Television Viewing, Physical Activity, and Loneliness in Late Life

Daily Electronic Media Use and Sleep in Late Life

OBJECTIVES

Daily electronic media use, including television viewing and computer use, is common in older adulthood. Yet, increased electronic media usage may disrupt nightly sleep, leading to sleeping fewer hours and more sleep disruptions. The current study examined these relationships in older adulthood, as well as the potential buffering effect of having a regular sleep schedule.

METHODS

Older adults (N = 273) from the Daily Experiences and Well-Being Study (DEWS) completed 5-6 days of data collection where they answered questions at the beginning of the day about the previous night's sleep as well as questions throughout the day about daily electronic media use. They also wore Actical accelerometers to capture sleep regularity.

RESULTS

Older adults reported sleeping fewer hours and having more sleep disturbances on days when they reported more instances of computer use. Sleep regularity moderated the daily association between TV viewing and sleep disturbances such that daily TV viewing was associated with more sleep complaints only for older adults who had less regular sleep patterns. However, sleep regularity no longer moderated this association when accounting for napping behavior.

DISCUSSION

These findings provide evidence that older adults sleep worse after days when they engage in more electronic media use. The association with TV viewing with sleep disturbances on any given day is somewhat mitigated by engaging in regular sleep patterns. Researchers discuss the importance of assessing electronic media use and sleep in daily life as the role of sleep regularity may be a modifiable protective factor.

Momentary loneliness and intrusive thoughts among older adults: the interactive roles of mild cognitive impairment and marital status

OBJECTIVES

Loneliness is associated with maladaptive cognitions, yet little is known about the association between loneliness and intrusive thinking during older adulthood. Links between loneliness and intrusive thoughts may be particularly strong among individuals with mild cognitive impairment (MCI), who may have greater difficulty regulating emotion and intrusive thoughts. In contrast, having close relationships (e.g. being married) may serve as a protective factor as marital status is associated with better overall well-being.

METHOD

Participants were 316 older adults (recruited from the Bronx, NY, as part of a larger study) without dementia at study intake (40% Black; 13% Hispanic, Mage = 77.45 years, 67% women) who completed ecological momentary assessments five times daily for 14 consecutive days (13,957 EMAs total). Multilevel modeling was used to examine the association between momentary loneliness and intrusive thoughts and whether MCI and marital status interacted to moderate this association.

RESULTS

There was a significant three-way interaction (β = -0.17, p < 0.05), such that lagged momentary loneliness was positively associated with intrusive thoughts (3-4 h later) for those with MCI who were not married.

CONCLUSION

Findings suggest that among older adults with MCI, being married may be a protective factor and being unmarried may be a risk factor for experiencing loneliness and subsequent intrusive thoughts.

The surprising role of marital status on sport second-screening: demographic influences during the 2022 world cup viewing in Israel

To better understand what characterizes those who use a second screen while watching sport, the study examine a variety of demographic factors influencing browsing device trends before, during ("second screen"), and after sports games. It does so by utilizing survey data from Israeli viewers of the 2022 World Cup using a convenience sample (N = 242). In line with our hypotheses, those with higher education and higher reported income were more likely to browse devices for information around and during games. Against our hypothesis, young adults were less likely to engage in browsing before, during and after the games, possibly because they tend to watch games with friends or in public places. Divorced and single individuals are more likely to engage in multi-platform browsing and second-screening during sport games vs. married participants, who tended to watch the games with friends or in public places. The results are the first to indicate the important role of marital status in second-screening during sport games. Overall, they depict a picture of the average second-screener as a non-married older male with higher income and education, thus indicating that higher intellect combined with non-marital status, thus potentially more spare time as well as possibly higher levels of loneliness and during games are linked to sport second-screening. The results are the first to highlight the important role of marital status over young age on the tendency to second screen during sport games.

