1
|
Girault C, Schramm S, Tolstrup JS, Ekholm O, Bramming M. Changes in loneliness prevalence in Denmark in the 21st century: Age-period-cohort analysis. Scand J Public Health 2024; 52:692-697. [PMID: 37387263 DOI: 10.1177/14034948231182188] [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] [Indexed: 07/01/2023]
Abstract
AIM The aim of this study was to investigate changes in the prevalence of loneliness in Denmark from 2000 to 2021 by conducting age-period-cohort analysis. METHODS Our study was based on a sample (N=83,437; age: ⩾16 years) of the Danish Health and Morbidity Surveys conducted in Denmark in 2000, 2005, 2010, 2013, 2017 and 2021. We used logistic regression models by gender to estimate the age-period-cohort effects, with loneliness as the dependent variable and age, survey year and birth cohort as independent variables, mutually adjusted. RESULTS The prevalence of adult loneliness increased by each survey year over the entire period (from 13.2% in 2000 to 27.4% in 2021 among men and from 18.8% to 33.7% among women). Overall, a U-shaped curve, for the prevalence of loneliness among different age groups, was observed, which was most pronounced among women. The greatest increase in the prevalence of loneliness from 2000 to 2021 was observed among the youngest age group (16-24 years), with 28.4 and 30.7 percentage points for men and women. No significant cohort effect was observed. CONCLUSIONS The observed increase in loneliness prevalence from 2000 to 2021 was driven by period and age effects rather than cohort effects. It should be noted that data from 2021 were collected during a national lockdown due to an outbreak of COVID-19, which could explain part of the large increase in loneliness from 2017 to 2021.
Collapse
Affiliation(s)
- Clara Girault
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Stine Schramm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Maja Bramming
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| |
Collapse
|
2
|
Gordon NP, Stiefel MC. A brief but comprehensive three-item social connectedness screener for use in social risk assessment tools. PLoS One 2024; 19:e0307107. [PMID: 39028701 PMCID: PMC11259274 DOI: 10.1371/journal.pone.0307107] [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] [Received: 12/19/2023] [Accepted: 06/26/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND The 2014 IOM report "Capturing Social and Behavioral Domains and Measures in Electronic Health Records" described three subdomains of social relationships that affect patient health and well-being. However, most social risk screeners currently assess only one subdomain, frequency of social connections. We are proposing a three-item Brief Social Connectedness (SC) screener that additionally assesses risks in social/emotional support and loneliness/social isolation subdomains. METHODS For this cross-sectional study, we used data from a 2021 Kaiser Permanente Northern California (KPNC) social risk survey for 2244 members ages 35-85 years. The survey included three validated questions that covered the SC subdomains (frequencies of social contacts with people they care about, feeling lonely/socially isolated, and getting enough social/emotional support). Variables representing moderate/high versus low risk were created for each subdomain. We used weighted data for bivariate analyses and modified log-Poisson regression models that adjusted for age, sex, race, and ethnicity to examine cross-sectional associations among the three subdomain risks, as well as with two structural SC risks, living alone and not being in a committed relationship. We then used modified log-Poisson regression models to study cross-sectional associations of these five SC variables with three single-item self-report measures of emotional health. RESULTS In regression models that included all five SC variables, loneliness/social isolation and social/emotional support risks were significantly associated with all three emotional health measures, while frequency of social contacts, living alone, and no committed relationship were not. However, low frequency of social contacts and no committed relationship significantly increased risk of often feeling lonely/socially isolated and lacking in social/emotional support. CONCLUSIONS A three-item social connectedness screener that assessed risks of loneliness/social isolation, inadequate social/emotional support, and low frequency of social contacts provided more comprehensive information about emotional health risks than social connection frequency alone.
