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Ran Z, Wei J, Yang G, Yang C. Prevalence of social isolation in the elderly: A systematic review and meta-analysis. Geriatr Nurs 2024; 58:87-97. [PMID: 38781629 DOI: 10.1016/j.gerinurse.2024.05.008] [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: 03/12/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
Social isolation has become a global issue among the elderly, posing serious challenges to both social and public health. We assessed the prevalence of elderly social isolation and its related factors. Eight electronic databases were searched up to June 28th, 2023. A meta-analysis of the included literature was performed using Stata 16.0. The results showed that the incidence of social isolation in the elderly was 33 % [95 % CI (0.28, 0.38)]. The subgroup analysis revealed that people over 80, with a sample size under 500, assessed using the Lubben Social Network scale and Social Network Index scale, experienced higher social isolation, especially if they were living alone and lacked higher education. It is suggested to pay attention to the psychological well-being of elderly individuals living alone and lacking a high level of education. Early screening could help reduce the incidence of social isolation, and hence its implications, among the elderly.
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Affiliation(s)
- Zhenrong Ran
- Master's Degree, Nursing Department, Chongqing Traditional Chinese Medicine Hospital, Chongqing, PR China
| | - Jiajia Wei
- Undergraduate Degree, Nursing Department, Chongqing Traditional Chinese Medicine Hospital, Chongqing, PR China
| | - Guangjin Yang
- Undergraduate Degree, Nursing Department, Chongqing Traditional Chinese Medicine Hospital, Chongqing, PR China
| | - Chanjuan Yang
- Master's Degree, Nursing Department, Chongqing Traditional Chinese Medicine Hospital, Chongqing, PR China.
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Yarish NM, Posis AIB, Nguyen S, Weitlauf J, Bellettiere J, Saquib N, Richey PA, Allison M, Kroenke C, Goveas JS, Coday M, LaCroix AZ. Loneliness, social isolation, and cardiovascular disease among nonveteran and veteran women. J Women Aging 2024:1-12. [PMID: 38659158 DOI: 10.1080/08952841.2024.2336655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024]
Abstract
We examined the prospective associations of social isolation and loneliness with incident cardiovascular disease (CVD) among aging nonveteran and veteran women, and effect modification by veteran status. Participants with no history of myocardial infarction (MI), stroke, coronary heart disease (CHD), or coronary heart failure from the Women's Health Initiative Extension Study II self-reported social isolation, loneliness, health behaviors, health status, and veteran status. CVD and CVD subevents were physician adjudicated. Hazard ratios (HR) and 95% confidence intervals (CI) for the Interquartile Range (IQR) in social isolation (IQR = 1) and loneliness (IQR=.33) were calculated using Cox proportional hazard models adjusting for sociodemographic, health behavior, and health status characteristics. Veteran status was tested as an effect modifier. Among 52,442 women (Mean age = 79 ± 6.1; veterans n = 1023; 89.2% non-Hispanic White), 3579 major CVD events occurred over an average 5.8 follow-up years. Compared to nonveterans, veteran women reported higher levels of social isolation (p < .01) and loneliness (p < .01). The CVD HR was 1.07 (95% CI, 1.04-1.10) for the IQR in social isolation and 1.03 (95% CI, 1.10-1.06) for the IQR in loneliness. The HR for the IQR in both social isolation and loneliness was 1.10 (95% CI, 1.05-1.15). Social isolation was associated with CHD (HR = 1.12; 95% CI, 1.03-1.21). The CHD HR for the IQR in social isolation was 1.12 (95% CI, 1.03-1.21). Associations did not differ by veteran status (all p-interactions > 0.08). Findings suggest that the adverse associations of social isolation and loneliness with CVD are similar among veteran and nonveteran women.
