Functional Limitations, Volunteering, and Diurnal Cortisol Patterns in Older Adults

Study protocol of the 'HEAL-HOA' dual randomized controlled trial: Testing the effects of volunteering on loneliness, social, and mental health in older adults

Background

Interventions to reduce loneliness in older adults usually do not show sustained effects. One potential way to combat loneliness is to offer meaningful social activities. Volunteering has been suggested as one such activity - however, its effects on loneliness remain to be tested in randomized controlled trials (RCT).

Methods

This planned Dual-RCT aims to recruit older adults experiencing loneliness, with subsequent randomization to either a volunteering condition (6 weeks of training before delivering one of three tele-based loneliness interventions to older intervention recipients twice a week for 6 months) or to an active control condition (psycho-education with social gatherings for six months). Power analyses require the recruitment of N = 256 older adults to detect differences between the volunteering and the active control condition (128 in each) on the primary outcome of loneliness (UCLA Loneliness Scale). Secondary outcomes comprise social network engagement, perceived social support, anxiety and depressive symptoms, self-rated health, cognitive health, perceived stress, sleep quality, and diurnal cortisol (1/3 of the sample). The main analyses will comprise condition (volunteering vs. no-volunteering) × time (baseline, 6-, 12-, 18-, 24-months follow-ups) interactions to test the effects of volunteering on loneliness and secondary outcomes. Effects are expected to be mediated via frequency, time and involvement in volunteering.

Discussion

If our trial can show that volunteers delivering one of the three telephone-based interventions to lonely intervention recipients benefit from volunteer work themselves, this might encourage more older adults to volunteer, helping to solve some of the societal issues involved with rapid demographic changes.

Long-term psychological consequences of parental bereavement prior to midlife: volunteering helps

OBJECTIVES

Losing a child prior to midlife may be a uniquely traumatic event that continues to compromise parents' well-being in later life. This study compared psychological well-being between bereaved and non-bereaved parents, and examined whether volunteering protects bereaved parents. Because most families have more than one child, we further explored whether the number of living children parents had differentiated bereaved parents in their well-being.

METHODS

We analyzed a pooled sample of parents aged 50+ (N = 12,023) from the Health and Retirement Study (2010/2012-2012/2014), including parents who lost a child prior to 50 and those who never lost a child. Two-level linear regression models were estimated to test the associations between child loss, volunteering, and psychological well-being, and examine the moderating effect of number of living children.

RESULTS

Bereaved parents reported more depressive symptoms and lower life satisfaction than their non-bereaved counterparts, which was more evident among parents with fewer children alive. Among bereaved parents, volunteering, particularly volunteering 100+ hours/year, was associated with better psychological well-being at baseline; yet, volunteering 1-99 hours/year led to a larger increase in life satisfaction over time. The benefits of volunteering held true regardless of the number of living children.

CONCLUSION

This study adds to our understanding of the lasting effect of parental bereavement and suggests volunteering as a potential intervention aimed at helping bereaved older parents. Findings identify parents with fewer children as a particularly vulnerable population in the face of child loss and calls for more resources allocated to help them.