Use of Information and Communication Technology (ICT) Devices Among the Oldest-Old: Loneliness, Anomie, and Autonomy

Mapping of technological strategies for reducing social isolation in homebound older adults: A scoping review

BACKGROUND

Homebound older adults (HOAs) are particularly vulnerable to social isolation and loneliness, which engender a poorer physical and mental health, and greater cognitive decline. The purpose of this review is to map the literature to identify potential technological strategies that reduce social isolation in HOAs, and to understand facilitators and barriers for adoption and implementation.

METHODS

Six databases including PubMed (MEDLINE), Google Scholar, Cochrane Database, EBSCOHost, National Library ProQuest, Web of Science, and the Journal of Medical Internet Research were searched for relevant articles. Peer-reviewed literature published in English from Jan 2014 to Feb 2024 that employed technological strategies applicable to HOAs and assessed social isolation or connectedness as an outcome measure were included.

RESULTS

107 studies were reviewed and classified into different technological categories based on their functions and features. A social technology framework encompassing delivery, hardware, software, content, training, and support was conceptualized with core characteristics identified from the reviewed technological strategies. Cost and complexity of technology, and resource commitment were identified as barriers while user-friendliness, content curation and a supportive ecosystem may facilitate the adoption of a technological strategy to address social isolation in HOAs.

CONCLUSION

There is a need for early and concerted effort to identify HOAs, provide technology training, and empower them to tap on the digital world to complement and/or supplement social interactions. Development of cost-effective and rapid-to-implement technology is vital for HOAs who are at highest risk to social isolation.

Older adults' online activities and cognition: Investigating the psychological mechanisms and age and gender differences

OBJECTIVES

This study aimed to investigate psychological mechanisms underlying the association between older adults' Internet use and cognition and examine potential age and gender group differences.

METHODS

2064 older participants were extracted from the Waves 2012, 2013, and 2016 Health and Retirement Study. Internet use was measured by two sets of variables: Internet access and different types of online activities (i.e., informational use, social use, online shopping, and online banking). Path analyses were applied to test the proposed mechanisms via three mediators (i.e., loneliness, depressive symptoms, and perceived control). Multi-group analyses were conducted to examine the potential group differences.

RESULTS

Internet use was positively associated with cognition. Despite the large direct effect, small but significant indirect effects via depressive symptoms and perceived control were identified across all online activities. Multi-group analyses revealed age-group differences in the mechanisms: depressive symptoms mediated the effects of all online activities on cognition among young-old adults, while perceived control mediated all the effects among old-old adults. Gender group differences were also identified: depressive symptoms mediated the effects of all online activities on cognition among older women and most online activities among older men, whereas perceived control mediated the associations between informational and instrumental (i.e., online shopping and banking) use and cognition among older men.

DISCUSSION

This study highlights the mediating effect of depressive symptoms and perceived control and age and gender differences regarding the Internet use-cognition association. Internet-based cognitive interventions should consider these psychological mediators and age and gender differences for the best results.

Autonomy, independence, and participation of nursing home habitants addressed by assistive technology: a scoping review

CONTEXT

Assistive technologies have been identified by researchers and public policies of the Western world to be promising tools to face the challenge of maintaining quality of life of older people, and especially for nursing home habitants. Independence, autonomy, and participation are major determinants of quality of life of nursing homes habitants. Maintaining quality of life is nowadays a priority for public health policies and institutions of the where the population is growing older every year.

METHOD

This PRISMA-ScR review aims to determine which assistive technologies are used to promote autonomy, independence, and social participation of nursing home habitants. An electronic search was conducted for English, French articles to identify research studies using CINAHL, PubMed, Cochrane Library, PsycINFO, and Googlescholar.

RESULTS

12 papers published between 2009 and 2023 described 6 assistive technologies: technologies integrated into the environment, monitoring technologies, surveillance technologies, information and communication technology, social assistance robots, virtual reality. Six types of AT are currently used worldwide to maintain autonomy, independence and participation of people living in nursing homes. Their use is mainly perceived as positive by habitants, care and non-care staff, next of kin, and experts despite some concerns regarding ethical, financial, consideration.

DISCUSSION

Nevertheless, their impact on habitant's autonomy, independence and participation still needs to be measured using suitable tools to understand their real impact on the quality of life of the elderly.

Internet use and loneliness among older Chinese adults

OBJECTIVES

This study examined the association between Internet use and loneliness among Chinese older adults (aged 60+) over a two-year period using nationally representative survey data from China.

METHODS

Using data from the 2016 and 2018 waves of the China Longitudinal Ageing Social Survey (N = 8,059), we estimated difference-in-differences regression models to assess the association between Internet use and levels of loneliness over time.

RESULTS

Compared to Internet non-users, Chinese older adults who were new Internet users, as well as those who were continuous Internet users, reported lower levels of loneliness over time (B = -0.21, p < 0.001 and B = -0.16, p < 0.001, respectively). Conversely, those Chinese older adults who used the Internet in wave 1 but then disengaged from using the Internet in wave 2 demonstrated an upward trend in loneliness over time, similar to Internet non-users (the estimate of difference-in-differences was non-significant for the comparison between disengaged-users and non-users: B = -0.03, p = 0.42).

CONCLUSION

This study provided new evidence to support the potential benefits of Internet use for reducing the risk of loneliness among Chinese older adults. The findings suggested that supporting current Internet users to remain digitally engaged is as important as encouraging Internet non-users to cross the digital divide.

Digital exclusion and cognitive impairment in older people: findings from five longitudinal studies

OBJECTIVES

Older people are more likely to have digital exclusion, which is associated with poor health. This study investigated the relationship between digital exclusion and cognitive impairment in older adults from 23 countries across five longitudinal surveys.

DESIGN AND MEASUREMENTS

Digital exclusion is defined as self-reported non-use of the Internet. We assessed cognitive impairment on three dimensions: orientation, memory, and executive function. We used generalized estimation equations fitting binary logistic regression with exchangeable correlations to study the relationship between digital exclusion and cognitive impairment, and apply the minimum sufficiently adjusted set of causally directed acyclic graphs as the adjusted variable.

SETTING AND PARTICIPANTS

We pooled a nationally representative sample of older adults from five longitudinal studies, including the China Health and Retirement Longitudinal study (CHARLS), the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Study (HRS), the Mexican Health and Ageing Study (MHAS) and the Survey of Health, Ageing and Retirement in European (SHARE).

RESULTS

We included 62,413 participants from five longitudinal studies. Digital exclusion varied by country, ranging from 21.69% (SHARE) in Denmark to 97.15% (CHARLS) in China. In the original model, digital exclusion was significantly associated with cognitive impairment in all five studies. In the adjusted model, these associations remained statistically significant: CHARLS (Odds ratio [OR] = 2.81, 95% confidence interval [CI] 1.84-4.28, ELSA (1.92 [1.70-2.18]), HRS(2.48[2.28-2.71), MHAS (1.92 [1.74-2.12]), and SHARE (2.60 [2.34-2.88]).

CONCLUSION

Our research shows that a significant proportion of older people suffer from digital exclusion, especially in China. Digital exclusion was positively correlated with cognitive impairment. These findings suggest that digital inclusion could be an important strategy to improve cognitive function and reduce the risk of cognitive impairment in older adults.