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Affiliation(s)
- Natalie M Yarish
- School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia, USA
| | - Alexander Ivan B Posis
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, California, USA
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Steve Nguyen
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, California, USA
| | - Julie Weitlauf
- Veterans Affairs Palo Alto Health Care System, Livermore, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - John Bellettiere
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, California, USA
| | - Nazmus Saquib
- Sulaiman Al Rajhi University, Al Bukayriyah, Saudi Arabia
| | - Phyllis A Richey
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Matthew Allison
- Division of Preventive Medicine, Department of Family Medicine, UC San Diego, San Diego, California, USA
| | - Candyce Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | | | - Mace Coday
- University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, California, USA
- Women's Health Initiative, USA
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Eliacin J, Patterson SM, Mendez DM, Burgess DJ, Traylor MH, Borden MY, Slaven JE, Matthias MS. Findings from a Peer-Facilitated, Social Isolation Intervention in the Veterans Health Administration Healthcare System: A Mixed-Methods, Pilot Feasibility Study. J Gen Intern Med 2023; 38:3460-3471. [PMID: 37723366 PMCID: PMC10713941 DOI: 10.1007/s11606-023-08387-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/21/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Social isolation is a global public health threat. Veterans are particularly at risk for social isolation due to high rates of comorbid physical and mental health problems. Yet, effective interventions are limited. OBJECTIVES Our primary objective was to assess the feasibility and acceptability of CONNECTED, a novel, transdiagnostic intervention to reduce social isolation that includes individual and group components and is delivered by peers via telehealth. Secondary objectives were to identify appropriate outcome measures and explore preliminary intervention effects. METHODS This was a two-phase study. In Phase 1, to evaluate study feasibility, we surveyed 200 veterans to assess prevalence of social isolation and their interest in social connectedness interventions. In Phase 2, we employed a mixed-methods, pre-post study design in which we piloted CONNECTED with 19 veterans through 2 successive cohorts to further assess feasibility, to evaluate acceptability, and to explore preliminary effectiveness. Quantitative analyses involved descriptive and bivariate analyses as well as multivariate modeling. Qualitative interviews were analyzed using thematic analysis. RESULTS For Phase 1, 39% of veterans surveyed were socially isolated. Participants who were ≤ 55 years old, caregivers, and those who experienced unmet social needs were more likely to report social isolation. Over 61% expressed interest in VA programs to reduce social isolation. For Phase 2, the pilot intervention, recruitment rate was 88% and the enrollment rate was 86%. Retention rates for the two cohorts were 80% and 50%, respectively, and satisfaction rates among intervention completers were 100%. Results also showed statistically significant improvements in social isolation (+ 5.91, SD = 4.99; p = .0028), social support (+ 0.74, SD = 1.09; p = .03), anxiety (-3.92, SD = 3.73; p = .003), and depression (-3.83, SD = 3.13; p = .001). Results for the other measures were not statistically significant. CONCLUSION CONNECTED is a feasible and acceptable intervention and is likely to be an effective tool to intervene on social isolation among veterans.
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Affiliation(s)
- Johanne Eliacin
- Department of Veterans Affairs, VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
- Regenstrief Institute, Indianapolis, IN, USA.
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Scott M Patterson
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Diana M Mendez
- Department of Psychiatry, Orlando VA Healthcare System, Orlando, FL, USA
| | - Diana J Burgess
- Center for Care Delivery and Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Morgan H Traylor
- Department of Veterans Affairs, VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Maria Y Borden
- Department of Veterans Affairs, VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - James E Slaven
- Deparmtent of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Marianne S Matthias
- Department of Veterans Affairs, VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
- Regenstrief Institute, Indianapolis, IN, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Johnson A, Moreland M, Kiernan MD, Collins T, Wilson-Menzfeld G. Understanding evidence and provision of services around social isolation and loneliness of military widow/ers: A scoping review. PLoS One 2023; 18:e0293182. [PMID: 38011120 PMCID: PMC10681208 DOI: 10.1371/journal.pone.0293182] [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: 05/02/2023] [Accepted: 10/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Whilst the uniqueness of loneliness and social isolation is now recognised for members of the Armed Forces Community, there is currently a lack of evidence examining these experiences within the Military Widow/er population. Therefore, this scoping review aimed to search and synthesise the current evidence base exploring experiences of loneliness and social isolation in this community. METHOD Six databases were searched; ASSIA; CINAHL; ProQuest Dissertation & Theses Global; PsycArticles; Medline; Web of Science. Any article type was included if they focused on UK or international Military Widows and loneliness and social isolation. In the absence of loneliness and social isolation, related aspects were included, for example, social support. RESULTS A thematic synthesis was completed on the nine eligible papers, where key findings were coded and generated into four themes; Experiences of Loneliness and Social Isolation, The Uniqueness of the Military, Access to Social Support, and The Importance of Peer Support. CONCLUSIONS Evidence supports the need for military-specific support services with peers who recognise the individuals' unique experiences of loneliness and social isolation. None of the available evidence focused specifically on social isolation, however this was often prevalent in the results. All of the studies were carried out in the USA and Israel, with none including the views of widowers. Further evidence is required, particularly relating to a UK-context.
