Social withdrawal and psychological well-being in later life: does marital status matter?

Social frailty in older adults: A concept analysis

BACKGROUND

Social frailty has been increasingly prevalent due to the aging populations. This concept is a relatively new topic in the gerontology. Older adults experiencing social isolation because of social frailty remain in a state of loneliness or depression. Many misconceptions exist regarding the association between social frailty and high levels of loneliness and depression in older adults, which may exacerbate their condition.

OBJECTIVE

To analyze the concept of social frailty on the basis of method introduced by Rodgers and Knafl.

DESIGN

Rodgers and Knafl' evolutionary concept analysis INFORMATION SOURCES: PubMed, Cochrane Library, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Embase were searched for the terms "Social frailty" and "Elderly" OR "Older adults" OR "Aged."

RESULTS

A total of 65 articles on social frailty were selected from 4 databases and subjected to concept analysis based on Rodgers and Knafl' evolutionary concept. Data extraction and analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The analysis yielded 4 domains (11 subdomains) of antecedents, 3 attributes, and 2 domains (28 subdomains) of consequences.

CONCLUSION

The study findings contribute to a comprehensive and structured understanding of social frailty for health-care workers and the general public. Emphasizing the concept of social frailty can increase the levels of awareness and vigilance among health-care workers regarding the risks associated with social frailty in older adults.

Development and validation of a risk prediction model for older adults with social isolation in China

BACKGROUND

Older adults are vulnerable to social isolation due to declining physical and cognitive function, decreased interpersonal interactions, and reduced outdoor activities after retirement. This study aimed to develop and validate a predictive model to assess the risk of social isolation among older adults in China.

METHODS

Using data from the 2011 China Health and Retirement Longitudinal Study (CHARLS). The study cohort was randomly divided into training and validation groups in a 70:30 ratio. We used least absolute shrinkage and selection operator (LASSO) regression analysis with tenfold cross-validation to identify optimal predictive factors and examined the correlates of social isolation using logistic regression. A nomogram was constructed for the predictive model, and its accuracy was assessed using calibration curves. The predictive performance of the model was assessed using area under the receiver operating characteristic (ROC) curve and decision curve analysis (DCA).

RESULTS

From the 2011 CHARLS database, 4,747 older adults were included in the final analysis, of whom 1,654 (34.8%) experienced social isolation. Multifactorial logistic regression identified educational level, marital status, gender, physical activity, physical self -maintenance ability, and number of children as predictive factors for social isolation. The predictive model achieved an AUC of 0.739 (95%CI = 0.722-0.756) in the training set and 0.708 (95%CI = 0.681-0.735) in the validation set. The Hosmer-Lemeshow test yielded P values of 0.111 and 0.324, respectively (both P > 0.05), indicating significant agreement between the nomogram and observed outcomes. The nomogram showed excellent predictive ability according to ROC and DCA.

CONCLUSIONS

The predictive model developed to assess the risk of social isolation in the Chinese older adults shows promising utility for early screening and intervention by clinical healthcare professionals.

“It’s Allowed Me to Be a Lot Kinder to Myself”: Exploration of the Self-Transformative Properties of Solitude During COVID-19 Lockdowns

The Coronavirus (COVID-19) national lockdowns profoundly affected the lives of many, as significant portions of the U.K. population were involuntarily sequestered away from their usual social landscapes into newfound states of solitude. Many millennials (those between the ages of 25 and 40 at the point of study), having lived in an age of constant connection, found themselves in an extended period of solitude for the first time. The current qualitative study explores through Interpretative Phenomenological Analysis (IPA) how some UK millennials were able to harness the unique self-transformative properties of positive solitude during the COVID-19 national lockdowns. Analysis revealed a narrative of self-discovery, as domains of positive solitude granted the participants freedom from the demands of performative social burdens and encouraged opportunities to engage with mindfulness and meaningful introspection. These activities, within the experience of solitude, encouraged an alignment of inward beliefs and outward behaviors for the participants, thus helping them to cultivate a more congruent self-concept and subsequently a heightened sense of authenticity and enhanced psychological well-being. Clinical implications leading on from the current study highlight the importance of mindfulness and other solitude-promoting interventions as a method to ameliorate depressive symptoms and improve psychological well-being.

Informal Caregiving, Loneliness and Social Isolation: A Systematic Review

Background: Several empirical studies have shown an association between informal caregiving for adults and loneliness or social isolation. Nevertheless, a systematic review is lacking synthesizing studies which have investigated these aforementioned associations. Therefore, our purpose was to give an overview of the existing evidence from observational studies. Materials and Methods: Three electronic databases (Medline, PsycINFO, CINAHL) were searched in June 2021. Observational studies investigating the association between informal caregiving for adults and loneliness or social isolation were included. In contrast, studies examining grandchild care or private care for chronically ill children were excluded. Data extractions covered study design, assessment of informal caregiving, loneliness and social isolation, the characteristics of the sample, the analytical approach and key findings. Study quality was assessed based on the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Each step (study selection, data extraction and evaluation of study quality) was conducted by two reviewers. Results: In sum, twelve studies were included in our review (seven cross-sectional studies and five longitudinal studies)—all included studies were either from North America or Europe. The studies mainly showed an association between providing informal care and higher loneliness levels. The overall study quality was fair to good. Conclusion: Our systematic review mainly identified associations between providing informal care and higher loneliness levels. This is of great importance in assisting informal caregivers in avoiding loneliness, since it is associated with subsequent morbidity and mortality. Moreover, high loneliness levels of informal caregivers may have adverse consequences for informal care recipients.