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Zarling A, Kim J, Russell D, Cutrona C. Increasing Older Adults' Social Connectedness: Development and Implementation of a Web-Assisted Acceptance and Commitment Therapy-Based Intervention. JMIR Aging 2024; 7:e47943. [PMID: 38647321 PMCID: PMC11058557 DOI: 10.2196/47943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 04/25/2024] Open
Abstract
In this article, we will provide a rationale for a web-assisted acceptance and commitment therapy (ACT) approach to loneliness among older adults, drawing upon theories from the literature on adult development and aging, emotion regulation, and loneliness. The intervention program was developed using the principles of ACT, which is a cognitive behavioral approach and unified model of human behavior change and psychological growth. The ACT intervention focuses on developing nonjudgmental present-focused awareness of internal experiences (thoughts, emotions, and memories) through strategies such as acceptance and mindfulness rather than directly modifying or removing them per se. The ACT intervention appears well-suited to assist older adults in coping with the challenges of aging, as the focus is on an individual’s willingness to sit with internal experiences out of one’s control (ie, acceptance), stepping back from negative or critical thoughts and developing greater kindness toward oneself (ie, defusion), discerning what is most important to one’s true self (ie, values), and building larger patterns of effective action based on such values (ie, committed action). The ACT intervention was developed as a resource for older adults who are socially isolated or having difficulty with social connectedness. Eight modules comprise the web-assisted ACT intervention program, which includes reading materials, video clips, and activities. Each module is followed by a summary, a homework assignment, a short quiz to assess learning, and a moderated discussion with a coach. The intervention program begins with reconnecting participants with their values. The goal of the ACT intervention program is to foster flexibility in a participant’s behavior so they can behave consistently with their chosen values, rather than becoming locked into a pattern of behavior that is driven by avoiding distress or discomfort. The ACT intervention approach is both novel and innovative, as it is based on ACT and leverages a behavioral health web platform that is flexible and inclusive in its design. The ACT intervention aims to help older adults become more socially connected, less lonely, and more satisfied with their relationships with other people. The emphasis that ACT places on values and living life in accordance with one’s values renders it an approach ideally suited to older adults. Finally, recommendations for future research regarding this approach to addressing loneliness among older adults is addressed.
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Affiliation(s)
- Amie Zarling
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, United States
| | - Joseph Kim
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, United States
| | - Daniel Russell
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, United States
| | - Carolyn Cutrona
- Department of Human Development and Family Studies, Iowa State University, Ames, IA, United States
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Labrie D, Lapierre N, Mortenson WB, Allaire AS, Schmouth MÈ, Routhier F. Exploratory study on the adaptation of online services offered to people with disabilities, in the context of the COVID-19 pandemic. Disabil Rehabil Assist Technol 2024:1-11. [PMID: 38462813 DOI: 10.1080/17483107.2024.2326593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/26/2024] [Indexed: 03/12/2024]
Abstract
Aim: During the COVID-19 pandemic, many community organizations offering services to people with disabilities (PWD) changed their service delivery, switching from in-person to remote services. However, little is known about what it was like for organizations to quickly pivot their service delivery. The study explored barriers and facilitators to access community services for PWD and identified potential improvements to these services.Methods: The study used a mixed method, multiple case study design, which included a convenience sample of 27 participants recruited from four community organizations delivering services to PWD. Participating staff and members participated in six different focus groups and completed a questionnaire about their level of satisfaction regarding the evolution of the services. Inductive thematic analysis was conducted on the focus group data and the data from the questionnaires were descriptively analyzed.Results: The thematic analyses revealed four themes: "Succeeding in adapting the interventions to continue providing services", "Enjoying a lot of new things about the new online modality", "Key elements that have facilitated the transition" and "Facing some difficulties implementing online services". The median satisfaction score demonstrated that the participants were satisfied with the services. The success of these organizational changes relied on the adoption of new methods and approaches to service delivery.Conclusion: Through this study, barriers and facilitators that the organizations and their beneficiaries have experienced during the pandemic were identified as well as suggestions for improvement. The organizations consider maintaining online services beyond the pandemic to offer PWD easier access to community services.
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Affiliation(s)
- Dylane Labrie
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Nolwenn Lapierre
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- International Collaboration on Repair Discoveries, Vancouver, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver, Canada
| | - Anne-Sophie Allaire
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Marie-Ève Schmouth
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Canada
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Balki E, Holland C, Hayes N. Use and Acceptance of Digital Communication Technology by Older Adults for Social Connectedness During the COVID-19 Pandemic: Mixed Methods Study. J Med Internet Res 2023; 25:e41535. [PMID: 37531187 PMCID: PMC10433026 DOI: 10.2196/41535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/10/2023] [Accepted: 06/17/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Older adults are at higher risk for health issues, including mental health problems. This was especially apparent during the COVID-19 pandemic, where older adults were simultaneously more vulnerable to the disease and the mental health concerns created by social distancing. Subsequently, the use of digital communication technology (DCT) became a critical option for maintaining social connectedness in older adults. Prior to the pandemic, the low uptake and use of technology by older adults was an established problem, known as the digital divide. However, not much is known about how this may have changed as a result of the pandemic. OBJECTIVE This study aims to explore how older adults maintained social connectedness through DCT during the pandemic and to understand factors influencing the use and acceptance of DCT. METHODS A mixed methods explorative field study was set up, involving surveys and interviews of 25 community-dwelling older adults (65-88 years old) living in the United Kingdom. The surveys included the internet acceptance questionnaire (based on the Technology Acceptance Model [TAM]); COVID-19 dysfunctional anxiety was captured using the COVID-19 Anxiety Scale (CAS). Background information (demographics, use of technology) was gathered before conducting semistructured interviews. We hypothesized that CAS would affect constructs of TAM and that predictive constructs of TAM would have remained valid during the pandemic. We also posited that there would be unidentified themes outside TAM that impacted the acceptance and use of DCT. We used the quantitative data to guide the semistructured interviews, which were then analyzed through thematic analysis to identify additional themes. RESULTS Correlational analysis showed that CAS influences all constructs of TAM. We also saw that the predictive constructs of TAM, especially the perceived ease of use (PEU) and perceived usefulness (PU), remained valid during the pandemic. Common acceptance-influencing themes were encountered in both quantitative and qualitative analyses, with 3 matching the known constructs of TAM (PU, PEU, and behavioral intention). We identified 2 additional themes affecting acceptance, namely influence of the pandemic (situational context) and privacy and security concerns. DCT use (especially email and videoconferencing use) increased during the pandemic, but the results related to social networking sites were mixed. CONCLUSIONS The COVID-19 pandemic impacted technology acceptance and use by older adults, encouraging their use of certain DCT apps (email and videoconferencing apps, such as WhatsApp). These apps helped insulate them from adverse effects (social isolation and loneliness). Other social networking apps, however, exerted a negative influence, increasing anxiety and a general feeling of negativity. Future studies should maximize older adult agency related to design, privacy, security, and user requirements for development. We also recommend that when studying DCT acceptance for older adults, our additional identified themes should be considered alongside the existing TAM constructs.