Sedentary Behavior and Physical Frailty Among Rural Older Adults in China: The Moderating Effect of Social Isolation

OBJECTIVES

Few studies have explored the mechanisms underlying the relationship between sedentary behavior and physical frailty. The aim of this study was to investigate the moderating effect of social isolation on the association between sedentary behavior and physical frailty among older adults in rural China.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

Data were from 3238 individuals aged ≥60 years from rural areas in China.

METHODS

Binary logistic regression was used to explore the association between sedentary behavior and physical frailty and the moderating effect of social isolation.

RESULTS

The prevalence of physical frailty was 18.7% among the older adults, and 17.0% of them were sedentary for ≥8 h/d. Compared with older adults with sedentary behavior for <4 h/d, participants with sedentary behavior for ≥8 h/d were more likely to suffer from physical frailty [odds ratio (OR), 2.26; 95% CI, 1.57-3.27]. We found that social isolation may aggravate this relationship (OR, 3.31; 95% CI, 2.06-5.32), especially for rural older adults who were sedentary for ≥8 h/day.

CONCLUSION AND IMPLICATIONS

More sedentary behavior was associated with higher risk of physical frailty, which was especially apparent among older adults with social isolation, suggesting that sedentary older people who experienced social isolation were more vulnerable to physical frailty. Decreasing sedentary behavior in older adults and encouraging them to participate in interactive social activities could help prevent physical frailty.

StandUPTV: Preparation and optimization phases of a mHealth intervention to reduce sedentary screen time in adults

Recreational sedentary screen time (rSST) is the most prevalent sedentary behavior for adults outside of work, school, and sleep, and is strongly linked to poor health. StandUPTV is a mHealth trial that uses the Multiphase Optimization Strategy (MOST) framework to develop and evaluate the efficacy of three theory-based strategies for reducing rSST among adults. This paper describes the preparation and optimization phases of StandUPTV within the MOST framework. We identified three candidate components based on previous literature: (a) rSST electronic lockout (LOCKOUT), which restricts rSST through electronic means; (b) adaptive prompts (TEXT), which provides adaptive prompts based on rSST behaviors; and (c) earning rSST through increased moderate-vigorous physical activity (MVPA) participation (EARN). We also describe the mHealth iterative design process and the selection of an optimization objective. Finally, we describe the protocol of the optimization randomized controlled trial using a 23 factorial experimental design. We will enroll 240 individuals aged 23-64 y who engage in >3 h/day of rSST. All participants will receive a target to reduce rSST by 50% and be randomized to one of 8 combinations representing all components and component levels: LOCKOUT (yes vs. no), TEXT (yes vs. no), and EARN (yes vs. no). Results will support the selection of the components for the intervention package that meet the optimization objective and are acceptable to participants. The optimized intervention will be tested in a future evaluation randomized trial to examine reductions in rSST on health outcomes among adults.

Examining the Bidirectional Nature of Loneliness and Anxiety Among Older Adults in Daily Life

OBJECTIVES

Loneliness in later life increases the risk for adverse health outcomes; however, less is known about how loneliness is maintained. Anxiety may play an important role in maintaining loneliness, but little is known about how this connection plays out over time in daily life. This study thus focused on the within-person associations between momentary loneliness and anxiety among older adults.

METHODS

Participants were 317 diverse older adults (40% Black; 13% Hispanic, mean age = 77.45 years, 67% women) systematically recruited from the Bronx, NY, who completed ecological momentary assessments 5 times daily for 14 consecutive days. Multilevel models tested bidirectional contemporaneous, momentary cross-lagged (t - 1), day-level cross-lagged (average day to end of day), and day-to-day cross-lagged associations between loneliness and anxiety. Separate sensitivity analyses controlled for concurrent overall mood valence or depressed state. Gender and mild cognitive impairment (MCI) status were tested as moderators at all timescales.

RESULTS

Significant bidirectional associations between loneliness and anxiety were found at the contemporaneous and momentary cross-lagged (t - 1) timescales. Higher average daily loneliness predicted higher end-of-day anxiety, but not vice versa. Loneliness and anxiety were not significantly associated from day to day. Sensitivity analyses revealed some associations varied depending on inclusion of either concurrent mood valence or depressed state. Neither gender nor MCI status moderated associations at any timescale.

