | - Yao Zhaoyu
- College of Humanities and Social Development, Nanjing Agricultural University, Nanjing, China
- Jin Shanbao Institute for Agricultural and Rural Development Research Institute, Nanjing, China
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8
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Wang S, Reaves S, Newman M, Castaneda S, Emery-Tiburcio E. CATCH-ON Connect: a tablet intervention to address social isolation and loneliness. Aging Ment Health 2024; 28:633-637. [PMID: 37278693 DOI: 10.1080/13607863.2023.2217501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/16/2023] [Indexed: 06/07/2023]
Abstract
Technology can aid in alleviating social isolation and loneliness among older adults, however some older adults lack the knowledge and necessary skills to use the technology. OBJECTIVES The purpose of this study was to examine the impact of CATCH-ON Connect, a cellular enabled tablet technical assistance program, on social isolation and loneliness among older adults. METHODS This is a single-group pre-post program evaluation of the CATCH-ON Connect program. RESULTS While there was no statistically significant change in social isolation, older adult participants reported significantly lower levels of loneliness following intervention. CONCLUSION This project demonstrates that tablet programs with technical assistance may benefit older adults. Further investigation is warranted to determine the impact of the internet access itself, the technical assistance, or both.
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Affiliation(s)
- Siqi Wang
- Rush University Medical Center, Chicago, IL, USA
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9
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Elias C, Nunes MC, Saadatian-Elahi M. Epidemiology of community-acquired pneumonia caused by S treptococcus pneumoniae in older adults: a narrative review. Curr Opin Infect Dis 2024; 37:144-153. [PMID: 38323404 DOI: 10.1097/qco.0000000000001005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
PURPOSE OF REVIEW This review covers updated perspectives on different aspects of pneumococcal community-acquired pneumonia (pCAP), including the epidemiology, clinical presentation, risk factors, antibiotic treatment, and existing preventive strategies in older adults. RECENT FINDINGS pCAP remains the most prevalent condition among lower respiratory tract infections in the older adults according to Global Burden of Diseases 2019. Older adults can display atypical symptoms such as confusion, general clinical deterioration, new onset of and exacerbation of underlying illness that might trigger clinical suspicion of pCAP. Older adults with pCAP often experience increased disease severity and a higher risk of pulmonary complications compared with younger individuals, owing to age-related changes in immunity and a higher prevalence of comorbidities. Vaccination stands fundamental for prevention, emphasizing the need for effective immunization strategies, specifically tailored for older adults. There is a pressing need to reinforce efforts aimed at boosting pneumococcal vaccination rates. SUMMARY Despite a high morbidity and mortality, the burden of pCAP, in particular hospital admission and occurrence of invasive infections, among the elderly population is not sufficiently documented. This review findings emphasize the substantial burden of pCAP in this vulnerable population, driven by factors such as advancing age and underlying comorbidities. The emergence of antibiotic-resistant pneumococcal strains further complicates treatment decisions and highlights the importance of tailored approaches for managing pCAP in older adults.
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Affiliation(s)
- Christelle Elias
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon
- Équipe Santé Publique, Epidémiologie et Eco-évolution des Maladies Infectieuses (PHE ID), Centre International de Recherche en Infectiologie (CIRI), Université de Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon
| | - Marta C Nunes
- Équipe Santé Publique, Epidémiologie et Eco-évolution des Maladies Infectieuses (PHE ID), Centre International de Recherche en Infectiologie (CIRI), Université de Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon, Lyon, France
- South African Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mitra Saadatian-Elahi
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon
- Équipe Santé Publique, Epidémiologie et Eco-évolution des Maladies Infectieuses (PHE ID), Centre International de Recherche en Infectiologie (CIRI), Université de Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon
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Tanabe K, Sugawara Y, Sakurai E, Motomura Y, Okada Y, Tsukao A, Kuno S. Impact of subjective well-being on physical frailty in middle-aged and elderly Japanese with high social isolation. PLoS One 2024; 19:e0297837. [PMID: 38408094 PMCID: PMC10896516 DOI: 10.1371/journal.pone.0297837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 01/13/2024] [Indexed: 02/28/2024] Open
Abstract
Social isolation exacerbates physical frailty and is associated with subjective well-being. Even those with high levels of social isolation may have different health statuses depending on the type of isolation and their subjective well-being. However, the effect of subjective well-being on the relationship between social isolation and physical frailty remains unclear. This study examined whether the risk of physical frailty was the same for individuals with social isolation according to high and low subjective well-being. The study participants included 1,953 middle-aged Japanese adults aged 45 years and older. Physical frailty was assessed using a modified version of the Fried phenotype criteria. Probabilistic Latent Semantic Analysis was used to classify participants according to social isolation indicators. Subsequently, we focused on the groups with high social isolation and classified them according to whether their subjective well-being was high or low. Subjective well-being was evaluated using the Shiawase and Ikigai scales, which are concepts used in Japan. Finally, we used survival time analysis to examine the relationship between Shiawase or Ikigai and physical frailty in groups with high social isolation. The participants were classified into four groups based on their social isolation status. The physical frailty rate of the high social isolation class was 37.0%, which was significantly higher than that of the other classes. Survival time analysis revealed that among people with high social isolation, those with high Shiawase and Ikigai had a significantly lower risk of physical frailty than those with low Shiawase and Ikigai. All individuals with high social isolation are not at a high risk of physical frailty. The findings reveal that even those with high level of social isolation may have a lower risk of physical frailty if their subjective well-being is high. These results will contribute to promoting the prevention of frailty in middle-aged and older adults.