Collapse
Affiliation(s)
- Nancy P. Gordon
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Matthiew C. Stiefel
- Institute for Healthcare Improvement, Boston, Massachusetts, United States of America
| |
Collapse
|
3
|
Floyd K, Hesse C, Ray CD, Mikkelson AC. Interpersonal Loneliness Predicts the Frequency and Intensity of Nightmares: An Examination of Theoretic Mechanisms. THE JOURNAL OF PSYCHOLOGY 2024:1-21. [PMID: 39013019 DOI: 10.1080/00223980.2024.2378418] [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: 03/27/2024] [Accepted: 07/03/2024] [Indexed: 07/18/2024] Open
Abstract
The evolutionary theory of loneliness (ETL) argues that human belongingness is essential to survival and failing to meet belongingness needs constitutes a threat to viability. In two separate studies (total N = 1,609), links between loneliness and nightmares were examined as a test of ETL postulates. As hypothesized, loneliness predicted nightmare frequency (both studies) and nightmare intensity (Study Two only). Although stress mediated the relationship between loneliness and nightmare frequency in Study One, stress was not a significant mediator of this relationship in Study Two. As predicted, in Study Two both hyperarousal and rumination mediated the relationships between loneliness and nightmare frequency and between loneliness and nightmare intensity. Theoretical implications include support for both the aversive signaling and implicit vigilance postulates of ETL.
Collapse
|
4
|
Grocott B, Neta M, Chen F, LeMoult J. Associations of state and chronic loneliness with interpretation bias: The role of internalizing symptoms. Behav Res Ther 2024; 180:104603. [PMID: 38959695 DOI: 10.1016/j.brat.2024.104603] [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: 02/13/2024] [Revised: 05/29/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024]
Abstract
Loneliness is common and, while generally transient, persists in up to 22% of the population. The rising prevalence and adverse impacts of chronic loneliness highlight the need to understand its underlying mechanisms. Evolutionary models of loneliness suggest that chronically lonely individuals demonstrate negative interpretation biases towards social information. It may also be that such biases are exacerbated by momentary increases in state loneliness, or elevated anxiety or depression. Yet, little research has tested these possibilities. The current study aimed to advance understandings of loneliness by examining associations of chronic loneliness with individual differences in negative interpretation bias for social (relative to non-social) stimuli, and testing whether these associations change in the context of increased state loneliness and current levels of anxiety and depressive symptoms. These aims were explored in 591 participants who completed an interpretation bias task before and after undergoing a state loneliness induction. Participants also self-reported chronic loneliness, anxiety, and depression. Linear mixed models indicated that only state (but not chronic) loneliness was associated with more positive interpretations of non-social stimuli, with greater anxiety and depressive symptoms predicting more negative interpretations. Implications of these findings for present theoretical models of loneliness are discussed.
Collapse
|
5
|
Becher H, Krist L, Menzel J, Fernholz I, Keil T, Kreutz G, Schmidt A, Streit F, Willich SN, Weikert C. Music-Making and Depression and Anxiety Before and During the COVID-19 Pandemic-Results From the NAKO Cohort Study in Germany. Int J Public Health 2024; 69:1606993. [PMID: 38978833 PMCID: PMC11228560 DOI: 10.3389/ijph.2024.1606993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/06/2024] [Indexed: 07/10/2024] Open
Abstract
Objectives To investigate the association of musical activity with mental health during the COVID-19 pandemic. Methods A total of 3,666 participants reported their musical activity before and mental health indicators before and during the pandemic. Depression was assessed with the Patient Health Questionnaire, anxiety with the Generalized Anxiety Disorder scale. The association between mental health scores and musical activities was investigated using linear regression. Results Within the last 12 months, 22.1% of the participants reported musical activity (15.1% singing, 14.5% playing an instrument). Individuals with frequent singing as their main musical activity had higher scores before the pandemic than non-musicians and the worsening during the pandemic was more pronounced compared to non-musicians. Instrumentalists tended to have slightly lower scores than non-musicians indicating a possible beneficial effect of playing an instrument on mental health. Conclusion The pandemic led to a worsening of mental health, with singers being particularly affected. Singers showed poorer mental health before the pandemic. The tendency for instrumentalists to report lower depression scores compared to non-musicians may support the hypothesis that music-making has a beneficial effect on health.