Can a "Pandemic Life Adaptation" Digital Technology Curriculum Reduce the Digital Disadvantage of Older Adults During COVID-19? An Intervention Study from Shanghai

Older adults are at a digital disadvantage because of social stereotypes and a lack of social support; however, smartphones have become a necessary technology to cope with crises and daily life in China, especially during the pandemic. This study aimed to help marginalized older adults take on new tasks by developing digital technology education that used a framework of social cognitive theory in social work. The study followed a quasi-experimental design in which 153 elderly people were recruited from three community service centers; 90 of the participants received 6-weekly intervention. Intent-to-treat analysis, effect size calculations, and sensitivity analysis were conducted. The findings show that digital education significantly enhanced two domains of digital life adaptation abilities: general digital life adaptation abilities [g = .50, 95% CI (.70, 2.69)] and pandemic digital life adaptation abilities [g = .89, 95% CI (.96, 2.07)]. The intervention also improved three domains of digital self-efficacy: sharing and communication [g = .55, 95% CI (.04, .48)], verification [g = .34, 95% CI (.01, .59)], and influencing others [g = .53, 95% CI (.13, .77)]. The study showed that the new intervention approach reduced the harm to vulnerable older adults in the digital wave, especially during the pandemic.

Perceived Benefits and Disadvantages Associated with the Use of the Electronic Consultation Register by Health Providers in the Health District of Toma, Burkina Faso

Background and Objective

Most countries in sub-Saharan Africa need to catch up in integrating information and communication technologies (ICT) into their health systems. This is mainly because of the need for more infrastructure that allows for reasonable use of the technologies. To support the actions of the Ministry of Health of Burkina Faso, a Non-governmental Organization (NGO) has implemented the integrated electronic diagnostic approach (IeDA) Project. The project includes the deployment of an electronic consultation register (ECR). This article aims to explore the perceptions of healthcare providers on the benefits and disadvantages of using the ECR.

Methods

We conducted a qualitative, descriptive study through individual semi-structured interviews with healthcare providers. Data were collected in the Toma health district in December 2021. In addition, a thematic analysis was performed using NVivo software.

Results

Thirty-five healthcare workers were interviewed (19 nurses, 7 midwives, 6 mobile community health and hygiene workers, and 3 birth attendants). Two main themes emerged from our analyses, which are the advantages and disadvantages perceived by ECR users. Our data suggest that using the ECR had many benefits ranging from improving healthcare providers' knowledge and performance in terms of patients' care, assisting and helping in patient diagnosis and treatment and improving patient satisfaction. However, the participants also shared their negative perceptions about the ECR, mentioning that it increased their workload. They also reported lengthened consultation time and work duplication as the tool was still in its trial phase and was used along with the paper consultation register.

Conclusion and Global Health Implications

The ECR is an effective tool for diagnosis and management, which has several advantages and reasonably satisfies patients. However, disadvantages, including increased workload and lack of fluidity and stability of the system, must be considered to ensure better usability.

Older Adults, Tablets, and Ambivalence: A Grounded Theory Study of a One-Tablet-Per Older Person, Public Program in Uruguay

This study used grounded theory to investigate older Uruguayans' use of tablets delivered through a public program called Plan Ibirapitá. This program was developed in 2015, by the leftist government that was in power at that time, to promote the digital inclusion of individuals considered to be excluded from the benefits of the information society, such as older adults. Through Plan Ibirapitá, older adults who receive a pension below approximately 900 USD, receive a tablet for free, training for its use, and 1 GB of monthly internet. According to the program's Fifth-Use Survey from 2019, almost 60% of those who received Plan Ibirapitá's tablet do not use it. To examine the relationship between older adults and the tablets, twenty-six participants were interviewed about their experiences with this device. Results suggest that the relationship they established with the tablets is ambivalent. On the one hand, the participants see information and communication technology (ICT) as modern tools that are useful for communicating with loved ones. On the other hand, they understood their lives as busy for which tablets were mostly unnecessary. These findings indicate that including older people into the digital world is more complex than distributing devices top-down.

Care-ethical considerations of technology-care-assemblages

Technology plays a major role in care. Against the background of demographic ageing, the use of assistive technologies to support and relieve carers in their work is becoming more and more important. One sector that is increasingly coming into focus is home care by family caregivers. Here, the use of assistive technologies takes place under specific conditions. The article proposes a care-ethical perspective to understand these conditions. It critically discusses issues of power and participation in the negotiation of care that can be associated with the use of technology and outlines a care-ethical perspective on technocare.

Digital Health Technology Use Among Older Adults: Exploring the Impact of Frailty on Utilization, Purpose, and Satisfaction in Korea

BACKGROUND

The importance of digital technology is increasing among older adults. In this study, the digital health technology utilization status, purpose, and satisfaction of older adults were investigated according to frailty.

METHODS

A face-to-face survey was conducted among adults aged 65 years or older. Frailty was defined using the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight scale.

RESULTS

A total of 505 participants completed the survey, with 153 (30.3%) identified as pre-frail or frail and 352 (69.7%) as healthy. All respondents used smartphones; 440 (87.1%) were application users, and 290 (57.4%) were healthcare application users. Wearable devices were used by only 36 patients (7.1%). Pre-frail or frail respondents used social media more frequently than healthy respondents (19.4% vs. 7.4%, P < 0.001). Among the respondents, 319 (63.2%) were not able to install or delete the application themselves, and 277 (54.9%) stated that the application was recommended by their children (or partner). Pre-frail and frail respondents used more healthcare applications to obtain health information (P = 0.002) and were less satisfied with wearable devices (P = 0.02).

CONCLUSION

The usage rate of digital devices, including mobile phones among older adults in Korea is high, whereas that of wearable devices is low. There was a notable difference in the services used by pre-frail and frail respondents compared to healthy respondents. Therefore, when developing digital devices for pre-frail and frail older adults, it is crucial to incorporate customized services that meet their unique needs, particularly those services that they frequently use.

The age-based digital divide in an increasingly digital world: A focus group investigation during the COVID-19 pandemic

BACKGROUND AND OBJECTIVES

Previous research has identified numerous benefits of information and communication technology (ICT) on the well-being of older adults. However, it has been increasingly recognized that older adults do not necessarily catch up with the rapidly digitalized society, known as the 'age-based digital divide'. The progress of digitalization has been accelerated during the COVID-19 pandemic, which may have widened the digital divide. This study aimed to gain a better understanding of their living experience and concerns about digital exclusion during the pandemic. The perceptions of older adults in Hong Kong, a highly digitalized, metropolitan city, towards the digital age and its impact on their daily living during the COVID-19 pandemic were explored.

RESEARCH DESIGN AND METHODS

We conducted 12 focus group interviews with 77 community-dwelling older adults during the COVID-19 pandemic. Data were analyzed using thematic analysis, applying both organization, reduction, and refinement.

RESULTS

Four themes were identified: 1) Diversified means to access community information; 2) Facilitated daily living through the usage of ICTs; 3) Concerns about age-related decline in function; and 4) Fear of digital exclusion and accelerated digitalization during the pandemic. The results indicate that ICT provided numerous benefits to the daily life of older adults, but our participants also expressed concerns about age-related losses and the fear of digital exclusion due to the ongoing digitalization of society.

DISCUSSION AND IMPLICATIONS

Our findings indicated that older adults do not necessarily benefit from technological innovations, which are becoming more pervasive during the pandemic. To create age-friendly environments that cater to the needs of all members of society in the digital age, policymakers and service providers should provide diverse choices for older adults, rather than relying solely on one-size-fits-all technological solutions.