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Affiliation(s)
- Kai Tanabe
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
- R&D Center for Smart Wellness City Policies, University of Tsukuba, Tsukuba, Japan
| | - Yuki Sugawara
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
- Degree Programs in Systems and Information Engineering, Graduate School of Science and Technology, University of Tsukuba, Tsukuba, Japan
| | - Eiichi Sakurai
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Yoichi Motomura
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Yukihiko Okada
- Faculty of Systems and Information Engineering, University of Tsukuba, Tsukuba, Japan
- Center for Artificial Intelligence Research, University of Tsukuba, Tsukuba, Japan
| | - Akiko Tsukao
- Tsukuba Wellness Research Co., Ltd., Chiba, Japan
| | - Shinya Kuno
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
- R&D Center for Smart Wellness City Policies, University of Tsukuba, Tsukuba, Japan
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Chiu CJ, Hou SY, Wang CL, Tang HH, Kuo PC, Liang SF, Kuo PF. The middle-aged and older Chinese adults' health using actigraphy in Taiwan (MOCHA-T): protocol for a multidimensional dataset of health and lifestyle. BMC Public Health 2024; 24:87. [PMID: 38178012 PMCID: PMC10765675 DOI: 10.1186/s12889-023-17552-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Older adults keep transforming with Baby Boomers and Gen Xers being the leading older population. Their lifestyle, however, is not well understood. The middle-aged and older Chinese adults' health using actigraphy in Taiwan (MOCHA-T) collected both objective and subjective data to depict the health and lifestyle of this population. The objectives, design, and measures of the MOCHA-T study are introduced, and the caveats and future directions related to the use of the data are presented. METHODS People aged 50 and over were recruited from the community, with a subset of women aged 45-49 invited to supplement data on menopause and aging. Four instruments (i.e., self-reported questionnaires, diary, wrist actigraphy recorder, and GPS) were used to collect measures of sociodemographic, health, psychosocial, behavioral, temporal, and spatial data. RESULTS A total of 242 participants who returned the informed consent and questionnaires were recruited in the MOCHA-T study. Among them, 94.6%, 95.0%, and 25.2% also completed the diary, actigraphy, and GPS data, respectively. There was almost no difference in sociodemographic characteristics between those with and without a completed diary, actigraphy, and GPS data, except for age group and educational level for those who returned completed actigraphy data. CONCLUSION The MOCHA-T study is a multidimensional dataset that allows researchers to describe the health, behaviors, and lifestyle patterns, and their interactions with the environment of the newer generation of middle-aged and older adults in Taiwan. It can be compared with other countries with actigraphy and GPS-based lifestyle data of middle-aged and older adults in the future.
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Affiliation(s)
- Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Szu-Yu Hou
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Liang Wang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Han Tang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Ching Kuo
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Fu Liang
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Pei-Fen Kuo
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
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Suen AO, Iyer AS, Cenzer I, Farrand E, White DB, Singer J, Sudore R, Kotwal A. National Prevalence of Social Isolation and Loneliness in Adults with Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 2023; 20:1709-1717. [PMID: 37463307 PMCID: PMC10704233 DOI: 10.1513/annalsats.202304-288oc] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/17/2023] [Indexed: 07/20/2023] Open
Abstract
Rationale: Social isolation and loneliness are gaining recognition for their role in health outcomes, yet they have not been defined in people with chronic obstructive pulmonary disease (COPD). Objective: To determine the national prevalence of and characteristics associated with social isolation and loneliness in people with COPD. Methods: This is a cross-sectional study of community-dwelling adults aged ⩾50 years in the nationally representative HRS (Health and Retirement Study) (2016-2018). Participants self-reported COPD and supplemental oxygen use and were categorized into three groups: 1) no COPD; 2) COPD; and 3) COPD on oxygen. Social isolation was defined using a nine-item scale indicating minimal household contacts, social network interaction, and community engagement. Loneliness was measured using the 3-Item UCLA Loneliness Scale. Multivariable logistic regression defined prevalence and associated characteristics for both. Results: Participants (n = 10,384) were on average 68 years old (standard deviation, ±10.5), 54% female, 10% Black, 11% self-reported COPD, and 2% self-reported supplemental oxygen. Overall, 12% were socially isolated, 12% lonely, and 3% both socially isolated and lonely. People with COPD had a higher adjusted prevalence of social isolation (no COPD: 11%; COPD: 16%; COPD on oxygen: 20%; P < 0.05) and loneliness (no COPD: 11%; COPD: 18%; COPD on oxygen: 22%; P < 0.001). In those with COPD, characteristics associated with social isolation (P < 0.05) included sex (men: 22%; women: 13%), non-Hispanic White ethnicity (White: 19%; Black: 7%), low net worth (<$6,000: 32%; $81,001-$239,000: 10%), depression (depression: 24%; no depression: 14%), having difficulty with one or more activities of daily living (one or more difficulty: 22%; no difficulty: 14%), and current cigarette use (current: 24%; never: 13%). Characteristics associated with loneliness (P < 0.05) included younger age (50-64 yr: 22%; 75-84 yr: 12%), being single (single: 32%; married: 12%), depression (depression: 36%; no depression: 13%), having difficulty with one or more activities of daily living (one or more difficulty: 29%; no difficulty: 15%), diabetes (diabetes: 26%; no diabetes: 17%), and heart disease (heart disease 23%; no heart disease: 17%). Conclusions: Nearly one in six adults with COPD experience social isolation, and one in five experience loneliness, with almost twice the prevalence among those on supplemental oxygen compared with the general population. Demographic and clinical characteristics identify those at highest risk to guide clinical and policy interventions.