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Affiliation(s)
- Eric Balki
- Centre for Ageing and Research, Division of Health, Lancaster University, Lancaster, United Kingdom
| | - Carol Holland
- Centre for Ageing and Research, Division of Health, Lancaster University, Lancaster, United Kingdom
| | - Niall Hayes
- Nottingham Trent University, The Directorate, Notthingham, United Kingdom
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Zhu D, Al Mahmud A, Liu W. Social connections and participation among people with mild cognitive impairment: barriers and recommendations. Front Psychiatry 2023; 14:1188887. [PMID: 37476544 PMCID: PMC10356108 DOI: 10.3389/fpsyt.2023.1188887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023] Open
Abstract
Objective Social connections and participation are essential for individuals with mild cognitive impairment (MCI) to prevent the progression of cognitive decline and enhance their overall well-being. However, existing research has primarily focused on environmental barriers, overlooking personal factors and the interconnected nature of these barriers. Moreover, there is a lack of understanding regarding social connections and participation challenges specific to people with MCI in low- and middle-income countries. Therefore, this study aimed to explore the barriers that hinder social connections and participation among people with MCI in China and investigate opportunities to design appropriate supportive interventions. Methods Thirty-one people with MCI (13 males and 18 females; mean age = 82.74 years, SD = 7.69; mean MoCA score = 21.26, SD = 2.44) and 13 caregivers were recruited to attend focus groups. In addition, 10 therapists were interviewed using a semi-structured interview guide. Focus groups and interviews were audio-recorded, transcribed, and analyzed using a framework analysis approach. Results We found that the ability to build social connections among people with MCI is affected by mobility challenges, intensive grandparenting responsibilities, availability of suitable activities, and feelings of exclusion in a closed-minded community environment. Personal reasons, such as lower social efficacy, inability to find suitable social activities, and intensive family responsibilities, discourage people with MCI from social participation. The digital literacy of people with MCI depends on their motivation to learn and use digital tools; people with MCI who live in a community have a higher digital literacy than those living in care centers. The motivation to achieve digital literacy is affected by perceived benefits, costs of technology use, and social influence. Conclusion Multidimensional initiatives are needed to address barriers to social connections, participation, and technology adoption among individuals with MCI. This includes organizing and engaging in social activities, promoting awareness and education on the importance of social participation, and exploring technology-based interventions to improve memory and storytelling abilities. These efforts can create a supportive environment and empower individuals with MCI to participate actively in social interactions, enhancing their overall well-being.
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Affiliation(s)
- Di Zhu
- Swinburne University of Technology, Hawthorn, VIC, Australia
- Beijing Normal University, Beijing, China
| | | | - Wei Liu
- Beijing Normal University, Beijing, China
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Pollak C, Verghese J, Blumen H. Loneliness and Functional Decline in Aging: A Systematic Review. Res Gerontol Nurs 2023; 16:202-212. [PMID: 37159388 PMCID: PMC10926714 DOI: 10.3928/19404921-20230503-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Loneliness is prevalent in adults aged ≥65 years in the United States and is associated with functional decline. The purpose of the current review was to synthesize evidence on the relationship between loneliness and functional decline using Roy's Adaptation Model as a theoretical framework. A comprehensive review of PubMed, Medline, and Embase databases was performed. Inclusion criteria were samples including adults primarily aged >60 years, peer-reviewed, published in the English language, and included a measure for loneliness and function. A total of 47 studies were analyzed. Most studies examined correlates, risk factors, and predictors of loneliness, rather than the relationship between loneliness and function. Evidence suggests there is bidirectionality in the relationship between loneliness and functional decline. Loneliness is associated with functional decline in aging via multiple possible pathways. Further studies are needed to determine causality and biological mechanisms underlying the relationship. [Research in Gerontological Nursing, 16(4), 202-212.].
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Pan H, Qualter P, Barreto M, Stegen H, Dury S. Loneliness in Older Migrants: Exploring the Role of Cultural Differences in Their Loneliness Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2785. [PMID: 36833479 PMCID: PMC9957511 DOI: 10.3390/ijerph20042785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION AND BACKGROUND The scientific literature suggests the necessity of studying loneliness from a broader social perspective. This article aims to broaden the research on loneliness in older migrants by exploring the role of cultural differences through the lens of the social environment (as measured in social capital, discrimination, and ageism) and social situation (as measured in relational mobility, childness, and marital status). Based on Hofstede's Individualism Index, older migrants involved in the BBC Loneliness Experiment (N = 2164) were classified into three groups: cultural migrants (i.e., from a collectivist to individualist culture) (N = 239), migrants with a similar culture (i.e., within an individualist culture) (N = 841), and ageing non-migrants (N = 1084). OBJECTIVES The two main objectives were (1) to compare the levels of loneliness among these three groups, and (2) to unravel how different influencing factors, such as the social environment, social situation, coping strategies, and personal characteristics, are related to loneliness. METHODS Bivariate analyses were performed to determine the differences in the loneliness, social environment, social situation, and personal characteristic variables between the groups, with adjusted p-values according to the Bonferroni correction to limit the potential for type I errors (α = 0.005). Multiple linear regressions were performed to unravel the relationships between loneliness and the different influencing factors, namely the social environment, social situation, coping strategies, and personal characteristics. RESULTS The bivariate analyses show no significant difference in loneliness across the three groups. The multiple linear regressions demonstrate that the social environment (i.e., social capital, discrimination, and ageism) is significantly associated with loneliness. Social capital acts as a protective factor for cultural migrants (β = -0.27, p < 0.005, 95% CI [-0.48, -0.05]), similar-culture migrants (β = -0.13, p < 0.005, 95% CI [-0.25, -0.03]), and non-migrants (β = -0.21, p < 0.001, 95% CI [-0.28, -0.12]). Discrimination and ageism are both risk factors for loneliness across the three groups. Social situation, as measured in married/cohabitation status and relational mobility, shows a significant association with loneliness in the non-migrants and similar-culture migrants but not the cultural migrants. In terms of individual resources for coping strategies, engagement in active coping is protective for all three groups. Non-coping, the unawareness of any coping strategies, is a risk factor, while passive coping shows no significant association. DISCUSSION The results show that the structural factor of the social environment in which older migrants' find themselves, rather than their culture of origin, is more important for older migrants' feelings of loneliness in later life. A favorable social environment with high social capital and low levels of discrimination and ageism protects against loneliness in the ageing population across cultures. Practical implications for loneliness interventions for older migrants are put forward.
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Affiliation(s)
- Honghui Pan
- Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
- Brussels Interdisciplinary Research Centre on Migration and Minorities (BIRMM), Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
- Society and Ageing Research Lab, Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
| | - Pamela Qualter
- Manchester Institute of Education, University of Manchester, Manchester M13 9PL, UK
| | - Manuela Barreto
- Department of Psychology, University of Exeter, Exeter EX4 4QG, UK
| | - Hannelore Stegen
- Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
- Society and Ageing Research Lab, Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
| | - Sarah Dury
- Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Vrije Universiteit Brussel (VUB), 1050 Brussels, Belgium
- Society and Ageing Research Lab, Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
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Gómez-Zúñiga B, Pousada M, Armayones M. Loneliness and disability: A systematic review of loneliness conceptualization and intervention strategies. Front Psychol 2023; 13:1040651. [PMID: 36760915 PMCID: PMC9905422 DOI: 10.3389/fpsyg.2022.1040651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/07/2022] [Indexed: 01/26/2023] Open
Abstract
Introduction People with disabilities experience loneliness to a greater extent than people without disabilities. To better understand this problem, we have conducted a systematic review of studies that involved disability and loneliness. The aims are to research what loneliness is and to conceptualize and define it in the context of disability, and the intervention strategies that have been developed. Methods The research protocol is based on the PRISMA guidelines. Two hundred and eighty-one papers were screened and 75 reports were assessed for eligibility. Results We have not found whether loneliness in disability is a single construct or a collection of various subtypes. We have found that there are protective factors against loneliness in disabled people, such as having a job or living in an environment without physical barriers. Discussion In terms of the interventions for people with disabilities, the same strategies have been adopted as for the non-disabled: social skills training, enhanced social support, opportunities for interactions, and cognitive training.
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Affiliation(s)
- Beni Gómez-Zúñiga
- Psychology and Educational Sciences Studies, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Modesta Pousada
- Psychology and Educational Sciences Studies, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Manuel Armayones
- eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain,*Correspondence: Manuel Armayones,
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Halpern N, Rickly JM, Hansen M, Fellenor J. COVID-19 and vision impairment: Constraints negotiation, participation, and well-being during lockdown in the United Kingdom. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2023; 41:3-19. [PMID: 36605535 PMCID: PMC9791003 DOI: 10.1177/02646196211009931] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In response to the Coronavirus disease, the United Kingdom (UK) government introduced lockdown measures requiring people to isolate and adhere to social distancing. This article uses Constraints Negotiation Theory to examine effects of the lockdown on people with vision impairment (PwVI). The research is based on an online survey of 639 PwVI in the UK. The analysis was conducted using partial least squares structural equation modelling in SmartPLS. The findings show that the lockdown had a negative effect on the participation and well-being of PwVI. However, they also show that the negative effects could be negotiated by adapting activities. This emphasises the need for a more inclusive response to current or future pandemics that recognises the vulnerabilities of PwVI and helps them to overcome the challenges associated with any measures that are introduced.