DISCUSSION

Findings shed light on the complex temporal ordering of loneliness and anxiety in daily life and extend contemporary theoretical notions of loneliness, including the possibility of interventions that target key moments in daily life.

The Predictors of Negative and Positive Affect among People with Dementia: A Cross-Sectional Study

Background and Objectives: This cross-sectional study examined the predictors of negative and positive affect among individuals with dementia. Materials and Methods: A sample of 102 Jordanian participants diagnosed with dementia was recruited from residential care facilities, and data were collected using different measures. Results: The results revealed that higher levels of negative affect were significantly associated with increased physical and verbal agitation among individuals with dementia. Conversely, lower levels of positive affect were associated with residing in a nursing home. Conclusions: These findings highlight the importance of recognizing the impact of both negative and positive affect on the well-being of individuals with dementia. Interventions targeting the reduction of negative affect and promoting positive affect could alleviate agitation and enhance emotional closeness in this population.

Differences in Physical Activity, Sedentary Behavior, and Mental Health of the Older Population in South Korea Based on Marital Status and Gender

The primary purpose of the present study was to assess differences in physical activity (PA), sedentary behavior (SB), and mental health (i.e., depression, suicidal thoughts, and cognitive function) by marital status (i.e., married and widowed) within an aging population in South Korea. PA, SB, and mental health were evaluated in 9092 older adults by comparing the married group (n = 5773, 73.2 ± 5.9 years, 63.5%) to the widowed group (n = 3319, 75.8 ± 6.8 years, 36.5%). Between-group differences in PA, SB, depression, and cognitive function were tested using independent t-tests, and the association between marital status and gender was evaluated using two-way ANOVA. Suicidal thoughts were analyzed using a Mann-Whitney U-test. Older adults in the widowed group participated in significantly less PA (p < 0.001) and had higher SB (p < 0.001) per week, especially the widows, who had significantly less PA (p < 0.01) and had higher SB (p < 0.001) compared to married women. Participants in the widowed group experienced more depression (p < 0.001) and suicidal thoughts (p < 0.001) and had significantly lower cognitive function compared to participants in the married group (p < 0.001). Between the two groups, widowers were more vulnerable to all mental health factors compared to those in the married group. At the same time, widows were only more vulnerable to depression and cognitive function compared to women in the married group. Findings indicated that the presence of a spouse is strongly associated with higher PA levels, lower SB, and better mental health among older adults. Spouses are the primary social supports and play a major role in the health and emotional well-being of the aging population. Given the importance of the spouse, our study suggests that health educators working with older widows should prioritize several different forms of social support to benefit their physical and mental health.

Daily social interactions and momentary loneliness: The role of trait loneliness and neuroticism

OBJECTIVES

Loneliness has been linked to poor mental and physical health outcomes in later life. Little is known about how daily social interactions relate to older adults' everyday experiences of loneliness. This study examined the dynamic associations between social interactions and the momentary feelings of loneliness in older adults' daily lives. We further examined whether individual differences in trait loneliness and neuroticism influenced the extent to which daily social interactions were related to moment-to-moment change in loneliness.

METHOD

Participants were 317 community-dwelling older adults (aged 70-90 years) who reported their social interactions and momentary feelings of loneliness 5 times daily for 14 consecutive days using smartphones.

RESULTS

Having more frequent, more pleasant, and in-person social interactions, as well as interactions with family and friends specifically, significantly predicted lower momentary loneliness a few hours later. Higher levels of momentary loneliness, in turn, predicted less likelihood of engaging in these types of social interactions subsequently. In addition, older adults with higher (vs. lower) trait loneliness and neuroticism experienced greater decreases in momentary feelings of loneliness after having more frequent or pleasant social interactions, or interactions with family members.

DISCUSSION

These results expand our understanding of the dynamic associations between daily social interactions and loneliness in later life and provide insights to inform future research, including the possibility of behavioral interventions that target social interactions to reduce the risk for loneliness.

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.