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Affiliation(s)
- Angela O. Suen
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | - Anand S. Iyer
- Division of Pulmonary, Allergy, and Critical Care Medicine, Center for Palliative and Supportive Care, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama; and
| | - Irena Cenzer
- Division of Geriatrics, and
- Division of Palliative Care Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Erica Farrand
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | - Douglas B. White
- Program on Ethics and Decision Making in Critical Illness, Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Rebecca Sudore
- Division of Geriatrics, and
- Division of Palliative Care Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Ashwin Kotwal
- Division of Geriatrics, and
- Division of Palliative Care Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California
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Bravata DM, Kim J, Russell DW, Goldman R, Pace E. Digitally Enabled Peer Support Intervention to Address Loneliness and Mental Health: Prospective Cohort Analysis. JMIR Form Res 2023; 7:e48864. [PMID: 37930770 PMCID: PMC10660210 DOI: 10.2196/48864] [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: 05/09/2023] [Revised: 09/08/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Social isolation and loneliness affect 61% of US adults and are associated with significant increases in excessive mental and physical morbidity and mortality. Annual health care spending is US $1643 higher for socially isolated individuals than for those not socially isolated. OBJECTIVE We prospectively evaluated the effects of participation with a digitally enabled peer support intervention on loneliness, depression, anxiety, and health-related quality of life among adults with loneliness. METHODS Adults aged 18 years and older living in Colorado were recruited to participate in a peer support program via social media campaigns. The intervention included peer support, group coaching, the ability to become a peer helper, and referral to other behavioral health resources. Participants were asked to complete surveys at baseline, 30, 60, and 90 days, which included questions from the validated University of California, Los Angeles Loneliness Scale, Patient Health Questionnaire 2-Item Scale, General Anxiety Disorder 7-Item Scale, and a 2-item measure assessing unhealthy days due to physical condition and mental condition. A growth curve modeling procedure using multilevel regression analyses was conducted to test for linear changes in the outcome variables from baseline to the end of the intervention. RESULTS In total, 815 ethnically and socially diverse participants completed registration (mean age 38, SD 12.7; range 18-70 years; female: n=310, 38%; White: n=438, 53.7%; Hispanic: n=133, 16.3%; Black: n=51, 6.3%; n=263, 56.1% had a high social vulnerability score). Participants most commonly joined the following peer communities: loneliness (n=220, 27%), building self-esteem (n=187, 23%), coping with depression (n=179, 22%), and anxiety (n=114, 14%). Program engagement was high, with 90% (n=733) engaged with the platform at 60 days and 86% (n=701) at 90 days. There was a statistically (P<.001 for all outcomes) and clinically significant improvement in all clinical outcomes of interest: a 14.6% (mean 6.47) decrease in loneliness at 90 days; a 50.1% (mean 1.89) decline in depression symptoms at 90 days; a 29% (mean 1.42) reduction in anxiety symptoms at 90 days; and a 13% (mean 21.35) improvement in health-related quality of life at 90 days. Based on changes in health-related quality of life, we estimated a reduction in annual medical costs of US $615 per participant. The program was successful in referring participants to behavioral health educational resources, with 27% (n=217) of participants accessing a resource about how to best support those experiencing psychological distress and 15% (n=45) of women accessing a program about the risks of excessive alcohol use. CONCLUSIONS Our results suggest that a digitally enabled peer support program can be effective in addressing loneliness, depression, anxiety, and health-related quality of life among a diverse population of adults with loneliness. Moreover, it holds promise as a tool for identifying and referring members to relevant behavioral health resources.
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Affiliation(s)
- Dena M Bravata
- Center for Primary Care and Outcomes Research, Stanford University, San Francisco, CA, United States
- Wisdo Health, Inc, New York, NY, United States
| | - Joseph Kim
- Wisdo Health, Inc, New York, NY, United States
- Department of Human Development & Family Studies, Iowa State University, Ames, IA, United States
| | - Daniel W Russell
- Wisdo Health, Inc, New York, NY, United States
- Department of Human Development & Family Studies, Iowa State University, Ames, IA, United States
| | - Ron Goldman
- Wisdo Health, Inc, New York, NY, United States
- Department of Technology Management and Innovation, Tandon School of Engineering, New York University, New York City, NY, United States
| | - Elizabeth Pace
- Peer Assistance Services, Inc, Denver, CO, United States
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Li S, Zhang M, Han D, Wu Y, Zhao J, Liao H, Ma Y, Yan C, Wang J. The effects of loneliness and social isolation on cognitive impairment-free life expectancy in older adults. Aging Ment Health 2023; 27:2120-2127. [PMID: 36951609 DOI: 10.1080/13607863.2023.2191926] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 02/27/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVES This article aimed to examine the effects of social connection comprising loneliness and social isolation on cognitive impairment-free life expectancy (CIFLE). METHODS Data on 28,563 older adults (aged 65+) were drawn from the Chinese Longitudinal Healthy Longevity Survey with a median follow-up of 4.00 years. Multistate Markov models were used to estimate the independent and joint effects of social connection with CIFLE. Cognitive impairment was measured by the modified Mini-Mental State Examination. RESULTS For men and women, respectively, reduced CIFLEs at age 65 associated with loneliness were 0.95 (95% CI: 0.41-1.48) and 1.35 (95%: CI 0.77-1.90) years, and those associated with social isolation were 2.23 (95% CI: 1.67-2.78) and 2.49 (95% CI: 1.67-3.30) years. Compared with those with neither loneliness nor social isolation ('neither' group), older adults at age 65 with both loneliness and social isolation ('both group') lost CIFLEs of 2.68 (95% CI: 1.89-3.48) and 3.51 (95% CI, 2.55-4.47) years for men and women, respectively. Similar patterns were observed in the oldest-old adults (age 85 or over). A growth trend transpired in the difference of the proportion of the remaining CIFLE between 'neither' group and 'both' group with age. CONCLUSION Loneliness and social isolation are associated with decreased CIFLE in older Chinese adults. Policy makers and the public must be informed that early identification and management of loneliness and social isolation, especially when coexisting, are crucial.