Experienced barriers in the use of ICT for social interaction in older adults ageing in place: a qualitative systematic review protocol (SYSR-D-22-00848)

BACKGROUND

Several information and communication technologies (ICT) have been developed to enhance social connectedness of older adults aging in place, although they are not accessible for all. Barriers in using ICT might for example relate to health issues, sensory loss, lack of technical skills, or reluctance to use technologies. Though knowledge on these barriers is crucial for the development and implementation of ICT for older adults, no systematic review was found on this subject. The proposed qualitative systematic review aims to explore barriers experienced by older adults aging in place in using ICT for social interaction.

METHODS

The review will be conducted in accordance with the JBI methodology. Databases for search will include MEDLINE (via PubMed), CINAHL (via EBSCO), and Web of Science (ISI), among others. Included studies focus on older adults ageing in place 60 years or older. Pairs of authors will independently, by following agreed guidelines, assess the eligibility of studies, and extract data. The testing of eligibility criteria and screening of titles, abstracts, and full texts will be performed. The findings will describe for example populations, context, culture, and the phenomena of interest. Qualitative research findings will, where possible, be pooled by using JBI SUMARI for the meta-aggregation approach.

DISCUSSION

The mapping of published studies has the potential to identify research gaps in the existing literature, which again may inform developers and stakeholders in designing more user-friendly and adaptive ICT solutions for older people ageing in place.

SYSTEMATIC REVIEW REGISTRATION

CRD42022370044.

Maximizing the Benefit of Respite for Dementia Caregivers: A Study Protocol Describing the Development & Evaluation of the Time for Living & Caring (TLC) Intervention

Dementia caregivers are susceptible to adverse physical and mental health outcomes, given the often prolonged and challenging care and support they provide to family members with Alzheimer's Disease and Related Dementias (ADRD). This report describes a community-engaged implementation of a novel behavioral intervention - an "app" (interactive website) called TLC (Time for Living and Caring) that coaches caregivers on how to maximize the benefits associated with respite time. The rationale and features of the TLC intervention and the full research protocol used to develop and then evaluate its feasibility, acceptability, and initial efficacy are described here.

The Relationship Between Internet Use for Social Purposes, Loneliness, and Depressive Symptoms Among the Oldest Old

The internet enables communication with social partners and has been found to be related to higher psychological well-being among older adults. Using data from the representative German North Rhine-Westphalia 80+ (NRW80+) study (n = 1,698, Mage = 84.86), we conducted linear regression and mediation analyses to compare levels of loneliness and depressive symptoms of onliners using the internet for social or other purposes with offliners. Oldest old onliners used the internet mostly for social purposes, and this type of internet use was related to a significantly lower level of loneliness and fewer depressive symptoms compared to offliners. The mediation analysis revealed that internet use for social purposes was related to lower levels of loneliness, which in turn was associated with a lower number of depressive symptoms. The findings suggest that internet use for social purposes may help the oldest old to reduce feelings of loneliness and depressive symptoms.

Impact of employee digital competence on the relationship between digital autonomy and innovative work behavior: a systematic review

With the advent of the COVID-19 pandemic, the level of concern regarding employee digital competence has increased significantly. Several studies provide different surveys, but they cannot describe the relationship between digital autonomy and innovative work behaviour concerning the impact of employee digital competence. Hence, it is necessary to conduct a survey that provides a deeper understanding of these concerns and suggests a suitable study for other researchers. Using scientific publication databases and adhering to the PRISMA statement, this systematic literature review aims to offer a current overview of employee digital competence impact on the relationship between digital autonomy and innovative work behaviour from 2015 to 2022, covering definitions, research purposes, methodologies, outcomes, and limitations. When reviewing the selected articles, 18 articles were examined under relationship topics, and 12 articles reported on impact topics under different tasks. The main findings highlight the significance of digital competence and autonomy in promoting employee creativity, learning, and sharing knowledge. According to the review findings, employees with greater digital autonomy are more likely to engage in innovative work, leading to improved job performance and empowerment. Therefore, the development of digital autonomy prioritizes organizations by providing access to digital tools, training, and a supportive work environment. Overall, the current review indicates a strong positive correlation between digital autonomy, innovative work behaviour, and employee impact. This underscores the importance for organizations to not only participate in digital competence and skills, but also to create a culture that values autonomy, creativity, and innovation among its employees.

Effectiveness of laptop-based versus smartphone-based videoconferencing interaction on loneliness, depression and social support in nursing home residents: A secondary data analysis

INTRODUCTION

The worldwide coronavirus disease 2019 pandemic re-emphasises the importance of videoconferencing in supporting interactions between nursing home residents and their family and friends. However, there is a scarcity of comparative studies on how modalities of conferencing programs impact health outcomes. The purpose of this study was to compare laptop-based with smartphone-based videoconferencing programs on nursing home residents' perceptions of loneliness, depressive symptoms and social support.

METHODS

This retrospective secondary analysis used data from two previous studies on the effectiveness of videoconferencing programs (laptop-based and smartphone-based) to improve outcomes of loneliness, depressive symptoms and social support (type and source) among nursing home residents. Generalised estimating equations compared differences from baseline measures with measures at 1 and 3 months between the two groups with and without adjusting for the effects of confounding variables.

RESULTS

With the exception of age, there were no differences in demographics between participants in the laptop and smartphone groups. Neither changes from baseline in mean scores for loneliness nor depressive symptoms differed between groups. However, changes in mean scores from baseline between groups were significantly greater in the smartphone-based group compared with the laptop-based group for three types of social support: informational and appraisal at 1 and 3 months; and emotional at 3 months. Changes from baseline in mean scores for social support from friends (at 1 and 3 months) and other sources (at 3 months) were also significantly greater for the smartphone group compared with the laptop group.

DISCUSSION

The two modalities of videoconferencing did not differ in effects on depressive symptoms or loneliness. However, smartphones had a greater effect on the type and source of social support compared with laptops. Whether the small screen of a smartphone reduces users' anxiety and allows them to talk more on screen is worth studying.

Older adult communication types and emotional well-being outcomes during COVID-19 pandemic

BACKGROUND

The rationale for the present study is a result of the COVID-19 pandemic, as there are fewer opportunities available for older adults to engage in face-to-face interaction and social activities, which may result in changes in the communication methods with their social contacts. The purpose of this study was to explore the relationship between methods of social connectedness and emotional well-being outcomes among older adults at the start of the pandemic.

METHODS

Two thousand five hundred and fifty-eight older adults Medicare beneficiaries (65 + years of age) in the National Health and Aging Trends Study at wave 10 (June 2020 to January 2021) were selected for cross-sectional analysis. Participants were measured on brief questionnaires regarding forms of communication with family and friends before and during the pandemic. Emotional well-being outcomes were measured on single items of sadness/depressed and loneliness; as well as a 6-item Likert scale of anxiety during the pandemic. Paired sample t-tests were utilized to examine the forms of communication between before and during pandemic. Hierarchical regressions were conducted to assess the relationship between forms of communication and emotional well-being outcomes.

RESULTS

We found that there were overall decreases in communication frequency during pandemic. Findings from regression analyses indicated information communication technology (ICT) are associated with negative emotional well-being outcomes, whereas in-person social contact are associated with lower levels of negative affect.

CONCLUSION

These findings suggest utilizing higher levels of ICT has negative implications for older adults' emotional well-being, contrasting with the positive implication of in-person contacts. These findings highlight the role of ICT in emotional well-being among older adults during pandemic.