Collapse
Affiliation(s)
- Heiko Becher
- Institute of Global Health, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Juliane Menzel
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Food Safety, Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Isabel Fernholz
- Clinic for Audiology and Phoniatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Institute of Clinical Epidemiology and Biometry, Faculty of Medicine, University of Würzburg, Würzburg, Bavaria, Germany
- Bavarian Health and Food Safety Authority (LGL), Oberschleissheim, Germany
| | - Gunter Kreutz
- Department of Music, Carl von Ossietzky University Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Alexander Schmidt
- Clinic for Audiology and Phoniatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Department of Psychiatry and Psychotherapy, Hector Institute for Artificial Intelligence in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stefan N Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Cornelia Weikert
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Food Safety, Federal Institute for Risk Assessment (BfR), Berlin, Germany
| |
Collapse
|
6
|
Vasan S, Lim MH, Eikelis N, Lambert E. Investigating the relationship between early cardiovascular disease markers and loneliness in young adults. Sci Rep 2024; 14:14221. [PMID: 38902298 PMCID: PMC11190220 DOI: 10.1038/s41598-024-65039-8] [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: 11/28/2023] [Accepted: 06/17/2024] [Indexed: 06/22/2024] Open
Abstract
Loneliness is recognised as a risk factor for cardiovascular disease development. However, it is unclear whether loneliness itself or other closely related mental health symptoms, such as depression and social anxiety, are associated with the development of cardiovascular disease. In the present study, we examined the relationship between loneliness and several early cardiovascular disease markers in young adults, after controlling for depression and social anxiety. Sixty-six young adults (18-35 years old, Mage = 22.70; 75.8% females) completed psychological questionnaires and took part in several physiological tests assessing cardiovascular health (e.g., vascular function). Results revealed higher loneliness was significantly associated with shorter pulse transit time (β = - 0.70, p = 0.002; shorter pulse transit time is a subclinical marker for arterial stiffness). Additionally, results show that while loneliness and depression were both related to vascular dysfunction in young adults, the underlining physiological mechanisms through which they affect vascular function may be different. Specifically, higher loneliness was associated with increased arterial stiffness, whereas depression was associated with increased endothelial dysfunction (β = - 0.43, p = 0.04). Our findings indicate that presence of loneliness and depression in young adults may be accompanied by early indicators of poor cardiovascular health, such as arterial stiffness and endothelial dysfunction. Results from the study further support the link between loneliness and cardiovascular disease development.
Collapse
Affiliation(s)
- Shradha Vasan
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, 3122, Australia.
- Department of Mental Health Services, St. Vincent's Hospital Melbourne, Melbourne, Australia.
| | - Michelle H Lim
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, 3122, Australia
- Prevention Research Collaboration, Sydney School of Public Health, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Nina Eikelis
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, 3122, Australia
| | - Elisabeth Lambert
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, 3122, Australia
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| |
Collapse
|
7
|
DurmuŞ Sarıkahya S, Terzi A, Kanbay Y, Çınar Özbay S, Gelin D. The mediating role of loneliness in the effect of physical activity barriers on quality of life. Psychogeriatrics 2024; 24:572-581. [PMID: 38430001 DOI: 10.1111/psyg.13099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/05/2024] [Accepted: 02/15/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND This study aims to examine the mediating role of loneliness in the effect of physical activity barriers on quality of life. METHODS The sample of the study consisted of 374 people over the age of 65 who applied to a hospital. The data collection tools used in the study are 'Personal Information Form', 'Physical Activity Barriers Questionnaire' 'World Health Organization Quality of Life Instrument-Older Adults Module' and 'Loneliness Scale for the Elderly'. The mediating effect analysis was conducted through the 'Process Macro' developed by Hayes. RESULTS According to the obtained results, loneliness mediates the relationship between physical activity barriers and quality of life. Individuals with high levels of loneliness and physical activity barriers have lower levels of quality of life. When the results of the regression analysis indicating the mediating effect were analyzed, it was determined that the effect of physical activity barriers on quality of life were negative and significant. As the level of physical activity barriers increases, the level of quality of life decreases. CONCLUSION In conclusion, it was determined that loneliness plays a mediating role in the relationship between physical activity barriers and the level of quality of life. The study results suggest that adopting a physically active lifestyle is important to reduce adverse health outcomes in the elderly.