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Affiliation(s)
- Sangsang Li
- Department of Health Management, School of Medicine and Health Management of Huazhong University of Science and Technology, Wuhan, China
| | - Mei Zhang
- Department of Health Management, School of Medicine and Health Management of Huazhong University of Science and Technology, Wuhan, China
| | - Dan Han
- Department of Health Management, School of Medicine and Health Management of Huazhong University of Science and Technology, Wuhan, China
| | - Yunyi Wu
- Department of Health Management, School of Medicine and Health Management of Huazhong University of Science and Technology, Wuhan, China
| | - Jie Zhao
- Department of Health Management, School of Medicine and Health Management of Huazhong University of Science and Technology, Wuhan, China
| | - Hui Liao
- Department of Health Management, School of Medicine and Health Management of Huazhong University of Science and Technology, Wuhan, China
| | - Ying Ma
- Department of Health Management, School of Medicine and Health Management of Huazhong University of Science and Technology, Wuhan, China
| | - Chaoyang Yan
- Department of Health Management, School of Medicine and Health Management of Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Health Management, School of Medicine and Health Management of Huazhong University of Science and Technology, Wuhan, China
- The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan, China
- Institute for Poverty Reduction and Development, Huazhong University of Science and Technology, Wuhan, China
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15
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Ashida T, Fujiwara T, Kondo K. Association between adverse childhood experiences and social integration among older people in Japan: Results from the JAGES study. Arch Gerontol Geriatr 2023; 114:105099. [PMID: 37329767 DOI: 10.1016/j.archger.2023.105099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/30/2023] [Accepted: 06/07/2023] [Indexed: 06/19/2023]
Abstract
Social integration, network, and support are beneficial to health. However, there is little evidence of the association between adverse childhood experiences (ACEs) and social integration in later life. This study investigates the association between ACE history and social integration in older people. We used data from the Japan Gerontological Evaluation Study (JAGES) 2013, which conducted a self-reported survey of functionally independent people aged ≥ 65 years from 30 municipalities across Japan and yielded information on ACE history. We conducted a Poisson regression analysis with robust error variances to assess the association between ACE history and social integration, adjusting for sex, age, childhood economic hardship, adult socioeconomic status, health status, living status, and trust in others. The number of respondents with at least one incident of ACE was approximately 36.8%. The prevalence ratios for those who reported a history of ACEs were as follows: housebound 1.495 (95% confidence interval [CI]: 1.19-1.88), small network size 1.146 (95% CI: 1.10-1.19), low network contact 1.059 (95% CI: 1.00-1.059), non-membership sports group 1.038 (95% CI: 1.00-1.07), and non-membership hobby group 1.06 (95% CI: 1.03-1.09). Among older people in Japan, a history of ACEs is inversely associated with social integration. These findings support the life course approach and suggest that adverse events in early life may have an impact on social life in old age. In order to promote healthy aging, it is important to recognize the significant impact of early-life adversities that can extend into later life.
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Affiliation(s)
- Toyo Ashida
- Faculty of Economics, Keio University, Tokyo, Japan.
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Janssen J, Châtel B, Den Heijer N, Tieben R, Deen M, Corten R, Peeters G, Olde Rikkert M. A Digital Gaming Intervention to Strengthen the Social Networks of Older Dutch Adults: Mixed Methods Process Evaluation of a Digitally Conducted Randomized Controlled Trial. JMIR Form Res 2023; 7:e45173. [PMID: 37862093 PMCID: PMC10625069 DOI: 10.2196/45173] [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: 12/19/2022] [Revised: 05/19/2023] [Accepted: 08/31/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Digital loneliness interventions for older adults are promising, yet conclusive evidence is lacking due to a lack of randomized controlled trials (RCTs) and difficulties with recruitment. Process evaluation of performed RCTs is essential to inform future interventions. Still, it is rarely carried out, resulting in an overly optimistic view of the impact of eHealth interventions on loneliness in older adults and options to conduct such research entirely remotely. OBJECTIVE We describe a mixed methods process evaluation of a digitally conducted RCT assessing the effectiveness of a mobile social gaming app to facilitate meaningful social interactions in older adults. METHODS We analyzed the questionnaire and game data of the RCT participants to evaluate recruitment and onboarding, intervention adherence, and intervention acceptability. The RCT participants were allocated either to the main group of older adults (aged 65 years or older) or the side group (aged between 18 and 64 years). The side group used networking to play with the older adults. We also conducted 6 post-RCT evaluation interviews and 1 focus group with a total of 4 RCT participants and 5 welfare organization representatives that aided in RCT recruitment. RESULTS In total, 371 people aged 18 years or older signed up for the RCT, of which 64% (238/371) were aged 65 years or older. Of the total sample, 20% (76/371) installed the app and signed informed consent, showing a large dropout during onboarding. The high number of questions was a relevant barrier for participants. Both questionnaire and gameplay adherence were low. Participants indicated that the games elicited contact and a feeling of togetherness and proposed challenging and competitive games with increasing difficulty levels. They suggested focusing on enjoying the games rather than administering questionnaires. CONCLUSIONS Conducting a remote digital trial of a social gaming intervention for older adults is a great challenge. Remote recruitment and informed consent acquisition may often not result in sufficient participation. Personal engagement with fellow participants and researchers might be essential for adherence and enjoyment. Future digital gaming interventions should start with small-scale studies with in-person contact, repeated instructions, and fewer questionnaires.
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Affiliation(s)
- Jeroen Janssen
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bas Châtel
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nora Den Heijer
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Rob Tieben
- Games for Health, Eindhoven, Netherlands
| | - Menno Deen
- Super Menno Monster, Utrecht, Netherlands
| | - Rense Corten
- Department of Sociology / Interuniversity Center for Social Science Theory and Methodology, Utrecht University, Utrecht, Netherlands
| | - Geeske Peeters
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, Netherlands
- Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marcel Olde Rikkert
- Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Geriatric Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
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Mishra B, Pradhan J, Dhaka S. Identifying the impact of social isolation and loneliness on psychological well-being among the elderly in old-age homes of India: the mediating role of gender, marital status, and education. BMC Geriatr 2023; 23:684. [PMID: 37864212 PMCID: PMC10589928 DOI: 10.1186/s12877-023-04384-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 10/05/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Social isolation and loneliness can be detrimental to the overall functioning of the older adults. The study examines the impact of social isolation and loneliness on the psychological well-being of older adults residing in various old-age homes in India and investigates the mediating role of gender, marital status, and education level in the way social isolation and loneliness affect psychological well-being. METHODS Data has been collected from 320 individuals aged sixty years or above. Data were collected using standardized measures like Lubben Social Network Scale- 6, revised UCLA Loneliness Scale, and shortened version of psychological well-being scale by Ryff & Keyes (1995). Multivariate and mediation analysis were performed to understand the associations of social isolation and loneliness with psychological well-being. RESULTS A statistically significant MANOVA effect was obtained for social isolation (F = 3.836, p < .01), and loneliness (F = 3.782, p < .01). Gender and education as independent factors were significantly associated with the psychological well-being of individuals. However, both gender and education did not mediate the impact of social isolation and loneliness on the psychological well-being of older adults. Further, marital status had a partial mediating effect on the relationship between social isolation, loneliness, and psychological well-being. CONCLUSIONS The findings of the study can be incorporated into measures aiming at alleviation of feelings of social isolation and loneliness among the elderly. Further, the findings can be used to design various intervention strategies aimed at the reduction of social isolation and loneliness among older adults and the restoration of their psychological well-being.