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Affiliation(s)
- Nigel Halpern
- Nigel Halpern, Department of Marketing,
Kristiania University College, Postboks 1190 Sentrum, 0107 Oslo, Norway.
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Lapierre N, Olatona O, Labrie D, Gagnon M, Paquette Raynard E, Mortenson WB, Routhier F. Providing community services for persons with disabilities during the COVID-19 pandemic: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3746-e3760. [PMID: 36168783 DOI: 10.1111/hsc.14050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 08/01/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Community organisations and municipalities support people with disabilities by providing resources and services that are essential for their engagement in the community. Their services were particularly impacted by restrictions related to the COVID-19 pandemic. The aim of the study is to identify scientific literature that examines how community organisations and municipalities adapted services and resources provided to people with disabilities as a result of the COVID-19 pandemic. A scoping review was conducted by searching the databases Medline, Embase, CINAHL, PsycINFO and Web of Science Core Collection in January 2021. Fifteen studies were included from the initial search strategy of 7651 individual studies. Most of the studies were quantitative studies (73.3%; n = 11) and aimed at describing the adaptations put in place during the COVID-19 pandemic (66.7%; n = 10). Most services and resources involved some form of preventive healthcare (66.7%; n = 10). The adaptation of modalities for delivering resources and services varied widely across organisations (e.g. online or a combination of online and in-person) but mostly led to an improvement of the studied outcome (e.g. social skills, quality of life). Barriers (e.g. need for a reliable internet connection, lack of technology literacy from the member) and facilitators (e.g. flexibility and planning from the organisations) for these adaptations have been identified, but there is little information surrounding their cost. The results highlight that the delivery of online services has increased since the inception of the COVID-19 pandemic with valuable outcomes. However, further research is needed to better identify the barriers, facilitators and outcomes of remote services to better face future large-scale disasters like the COVID-19 pandemic and to better support individuals who cannot reach in-person services.
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Affiliation(s)
- Nolwenn Lapierre
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, Québec, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver, British Columbia, Canada
| | - Olatioluwase Olatona
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver, British Columbia, Canada
| | - Dylane Labrie
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Québec, Canada
| | | | | | - William Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver, British Columbia, Canada
| | - François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, Québec, Canada
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García C, Moreno L, Alacreu M, Muñoz FJ, Martínez LA. Addressing Psychosocial Factors in Cognitive Impairment Screening from a Holistic Perspective: The DeCo-Booklet Methodology Design and Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12911. [PMID: 36232215 PMCID: PMC9565987 DOI: 10.3390/ijerph191912911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/01/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Cognitive impairment (CI), an intermediate phase between the decline in physiological cognition and dementia, is known to be mediated by a variety of risk and protective factors, with age being the most influential of these. The multifactorial nature of CI and the worldwide phenomenon of an aging population makes decoupling old age from disease through the concept of healthy aging (HA) a matter of major interest. Focusing on psychosocial variables and psychological constructs, here we designed and piloted a data collection booklet (DeCo-B) to assess CI and HA from a holistic perspective. The DeCo-B comprises six sections: sociodemographic factors, CI, meaning in life, psychosocial factors, health problems, and lifestyle. The estimated prevalence of CI and HA in our cohort were 24.4% and 6.6%, respectively. Spearman correlations mainly identified pairwise associations between the meaning in life domains and psychosocial variables. Moreover, age, marital status, purpose in life, resilience, chronic pain, cognitive reserve, and obstructive sleep apnea were significantly associated with an increased risk of CI. Our results showed that DeCo-B is a suitable tool for researching how modifiable risk and protective factors influence cognitive status. The complex interrelationships between variables should be further investigated and, for practical reasons, the questionnaire should be optimized in future work.
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Affiliation(s)
- Cristina García
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
- Community Pharmacist, 02161 Albacete, Spain
| | - Lucrecia Moreno
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
| | - Mónica Alacreu
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
| | - Francisco J. Muñoz
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
| | - Luis A. Martínez
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Community Pharmacist, 02161 Albacete, Spain
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Tian G, Li R, Cui Y, Zhou T, Shi Y, Yang W, Ma Y, Shuai J, Yan Y. Association between disability, social support and depressive symptoms in Chinese older adults: A national study. Front Public Health 2022; 10:980465. [PMID: 36062100 PMCID: PMC9437525 DOI: 10.3389/fpubh.2022.980465] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/21/2022] [Indexed: 01/25/2023] Open
Abstract
Objective Disability and social support can impact depressive symptoms of the elderly. Yet, studies infrequently discuss the moderating role of social support when evaluating the association between disability and depressive symptoms. The purpose of this study was to explore the association between disability, social support, and depressive symptoms among the Chinese elderly, and further examine the moderating effect of social support. Materials and methods Using the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) data set, we finally selected 9,231 Chinese elderly after screening. The Center for Epidemiologic Studies Depression Scale (CESD-10) was used to evaluate depressive symptoms in the elderly. Disability was measured by basic activities of daily living (B-ADL) and instrumental activities of daily living (I-ADL). Social support included contact with family and friends, sick care, and money received, measured by five self-reported questions. We used multiple linear regression and moderating model to explore the association between disability, social support, and depressive symptoms. Results A total of 9,231 patients were included in this study, and approximately 26.75% of the elderly had depressive symptoms. Study found that depressive symptoms were associated with social support (β B-ADL = -0.108, 95% CI: -0.168- -0.047; β I-ADL = -0.098, 95% CI: -0.156- -0.039), β B-ADL (β = 0.296, 95% CI: 0.248-0.343) and I-ADL (β = 0.174, 95% CI: 0.152-0.195). Moreover, the result also showed that social support moderated the effects of B-ADL ( β B - A D L * s o c i a l s u p p o r t = 0.034, 95% CI: 0.014-0.053, F = 11.57, p = 0.001) and I-ADL ( β I - A D L * s o c i a l s u p p o r t = 0.025, 95% CI: 0.017-0.033) on depressive symptoms. Conclusions The study suggests that disability and social support can affect depressive symptoms, and social support moderates the effect of disability on depressive symptoms. Therefore, taking effective measures to reduce the elderly disability rate of disability and increase their social support are necessary condition for realizing mental health.
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12
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Morese R, Palermo S. Feelings of loneliness and isolation: Social brain and social cognition in the elderly and Alzheimer's disease. Front Aging Neurosci 2022; 14:896218. [PMID: 35936772 PMCID: PMC9353216 DOI: 10.3389/fnagi.2022.896218] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/06/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Rosalba Morese
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland
| | - Sara Palermo
- Department of Psychology, University of Turin, Turin, Italy
- Neuroradiology Unit, Department of Diagnostic and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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13
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Guastafierro E, Toppo C, Corso B, Romano R, Campioni R, Brambilla E, Facchini C, Bordoni S, Leonardi M. Social Network and Environment as Determinants of Disability and Quality of Life in Aging: Results From an Italian Study. Front Med (Lausanne) 2022; 9:854779. [PMID: 35677824 PMCID: PMC9168123 DOI: 10.3389/fmed.2022.854779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/25/2022] [Indexed: 11/17/2022] Open
Abstract
Background The increase in life expectancy is leading to a worldwide increase in chronic diseases and disability, with significant concern about their management and long-term care. Investigating the aging process using a bio-psychosocial perspective is essential to understanding how to reduce disability and improve the quality of life of aging people. This study aims to explore the role of social networks and built environment as predictors of disability and quality of life in the Italian population aged over 50 years. Materials and Methods The research protocol is composed of several tools: World Health Organization Disability Assessment Scale 2.0 (WHODAS 2.0), World Health Organization Quality of Life Assessment in Aging (WHOQOL-AGE), Social Network Index (SNI), the Courage Built Environment Self-Reported Questionnaire (CBE-SR), and collection of sociodemographic information and information on health system coverage. Results A total of 431 people were administered the protocol, and among them, 209 were males and 222 were females, with a mean age of 70 years. The majority of the sample reported earning a middle or high school diploma, and 60.6% of the sample declared to have a good health status. The results showed that people with a good social support network have higher levels of functioning and quality of life. However, the built environment did not significantly predict either disability or quality of life. Conclusions These results could provide elements for dialogue with institutions and policymakers. This is fundamental to develop active policies aimed at the implementation of services and systems to promote healthy aging process.