Collapse
Affiliation(s)
- Selma DurmuŞ Sarıkahya
- Department of Public Health Nursing, Faculty of Health Sciences, Artvin Coruh University, Artvin, Turkey
| | - Amine Terzi
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Artvin Coruh University, Artvin, Turkey
| | - Yalçın Kanbay
- Department of Psychiatric Nursing, Faculty of Health Sciences, Artvin Coruh University, Artvin, Turkey
| | | | - Dilek Gelin
- Clinic of Neurology, Kayseri City Hospital, Kayseri, Turkey
| |
Collapse
|
8
|
Yarish NM, Posis AIB, Nguyen S, Weitlauf J, Bellettiere J, Saquib N, Richey PA, Allison M, Kroenke C, Goveas JS, Coday M, LaCroix AZ. Loneliness, social isolation, and cardiovascular disease among nonveteran and veteran women. J Women Aging 2024:1-12. [PMID: 38659158 DOI: 10.1080/08952841.2024.2336655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024]
Abstract
We examined the prospective associations of social isolation and loneliness with incident cardiovascular disease (CVD) among aging nonveteran and veteran women, and effect modification by veteran status. Participants with no history of myocardial infarction (MI), stroke, coronary heart disease (CHD), or coronary heart failure from the Women's Health Initiative Extension Study II self-reported social isolation, loneliness, health behaviors, health status, and veteran status. CVD and CVD subevents were physician adjudicated. Hazard ratios (HR) and 95% confidence intervals (CI) for the Interquartile Range (IQR) in social isolation (IQR = 1) and loneliness (IQR=.33) were calculated using Cox proportional hazard models adjusting for sociodemographic, health behavior, and health status characteristics. Veteran status was tested as an effect modifier. Among 52,442 women (Mean age = 79 ± 6.1; veterans n = 1023; 89.2% non-Hispanic White), 3579 major CVD events occurred over an average 5.8 follow-up years. Compared to nonveterans, veteran women reported higher levels of social isolation (p < .01) and loneliness (p < .01). The CVD HR was 1.07 (95% CI, 1.04-1.10) for the IQR in social isolation and 1.03 (95% CI, 1.10-1.06) for the IQR in loneliness. The HR for the IQR in both social isolation and loneliness was 1.10 (95% CI, 1.05-1.15). Social isolation was associated with CHD (HR = 1.12; 95% CI, 1.03-1.21). The CHD HR for the IQR in social isolation was 1.12 (95% CI, 1.03-1.21). Associations did not differ by veteran status (all p-interactions > 0.08). Findings suggest that the adverse associations of social isolation and loneliness with CVD are similar among veteran and nonveteran women.
Collapse
Affiliation(s)
- Natalie M Yarish
- School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia, USA
| | - Alexander Ivan B Posis
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, California, USA
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Steve Nguyen
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, California, USA
| | - Julie Weitlauf
- Veterans Affairs Palo Alto Health Care System, Livermore, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - John Bellettiere
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, California, USA
| | - Nazmus Saquib
- Sulaiman Al Rajhi University, Al Bukayriyah, Saudi Arabia
| | - Phyllis A Richey
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Matthew Allison
- Division of Preventive Medicine, Department of Family Medicine, UC San Diego, San Diego, California, USA
| | - Candyce Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | | | - Mace Coday
- University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, California, USA
- Women's Health Initiative, USA
| |
Collapse
|
9
|
Jacobs KA. Digital loneliness-changes of social recognition through AI companions. Front Digit Health 2024; 6:1281037. [PMID: 38504806 PMCID: PMC10949182 DOI: 10.3389/fdgth.2024.1281037] [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: 12/11/2023] [Accepted: 02/15/2024] [Indexed: 03/21/2024] Open
Abstract
Inherent to the experience of loneliness is a significant change of meaningful relatedness that (usually negatively) affects a person's relationship to self and others. This paper goes beyond a purely subjective-phenomenological description of individual suffering by emphasizing loneliness as a symptomatic expression of distortions of social recognition relations. Where there is loneliness, a recognition relation has changed. Most societies face an increase in loneliness among all groups of their population, and this sheds light on the reproduction conditions of social integration and inclusion. These functions are essential lifeworldly components of social cohesion and wellbeing. This study asks whether "social" AI promotes these societal success goals of social integration of lonely people. The increasing tendency to regard AI Companions (AICs) as reproducers of adequate recognition is critically discussed with this review. My skepticism requires further justification, especially as a large portion of sociopolitical prevention efforts aim to fight an increase of loneliness primarily with digital strategies. I will argue that AICs rather reproduce than sustainably reduce the pathodynamics of loneliness: loneliness gets simply "digitized."