Associations between sedentary behaviour patterns and depression among people aged 60 and older in Hebei Province of China

BACKGROUND

Sedentary behaviours (SBs) are now considered a risk factor for depression. Older adults are sedentary most of the time and are at a high risk of depression. However, not all types of SBs have adverse effects on mental health. Passive SBs (such as watching TV) increase the risk of depression, whereas mentally active SBs (such as using the internet and reading) decrease the risk of depression. The aim of this study was to explore the associations between type of SBs (i.e., passive and mentally active SBs) and depression among people aged 60 years and older in the Hebei Province of China.

METHODS

This cross-sectional study used data from the baseline survey of the Community-based Cohort Study on Nervous System Diseases. A total of 2679 older adults aged ≥60 years from the Hebei Province of China were included in this study. The type and time spent on SBs were self-reported. Watching TV was defined as a passive SB, whereas internet use, reading, and social SBs (including communicating with others and playing chess) were defined as mentally active SBs. Depression was evaluated using the Geriatric Depression Scale. The maximal possible score was 30 points, and ≥ 11 points indicated depression. Logistic regression analysis was used to assess the relationship between SBs and depression. Covariates included sex, age, education, employment, smoking, alcohol consumption, sleep duration, domestic work, physical exercise, body mass index (BMI), and chronic diseases.

RESULTS

At baseline, the participants who spent two or more hours and 0 h on passive SBs (i.e., TV viewing) had a greater risk of depression (=0 h: adjusted OR = 2.09, 95% CI = 1.18-3.76; 2-3 h: OR = 2.21, 95% CI = 1.16-4.16; > 3 h: OR = 3.59, 95% CI = 1.93-6.68) than the participants who spent 1-2 h on passive SBs. The participants who spent > 1 h on mentally active SBs had a lower risk of depression (adjusted OR = 0.26, 95% CI = 0.06-0.71) than the participants who did not engage in mentally active SBs. Not all mentally active SBs were linked to depression. The participants who engaged in social SBs had a lower risk of depression (adjusted OR: 0.24, 95% CI: 0.06-0.66) than the participants who did not engage in social SBs.

CONCLUSIONS

Spending 2 h or more per day on passive SBs (watching TV) was associated with a high risk of depression among people aged 60 years and older in the Hebei Province of China. Mentally active SBs (predominantly social SBs) could reduce the risk of depression. Some participants with depression probably did not watch TV. These findings suggested that spending more time on social SBs (such as communicating with others and playing chess) rather than watching TV may have important public health implications for preventing and managing depression among older Chinese adults. Moreover, society should attend to the mental health of elderly adults who do not watch TV as they may be more prone to suffer from depressive symptoms.

Sedentary Behavior and Happiness: The Mediation Effects of Social Capital

Background and Objectives

This study aimed to examine the associations between time spent in 6 different domains of sedentary behavior and happiness and whether social capital mediated such associations among adults and older adults living in a rural area of Japan.

Research Design and Methods

Cross-sectional data from 3,357 participants (mean age: 60 ± 16 years) were used. 6 domains of sedentary behavior, happiness, and social capital were assessed using a self-report questionnaire. Age-stratified multivariable linear regression models adjusted for covariates were used to examine the associations between 6 domains of sedentary behavior and happiness. For relationships where the direct effect was significant, we tested the mediating effects of 2 social capital measures.

Results

Among both adults and older adults, more time spent viewing television was significantly associated with lower happiness scores, and more time spent engaging in other leisure activities was significantly associated with higher happiness scores. In addition, more time spent using cell phones and computers was significantly associated with lower happiness scores among the adults. Engaging in activities with neighbors significantly mediated the relationship between other leisure activities and happiness in the adults and older adults, and between television viewing and happiness in the older adults.

Discussion and Implications

Our findings indicated that less television viewing and more mentally active sedentary behavior (e.g., talking with others and engaging in hobbies) were associated with greater happiness. One aspect of social capital, engaging in activities with neighbors, acts as a potential mediator for relationships between sedentary behavior and happiness.