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Affiliation(s)
- Erika Guastafierro
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Claudia Toppo
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | | | | | | | - Carla Facchini
- Department of Sociology, University of Milano-Bicocca, Milan, Italy
- Associazione Nestore, Milan, Italy
| | | | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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14
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Shankar A, Kidd T. Loneliness in Older Indian Dyads. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5302. [PMID: 35564697 PMCID: PMC9101006 DOI: 10.3390/ijerph19095302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Loneliness has been recognised as a major public health concern in older adults in developed nations, with little focus on low- and middle-income countries such as India. While the protective nature of social relationships on loneliness has been explored in the context of marriage, typically these benefits are examined in individual spouses rather than within the marital dyad. METHODS A sample of 398 opposite-sex married Indian couples (mean age 54.8 years) was obtained from the pilot wave of the Longitudinal Aging Study in India (LASI) conducted in 2010. These cross-sectional data were analysed using the Actor-Partner Interdependence Model, with one's own and one's partner's cognitive function, functional limitations, depressive symptoms, employment status and contact with friends included as predictors of loneliness. RESULTS There were no gender differences in the pattern of associations. Depression was positively associated with loneliness with actor and partner effects being significant. One's partner being employed was associated with less loneliness. CONCLUSIONS The sample showed low levels of depression, loneliness, and reduced functionality; however, depression still predicted one's own and one's partner's loneliness. Future work using longitudinal data could examine the role of employment in loneliness, particularly within the context of gender roles.
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Affiliation(s)
- Aparna Shankar
- Department of Psychological Sciences, FLAME University, 401 Phoenix Complex, Bund Garden Rd., Opp. Residency Club, Pune 411001, India
| | - Tara Kidd
- Department of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK;
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15
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Telerehabilitation in response to constrained physical distance: an opportunity to rethink neurorehabilitative routines. J Neurol 2022. [PMID: 33449202 DOI: 10.1007/s00415-021-10397-w/tables/2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Ensuring proper dosage of treatment and repetition over time is a major challenge in neurorehabilitation. However, a requirement of physical distancing to date compromises their achievement. While mostly associated to COVID-19, physical distancing is not only required in a pandemic scenario, but also advised for several clinical conditions (e.g. immunocompromised individuals) or forced for specific social contexts (e.g. people living in remote areas worldwide). All these contexts advocate for the implementation of alternative healthcare models. The objective of this perspective is to highlight the benefits of remote administration of rehabilitative treatment, namely telerehabilitation, in counteracting physical distancing barriers in neurorehabilitation. Sustaining boosters of treatment outcome, such as compliance, sustainability, as well as motivation, telerehabilitation may adapt to multiple neurological conditions, with the further advantage of a high potential for individualization to patient's or pathology's specificities. The effectiveness of telerehabilitation can be potentiated by several technologies available to date: virtual reality can recreate realistic environments in which patients may bodily operate, wearable sensors allow to quantitatively monitor the patient's performance, and signal processing may contribute to the prediction of long-term dynamics of patient recovery. Telerehabilitation might spark its advantages far beyond the mere limitation of physical distancing effects, mitigating criticalities of daily neurorehabilitative practice, and thus paving the way to the envision of mixed models of care, where hospital-based procedures are complementarily integrated with telerehabilitative ones.
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16
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Oliver-Hall H, Ratschen E, Tench CR, Brooks H, Constantinescu CS, Edwards L. Pet Ownership and Multiple Sclerosis during COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312683. [PMID: 34886405 PMCID: PMC8656830 DOI: 10.3390/ijerph182312683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/11/2021] [Accepted: 11/27/2021] [Indexed: 12/15/2022]
Abstract
Background: Multiple sclerosis (MS) is associated with lower quality of life, reduced social participation, and decreased self-efficacy. The COVID-19 pandemic has had documented effects on the health and wellbeing of people with and without MS. Previous research has demonstrated the positive impact pets can have for people living with long-term conditions. Objectives: To explore the rates of pet ownership and pet attachment in people living with MS and pet ownership associations with quality of life, satisfaction with social roles, and self-efficacy scores; and to explore the effects of the COVID-19 outbreak on people’s perceived relationships with their pets. Materials and Methods: A postal questionnaire was distributed to members of a local MS Register and a control group of people without MS. The questionnaire assessed quality of life, satisfaction with social roles, self-efficacy, the perceived roles of pets, and pet-related concerns experienced during the COVID-19 pandemic. Results: No apparent difference in attachment to pets was found between the patient and control groups. Pet ownership and level of attachment were not associated with differences in quality of life or self-efficacy scores in people living with MS. Using multiple regression analysis, pet ownership was associated with a decrease in satisfaction with participation in social roles, but with the estimated effect being small compared to having a diagnosis of MS or being unemployed. Most participants reported that pets had positive roles during the pandemic, and the most reported pet-related concern was access to veterinary treatment. Conclusion: Pet owners both with and without MS reported subjective benefits to their wellbeing from pet ownership during COVID-19, although analysis suggested that pet ownership was associated with a reduction in satisfaction with social roles. The study had several limitations and suggestions are made for future work.
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Affiliation(s)
- Holly Oliver-Hall
- Division of Medical Sciences and Graduate Entry Medicine, Royal Derby Hospital, University of Nottingham, Uttoxeter Road, Derby DE22 3DT, UK;
| | - Elena Ratschen
- Department of Health Sciences, University of York, York YO10 5DD, UK;
| | - Christopher R. Tench
- Mental Health & Clinical Neurosciences, Clinical Neurology, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (C.R.T.); (C.S.C.)
- NIHR Nottingham Biomedical Research Centre, Queen’s Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK
| | - Helen Brooks
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester M13 9PL, UK;
| | - Cris S. Constantinescu
- Mental Health & Clinical Neurosciences, Clinical Neurology, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK; (C.R.T.); (C.S.C.)
- Department of Neurology, Cooper University Hospital, Camden, NJ 08103, USA
| | - Laura Edwards
- Division of Medical Sciences and Graduate Entry Medicine, Royal Derby Hospital, University of Nottingham, Uttoxeter Road, Derby DE22 3DT, UK;
- Division of Rehabilitation Medicine, Florence Nightingale Community Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, London Road, Derby DE1 2QY, UK
- Correspondence:
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17
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Li H, Wang C. The Relationships Among Structural Social Support, Functional Social Support, and Loneliness in Older Adults: Analysis of Regional Differences Based on a Multigroup Structural Equation Model. Front Psychol 2021; 12:732173. [PMID: 34650489 PMCID: PMC8507854 DOI: 10.3389/fpsyg.2021.732173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: This study investigated the relationship between structural social support and loneliness and explored whether functional social support had an intermediate role therein. It also employed a multigroup structural equation model to compare mediation models among older adults living in cities, towns, and rural areas. Methods: Using a self-made demographics questionnaire, the structural-functional social support scale, and the 3-item UCLA loneliness scale, this study collected information from 1,325 older adults identified via convenient sampling. Results: The results showed that as: (1) compared with older adults living in towns, older urban, and rural adults had higher structural social support and experienced less loneliness, while older adults' functional social support showed no difference among the three regions (2) An analysis of the models of regional differences indicated that functional social support served as a full mediator in the relationship between structural social support and loneliness in urban older adults, and a partial mediator for older adults living in towns and rural areas. Conclusion: The relationship between structural social support and loneliness is mediated by functional social support, and this mediation model varies between older adults in cities and towns/rural areas. This study helps us understand possible mechanisms through which structural social support impacts loneliness. It suggests that nursing strategies for older adults should be adjusted according to the region and direct greater focus on the function (or quality) of the social support network and older adults living in towns.