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Affiliation(s)
- Amy Johnson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Mary Moreland
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Matthew D. Kiernan
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Tracy Collins
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
| | - Gemma Wilson-Menzfeld
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
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Ortmeyer HK, Giffuni J, Etchberger D, Katzel L. The Role of Companion Dogs in the VA Maryland Health Care System Whole Health(y) GeroFit Program. Animals (Basel) 2023; 13:3047. [PMID: 37835653 PMCID: PMC10571922 DOI: 10.3390/ani13193047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
GeroFit is a gym-based exercise program that promotes health and wellness among older sedentary veterans. The aims of the current study were to determine whether providing a companion dog as an alternative to gym-based exercise would similarly affect whole health outcomes. A total of 15 (n = 15) veterans (62 ± 11 years of age; 13 of 15 >54 years of age) underwent physical function testing, completed global and whole health questionnaires, and wore an accelerometer for 7 days before (baseline) and 3 months after a dog came into their home. The participants completed the Pet Attachment Scale (PAS), Dog Owner-Specific Quality of Life (DOQOL), and Canine Behavioral Assessment and Research questionnaires at 3 months. Cardiorespiratory endurance, lower body strength, daily steps, and time spent engaging in moderate physical activity all increased compared to the baseline levels. Body weight decreased among veterans whose body mass index was ≥30 (n = 11). The PAS and DOQOL scores indicated high attachment and positive effects on quality of life after having a dog in the home, with all veterans agreeing that having a dog improved the number of social activities they performed. We conclude that providing a companion dog to veterans not inclined to participate in gym-based exercise is an effective alternative method of promoting health and wellness in this population.
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Affiliation(s)
- Heidi K. Ortmeyer
- Geriatric Research Education Clinical Center, VA Maryland Health Care System, Baltimore, MD 21201, USA; (J.G.); (D.E.); (L.K.)
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Jamie Giffuni
- Geriatric Research Education Clinical Center, VA Maryland Health Care System, Baltimore, MD 21201, USA; (J.G.); (D.E.); (L.K.)
| | - Danielle Etchberger
- Geriatric Research Education Clinical Center, VA Maryland Health Care System, Baltimore, MD 21201, USA; (J.G.); (D.E.); (L.K.)
| | - Leslie Katzel
- Geriatric Research Education Clinical Center, VA Maryland Health Care System, Baltimore, MD 21201, USA; (J.G.); (D.E.); (L.K.)
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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Factors Associated With Social Isolation in Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2023; 24:322-330.e6. [PMID: 36549651 DOI: 10.1016/j.jamda.2022.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Social isolation is a global health issue that affects older adults throughout their lives. This study aimed to identify the factors associated with social isolation in older adults. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Adults aged 60 years and older. METHODS We searched for observational studies without language restrictions in 11 databases from inception to August 2022. Pooled odds ratio (OR) and 95% CI were calculated using the R software (version 4.2.1). The modified Newcastle-Ottawa Scale was used to evaluate the risk of bias. RESULTS Eighteen factors were grouped into 5 themes. The following 13 factors were statistically significant: (1) demographics theme: aged 80 years and older (OR: 2.41; 95% CI: 1.20-4.85), less than or equal to a high school degree (OR: 1.68; 95% CI: 1.44-1.97), smoking (OR: 1.43; 95% CI: 1.18-1.73), and male (OR: 1.38; 95% CI: 1.01-1.89); (2) environment theme: low social support (OR: 7.77; 95% CI: 3.45-17.50) and no homeownership (OR: 1.38; 95% CI: 1.25-1.51); (3) role theme: no social participation (OR: 3.18; 95% CI: 1.30-7.80) and no spouse (OR: 2.61; 95% CI: 1.37-4.99); (4) physical health: hearing loss (OR: 2.78; 95% CI: 1.54-5.01), activities of daily living impairment (OR: 2.38; 95% CI: 1.57-3.61), and poor health status (OR: 1.52; 95% CI: 1.32-1.74); and (5) mental health: cognitive decline (OR: 1.85; 95% CI: 1.40-2.45) and depression (OR: 1.72; 95% CI: 1.21-2.44). CONCLUSIONS AND IMPLICATIONS Social isolation in older adults is associated with various factors. Hence, focused intervention should be adopted for older adults. In addition, further longitudinal studies are required to confirm a direct link between multiple factors and social isolation.
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Khanna A, Dryden EM, Bolton RE, Wu J, Taylor SL, Clayman ML, Anwar C, Kasom D, McGowan M, Mullur RS, Bokhour BG, Hyde J. Promoting Whole Health and Well-Being at Home: Veteran and Provider Perspectives on the Impact of Tele-Whole Health Services. Glob Adv Health Med 2022; 11:2164957X221142608. [PMID: 36452292 PMCID: PMC9703484 DOI: 10.1177/2164957x221142608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
Background The Veterans Health Administration (VA) is undergoing a transformation in how healthcare is organized and provided. This transformation to a Whole Health System of Care encompasses the integration of complementary and integrative health services, education, and Whole Health coaching to develop Veterans' self-care skills. During the COVID-19 pandemic, these services were provided via telehealth (tele-WH). Objective We sought to understand Veteran and provider perspectives on how tele-WH impacts Veteran engagement in Whole Health-aligned services and the impact on their well-being. Methods Semi-structured interviews were conducted with 51 providers who delivered tele-WH at 10 VA Medical Centers (VAMCs) and 19 Veterans receiving tele-WH at 6 VAMCs. Participants were asked about their experiences with tele-WH, what they perceived to be the impact of tele-WH on Veterans, and their preferences moving forward. Interviews were transcribed, and a content analysis was performed using a rapid approach. Results We identified 3 major themes that describe the perceived impact of tele-WH on Veterans. These include: (1) increased use of Whole Health-aligned services; (2) deeper engagement with Whole-Health aligned services; and (3) improvements in social, psychological, and physical well-being. Conclusion Tele-WH is perceived to be a strong complement to in-person services and is a promising mechanism for improving engagement with Whole Health-aligned services and promoting Veteran well-being. Future research is needed to measure outcomes identified in this study and to support more equitable access to telehealth for all.