Digital Practices by Citizens During the COVID-19 Pandemic: Findings From an International Multisite Study

BACKGROUND

The COVID-19 pandemic brought digital practices and engagement to the forefront of society, which were based on behavioral changes associated with adhering to different government mandates. Further behavioral changes included transitioning from working in the office to working from home, with the use of various social media and communication platforms to maintain a level of social connectedness, especially given that many people who were living in different types of communities, such as rural, urban, and city spaces, were socially isolated from friends, family members, and community groups. Although there is a growing body of research exploring how technology is being used by people, there is limited information and insight about the digital practices employed across different age cohorts living in different physical spaces and residing in different countries.

OBJECTIVE

This paper presents the findings from an international multisite study exploring the impact of social media and the internet on the health and well-being of individuals in different countries during the COVID-19 pandemic.

METHODS

Data were collected via a series of online surveys deployed between April 4, 2020, and September 30, 2021. The age of respondents varied from 18 years to over 60 years across the 3 regions of Europe, Asia, and North America. On exploring the associations of technology use, social connectedness, and sociodemographic factors with loneliness and well-being through bivariate and multivariate analyses, significant differences were observed.

RESULTS

The levels of loneliness were higher among respondents who used social media messengers or many social media apps than among those who did not use social media messengers or used ≤1 social media app. Additionally, the levels of loneliness were higher among respondents who were not members of an online community support group than among those who were members of an online community support group. Psychological well-being was significantly lower and loneliness was significantly higher among people living in small towns and rural areas than among those living in suburban and urban communities. Younger respondents (18-29 years old), single adults, unemployed individuals, and those with lower levels of education were more likely to experience loneliness.

CONCLUSIONS

From an international and interdisciplinary perspective, policymakers and stakeholders should extend and explore interventions targeting loneliness experienced by single young adults and further examine how this may vary across geographies. The study findings have implications across the fields of gerontechnology, health sciences, social sciences, media communication, computers, and information technology.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.3389/fsoc.2020.574811.

Longitudinal Associations Between Disaster Damage and Falls/Fear of Falling in Older Adults: 9-Year Follow-Up of Survivors of the 2011 Great East Japan Earthquake and Tsunami

Background and Objectives

Fear of falling and falls are common in older adults. However, their associations with natural disaster exposures remain poorly understood. This study aims to examine longitudinal associations between disaster damage with fear of falling/falls among older disaster survivors.

Research Design and Methods

In this natural experiment study, the baseline survey (4,957 valid responses) took place 7 months before the 2011 Great East Japan Earthquake and Tsunami, and 3 follow-ups were conducted in 2013, 2016, and 2020. Exposures were different types of disaster damage and community social capital. Outcomes were fear of falling and falls (including incident and recurrent falls). We used lagged outcomes in logistic models adjusting for covariates and further examined instrumental activities of daily living (IADLs) as a mediator.

Results

The baseline sample had a mean (standard deviation) age of 74.8 (7.1) years; 56.4% were female. Financial hardship was associated with fear of falling (odds ratio (OR), 1.75; 95% confidence interval (CI) [1.33, 2.28]) and falls (OR, 1.29; 95% CI [1.05, 1.58]), especially recurrent falls (OR, 3.53; 95% CI [1.90, 6.57]). Relocation was inversely linked with fear of falling (OR, 0.57; 95% CI [0.34, 0.94]). Social cohesion was protectively associated with fear of falling (OR, 0.82; 95% CI [0.71, 0.95]) and falls (OR, 0.88; 95% CI [0.78, 0.98]) whereas social participation increased the risk of these issues. IADL partially mediated observed associations between disaster damage and fear of falling/falls.

Discussion and Implications

Experiences of material damage rather than psychological trauma were associated with falls and fear of falling, and the increased risk of recurrent falls revealed a process of cumulative disadvantage. Findings could inform targeted strategies for protecting older disaster survivors.

Internet usage among the oldest-old: does functional health moderate the relationship between internet usage and autonomy?

In recent years, research on internet usage in old age and its associations with well-being outcomes has increased. However, the oldest-old age group (80 years and older) is frequently underrepresented, and autonomy and functional health are rarely considered in these studies. By applying moderation analyses with a representative dataset of the oldest-old in Germany (N = 1863), our study has analyzed the hypothesis that the autonomy of older individuals, in particular of those with limited functional health, can be enhanced by internet usage. The moderation analyses indicate that the positive association between internet usage and autonomy is greater for older individuals with lower functional health. This association remained significant after controlling for social support, housing situation, education, gender, and age. Explanations for these results are discussed, and imply that further research is needed to understand the relationships between internet usage, functional health, and autonomy.

Older Adults' Use of a Research-Based Web Platform for Social Interaction

Loneliness and social isolation are triggers for unfavorable changes in older adults' health and well-being. Information and communication technology (ICT) can be used by older adults to mitigate the negative effects of loneliness and social isolation. However, ICT needs to be customized to the specific needs and conditions of older adults. The aim of this study was to explore older adults' use of a new, co-designed and research-based web platform for social interaction from the perspectives of older adults, researchers, and social services personnel. The study is an intervention study with a multimethod approach in which 20 older adults used the web platform for social interaction "the Fik@ room" for eight weeks. Quantitative and qualitative data were collected pretest, during the test, and posttest. The Fik@ room met the expectations of those older adults who completed the study. It enabled them to expand their social network and develop new friendships, but their experiences of loneliness were not reduced. The involvement of social services personnel in recruitment and support was important in facilitating older adults' use of the Fik@ room. Our study contributes knowledge about a new, co-designed and research-based web platform, customized specifically for older adults, which is valuable in guiding the design and delivery of future web platforms for social interaction among older adults.

Digital Storytelling as an Intervention for Older Adults: A Scoping Review

The population of older adults is rapidly increasing worldwide. Owing to fewer interactions between generations, older adults experience ageism and various psychological issues, such as depression and loneliness. Digital storytelling (DST) has the potential to share vivid lived experiences, support the forming of social relationships, and lead to improved well-being. This scoping review examines the potential psychosocial benefits of individual DST interventions for older adults and people with dementia. We adopted the methodological framework for scoping reviews outlined in the Joanna Briggs Institute's (JBI) manual. A scoping review was performed using the following bibliographic databases: Web of Science, PubMed, Cochrane Library, CINAHL, Research Information Sharing Service, and National Assembly Library. There were 395 references retrieved, of which 19 articles were selected after applying inclusion and exclusion criteria. Our findings revealed that the most common effects of DST on older adults included the promotion of mental health, an increased amount of meaningful community connections, greater digital literacy, the mitigation of negative ageism, and enhanced intellectual ability. We suggest randomized controlled trials are conducted to confirm the efficacy of intergenerational DST intervention and the effects of DST interventions at multilevel outcomes, including the community level.

The association between information and communication technologies, loneliness and social connectedness: A scoping review

Older adults are at a higher risk of loneliness, compared to other demographics. The use of Internet Communication and Technologies (ICTs) among older adults is steadily increasing and given ICTs provide a means of enhancing social connectedness suggests they may have positive effects on reducing loneliness. Therefore, the aim of this scoping review was to examine the research that explores how ICTs may be implicated in mitigating loneliness and increasing social connectedness among older adults. After the examination of 54 articles, we identified three major themes within the literature: (1) ICTs were associated with a reduction in loneliness and increase in wellbeing. (2) ICTs promoted social connectedness by facilitating conversations. (3) Factors such as training, self-efficacy, self-esteem, autonomy, and the design/features, or affordances, of ICTs contribute toward the associations between ICT use and wellbeing. The heterogeneity of methodologies, statistical reporting, the small sample sizes of interventional and observational studies, and the diversity of the experimental contexts underline the challenges of quantitative research in this field and highlights the necessity of tailoring ICT interventions to the needs and contexts of the older users.