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Affiliation(s)
- Bijeta Mishra
- National Institute of Technology, Rourkela, Odisha, India
| | | | - Suman Dhaka
- Indian Institute of Technology, Jodhpur, Rajasthan, India.
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18
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Kirk L, Eull D, Flaten C, Paun O. Combating Social Isolation in Older Adults: An Intergenerational Nursing Communication Project. J Psychosoc Nurs Ment Health Serv 2023; 61:7-11. [PMID: 37800864 DOI: 10.3928/02793695-20230915-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
The importance of social connection to health and well-being has long been recognized. Social isolation is prevalent and impactful in the lives of older adults across care settings. A semester-long communication-focused clinical project was developed and piloted with sophomore Bachelor of Nursing Science students during Fall 2020 and replicated in Fall 2021 and 2022. Students were paired with older adult volunteers/mentors from a senior living organization and contacted mentors every 2 weeks over the 15-week semester. Older adult volunteers served as mentors, sharing their wisdom and life experiences. Students practiced their communication skills and learned about their mentor's life. Pre- and post-activity surveys of student attitudes toward older adults/aging suggested a dramatic and positive shift in perspective, and mentors rated the experience highly favorably. Intergenerational communication and relationship building has the potential to combat social isolation, promote healing and growth, and enable mutually beneficial engagement. [Journal of Psychosocial Nursing and Mental Health Services, 61(10), 7-11.].
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Gofine M, Laynor G, Schoenthaler A. Characteristics of programmes designed to link community-dwelling older adults in high-income countries from community to clinical sectors: a scoping review protocol. BMJ Open 2023; 13:e072617. [PMID: 37699628 PMCID: PMC10503318 DOI: 10.1136/bmjopen-2023-072617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/24/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION Research on effectively navigating older adults into primary care is urgently needed. Community-clinic linkage models (CCLMs) aim to improve population health by linking the health and community sectors in order to improve patients' access to healthcare and, ultimately, population health. However, research on community-based points of entry linking adults with untreated medical needs into the healthcare sector is nascent. CCLMs implemented for the general adult population are not necessarily accessible to older adults. Given the recency of the CCLM literature and the seeming rarity of CCLM interventions designed for older adults, it is appropriate to employ scoping review methodology in order to generate a comprehensive review of the available information on this topic. This protocol will inform a scoping review that reviews characteristics of community-based programmes that link older adults with the healthcare sector. METHODS AND ANALYSIS The present protocol was developed as per JBI Evidence Synthesis best practice guidance and reporting items for the development of scoping review protocols. The proposed scoping review will follow Levac and colleagues' update to Arksey and O'Malley's scoping review methodology. Healthcare access at the system and individual levels will be operationalised in data extraction and analysis in accordance with Levesque and colleagues' Conceptual Framework of Access to Health. The protocol complies with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Beginning in August 2023 or later, citation databases (AgeLine (Ebsco); CINAHL Complete; MEDLINE (PubMed); Scopus Advanced (Elsevier); Social Services Abstracts (ProQuest); Web of Science Core Collection (Clarivate)) and grey literature (Google; American Public Health Association Annual Meeting Conference Proceedings; SIREN Evidence & Resource Library) will be searched. ETHICS AND DISSEMINATION The authors plan to disseminate their findings in conference proceedings and publication in a peer-reviewed journal and deposit extracted data in the Figshare depository. The study does not require Institutional Review Board approval. REGISTRATION DETAILS Protocol registered in Open Science Framework (DOI https://doi.org/10.17605/OSF.IO/2EF9D).
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Affiliation(s)
- Miriam Gofine
- Department of Population Health, NYU Langone Health, New York City, New York, USA
- Vilcek Institute of Graduate Biomedical Sciences, NYU Langone Health, New York City, New York, USA
| | - Gregory Laynor
- Health Sciences Library, New York University Grossman School of Medicine, New York City, New York, USA
| | - Antoinette Schoenthaler
- Department of Population Health, NYU Langone Health, New York City, New York, USA
- Institute for Excellence in Health Equity, NYU Langone Health, New York City, New York, USA
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20
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Chen YC, Taylor HO, Hung N, Chan CLW. Later-life depressive symptoms during the Covid-19 pandemic: Investigations of individual, cumulative, and synergistic effects of social isolation. Aging Ment Health 2023; 27:1702-1710. [PMID: 36721924 DOI: 10.1080/13607863.2023.2172137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 01/13/2023] [Indexed: 02/02/2023]
Abstract
OBJECTIVES This study examines associations between social isolation and depressive symptoms among Hong Kong Chinese adults aged 65 and older by investigating the distinct effects of individual indicators, cumulative index, and typologies of social isolation during the Covid-19 pandemic. METHODS We used a sample of 260 older adults from a cross-sectional, city-wide online survey targeting 1,109 aged 45+ adults through purposive sampling. Seven indicators of social isolation (not married; living alone; not engaging in social/organizational activities; no social contact with friends or families; lack of family and friends networks; loneliness) using Cornwell & Waite's framework were selected to construct three unique types of social isolation measures. We used latent class analysis (LCA) and regression models to examine the effects of varied typologies of social isolation on depressive symptoms. RESULTS Individual model of social isolation showed that lack of social contact and feeling lonely were significant predictors of depressive symptoms. A strong linear-trend gradient effect of cumulative social isolation on depressive symptoms was also observed. The LCA model identified four typologies of social isolation (socially isolated; living alone but socially engaged; married but lacking social ties, and not socially isolated); those in the 'socially isolated' and 'married but lacking social ties' groups had the most depressive symptoms. CONCLUSION Three operationalizations of social isolation demonstrated different utilities and implications in assessing the impacts of social isolation on depressive symptoms. Social contacts and loneliness, rather than living status or other characteristics of isolation, were the factors most strongly associated with depressive symptoms. Support programs should target lonely older adults who lack social engagement opportunities, as they are at increased risk of depression.