Collapse
Affiliation(s)
- Kerrin Artemis Jacobs
- Department of Philosophy, Ethics, and Religious Studies, Faculty of Humanities and Human Sciences (Graduate School), University of Hokkaido, Sapporo, Japan
- Center for Human Nature, Artificial Intelligence, and Neuroscience (CHAIN), University of Hokkaido, Sapporo, Japan
| |
Collapse
|
10
|
Lange LJ, Ames SC, Ames GE, Heckman MG, White LJ, Roy V, Foran JM. Loneliness, immunological recovery patterns, and health-related quality of life (HRQOL) outcomes in patients receiving hematopoietic stem cell transplantation. BMC Psychol 2024; 12:40. [PMID: 38243338 PMCID: PMC10797957 DOI: 10.1186/s40359-024-01535-w] [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: 08/18/2023] [Accepted: 01/11/2024] [Indexed: 01/21/2024] Open
Abstract
PURPOSE Loneliness may compromise health-related quality of life (HRQOL) outcomes and the immunological impacts of loneliness via neuroendocrinological mechanisms likely have consequences for patients who have undergone a hematopoietic stem cell transplantation (HSCT). RESEARCH APPROACH AND MEASURES Loneliness (pre-transplant), immunological recovery (Day 30, Day 100, 1-year post-transplant), and HRQOL (Day 100, 1 year) were measured in a sample of 205 patients completing a HSCT (127 autologous, 78 allogenic). RESULTS Greater levels of pre-transplant loneliness predicted poorer HRQOL at Day 100 and 1-year follow-up. Loneliness also was associated with higher absolute neutrophil to absolute lymphocyte (ANC/ALC) ratios in the entire sample at Day 30, which in turn was associated with Day 100 HRQOL. CONCLUSIONS Findings demonstrate that pretransplant loneliness predicts HRQOL outcomes and associates with inflammatory immunological recovery patterns in HSCT patients. The balance of innate neutrophils to adaptive lymphocytes at Day 30 present a distinct profile in lonely individuals, with this immunity recovery profile predicting reduced HRQOL 100 days after the transplant. Addressing perceptions of loneliness before HSCT may be an important factor in improving immunological recovery and HRQOL outcomes.
Collapse
Affiliation(s)
- Lori J Lange
- Department of Psychology, University of North Florida, 1 UNF Drive, 32224, Jacksonville, FL, USA.
| | - Steven C Ames
- Division of Hematology and Oncology, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Gretchen E Ames
- Department of Surgery, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Michael G Heckman
- Division of Clinical Trials and Biostatistics, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Launia J White
- Division of Clinical Trials and Biostatistics, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Vivek Roy
- Division of Hematology and Oncology, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - James M Foran
- Division of Hematology and Oncology, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| |
Collapse
|
11
|
Kapoulea EA, Ready RE, Ginn JC. Loneliness and risk for cardiovascular disease in the United States and Japan: The effects of nationality, collectivism, and gender. Soc Sci Med 2023; 337:116299. [PMID: 37837950 DOI: 10.1016/j.socscimed.2023.116299] [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: 07/23/2022] [Revised: 09/01/2023] [Accepted: 09/29/2023] [Indexed: 10/16/2023]
Abstract
RATIONALE Loneliness is a global concern associated with adverse effects on cardiovascular disease (CVD) that may differ by nationality, collectivism, and gender. OBJECTIVE This study examined whether associations between loneliness and CVD indicators (e.g., metabolic dysregulation [MetD], inflammation, sleep dysfunction) would vary by nationality, collectivism, and gender. We predicted that loneliness would be associated with poorer CVD values in (1) Japan than the United States (U.S.), (2) in individuals higher rather than lower in collectivism, and (3) our exploratory hypotheses about gender were that loneliness would interact with gender to be associated with differential CVD indicators in the U.S. versus Japan. METHODS Participants (aged 36 to 78) from the MIDUS Refresher Biomarker (n = 644) and the MIDJA 2 Biomarker studies (n = 293) completed questionnaires, bloodwork, and a physical exam. U.S. participants were from multiple cities, and Japanese participants were from Tokyo. Loneliness was measured via responses to the question, "How often in the past week did you feel lonely?" Logistic regression and path analyses using structural equation modeling determined individual differences in loneliness, whether loneliness predicted CVD indicators, and whether nationality, collectivism, and gender moderated these associations. RESULTS Loneliness was prevalent in the U.S. (25.39%) and Japan (20.82%). Unexpectedly, Japanese adults reported less collectivism than U.S. adults. We found significant interactions of (1) nationality and gender on MetD and inflammation, (2) gender and loneliness on sleep dysfunction, and (3) nationality and loneliness on MetD. Loneliness was associated with greater MetD in the U.S. but not in Japan. CONCLUSIONS Cultural influences on loneliness contradicted expectations and suggested caution when equating nationality with cultural values. Our Japanese sample was from Tokyo, which may have lower collectivism than rural Japanese regions. We recommend future studies consider geographic location when examining associations between loneliness, collectivism, and CVD.