Welfare technology interventions among older people living at home-A systematic review of RCT studies

The main goal of health services is for the elderly to maintain their mental and physical health and live at home independently for as long as possible. Various technical welfare solutions have been introduced and tested to support an independent life. The aim of this systematic review was to examine different types of interventions and assess the effectiveness of welfare technology (WT) interventions for older people living at home. This study was prospectively registered in PROSPERO (CRD42020190316) and followed the PRISMA statement. Primary randomized control trial (RCT) studies published between 2015 and 2020 were identified through the following databases: Academic, AMED, Cochrane Reviews, EBSCOhost, EMBASE, Google Scholar, Ovid MEDLINE via PubMed, Scopus, and Web of Science. Twelve out of 687 papers met the criteria for eligibility. We used risk-of-bias assessment (RoB 2) for the included studies. Based on the RoB 2 outcomes that showed a high risk of bias (>50%) and high heterogeneity of quantitative data, we decided to narratively summarize the study characteristics, outcome measures, and implications for practice. The included studies were conducted in six countries, namely the USA, Sweden, Korea, Italy, Singapore, and the UK. One was conducted in three European countries (the Netherlands, Sweden, and Switzerland). A total of 8437 participants were sampled, and individual study sample sizes ranged from 12 to 6742. Most of the studies were two-armed RCTs, except for two that were three-armed. The duration of the welfare technology tested in the studies ranged from four weeks to six months. The employed technologies were commercial solutions, including telephones, smartphones, computers, telemonitors, and robots. The type of interventions were balance training, physical exercise and function, cognitive training, monitoring of symptoms, activation of emergency medical systems, self-care, reduction of death risk, and medical alert protection systems. The latter studies were the first of their kind and suggested that physician-led telemonitoring could reduce length of hospital stay. In summary, welfare technology seems to offer solutions to supporting elderly people at home. The results showed a wide range of uses for technologies for improving mental and physical health. All studies showed encouraging results for improving the participants' health status.

Effectiveness of the non-face-to-face comprehensive elderly care application "smart silver care" for community-dwelling elderly: A randomized controlled trial

Background

Quality of life for the elderly has become an important issue, and services aimed at improving it have typically been provided face-to-face. However, coronavirus disease 2019 has limited the use of face-to-face services, and the need to convert such systems to online interfaces has emerged.

Objective

This study evaluates the effectiveness of a non-face-to-face comprehensive elderly care application called "Smart Silver Care."

Methods

This study was designed as a randomized controlled trial. Sixty community-dwelling elderly individuals were randomly assigned to experimental and control groups in a 1:1 ratio. The participants participated in the "Smart Silver Care" intervention using a tablet and smartwatch based on the programs we provided. The participants performed five tasks, five days a week, consisting of physical, emotional, and cognitive programs. Participants could communicate with the researchers in real-time from their homes, and the researchers could remotely supervise their performance.

Results

We found positive effects on the relevant scales testing fall risk (Activities-Specific Balance Confidence [ABC] Scale, p = 0.028; Timed Up and Go [TUG] test, p = 0.001). However, there was no time × group interaction between the experimental and control groups on the relevant scales for depression and quality of life (Short Form-Geriatric Depression Scale [SGDS]-K: p = 0.225; EuroQol five-dimension five-level [EQ-5D-5L], p = 0.172). While the SGDS-K and EQ-5D-5L did not show statistical significance, we found improvement trends in the experimental group.

Conclusions

The findings of this study show that Smart Silver Care significantly improved the participants' TUG and ABC scores in community-dwelling elderly, and a qualitative evaluation confirmed that it could be conveniently used by the elderly. Thus, Smart Silver Care offers a feasible intervention to improve the quality of life of the elderly, including physical aspects.

Social and Emotional Loneliness in Older Community Dwelling-Individuals: The Role of Socio-Demographics

BACKGROUND

Social determinants have a major influence on individuals' health, and among them, loneliness has an important impact on the health of the elderly.

OBJECTIVES

The aims were to determine loneliness and its social and emotional components in a sample of elderly people and to assess its prevalence and associations with sociodemographic variables.

METHODS

Analytical, cross-sectional, observational research was carried out based on a population over 60 years of age in Valencia (Spain). Loneliness was assessed with the De Jong-Gierveld Loneliness Scale.

RESULTS

Five-hundred and thirty community-dwelling individuals participated. The mean age of the sample was 72.7 years (84.2% women); 36.2% suffered from moderate loneliness and 6.6% suffered from extreme loneliness. The sociodemographic variables most significantly related to loneliness were being single, separated, or divorced (p < 0.01). Among widowers, loneliness was inversely associated with years of widowhood (p < 0.01). Having sons/daughters was a significant protective factor (p < 0.05), while having grandchildren or siblings did not have a significant influence. The ability to walk and smartphone and video call use were not associated with loneliness.

CONCLUSIONS

There is a high prevalence of unwanted loneliness in community-dwelling individuals, and some social factors play an important role. Interventions against loneliness among older people are a priority for welfare and public health.

eHealth Platforms to Promote Autonomous Life and Active Aging: A Scoping Review

New technologies, namely eHealth platforms, are being used more than ever before. These platforms enable older people to have a more independent lifestyle, enhance their participation, and improve their well-being. Information and communication technologies are expected to be linked to the triad of aging, social inclusion, and active participation, which is in line with the implementation of Smart Healthy and Age-Friendly Environments. This scoping review aimed to map eHealth platforms designed to promote autonomous life and active aging. The Joanna Briggs Institute methodology and the PRISMA-ScR checklist were used. A search was conducted on MEDLINE (via PubMed), CINAHL Complete (via EBSCOhost), Scopus, Cochrane Database of Systematic Reviews (via EBSCOhost), SciELO, DART-Europe, CAPES, and MedNar databases. Fourteen studies were included. This scoping review synthesized information on eHealth platforms designed to promote active living, their domains of intervention, and the outcomes assessed in those studies that have implemented and evaluated these eHealth platforms.

Perceptions on Extending the Use of Technology after the COVID-19 Pandemic Resolves: A Qualitative Study with Older Adults

The COVID-19 pandemic of the last two years has affected the lives of many individuals, especially the most vulnerable and at-risk population groups, e.g., older adults. While social distancing and isolation are shown to be effective at decreasing the transmission of the virus, these actions have also increased loneliness and social isolation. To combat social distancing from family and friends, older adults have turned to technology for help. In the health sector, these individuals also had a variety of options that strengthened eHealth care services. This study analyzed the technologies used during the COVID-19 pandemic by a group of older people, as well as explored their expectations of use after the pandemic period. Qualitative and ethnographic interviews were conducted with 10 Portuguese older adults, and data were collected over a period of seven months between 2020 and 2021. The research demonstrated that the use of current and new technologies in the post-pandemic future is likely to be related to overcoming: (i) insecurity regarding privacy issues; (ii) difficulties in using technologies due to the level of use of digital technology; and (iii) the human distancing and impersonal consequences of using these technologies.