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Affiliation(s)
- Yu-Chih Chen
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR
- Social Policy Institute, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Harry Owen Taylor
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Natalee Hung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR
| | - Cecilia L W Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR
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21
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Moitra S, Adan A, Akgün M, Anderson A, Brickstock A, Eathorne A, Farshchi Tabrizi A, Haldar P, Henderson L, Jindal A, Jindal SK, Kerget B, Khadour F, Melenka L, Moitra S, Moitra T, Mukherjee R, Semprini A, Turner AM, Murgia N, Ferrara G, Lacy P. Less Social Deprivation Is Associated With Better Health-Related Quality of Life in Asthma and Is Mediated by Less Anxiety and Better Sleep Quality. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2115-2124.e7. [PMID: 37087095 DOI: 10.1016/j.jaip.2023.03.052] [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: 10/10/2022] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Previous studies on health-related quality of life (HRQoL) in asthma have mainly focused on clinical and environmental determinants. Little is known about the role of social determinants on HRQoL in asthma. OBJECTIVES We aimed to investigate the association between social deprivation and HRQoL in asthma. METHODS A total of 691 adult asthmatics from Canada, India, New Zealand, and the United Kingdom were administered a digital questionnaire containing demographic information and questions about social and psychological attributes, sleep disturbances, and alcohol abuse. HRQoL was measured using the Short Form of the Chronic Respiratory Questionnaire (SF-CRQ). We analyzed the direct and indirect relationships between social deprivation and HRQoL using structural equation models with social deprivation as a latent variable. We tested for mediation via anxiety, depression, sleep disturbances, and alcohol abuse. RESULTS We found that less social deprivation (latent variable) was directly associated with better SF-CRQ domain scores such as dyspnea (regression coefficient β: 0.33; 95% confidence interval [CI]: 0.07 to 0.58), fatigue (β: 0.39; 95% CI: 0.14 to 0.64), and emotional function (β: 0.37; 95% CI: 0.11 to 0.62), but with the worse mastery score (β: -0.29; 95% CI: -0.55 to -0.03); however, those associations varied across participating countries. We also observed that among all individual social deprivation indicators, education, companionship, emotional support, instrumental support, and social isolation were directly associated with HRQoL, and the relationship between social deprivation and HRQoL was mediated through anxiety and sleep disturbances. CONCLUSIONS Our results demonstrated that less social deprivation was directly, and indirectly through less anxiety and better sleep quality, associated with better HRQoL in asthma.
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Affiliation(s)
- Subhabrata Moitra
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Metin Akgün
- Department of Chest Diseases, Ataturk University, Erzurum, Turkey; Department of Pulmonary Medicine, Ağrı İbrahim Çeçen University, School of Medicine, Ağrı, Turkey
| | | | - Amanda Brickstock
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Allie Eathorne
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Ali Farshchi Tabrizi
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Prasun Haldar
- Department of Medical Laboratory Technology, Supreme Institute of Management and Technology, Mankundu, West Bengal, India; Department of Physiology, West Bengal State University, Barasat, West Bengal, India
| | - Linda Henderson
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | | | | | - Bugra Kerget
- Department of Chest Diseases, Ataturk University, Erzurum, Turkey
| | - Fadi Khadour
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Lyle Melenka
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Saibal Moitra
- Department of Pulmonary Medicine, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Tanusree Moitra
- Department of Psychology, Barrackpore Rashtraguru Surendrananth College, Barrackpore, West Bengal, India
| | - Rahul Mukherjee
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Alex Semprini
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Alice M Turner
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Ferrara
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Paige Lacy
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Kleszynski K, Teasdale T, Golden-Pogue A, De La Garza F, Jennings LA. Advancing use of virtual visits and virtual education in Oklahoma nursing homes in response to COVID-19. J Am Geriatr Soc 2023; 71:1996-1999. [PMID: 36705434 DOI: 10.1111/jgs.18250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 01/28/2023]
Affiliation(s)
- Keith Kleszynski
- Section of Geriatrics, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Thomas Teasdale
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Andrea Golden-Pogue
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Flor De La Garza
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Lee A Jennings
- Section of Geriatrics, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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Kino S, Stickley A, Arakawa Y, Saito M, Saito T, Kondo N. Social isolation, loneliness, and their correlates in older Japanese adults. Psychogeriatrics 2023; 23:475-486. [PMID: 36966745 DOI: 10.1111/psyg.12957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/07/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Loneliness and social isolation are elevated in older adults and associated with a range of detrimental outcomes. Despite this, there has been little research on these phenomena or on similarities and differences in their occurrence or combination in older Japanese adults. The current study aims to (i) determine what factors are associated with social isolation and loneliness among older adults in Japan; and (ii) describe the characteristics of individuals who are socially isolated but not lonely, as well as those who feel lonely but are not socially isolated. METHODS Data were analysed from 13 766 adults aged ≥65 years who participated in the 2019 wave of the Japan Gerontological Evaluation Study. Poisson regression analysis was used to examine associations. RESULTS Among older Japanese adults, the attributes of higher age, male gender, lower socioeconomic status, being a welfare recipient, and having depressive symptoms were associated with social isolation, while lower socioeconomic status, unemployment, welfare receipt, and poor physical and mental health were associated with loneliness. In addition, better educated, and mentally and physically healthy people were less likely to feel lonely even when socially isolated, while people who were not working and who had mental or physical health problems were more likely to feel lonely even if they were not socially isolated. DISCUSSION Our results indicate that in order to reduce unwanted social isolation and loneliness among older Japanese adults, in the first instance the focus should be on those individuals who are socioeconomically disadvantaged and unhealthy.