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Affiliation(s)
- Haifeng Li
- School of Psychology, Fujian Normal University, Fuzhou, China
| | - Cong Wang
- Fuzhou Hualun Middle School, Fuzhou, China
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18
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Forward C, Khan HTA, Fox P, Usher L. The Health and Wellbeing of Older Women Living Alone in the UK: Is Living Alone a Risk Factor for Poorer Health? AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09426-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Pocuca N, Walter TJ, Minassian A, Young JW, Geyer MA, Perry W. The Effects of Cannabis Use on Cognitive Function in Healthy Aging: A Systematic Scoping Review. Arch Clin Neuropsychol 2021; 36:673-685. [PMID: 33159510 DOI: 10.1093/arclin/acaa105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Older adults (≥50 years) represent the fastest-growing population of people who use cannabis, potentially due to the increasing promotion of cannabis as medicine by dispensaries and cannabis websites. Given healthy aging and cannabis use are both associated with cognitive decline, it is important to establish the effects of cannabis on cognition in healthy aging. OBJECTIVE This systematic scoping review used preferred reporting items for systematic reviews and meta-analyses guidelines to critically examine the extent of literature on this topic and highlight areas for future research. METHOD A search of six databases (PubMed, EMBASE, PsycINFO, Web of Science, Family and Society Studies Worldwide, and CINAHL) for articles published by September 2019, yielded 1,014 unique results. RESULTS Six articles reported findings for older populations (three human and three rodent studies), highlighting the paucity of research in this area. Human studies revealed largely null results, likely due to several methodological limitations. Better-controlled rodent studies indicate that the relationship between ∆9-tetrahydrocannabinol (THC) and cognitive function in healthy aging depends on age and level of THC exposure. Extremely low doses of THC improved cognition in very old rodents. Somewhat higher chronic doses improved cognition in moderately aged rodents. No studies examined the effects of cannabidiol (CBD) or high-CBD cannabis on cognition. CONCLUSIONS This systematic scoping review provides crucial, timely direction for future research on this emerging issue. Future research that combines neuroimaging and cognitive assessment would serve to advance understanding of the effects of age and quantity of THC and CBD on cognition in healthy aging.
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Affiliation(s)
- Nina Pocuca
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - T Jordan Walter
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Arpi Minassian
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,Center for Stress and Mental Health, Veteran's Administration San Diego Hospital, San Diego, CA, USA
| | - Jared W Young
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Mark A Geyer
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - William Perry
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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20
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Mast BT, Molony SL, Nicholson N, Kate Keefe C, DiGasbarro D. Person-centered assessment of people living with dementia: Review of existing measures. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12138. [PMID: 34095438 PMCID: PMC8149970 DOI: 10.1002/trc2.12138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 10/19/2020] [Accepted: 10/27/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Person-centered care and assessment calls for measurement tools that help researchers and providers understand people with dementia, their social relationships, and their experience of the care environment. This paper reviewed available measures and evaluated their psychometric properties. METHODS Literature searches of major databases (PsycInfo, PubMed, EBSCO, CINAHL) for papers examining person-centered constructs in samples of people living with dementia or mild cognitive impairment. Reliability and validity coefficients were reviewed and reported. RESULTS We identified 26 unique measures that had been tested in samples of people living with dementia. Twelve measures of hope, well-being, engagement, social relationships, meaning, resilience, stigma, spiritual beliefs and practices, values and preferences, and positive psychology constructs had strong psychometric properties in samples with dementia. DISCUSSION A variety of reliability and valid measures were identified for use in person-centered care and research with people living with dementia. Additional measure development is needed for key person-centered concepts including dignity and strengths.
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Affiliation(s)
- Benjamin T. Mast
- Psychological & Brain SciencesUniversity of LouisvilleLouisvilleKentuckyUSA
| | | | | | | | - Diana DiGasbarro
- Psychological & Brain SciencesUniversity of LouisvilleLouisvilleKentuckyUSA
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21
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Burholt V, Windle G, Gott M, Morgan DJ. Technology-Mediated Communication in Familial Relationships: Moderated-Mediation Models of Isolation and Loneliness. THE GERONTOLOGIST 2021; 60:1202-1212. [PMID: 32369112 PMCID: PMC8059137 DOI: 10.1093/geront/gnaa040] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Indexed: 12/15/2022] Open
Abstract
Background and Objectives We examined whether technology-mediated communication has functional or emotional equivalence to face-to-face (FtF) contact in familial relationships, by scrutinizing the effects of phone, text/e-mail, and video contact on isolation and loneliness. Research Design and Methods We tested whether FtF contact with a relative would mediate the pathway between proximity to family and (i) isolation and (ii) loneliness. We then tested hypotheses that telephone, text/e-mails, and video contact would moderate this mediated pathway. We compared models for younger (<75) and older (≥75) cohorts, expecting to observe moderation effects for text/e-mail and video contact in the younger cohort only. Data were drawn from Wave 2 of CFAS Wales (United Kingdom) study (N = 2,099). Results Proximity to a relative had a significant indirect effect on isolation and loneliness through the mediating variable FtF contact. Phone and text/e-mail contact moderated the effect of FtF contact on isolation for all samples. None of the technologies moderated the impact of FtF contact on loneliness for the full sample. Telephone contact had a moderating influence on loneliness for the younger cohort only. Video calls had no significant moderation effect. Discussion and Implications Telephone and text/e-mail contact have functional equivalence to FtF contact in familial relationships. None of the forms of technological communication have emotional equivalence to the “gold standard” of embodied presence. The study demonstrates the importance of theorizing about the pathways to isolation and loneliness to better understand the likelihood of implementing successful interventions using technology-mediated communication within families.
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Affiliation(s)
- Vanessa Burholt
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.,School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.,Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University, Wales, UK
| | - Gill Windle
- School of Health Sciences, Bangor University, Wales, UK
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Deborah Jane Morgan
- Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University, Wales, UK
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22
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Fredericksen RJ, Gibbons LE, Fitzsimmons E, Nance RM, Schafer KR, Batey DS, Loo S, Dougherty S, Mathews WC, Christopoulos K, Mayer KH, Mugavero MJ, Kitahata MM, Crane PK, Crane HM. Impact and correlates of sub-optimal social support among patients in HIV care. AIDS Care 2021; 33:1178-1188. [PMID: 33443445 DOI: 10.1080/09540121.2020.1853660] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Social support (SS) predicts health outcomes among patients living with HIV. We administered a brief, validated measure of SS, the Multifactoral Assessment of Perceived Social Support, within a patient-reported outcomes assessment of health domains in HIV care at 4 U.S. clinics in English and Spanish (n = 708). In univariate analysis, low SS was associated with poorer engagement in care, antiretroviral adherence, and health-related quality of life; current methamphetamine/crystal use, depression, anxiety, and HIV stigma (all p < 0.001); any use of either methamphetamines/crystal, illicit opioids, or cocaine/crack (p = 0.001), current marijuana use (p = 0.012), nicotine use (p = 0.005), and concern for sexually transmitted infection exposure (p = 0.001). High SS was associated with undetectable viral load (p = 0.031). Multivariate analyses found low SS independently associated with depression (risk ratio (RR) 3.72, 95% CI 2.93-4.72), lower adherence (RR 0.76, 95% CI 0.64-0.89), poor engagement in care (RR 2.05, 95% CI 1.44-2.96), and having more symptoms (RR 2.29, 95% CI 1.92-2.75). Medium SS was independently associated with depression (RR 2.59, 95% CI 2.00-3.36), poor engagement in care (RR 1.62, 95% CI 1.15-2.29) and having more symptoms (RR 1.75, 95% CI 1.44-2.13). SS assessment may help identify patients at risk for these outcomes.