Faith Community Nurses Making a Difference for Older African Americans in a Pandemic

ABSTRACT

During and after COVID-19, African Americans experienced a disparate amount of social isolation and loneliness and subsequent increases in morbidity and mortality. Faith community nurses are equipped to assist community providers, health practitioners, and local officials in addressing gaps in older African Americans' financial, social, physical, and spiritual needs during social distancing.

Mobile Application Use and Loneliness among Older Adults in the Digital Age: Insights from a Survey in Hong Kong during the COVID-19 Pandemic

Existing literature on the associations between use of mobile applications (i.e., mobile apps) and loneliness among older adults (OAs) has been mainly conducted before the outbreak of the COVID-19 pandemic. Since mobile apps have been increasingly used by OAs during the pandemic, subsequent effects on social and emotional loneliness need updated investigation. This paper examines the relationship between mobile app use and loneliness among Hong Kong's OAs during the pandemic. In our research, 364 OAs with current use experience of mobile apps were interviewed through a questionnaire survey conducted during July and August 2021, which assessed the use frequency and duration of 14 mobile app types and levels of emotional and social loneliness. The survey illustrated communication (e.g., WhatsApp) and information apps were the most commonly used. Emotional loneliness was associated with the use of video entertainment (frequency and duration), instant communication (duration), and information apps (duration). Association between video entertainment apps' use and emotional loneliness was stronger among older and less educated OAs. Our findings highlight the distinctive relationships between different types of apps and loneliness among Hong Kong's OAs during the pandemic, which warrant further exploration via research into post-pandemic patterns and comparative studies in other regions.

Digitally Inclusive, Healthy Aging Communities (DIHAC): A Cross-Cultural Study in Japan, Republic of Korea, Singapore, and Thailand

One out of three people in Japan will be an older person before 2040. Half of those currently do not utilize the internet, smartphone apps, or digital technology. On the other hand, more than 70% of seniors in Republic of Korea use the internet, and 55% in Singapore had access to it in 2019. The use of digital technology for health promotion has the potential to promote individual and community empowerment, advocating for healthy, active aging. Maintaining equity in health promotion practice requires the digital inclusion of every senior. Therefore, we propose a cross-cultural study to explain the contextual influences of digital inclusion and its consequences on healthy aging in Japan, Korea, Singapore, and Thailand. Quantitatively: digital skills, e-health literacy, participation in health promotion, and quality of life will be analyzed in structural equation models. Qualitatively: thematic analysis will be developed to identify cultural patterns and contextual factors, making sense of what older persons in different countries materialize, say, do, think, and feel to reveal deeper beliefs and core values about digital inclusion and healthy aging. Logics and methods from this protocol would be useful to replicate the study in many countries globally. Evidence from this study is expected to pave the way to digitally inclusive, healthy aging communities (DIHAC) across Japan and Asia.

Findings from Talking Tech: A Technology Training Pilot Intervention to Reduce Loneliness and Social Isolation among Homebound Older Adults

Background and Objectives

Social isolation and loneliness are common among older adults and associated with negative health outcomes including cognitive decline, depression, suicide ideation, and mortality. Information and communication technology interventions are often used to combat loneliness and social isolation; however, homebound older adults face barriers to access. This study reports findings from a novel pilot intervention, called Talking Tech, designed to reduce loneliness and social isolation in homebound older adults by providing one-on-one, in-home technology training, a tablet, and the internet, to promote digital literacy and participation in a virtual senior center.

Research Design and Methods

Twenty-one homebound older adults participated in this 14-week, volunteer-delivered program. We used qualitative interviews with participants, volunteers, and program staff, weekly progress reports from volunteers, and quantitative pre- and postintervention surveys with participants to examine experiences and to evaluate the impact of the intervention on loneliness and social isolation. Qualitative data were analyzed using content analysis and pre- and postintervention survey data were compared.

Results

Participants reported increased technological literacy and use, increased access to online activities, and improved facilitation of social connections to existing and new networks. Additionally, during interviews, many participants reported that participating in Talking Tech alleviated their loneliness. While not statistically significant, our quantitative analysis revealed trends toward decreased participant feelings of loneliness and increased technology use. Additionally, intervention adoption and retention were high, with only one participant withdrawing from the intervention.

Discussion and Implications

This evaluation of the novel Talking Tech pilot intervention provides critical insights into strategies to reduce loneliness and isolation for older adults, with implications for future research, policy, and practice. Findings demonstrate that individualized technology training may be an acceptable way to improve well-being for homebound older adults.

Internet Use and Cognitive Functioning in Later Life: Focus on Asymmetric Effects and Contextual Factors

BACKGROUND AND OBJECTIVES

Despite emerging literature linking Internet usage and cognitive functioning in later life, research seldom takes changes in older adults' Internet use into account. How changes in Internet use influence older adults' cognitive decline over time, particularly in the context of sociodemographic factors that shape Information and Communication Technology (ICT) use, remains an open question.

RESEARCH DESIGN AND METHODS

Using 9 waves of panel data from the Health and Retirement Study (2002-2018), we examined within-person asymmetric effects of transitioning into and out of Internet use on cognitive functioning, and whether the associations vary across birth cohorts and by living arrangement.

RESULTS

Transitioning into Internet use (i.e., Internet use onset) was associated with improved cognitive functioning at a given wave and decelerated cognitive decline over time. Transitioning out of the Internet (i.e., Internet use cessation) was associated with worse cognitive functioning at a given wave and accelerated cognitive decline over time. Furthermore, birth cohort and living arrangement moderated these associations. The detrimental effect of transitioning out of Internet use was worse for older adults born in 1941 or before. The cognitive benefits of transitioning into Internet use were greater for those older adults who live alone.

DISCUSSION AND IMPLICATIONS

These findings highlight the interplay between technology, social environment, and cognitive functioning in later life. The salubrious effects of using the Internet, as well as the deleterious effects of ceasing to use such technology, underscore the importance of promoting digital literacy and access to ICT among the older adult population.

Managing Perceived Loneliness and Social-Isolation Levels for Older Adults: A Survey with Focus on Wearables-Based Solutions

As an inevitable process, the number of older adults is increasing in many countries worldwide. Two of the main problems that society is being confronted with more and more, in this respect, are the inter-related aspects of feelings of loneliness and social isolation among older adults. In particular, the ongoing COVID-19 crisis and its associated restrictions have exacerbated the loneliness and social-isolation problems. This paper is first and foremost a comprehensive survey of loneliness monitoring and management solutions, from the multidisciplinary perspective of technology, gerontology, socio-psychology, and urban built environment. In addition, our paper also investigates machine learning-based technological solutions with wearable-sensor data, suitable to measure, monitor, manage, and/or diminish the levels of loneliness and social isolation, when one also considers the constraints and characteristics coming from social science, gerontology, and architecture/urban built environments points of view. Compared to the existing state of the art, our work is unique from the cross-disciplinary point of view, because our authors' team combines the expertise from four distinct domains, i.e., gerontology, social psychology, architecture, and wireless technology in addressing the two inter-related problems of loneliness and social isolation in older adults. This work combines a cross-disciplinary survey of the literature in the four aforementioned domains with a proposed wearable-based technological solution, introduced first as a generic framework and, then, exemplified through a simple proof of concept with dummy data. As the main findings, we provide a comprehensive view on challenges and solutions in utilizing various technologies, particularly those carried by users, also known as wearables, to measure, manage, and/or diminish the social isolation and the perceived loneliness among older adults. In addition, we also summarize the identified solutions which can be used for measuring and monitoring various loneliness- and social isolation-related metrics, and we present and validate, through a simple proof-of-concept mechanism, an approach based on machine learning for predicting and estimating loneliness levels. Open research issues in this field are also discussed.