Collapse
Affiliation(s)
- Eleni A Kapoulea
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, USA.
| | - Rebecca E Ready
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, USA
| | - Joel C Ginn
- Department of Psychological and Neuroscience, Boston College, USA
| |
Collapse
|
12
|
Genova HM, Chen MH, Botticello A, Voelbel G, Kim G, Elsayed HE, Myszko Z, DeLuca J, McGrath RE, Arnett P, Goverover Y. An Examination of Positive and Negative Outcomes During the COVID-19 Pandemic Among Persons With Multiple Sclerosis. Am J Occup Ther 2023; 77:7706205090. [PMID: 38015490 DOI: 10.5014/ajot.2023.050287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
IMPORTANCE This study provides information to clinicians about how persons with MS coped in both positive and negative ways during a potentially traumatic experience (the coronavirus disease 2019 [COVID-19] pandemic), which will help clinicians to provide better services to this population in the face of stressful events. OBJECTIVE To describe both positive and negative outcomes among persons with multiple sclerosis (MS) and to examine whether resilience and social support were related to positive and negative outcomes during the peak of the pandemic. DESIGN An online survey administered during the COVID-19 pandemic. PARTICIPANTS Participants were 74 individuals with MS and 104 healthy controls (HCs) recruited through social media and community support groups. OUTCOMES AND MEASURES The survey included questionnaires that assessed both positive and negative responses to the pandemic, including benefit finding, loneliness, and distress. Resilience and social support were also assessed. RESULTS Differences were noted between persons with MS and HCs on negative but not positive outcomes. Better social support and resilience were related to positive outcomes. CONCLUSIONS AND RELEVANCE Both persons with MS and HCs were similar in benefit finding and stress management. However, negative outcomes were worse in the MS group. Our findings shed light on the importance of individuals with MS adopting a positive outlook to help during times of adversity. What This Article Adds: Among persons with disabilities such as multiple sclerosis, finding benefits during stressful times can be a potential coping mechanism. Furthermore, resilience and social support should be taken into account to moderate the effects of adverse events.