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Affiliation(s)
| | - L E Gibbons
- Medicine, University of Washington, Seattle, WA, USA
| | - E Fitzsimmons
- Medicine, University of Washington, Seattle, WA, USA
| | - R M Nance
- Medicine, University of Washington, Seattle, WA, USA
| | - K R Schafer
- Internal Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - D S Batey
- Medicine, University of Alabama, Birmingham, AL, USA
| | - S Loo
- Fenway Community Health, Boston, MA, USA
| | - S Dougherty
- Medicine, University of Alabama, Birmingham, AL, USA
| | - W C Mathews
- Medicine, University of California, San Diego, CA, USA
| | | | - K H Mayer
- Fenway Community Health, Boston, MA, USA
| | - M J Mugavero
- Medicine, University of Alabama, Birmingham, AL, USA
| | - M M Kitahata
- Medicine, University of Washington, Seattle, WA, USA
| | - P K Crane
- Medicine, University of Washington, Seattle, WA, USA
| | - H M Crane
- Medicine, University of Washington, Seattle, WA, USA
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23
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Nuara A, Fabbri-Destro M, Scalona E, Lenzi SE, Rizzolatti G, Avanzini P. Telerehabilitation in response to constrained physical distance: an opportunity to rethink neurorehabilitative routines. J Neurol 2021; 269:627-638. [PMID: 33449202 PMCID: PMC7809551 DOI: 10.1007/s00415-021-10397-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 02/07/2023]
Abstract
Ensuring proper dosage of treatment and repetition over time is a major challenge in neurorehabilitation. However, a requirement of physical distancing to date compromises their achievement. While mostly associated to COVID-19, physical distancing is not only required in a pandemic scenario, but also advised for several clinical conditions (e.g. immunocompromised individuals) or forced for specific social contexts (e.g. people living in remote areas worldwide). All these contexts advocate for the implementation of alternative healthcare models. The objective of this perspective is to highlight the benefits of remote administration of rehabilitative treatment, namely telerehabilitation, in counteracting physical distancing barriers in neurorehabilitation. Sustaining boosters of treatment outcome, such as compliance, sustainability, as well as motivation, telerehabilitation may adapt to multiple neurological conditions, with the further advantage of a high potential for individualization to patient's or pathology's specificities. The effectiveness of telerehabilitation can be potentiated by several technologies available to date: virtual reality can recreate realistic environments in which patients may bodily operate, wearable sensors allow to quantitatively monitor the patient's performance, and signal processing may contribute to the prediction of long-term dynamics of patient recovery. Telerehabilitation might spark its advantages far beyond the mere limitation of physical distancing effects, mitigating criticalities of daily neurorehabilitative practice, and thus paving the way to the envision of mixed models of care, where hospital-based procedures are complementarily integrated with telerehabilitative ones.
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Affiliation(s)
- Arturo Nuara
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy. .,Department of Biomedical, Metabolic, and Neuronal Sciences, University of Modena and Reggio Emilia, Modena, Italy. .,Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Maddalena Fabbri-Destro
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy
| | - Emilia Scalona
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy
| | - Stefano Elio Lenzi
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy
| | - Giacomo Rizzolatti
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy.,Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Pietro Avanzini
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, via Volturno 39/E, 43125, Parma, Italy.,Istituto Clinico Humanitas, Rozzano, Italy
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Pirhonen J, Tiilikainen E, Pekkarinen S, Lemivaara M, Melkas H. Can robots tackle late-life loneliness? Scanning of future opportunities and challenges in assisted living facilities. FUTURES 2020; 124:102640. [PMID: 33041358 PMCID: PMC7534874 DOI: 10.1016/j.futures.2020.102640] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/06/2020] [Accepted: 09/08/2020] [Indexed: 05/07/2023]
Abstract
This future-oriented study examines the opportunities and challenges offered by social robots and communication technology when aiming to decrease emotional and social loneliness in older people residing in assisted living (AL). The paper draws on prior literature on loneliness, elder care and social robots. The aim is to scan the futures regarding technology support for the frail older people in future AL. The analytical frame was built on Robert Weiss' division of relational functions: attachment, social integration, opportunity for nurturance, reassurance of worth, sense of reliable alliance, and guidance in stressful situations, and on a distinction between direct and indirect social robots. Our examinations show that social robots could tackle both emotional and social loneliness in assisted living by empowering people to engage in different forms of social interaction inside and outside the facility. However, ethical concerns of objectification, lack of human contact, and deception need to be thoroughly considered when implementing social robots in care for frail older people.
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Affiliation(s)
- Jari Pirhonen
- Faculty of Social Sciences, University of Helsinki, P.O. Box 4, 00014, Finland
| | - Elisa Tiilikainen
- Department of Social Sciences, University of Eastern Finland, Faculty of Social Sciences and Business Studies, 70211 Kuopio, Finland
| | - Satu Pekkarinen
- School of Engineering Science, Lappeenranta-Lahti University of Technology LUT, Mukkulankatu 19, 15210 Lahti, Finland
| | - Marjut Lemivaara
- Faculty of Social Sciences, Tampere University, P.O. Box 100, 33014, Finland
| | - Helinä Melkas
- School of Engineering Science, Lappeenranta-Lahti University of Technology LUT, Mukkulankatu 19, 15210 Lahti, Finland
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Cheung G, Rivera-Rodriguez C, Martinez-Ruiz A, Ma'u E, Ryan B, Burholt V, Bissielo A, Meehan B. Impact of COVID-19 on the health and psychosocial status of vulnerable older adults: study protocol for an observational study. BMC Public Health 2020; 20:1814. [PMID: 33256649 PMCID: PMC7702201 DOI: 10.1186/s12889-020-09900-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 11/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many countries around the world have adopted social distancing as one of the public health measures to reduce COVID-19 transmissions in the community. Such measures could have negative effects on the mental health of the population. The aims of this study are to (1) track the impact of COVID-19 on self-reported mood, self-rated health, other health and psychosocial indicators, and health services utilization of people who have an interRAI assessment during the first year of COVID-19; (2) compare these indicators with the same indicators in people who had an interRAI assessment in the year before COVID-19; and (3) report these indicators publicly as soon as data analysis is completed every 3 months. METHODS interRAI COVID-19 Study (iCoS) is an observational study on routinely collected national data using the interRAI Home Care and Contact Assessment, which are standardized geriatric assessment tools mandated for all people assessed for publicly funded home support services and aged residential care in New Zealand. Based on the 2018/19 figures, we estimated there are 36,000 interRAI assessments per annum. We will compare the four post-lockdown quarters (from 25th March 2020) with the respective pre-lockdown quarters. The primary outcomes are self-reported mood (feeling sad, depressed or hopeless: 0 = no, 1 = yes) and self-rated health (0 = excellent, 1 = good, 2 = fair, 3 = poor). We will also analyze sociodemographics, other secondary health and psychosocial indicators, and health services utilization. Descriptive statistics will be conducted for primary outcomes and other indicators for each of the eight quarters. We will compare the quarters using regression models adjusted for demographic characteristics using weights or additional variables. Key health and psychosocial indicators will be reported publicly as soon as data analysis is completed for each quarter in the 12-month post-lockdown period by using a data visualization tool. DISCUSSION This rapid translation of routinely collected national interRAI data will provide a means to monitor the health and psychosocial well-being of vulnerable older New Zealanders. Insights from this study can be shared with other countries that use interRAI and prepare health and social services for similar epidemics/pandemics in the future.