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Affiliation(s)
- Aishwarya Khanna
- US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Eileen M. Dryden
- US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Rendelle E. Bolton
- US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- Brandeis University, The Heller School for Social Policy and Management, MA, USA
| | - Juliet Wu
- US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Stephanie L. Taylor
- US Department of Veterans Affairs, Center for the Study of Health Care Innovation, Implementation & Policy, Los Angeles, CA, USA
- University of California Los Angeles, David Geffen School of Medicine, Department of Medicine School of Public Health, Department of Health Policy and Management, Los Angeles, CA, USA
| | - Marla L. Clayman
- US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- University of Massachusetts Chan Medical School, Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, 368 Plantation Street Worcester, MA 01605
| | - Chitra Anwar
- US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Danna Kasom
- US Department of Veterans Affairs, Center for the Study of Health Care Innovation, Implementation & Policy, Los Angeles, CA, USA
| | - Michael McGowan
- US Department of Veterans Affairs, Center for the Study of Health Care Innovation, Implementation & Policy, Los Angeles, CA, USA
| | - Rashmi S. Mullur
- US Department of Veterans Affairs, Center for the Study of Health Care Innovation, Implementation & Policy, Los Angeles, CA, USA
- Division of Diabetes, Endocrinology & Metabolism, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Integrative Medicine Collaborative, University of California Los Angeles Health, Los Angeles, CA, USA
| | - Barbara G. Bokhour
- US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- University of Massachusetts Chan Medical School, Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, 368 Plantation Street Worcester, MA 01605
| | - Justeen Hyde
- US Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
- Boston University School of Medicine, Section of General Internal Medicine, Department of Medicine, Boston, MA, USA
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Trujillo Tanner C, Yorgason JB, Richardson S, Redelfs AH, Serrao Hill MMY, White A, Stagg B, Ehrlich JR, Markides KS. Sensory Disabilities and Social Isolation Among Hispanic Older Adults: Toward Culturally Sensitive Measurement of Social Isolation. J Gerontol B Psychol Sci Soc Sci 2022; 77:2091-2100. [PMID: 35022736 PMCID: PMC9683500 DOI: 10.1093/geronb/gbac001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Sensory disabilities, including vision disability and hearing disability, increase risk for social isolation, which is associated with multiple negative health outcomes. Existing literature suggests that the cultural value of familism may provide a buffer against social isolation. We examined the longitudinal trajectory of social isolation among Hispanic older adults with self-reported vision disability (SRVD) and self-reported hearing disability and tested a modified measure of social isolation incorporating familism. METHODS We compared 8-year trajectories of social isolation among Hispanics (n = 445) and non-Hispanic Whites (n = 4,861) from the National Health and Aging Trends Study. We used structural equation modeling to explore the longitudinal relationships between sensory disability and social isolation while comparing 2 measures of social isolation. RESULTS Social isolation increased longitudinally for both groups, with SRVD significantly associated with higher initial levels. Social isolation started and remained higher across time among Hispanics. Using an adjusted measure of social isolation (added familial support), neither initial levels nor trajectories of social isolation differed between Hispanic and non-Hispanic White participants. DISCUSSION Initially, Hispanics appeared more socially isolated, reporting less social support from outside the home. Yet, we found that they were more likely to report family social connections. Traditional measures of social isolation focusing on social support outside of the home (neglecting support by family) may lack content validity among Hispanic groups. Culturally sensitive measures of social isolation will be increasingly consequential for future research and health policy to meet the needs of a diverse older population.
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Affiliation(s)
- Corinna Trujillo Tanner
- Address correspondence to: Corinna Trujillo Tanner, PhD, RN, MSN, College of Nursing, Brigham Young University, 432 KMBL, Provo, UT 84602, USA. E-mail:
| | | | | | - Alisha H Redelfs
- School of Public Health, Brigham Young University, Provo, Utah, USA
| | | | - Avalon White
- School of Family Life, Brigham Young University, Provo, Utah, USA
| | - Brian Stagg
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Kyriakos S Markides
- Department of Preventive Medicine and Population Health, University of Texas, Galveston, Texas, USA
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