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Affiliation(s)
- Shiho Kino
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Andrew Stickley
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuki Arakawa
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
- Center for Well-being and Society, Nihon Fukushi University, Nagoya, Japan
| | - Tami Saito
- Department of Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
- Japan Agency for Gerontological Evaluation Study (JAGES Agency), Tokyo, Japan
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Gao P, Mosazadeh H, Nazari N. The Buffering Role of Self-compassion in the Association Between Loneliness with Depressive Symptoms: A Cross-Sectional Survey Study Among Older Adults Living in Residential Care Homes During COVID-19. Int J Ment Health Addict 2023:1-21. [PMID: 36776917 PMCID: PMC9904273 DOI: 10.1007/s11469-023-01014-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2023] [Indexed: 02/10/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is an ongoing geriatric health emergency with a substantial increase in the prevalence of medical and mental health issues, particularly among older adults living in residential care homes. The knowledge of the risk and protective factors related to the psychological impact of the COVID-19 pandemic on older adults living in residential care homes is based on limited data. This study aimed to investigate whether loneliness mediates the effects of fear generated by a pandemic on depression. Additionally, we hypothesized that self-compassion moderates the effect of loneliness on depression. A sample comprised 323 older adults (females: n = 141, males: n = 182) with mean age = 74.98 years (standard deviation = 6.59, age 65-90) completed a survey comprising the Fear of COVID-19 Scale, De Jung Gierveld Loneliness Scale, the nine-item Patient Health Questionnaire, and the Self-compassion Scale. The results revealed that the total effect of fear on depression was statistically significant, with a medium effect size (Cohen's f 2 = .14) and this association was partially mediated by loneliness (β = .11, SE = .04, P < .001, t = 2.91, 95% CI 0.04-0.19). The self-compassion also moderated the loneliness effect on depression. The findings of this study support COVID-19 evidence, indicating that a greater level of fear generated by the pandemic is linked to depression and loneliness. The findings support the notion that self-compassion mitigates the adverse effects of stressful events in older adults. Customized self-compassion programs may be effective loneliness-mitigating interventions for older adults living in residential care homes. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-023-01014-0.
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Affiliation(s)
- Pengfei Gao
- School of Public Administration, East China Normal University, Shanghai, 200062 China
| | - Hasan Mosazadeh
- Department of Psychology, Kazimierz Wielki University, Bydgoszcz, Poland
| | - Nabi Nazari
- Faculty of Human Sciences, Department of Psychology, Lorestan University, Khorramabad, Iran
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25
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Kang JW, Oremus M. Examining the Combined Effects of Social Isolation and Loneliness on Memory: A Systematic Review. Arch Gerontol Geriatr 2023; 104:104801. [PMID: 36081231 DOI: 10.1016/j.archger.2022.104801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Some research suggests social isolation and loneliness are important risk factors for reduced successful aging and cognitive health. However, findings are inconsistent and no prior systematic review has investigated whether social isolation and loneliness are associated with the memory domain of cognition. This review examined whether social isolation and loneliness individually and jointly affected the memory of middle- and older-aged adults. METHODS We used PubMed, PsycInfo, and Scopus to search for comparative studies that examined the impact of both loneliness and social isolation (e.g., social activity, social networks) on memory (including all subtypes) in populations aged ≥ 45 years. Three raters performed data extraction and risk of bias assessment using the Joanna Briggs Institute checklist. Data were synthesized narratively following the Synthesis without Meta-Analysis guideline. RESULTS In 12 included articles, higher levels of loneliness and social isolation (combining a range of different indicators) were associated with lower memory performance, where the interaction between loneliness and social isolation had the largest adverse effect on memory, followed by social isolation alone, and followed by loneliness alone. However, substantial heterogeneity was observed in the composition of the two most common indicators of social isolation (social network size, social activity participation), with the magnitude of most results being clinically non-important. Most articles had moderate risk of bias. CONCLUSION This review found an inverse association between social isolation/loneliness and memory, and outlines future steps to systematically combine the two constructs and measure social isolation in a consistent, multi-modal format.
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Affiliation(s)
- Ji Won Kang
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1
| | - Mark Oremus
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1.
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26
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Poon AWC, Hofstaetter L, Judd‐Lam S. Social connectedness of carers: An Australian national survey of carers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5612-e5623. [PMID: 36057864 PMCID: PMC10087548 DOI: 10.1111/hsc.13987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/06/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
Carers of people living with a disability, mental health problems, alcohol or drug dependency, chronic condition, terminal illness or who are frail due to age may experience negative caregiving impacts. Although carers' social isolation has been reported in many qualitative studies, it has largely been neglected in quantitative studies. Using data collected in the Carers NSW 2020 National Carer Survey, this large-scale quantitative study aimed to identify the extent of Australian carers' social connectedness and what factors may be related to their social well-being. The validated Friendship Scale was used to measure social connectedness of 5585 carers. More than half (56.2%) of these carers were socially isolated. Analysis found that a longer duration of caring, more time spent weekly caring, living with the care recipient, caring for a greater number of people, receiving no help from others, higher reported psychological distress and reporting perceived needs were all associated with greater social isolation. Identifying as female or nonbinary/gender diverse, identifying with a culturally and linguistically diverse background, and caring as a parent, former partner or young carer were also related to poorer social connectedness. Health and social services need to consider the needs of carers, identify carers who are socially isolated and provide resources to promote social connectedness. Greater attention in practice and research to focus on carers' social connectedness to address this crucial caregiving experience is required.