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Affiliation(s)
- Gary Cheung
- Department of Psychological Medicine, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand. .,Brain Research New Zealand - Rangahau Roro Aotearoa, The University of Auckland, Auckland, New Zealand.
| | | | - Adrian Martinez-Ruiz
- Department of Psychological Medicine, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand.,Brain Research New Zealand - Rangahau Roro Aotearoa, The University of Auckland, Auckland, New Zealand.,Department of Demographic Epidemiology and Social Determinants, National Institute of Geriatrics of Mexico, Mexico City, Mexico
| | - Etuini Ma'u
- Department of Psychological Medicine, The University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand
| | - Brigid Ryan
- Brain Research New Zealand - Rangahau Roro Aotearoa, The University of Auckland, Auckland, New Zealand.,Department of Anatomy and Medical Imaging, The University of Auckland, Auckland, New Zealand
| | - Vanessa Burholt
- School of Nursing / School of Population Health, The University of Auckland, Auckland, UK.,Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University, Wales, New Zealand
| | - Ange Bissielo
- interRAI Services, Technical Advisory Services (TAS) Limited, Wellington, UK
| | - Brigette Meehan
- interRAI Services, Technical Advisory Services (TAS) Limited, Wellington, UK
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26
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Marston HR, Shore L, White P. How does a (Smart) Age-Friendly Ecosystem Look in a Post-Pandemic Society? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8276. [PMID: 33182413 PMCID: PMC7664882 DOI: 10.3390/ijerph17218276] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 12/24/2022]
Abstract
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.
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Affiliation(s)
- Hannah Ramsden Marston
- Health & Wellbeing Strategic Research Area, School of Health, Wellbeing & Social Care, The Open University, Milton Keynes, Buckinghamshire MK7 6HH, UK
| | - Linda Shore
- Mi:Lab, Department of Design Innovation, Maynooth University, W23 F2H6 Co. Kildare, Ireland;
| | - P.J. White
- DesignCORE, Humanities, Institute of Technology Carlow, R93 V960 Carlow, Ireland;
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27
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Morgan DJ, Burholt V. Loneliness as a Biographical Disruption-Theoretical Implications for Understanding Changes in Loneliness. J Gerontol B Psychol Sci Soc Sci 2020; 75:2029-2039. [PMID: 32812040 PMCID: PMC7566959 DOI: 10.1093/geronb/gbaa097] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES While a great deal is known about the risk factors that increase vulnerability to loneliness in later life, little research has explored stability and change in levels of loneliness. METHODS Narrative interviews were conducted with 11 participants who were identified as being lonely during Wave 1 of the Maintaining Function and Well-being in Later Life Study Wales (CFAS Wales). The interviews were used to explore stability and change in levels of loneliness from the perspective of older people themselves. The interviews focused on participant's perspectives of the events that triggered loneliness, stability, and change in levels of loneliness over time as well as participant's responses to loneliness. RESULTS The findings show that participants experienced losses and loneliness as biographical disruption. How participants and their wider social network responded to these losses had implications for the individual's trajectory through loneliness. DISCUSSION Drawing on a biographical lens, the study reframed the events that triggered loneliness as disruptive events. This article discusses the utility of biographical disruption in understanding stability and change in loneliness. The findings suggest how drawing on valued identities may help lonely adults transition out of loneliness.
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Affiliation(s)
- Deborah J Morgan
- Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University, UK
| | - Vanessa Burholt
- Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University, UK
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
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28
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Burholt V, Winter B, Aartsen M, Constantinou C, Dahlberg L, Feliciano V, De Jong Gierveld J, Van Regenmortel S, Waldegrave C. A critical review and development of a conceptual model of exclusion from social relations for older people. Eur J Ageing 2020; 17:3-19. [PMID: 32158368 PMCID: PMC7040153 DOI: 10.1007/s10433-019-00506-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Social exclusion is complex and dynamic, and it leads to the non-realization of social, economic, political or cultural rights or participation within a society. This critical review takes stock of the literature on exclusion of social relations. Social relations are defined as comprising social resources, social connections and social networks. An evidence review group undertook a critical review which integrates, interprets and synthesizes information across studies to develop a conceptual model of exclusion from social relations. The resulting model is a subjective interpretation of the literature and is intended to be the starting point for further evaluations. The conceptual model identifies individual risks for exclusion from social relations (personal attributes, biological and neurological risk, retirement, socio-economic status, exclusion from material resources and migration). It incorporates the evaluation of social relations, and the influence of psychosocial resources and socio-emotional processes, sociocultural, social-structural, environmental and policy contextual influences on exclusion from social relations. It includes distal outcomes of exclusion from social relations, that is, individual well-being, health and functioning, social opportunities and social cohesion. The dynamic relationships between elements of the model are also reported. We conclude that the model provides a subjective interpretation of the data and an excellent starting point for further phases of conceptual development and systematic evaluation(s). Future research needs to consider the use of sophisticated analytical tools and an interdisciplinary approach in order to understand the underlying biological and ecopsychosocial associations that contribute to individual and dynamic differences in the experience of exclusion from social relations.
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Affiliation(s)
- Vanessa Burholt
- Centre for Innovative Ageing, Swansea University, Swansea, Wales UK
| | - Bethan Winter
- Centre for Innovative Ageing, Swansea University, Swansea, Wales UK
| | - Marja Aartsen
- Centre for Welfare and Labour Research, OsloMet Oslo Metropolitan University, Oslo, Norway
| | | | - Lena Dahlberg
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Aging Research Center, Karolinska Institute, Solna, Sweden
| | - Villar Feliciano
- Department of Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Jenny De Jong Gierveld
- Faculty of Social Science, VU University Amsterdam, Amsterdam, The Netherlands
- Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
| | - Sofie Van Regenmortel
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - The Working Group on Exclusion from Social Relations, part of the COST-financed Research Network ‘Reducing Old-Age Exclusion: Collaborations in Research and Policy’ (ROSENet)
- Centre for Innovative Ageing, Swansea University, Swansea, Wales UK
- Centre for Welfare and Labour Research, OsloMet Oslo Metropolitan University, Oslo, Norway
- University of Nicosia Medical School, Nicosia, Cyprus
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Aging Research Center, Karolinska Institute, Solna, Sweden
- Department of Development and Educational Psychology, University of Barcelona, Barcelona, Spain
- Faculty of Social Science, VU University Amsterdam, Amsterdam, The Netherlands
- Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Family Centre Social Policy Research Unit, Lower Hutt, New Zealand
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29
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An Examination of Social Skills, Friendship Quality, and Loneliness for Adults with Williams Syndrome. J Autism Dev Disord 2020; 50:3649-3660. [PMID: 32076956 DOI: 10.1007/s10803-020-04416-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Individuals with Williams Syndrome (WS) are hypersocial, overfriendly, and experience social skills deficits that may adversely impact their social outcomes. This study examined the relation between social skills, friendship quality, and feelings of loneliness for adults with WS as reported by 114 parent-adult with WS dyads. Results indicate that although most friends do not live close-by, adults with WS have good quality friendships and do not report high feelings of loneliness. Positive friendship qualities were found to partially mediate the relationship between social skills impairments and social feelings of loneliness. Findings indicate that although adults with WS experience social skills deficits and struggle to maintain friendships in their immediate community, they still report positive friendship qualities and low feelings of loneliness.
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Li X, Wang J, Dong S, Fu J, Liu J. The Influence of Disabilities in Activities of Daily Living on Successful Aging: The Role of Well-Being and Residence Location. Front Public Health 2020; 7:417. [PMID: 32047732 PMCID: PMC6997131 DOI: 10.3389/fpubh.2019.00417] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 12/27/2019] [Indexed: 12/31/2022] Open
Abstract
This study aimed to investigate the effect of disability in activities of daily living (ADLs) on successful aging, and the possible moderators between them. Based on data from the Chinese Longitudinal Healthy Longevity Surveys (CLHLS), we used the Cox proportional hazards model of survival analysis and multivariate regression analysis (SPSS 16.0) to test our hypotheses. Mortality or cognition impairment were the dependents variables, and disability in ADLs was the independent variable. Well-being and residence location were the moderators. The results showed that in survey 2005, the Chinese elders with disability in ADLs, after controlling elder's gender, age, residence place, and marital status, often experienced more mortality and cognition impairment risk in the next 3 years. Our findings also showed that the increased mortality risk among elders with disability in ADLs was lower in those with higher well-being or younger age. The increased cognitive impairment risk among elders with disability in ADLs was lower in those living in the city than those living in a rural area or small towns. These findings contribute to a better understanding of the relationship between disability in ADLs and successful aging among Chinese elders. Our findings also expose other elements to consider such as psychological factors (e.g., well-being) and residence location in the relationships between the disability in ADLs and mortality (or cognition impairment), which have a psychological impact in successful aging of the Chinese elders.