Exploring the Nuanced Links Between Internet Use and Subjective Well-Being Among Older Adults: A Nordic Population-Based Study

Aim

The aim was to explore the various associations between subjective well-being and internet use among older adults in two regions in Finland and Sweden.

Methods

The data was collected through a population-based survey (N = 9,386) as part of the GERDA project conducted in 2016. The connection between subjective well-being (measured by perceived meaningfulness, happiness and life satisfaction) and internet use (distinguishing between internet users, non-users and users with support, and diverse internet activities) was studied by conducting binary regression analyses, calculating odds ratios with 95% confidence intervals. The analyses also controlled for key subjective well-being covariates.

Results

Statistically significant associations were found between perceived life meaningfulness and internet use. When looking into the specific internet-based activities under study, activities related to leisure and entertainment showed statistically significant associations to perceived meaningfulness as well as perceived happiness, also after controlling for potential covariates. However, internet use and the different internet activities failed to show statistical significant associations to life satisfaction in the adjusted regression model.

Conclusion

The things we do on the internet (the activities) as well as how we conceptualize and measure subjective well-being in this type of research studies seem to matter when it comes to the relationship between subjective well-being and internet use in later life. Internet use and internet activities displayed various connections to the subjective well-being proxies used in this study. Therefore, the complexity and multidimensionality of both subjective well-being and internet use and related links need to be carefully explored in order to deepen our understanding of experienced well-being among older adults in a digitized world.

Awareness of age-related change in very different cultural-political contexts: A cross-cultural examination of aging in Burkina Faso and Germany

Combining recent developments in research on personal views on aging (VoA) and a cross-country comparative approach, this study examined awareness of age-related change (AARC) in samples from rural Burkina Faso and Germany. The aims of this study were (1) to examine for an assumed proportional shift in the relationship between gains/losses toward more losses as predicted by life span psychology; (2) to estimate the association between AARC dimensions and subjective age; and (3) to examine the association between health variables and AARC. A cross-sectional method involving a large, representative sample from rural Burkina Faso that included participants aged 40 and older (N = 3,028) and a smaller convenience sample of German respondents aged 50 years and older (N = 541) were used to address these questions. A proportional shift toward more AARC-losses was more clearly observable in the sample from Burkina Faso as compared to the German reference. In both samples, subjective age was consistently more strongly related to AARC-losses than to AARC-gains. Within the sample from Burkina Faso, differential associations of AARC-gains and AARC-losses to health variables could be shown. In conclusion, the findings support key tenets of life span psychology including that age-related gains occur even late in life and that a shift toward more losses occurs with increasing age. Also, feeling subjectively younger may indeed be more strongly guided by lowered negative aging experiences than by increased positive ones.

Frequency of contact with friends and relatives via internet and psychosocial factors in middle-aged and older adults during the COVID-19 pandemic. Findings from the German Ageing Survey

OBJECTIVES

Previous studies have examined the association between frequency of contact with friends and relatives via internet and psychosocial factors (in terms of loneliness, life satisfaction and depressive symptoms). However, far less is known about such a link during the COVID-19 pandemic, particularly based on nationally representative samples. Therefore, the aim of this study was to examine this association among middle-aged/older adults.

METHODS/DESIGN

Data were taken from the short survey of the German Ageing Survey (June/July 2020, 3134 individuals in the analytical sample). The De Jong Gierveld scale was used to quantify loneliness, the Satisfaction with Life Scale was used to quantify life satisfaction and the 10-item version of the Center for Epidemiological Studies-Depression was used to quantify depressive symptoms.

RESULTS

Regressions showed that-compared to daily users-less frequent users of the internet for contact with friends and relatives reported increased loneliness, lower life satisfaction and more depressive symptoms. With regard to covariates, better psychosocial factors were associated with medium education (compared to low education), living with partner in the same household (compared to singles), better self-rated health, and favourable COVID-19 factors (in terms of decreased feeling that the Corona crisis is a threat for oneself, not having an infection with the coronavirus and an increased feeling that you can influence an infection with the coronavirus yourself).

CONCLUSIONS

Data suggest that individuals with a high frequency of contact with friends and relatives via internet reported better psychosocial factors. Future research in other cultural settings are required.

[The flourishing life : Society, politics and the practice of old age]

Im abschließenden Beitrag stellen die Autor*innen das Konzept „gelingende Lebensführung“ in den Mittelpunkt. Die Kernergebnisse der vorhergehenden Beiträge werden zusammengefasst und im Rahmen einer kritischen Diskussion in dieses Konzept eingeordnet. Vor dem Hintergrund werden Empfehlungen für die politische und gesellschaftliche Gestaltung von Rahmenbedingungen formuliert, die einer gelingenden Lebensführung im sehr hohen Alter dienlich sind und sie fördern.

Aging during COVID-19 in Germany: a longitudinal analysis of psychosocial adaptation

Existing theories of aging suggest that there may be similarities and differences in how COVID-19 impacts older people's psychosocial adaptation compared to younger age groups, particularly middle-aged individuals. To assess the degree to which these impacts vary, we analyzed data from 3098 participants between the ages of 40 and 79 from an online survey in Germany. Data were collected at three measurement occasions between the start of the nationwide lockdown in mid-March 2020 and the end of the lockdown in early August 2020. The survey focused on everyday experiences during the COVID-19 crisis and collected various satisfaction ratings (e.g., general life satisfaction, satisfaction with family life, satisfaction with social contacts). At baseline, participants also provided retrospective ratings of satisfaction for the period before the COVID-19 crisis. In our analyses, we compared satisfaction ratings of middle-aged (40-64 years) and older individuals (65-79 years) and found that both middle-aged and older participants experienced the greatest decreases in satisfaction with social contacts, with more pronounced decreases seen in middle-aged participants. A similar pattern was observed for general life satisfaction, but the overall decreases were less pronounced in both groups compared to the decreases in satisfaction with social contacts. We also observed a partial recovery effect in all measures at the last measurement occasion, and this effect was more pronounced in older adults. Findings were also confirmed using age as a continuous variable and checking for linear and nonlinear effects of outcomes across the age range. Although ageism arose during the pandemic in the sense that older adults were labeled as a "risk group," particularly at the start of the outbreak, we found consistently with other studies that middle-aged adults' satisfaction decreased to a greater extent than that of older adults.

Physical distancing is related to fewer electronic and in-person contacts and to increased loneliness during the COVID-19 pandemic among older Europeans

PURPOSE

During the COVID-19 pandemic older adults are asked to maintain physical distancing, which can be linked to loneliness. While older people are encouraged to use electronic communication to stay socially connected, it remains an open question whether electronic contacts are related to lower loneliness during the pandemic. This study examined the associations of physical distancing during the pandemic with loneliness and the role of in-person and electronic contacts with children and non-kin as explaining these associations across European regions.

METHODS

The study used data from Survey of Health, Ageing and Retirement in Europe (SHARE), collected during the COVID-19 pandemic in 2020. Mediation and moderation analyses tested the direct and indirect associations between physical distancing, contact frequency and loneliness, as well as the differences across European regions.