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Affiliation(s)
- Abner Weng Cheong Poon
- School of Social Sciences, Faculty of Arts, Design & ArchitectureUniversity of New SouthSydneyNew South WalesAustralia
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27
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Galassi F, Merizzi A, D’Amen B, Santini S. Creativity and art therapies to promote healthy aging: A scoping review. Front Psychol 2022; 13:906191. [PMID: 36225688 PMCID: PMC9549330 DOI: 10.3389/fpsyg.2022.906191] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 09/02/2022] [Indexed: 11/13/2022] Open
Abstract
The purpose of this scoping review is to investigate the value of creative arts therapies in healthy older adults. This article aims to shed light on current knowledge concerning the effectiveness of art therapies (ATs) for the prevention of common age-related conditions using the definition of art therapy provided by the American Art Therapy Association (AATA), as well as Cohen’s conceptual framework for the psychological conceptualization of the relationship between the arts and health in later life. The objective is to carefully capture subthreshold situations of distress, which are often not taken into account and primarily involve psychological aspects that are crucial in the multidimensional perspective of healthy aging. Twelve articles were selected and examined following an initial electronic search on 3 databases. A thematic analysis of the results identified four major themes: improving cognitive performance and proprioception; enhancing self-identity and meaningful life; reducing feelings of loneliness and depressive symptoms; and the importance of socialization. All these aspects constitute the basis for preventing psychological distress and enhancing mental well-being for healthy aging.
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28
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Szychowska A, Drygas W. Physical activity as a determinant of successful aging: a narrative review article. Aging Clin Exp Res 2022; 34:1209-1214. [PMID: 34873677 PMCID: PMC9151514 DOI: 10.1007/s40520-021-02037-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/18/2021] [Indexed: 02/06/2023]
Abstract
Population of older people in many countries is constantly growing, therefore the subject of successful aging has become important and a priority for public health policy-makers. A person who is successfully aging has low risk of chronic disease and disability, high physical function, good mental health and social engagement in older age. Lifestyle factors, such as diet and exercise, have been identified as determinants of successful aging. The aim of this narrative review is to compile the evidence from big cohort studies on the overall health of older people. Their results indicate that regular physical activity increases the chances of successful aging in older people, but only after reaching a sufficient threshold. Physical activity lowers the risk of many chronic diseases and cognitive decline commonly associated with older age, promotes social engagement and improves self-estimated well-being.
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Affiliation(s)
| | - Wojciech Drygas
- Department of Preventive Medicine, Medical University of Lodz, Łódź, Poland
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29
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Okpalauwaekwe U, Li CY, Tzeng HM. Social Determinants and Self-Care for Making Good Treatment Decisions and Treatment Participation in Older Adults: A Cross-Sectional Survey Study. NURSING REPORTS 2022; 12:198-209. [PMID: 35324566 PMCID: PMC8948722 DOI: 10.3390/nursrep12010020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/02/2022] [Accepted: 03/08/2022] [Indexed: 01/07/2023] Open
Abstract
Background: Community-dwelling adults who can perform self-care behaviors related to making treatment decisions and participating in treatment have been found to use less emergency care. In this exploratory study, we examined the relationships in older adults between five social determinants (urban/rural residence, sex, age, marital status, and education) and the perceived importance, desirability, and ability to perform 11 self-care behaviors related to making good treatment decisions and participating in treatment. Methods: This cross-sectional study surveyed 123 community-dwelling older adults living in the southern United States in 2015-2016. All participants were 65 years or older. Data were collected using the Patient Action Inventory for Self-Care and analyzed using descriptive, univariate, and multivariate logistic regression analyses. Results: The social determinants (identified as barriers) of self-care behaviors related to making good treatment decisions and participating in treatment were: having less than a high school education, being 75 years or older, and being separated from a spouse. Sex and residence were found to be neither barriers nor facilitators. Conclusions: Our findings suggest that, in older adults, attending to the needs related to health literacy education and improving social support might increase self-care behaviors related to making good treatment decisions and participating in treatment. Future research will compare the differences across diverse populations to validate our study findings.
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Affiliation(s)
- Udoka Okpalauwaekwe
- College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada;
| | - Chih-Ying Li
- Department of Occupational Therapy, School of Health Professions, The University of Texas Medical Branch, Galveston, TX 77555, USA;
| | - Huey-Ming Tzeng
- School of Nursing, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA
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30
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Barnes TL, Ahuja M, MacLeod S, Tkatch R, Albright L, Schaeffer JA, Yeh CS. Loneliness, Social Isolation, and All-Cause Mortality in a Large Sample of Older Adults. J Aging Health 2022; 34:883-892. [PMID: 35234547 PMCID: PMC9483694 DOI: 10.1177/08982643221074857] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objectives Using data from a large random sample of U.S. older adults (N = 7982),
the effect of loneliness and social isolation on all-cause mortality was examined
considering their separate and combined effects. Methods The UCLA-3 Loneliness Scale and the Social Network Index (SNI) were used to define
loneliness and social isolation. Cox proportional hazards regression models were
performed. Results Among study participants, there were 548 deaths. In separate, adjusted models,
loneliness (severe and moderate) and social isolation (limited and moderate social
network) were both associated with all-cause mortality. When modeled together, social
isolation (limited and moderate social network) along with severe loneliness remained
significantly associated with mortality. Discussion Results demonstrate that both loneliness and social isolation contribute to greater
risk of mortality within our population of older adults. As the COVID-19 pandemic
continues, loneliness and social isolation should be targeted safely in efforts to
reduce mortality risk among older adults.
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Affiliation(s)
| | - Manik Ahuja
- 19271UnitedHealth Group, Eden Prairie, MN, USA
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