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Affiliation(s)
- Xiaoshan Li
- School of Psychology, Jiangxi Normal University, Nanchang, China.,Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Jingjing Wang
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Shenghong Dong
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Jianping Fu
- College of Life Science, Jiangxi Normal University, Nanchang, China
| | - Jianping Liu
- School of Psychology, Jiangxi Normal University, Nanchang, China
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31
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Lui JZ, Young NP, Ebbert JO, Rosedahl JK, Philpot LM. Loneliness and Migraine Self-Management: A Cross-Sectional Assessment. J Prim Care Community Health 2020; 11:2150132720924874. [PMID: 32484017 PMCID: PMC7268119 DOI: 10.1177/2150132720924874] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Chronic illness is often comorbid with the psychological state of loneliness. Models of care for patients who experience chronic migraines may often lack an understanding of psychosocial influences of the illness. Addressing the effects of loneliness on the health behaviors of chronic migraine patients may further elucidate gaps in care that exist beyond the biomedical approach to migraine treatment. The primary aim of this study was to assess the relationship between loneliness and behavioral health decisions in chronic migraine patients, specifically patient ability to self-manage, and effectiveness of treatments. Methods: We conducted a cross-sectional survey among patients (n = 500) with migraine and assessed for the experience of loneliness by using the University of California, Los Angeles-Revised (UCLA-R) Three-item Loneliness Scale and the extent of migraine-related disability via the Migraine Disability Assessment (MIDAS). Furthermore, we evaluated patients for their ability to self-manage their migraines, and perceived effectiveness of treatment. Results: Nearly half of our population reported at least one measure of loneliness (230/500, 46.0%). Patients experiencing chronic migraine were statistically more likely to report feeling lonely when compared to patients with episodic migraines (P < .001). Patients who report loneliness had lower odds of feeling 'very satisfied" with their ability to self-manage their migraine symptoms (aOR = 0.34, 95% CI 0.14-0.81) and had lower odds of feeling "very satisfied" with their ability to avoid conditions that cause their headache (aOR = 0.39, 95% CI 0.16-0.91). Conclusions: Loneliness has significant effects on the illness experience of patients with chronic migraines, including their ability to self-manage or be satisfied with their current state of care. Psychosocial models of care that address loneliness among patients with chronic migraine may help improve health outcomes and management.
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32
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Mournet AM, Bower E, Van Orden KA. Domains of Functional Impairment and Their Associations with Thwarted Belonging and Perceived Burden in Older Adults. Clin Gerontol 2020; 43:95-103. [PMID: 31397645 PMCID: PMC6923585 DOI: 10.1080/07317115.2019.1650406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Functional impairment and social disconnection are risk factors for suicide in later life. This paper examines associations between domains of functional impairment and two forms of social disconnection that are empirically linked to suicide in later life - low (or thwarted) belonging and perceived burden on others.Methods: Participants are 62 older primary care patients (67.68% female, mean age = 72.05) who endorsed feeling lonely or like a burden. Participants completed self-report measures of low belonging and perceived burden (INQ-R) and domains of functional impairment (WHODAS 2.0) at a single time point.Results: Greater perceived burden was associated with greater impairment in activities of daily living ("self-care"), while greater thwarted belonging was associated with greater impairment in social functioning, when controlling for depressive symptoms and age. Domains of mobility, cognition and social participation were not associated with either belonging or perceived burden.Conclusions: Impairment in self-care (ADLs) and social functioning may be more strongly associated with perceived burden and thwarted belonging than other domains of functional impairment.Clinical Implications: Considering specific domains of functional impairment - rather than functioning more broadly - may facilitate tailored interventions to target suicide risk.
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Affiliation(s)
- Annabelle M Mournet
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Emily Bower
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Kimberly A Van Orden
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
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33
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Marston HR, Niles-Yokum K, Earle S, Gomez B, Lee DM. OK Cupid, Stop Bumbling around and Match Me Tinder: Using Dating Apps Across the Life Course. Gerontol Geriatr Med 2020; 6:2333721420947498. [PMID: 32844104 PMCID: PMC7418241 DOI: 10.1177/2333721420947498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/31/2020] [Accepted: 07/07/2020] [Indexed: 12/21/2022] Open
Abstract
Social connectedness, sex, and intimacy are all factors associated with positive aging, facing individuals in society across the life course. Phenomenal technological developments in the 21st century have led to the increased use of smartphones, mobile apps, and dating apps for a myriad of services, and engagements. This paper focuses on two specific cohorts' who have the opportunity to engage with dating apps, older adults and young citizens with life-limiting or life-threatening conditions, and highlights issues related to the intersection of technology, societal constructions of age, disability, and online dating.
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Affiliation(s)
| | | | - Sarah Earle
- The Open University, Milton Keynes, Buckinghamshire, UK
| | | | - David M. Lee
- Manchester Metropolitan University, Didsbury, Manchester, UK
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Morris ZA. Loneliness as a Predictor of Work Disability Onset Among Nondisabled, Working Older Adults in 14 Countries. J Aging Health 2019; 32:554-563. [PMID: 30964370 DOI: 10.1177/0898264319836549] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The objective of this study is to examine the relationship between loneliness and work disability and whether depression mediates the hypothesized relationship. Method: We draw on data from the 2013 and 2015 waves of the Survey of Health, Aging, and Retirement in Europe. We limited the sample to adults between the ages of 50 and 65 who were working and without work limitations in 2013, which consisted of 10,154 adults from 14 countries. We apply multivariate logistic regression and a binary mediation analysis with logistic regression to examine predictors of the onset of work disability in 2015. Results: Loneliness was predictive of future work disability onset when adjusting for other factors in the disablement process. Depression partly mediated the longitudinal relationship between loneliness and work disability. Discussion: The results indicate that addressing loneliness could mitigate the risk of depression and, in turn, work disability onset.
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35
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Hajek A, König HH. The association of falls with loneliness and social exclusion: evidence from the DEAS German Ageing Survey. BMC Geriatr 2017; 17:204. [PMID: 28874139 PMCID: PMC5584003 DOI: 10.1186/s12877-017-0602-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 08/24/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND It remains an open question whether falls are related with social relations, covering subjective (e.g., perceived loneliness) and more objective dimensions (e.g., number of important individuals in regular contact). Consequently, we aimed at examining the association between falls and social ties comprehensively, including loneliness, social exclusion and the number of important people in regular contact. METHODS Cross-sectional data were used from a population-based sample of community-dwelling individuals aged 40 and over (n = 7808) in Germany. Self-rated loneliness was quantified using a short version of the De Jong Gierveld Loneliness Scale. Perceived social exclusion was measured using a scale developed by Bude and Lantermann. Furthermore and in contrast to the subjective outcome measures, the more objective number of important people in regular contact was also used as outcome variable. The experience of a fall in the preceding 12 months (yes; no) was assessed. RESULTS Controlling for various possible confounding variables, linear regressions showed that experiencing a fall in the past 12 months was associated with higher social exclusion (β = .08, p < .001), and increased loneliness (β = .08, p < .001), whereas it was not associated with the number of important people in regular contact. CONCLUSIONS Findings stress the relation between falls and feelings of loneliness and social exclusion, whereas falls were unrelated to the more objective measure of number of important people in regular contact, suggesting that falls are particularly related to subjective measures of social ties and relations. This underlines the importance of interventions to prevent falls. Preventing falls in turn might help to prevent loneliness and social exclusion.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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