RESULTS

The results indicate that adults who reported higher frequency of physical distancing also felt lonelier during the pandemic. This association was partly explained by social contacts-those who practiced physical distancing maintained less in-person contact with children and non-kin and less electronic contact with non-kin, which were related to feeling lonelier. Adults in Southern European countries felt lonelier and reported more frequent contacts. The moderation analyses showed that the link between physical distancing and loneliness was found in the northern region, but not in the southern and eastern regions of Europe.

CONCLUSION

This study can indicate that attention should be paid to adults who may struggle to maintain social contacts in light of physical distancing guidelines.

Google Glass-Supported Cooperative Training for Health Professionals: A Case Study Based on Using Remote Desktop Virtual Support

Purpose

Observation of medical trainees’ care performance by experts can be extremely helpful for ensuring safety and providing quality care. The advanced technology of smart glasses enables health professionals to video stream their operations to remote supporters for collaboration and cooperation. This study monitored the clinical situation by using smart glasses for remote cooperative training via video streaming and clinical decision-making through simulation based on a scenario of emergency nursing care for patients with arrhythmia.

Participants and Methods

The clinical operations of bedside trainees, who is Google Glass Enterprise Edition 2(Glass EE2) wearers, were live streamed via their Google Glasses, which were viewed at a remote site by remote supporters via a desktop computer. Data were obtained from 31 nursing students using eight essay questions regarding their experience as desktop-side remote supporters.

Results

Most of the participants reported feeling uneasy about identifying clinical situations (84%), patients’ condition (72%), and trainees’ performance (69%). The current system demonstrated sufficient performance with a satisfactory level of image quality and auditory communication, while network and connectivity are areas that require further improvement. The reported barriers to identifying situations on the remote desktop were predominantly a narrow field of view and motion blur in videos captured by Glass EE2s, and using the customized mirror mode.

Conclusion

The current commercial Glass EE2 can facilitate enriched communication between remotely located supporters and trainees by sharing live videos and audio during clinical operations. Further improvement of hardware and software user interfaces will ensure better applicability of smart glasses and video streaming functions to clinical practice settings.

Nordic population-based study on internet use and perceived meaningfulness in later life: How they are linked and why it matters

AIM

The aim was to explore the association between internet use, the use of specific internet-based activities and perceiving life as meaningful, among older adults in two regions in Finland and Sweden.

METHODS

The data was collected through a population-based survey (N = 9386) as part of the GERDA project conducted in 2016. In order to analyse the associations between perceiving life as meaningful and internet use and related activities, odds ratios with a 95% confidence interval were calculated using binary logistic regression analysis, where socio-demographic factors and health status were controlled for.

RESULTS

Statistically significant associations were found between perceiving life as meaningful and internet use in later life. When looking further at the specific internet-based activities under study, activities related to leisure and entertainment showed a statistically significant connection to perceived meaningfulness in later life, after controlling for socio-demographic factors and health status.

CONCLUSIONS

The results indicated that there was a statistically significant positive association between internet use and perceiving life as meaningful in later life. Online activities related to leisure and entertainment seem to be especially associated with perceived meaningfulness. Although causal direction could not be determined, the results suggest that internet use may support the experience of wellbeing in everyday life among older persons, through the unlimited access to interest-driven activities that it provides.

COVID-19: Technology, Social Connections, Loneliness, and Leisure Activities: An International Study Protocol

Drawn from the stress process model, the pandemic has imposed substantial stress to individual economic and mental well-being and has brought unprecedented disruptions to social life. In light of social distancing measures, and in particular physical distancing because of lockdown policies, the use of digital technologies has been regarded as the alternative to maintain economic and social activities. This paper aims to describe the design and implementation of an online survey created as an urgent, international response to the COVID-19 pandemic. The online survey described here responds to the need of understanding the effects of the pandemic on social interactions/relations and to provide findings on the extent to which digital technology is being utilized by citizens across different communities and countries around the world. It also aims to analyze the association of use of digital technologies with psychological well-being and levels of loneliness. The data will be based on the ongoing survey (comprised of several existing and validated instruments on digital use, psychological well-being and loneliness), open for 3 months after roll out (ends September) across 11 countries (Austria, France, Germany, India, Malta, Portugal, Romania, Spain, Turkey, and UK). Participants include residents aged 18 years and older in the countries and snowball sampling is employed via social media platforms. We anticipate that the findings of the survey will provide useful and much needed information on the prevalence of use and intensities of digital technologies among different age groups, gender, socioeconomic groups in a comparative perspective. Moreover, we expect that the future analysis of the data collected will show that different types of digital technologies and intensities of use are associated with psychological well-being and loneliness. To conclude, these findings from the study are expected to bring in our understanding the role of digital technologies in affecting individual social and emotional connections during a crisis.

How does a (Smart) Age-Friendly Ecosystem Look in a Post-Pandemic Society?

COVID-19 has impacted not only the health of citizens, but also the various factors that make up our society, living environments, and ecosystems. This pandemic has shown that future living will need to be agile and flexible to adapt to the various changes in needs of societal populations. Digital technology has played an integral role during COVID-19, assisting various sectors of the community, and demonstrating that smart cities can provide opportunities to respond to many future societal challenges. In the decades ahead, the rise in aging populations will be one of these challenges, and one in which the needs and requirements between demographic cohorts will vary greatly. Although we need to create future smart age-friendly ecosystems to meet these needs, technology still does not feature in the WHO eight domains of an age-friendly city. This paper extends upon Marston and van Hoof's 'Smart Age-friendly Ecosystem' (SAfE) framework, and explores how digital technology, design hacking, and research approaches can be used to understand a smart age-friendly ecosystem in a post-pandemic society. By exploring a series of case studies and using real-life scenarios from the standpoint of COVID-19, we propose the 'Concept of Age-friendly Smart Ecologies (CASE)' framework. We provide an insight into a myriad of contemporary multi-disciplinary research, which are capable to initiate discussions and bring various actors together with a positive impact on future planning and development of age-friendly ecosystems. The strengths and limitations of this framework are outlined, with advantages evident in the opportunity for towns, regions/counties, provinces, and states to take an agile approach and work together in adopting and implement improvements for the greater benefits of residents and citizens.

Loneliness and Social Engagement in Older Adults Based in Lombardy during the COVID-19 Lockdown: The Long-Term Effects of a Course on Social Networking Sites Use

Older adults are less familiar with communication technology, which became essential to maintain social contacts during the COVID-19 lockdown. The present study aimed at exploring how older adults, previously trained for Social Networking Sites (SNSs) use, experienced the lockdown period. In the first two weeks of May 2020, telephone surveys were conducted with individuals aged 81-85 years and resident in Abbiategrasso (Milan), who previously participated in a study aimed at evaluating the impact of SNSs use on loneliness in old age (ClinicalTrials.gov, NCT04242628). We collected information on SNSs use, self-perceived loneliness, and social engagement with family and friends. Interviewed participants were stratified as trained (N = 60) and untrained (N = 70) for SNSs use, based on their attendance to group courses held the previous year as part of the main experimental study. The groups were comparable for sociodemographics and clinical features. Participants trained for SNSs use reported significantly higher usage of SNSs and reduced feeling of being left out. Compared to pre-lockdown levels, individuals trained for SNSs use showed a lighter reduction in social contacts. These findings support the utility of training older adults for SNSs use in order to improve their social inclusion, even in extreme conditions of self-isolation and perceived vulnerability.