Collapse
Affiliation(s)
- Helen M Genova
- Helen M. Genova, PhD, is Associate Director, Center for Autism Research, and Director, Social Cognition and Neuroscience Laboratory, Kessler Foundation, East Hanover, NJ, and Associate Professor, Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, the State University of New Jersey, Newark
| | - Michelle H Chen
- Michelle H. Chen, PhD, is Assistant Professor, Department of Neurology, Robert Wood Johnson Medical School, Rutgers, the State University of New Jersey, New Brunswick
| | - Amanda Botticello
- Amanda Botticello, PhD, MPH, is Associate Director, Centers for Outcomes & Assessment Research, Kessler Foundation, East Hanover, NJ, and Vice Chair of Research Education, Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, the State University of New Jersey, Newark
| | - Gerald Voelbel
- Gerald Voelbel, PhD, is Associate Professor, Department of Occupational Therapy, New York University, New York
| | - Grace Kim
- Grace Kim, PhD, is Associate Professor, Department of Occupational Therapy, New York University, New York
| | - Heba E Elsayed
- Heba E. Elsayed, MD, is Associate Research Scientist, Kessler Foundation, East Hanover, NJ
| | - Zuzanna Myszko
- Zuzanna Myszko, BA, is Doctoral Student, Montclair State University, Montclair, NJ
| | - John DeLuca
- John DeLuca, PhD, is Senior Vice President for Research and Training, Kessler Foundation, East Hanover, NJ, and Professor, Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, the State University of New Jersey, Newark
| | - Robert E McGrath
- Robert E. McGrath, PhD, is Professor, Psychology Department, School of Psychology and Counseling, Fairleigh Dickinson University, Teaneck, NJ
| | - Peter Arnett
- Peter Arnett, PhD, is Professor, Psychology Department, Pennsylvania State University, University Park
| | - Yael Goverover
- Yael Goverover, PhD, is Visiting Professor, Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, the State University of New Jersey, Newark, and Professor, Department of Occupational Therapy, New York University, New York;
| |
Collapse
|
13
|
Musbat S, Reuveni I, Magnezi R. Social networks as a protective factor for worsened self-perceived health status related to self-perceived changes in loneliness and health conditions in adults aged 50+ during the COVID-19 outbreak. Heliyon 2023; 9:e20529. [PMID: 37860515 PMCID: PMC10582293 DOI: 10.1016/j.heliyon.2023.e20529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/13/2023] [Accepted: 09/28/2023] [Indexed: 10/21/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) has emerged as a global pandemic, leading millions of people to change their lifestyles, especially older individuals who are the most at-risk population. Social isolation, the main preventive action to slow the pandemic's spread, reduced and drastically limited social connections, increasing older individuals' loneliness and stress, and worsening their health. We examined the connection between self-perceived changes in loneliness, the existence and type of social contact (face-to-face/electronic), and health conditions on self-perceived changes in health status during the outbreak, analyzing 51,778 individuals aged 50 plus from the Survey of Health, Ageing and Retirement in Europe (SHARE) database Wave 8 beta (June-August 2020). We found that the odds for worsened self-perceived health status were 249% higher among individuals who reported increased loneliness compared to the non-increase group and were lower in individuals with face-to-face contact (31%) or electronic contact (54%) during the outbreak. In addition, the odds for worsened self-perceived health status were higher for individuals with hypertension (17%), cancer (19%), chronic lung disease (25%), heart problems (27%), and other illnesses (32%). Based on the results obtained, electronic contact has shown a stronger connection as a protective factor for worsened self-perceived health since the outbreak compared to face-to-face interactions. Thus, adopting a policy that encourages the usage of electronic communications could reduce the burden on the healthcare system, particularly during pandemics, while improving patient health outcomes and minimizing pandemic-related health risks. This approach is especially important for older individuals, for whom any departure from home can cause an additional risk of exposure to the virus.
Collapse
Affiliation(s)
- Shay Musbat
- Department of Management, Health Systems Management Program, Bar-Ilan University, Ramat Gan 5290002, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem 9112001, Israel
| | - Racheli Magnezi
- Department of Management, Health Systems Management Program, Bar-Ilan University, Ramat Gan 5290002, Israel
| |
Collapse
|
14
|
Singh M, Nag A, Gupta L, Thomas J, Ravichandran R, Panjiyar BK. Impact of Social Support on Cardiovascular Risk Prediction Models: A Systematic Review. Cureus 2023; 15:e45836. [PMID: 37881384 PMCID: PMC10597590 DOI: 10.7759/cureus.45836] [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] [Accepted: 09/24/2023] [Indexed: 10/27/2023] Open
Abstract
Cardiovascular diseases (CVD) stand as the primary causes of both mortality and morbidity on a global scale. Social factors such as low social support can increase the risk of developing heart diseases and have shown poor prognosis in cardiac patients. Resources such as PubMed and Google Scholar were searched using a boolean algorithm for articles published between 2003 and 2023. Eligible articles showed an association between social support and cardiovascular risks. A systematic review was conducted using the guidance published in the Cochrane Prognosis Method Group and the PRISMA checklist, for reviews of selected articles. A total of five studies were included in our final analysis. Overall, we found that participants with low social support developed cardiovascular events, and providing a good support system can decrease the risk of readmission in patients with a history of CVD. We also found that integrating social determinants in the cardiovascular risk prediction model showed improvement in accessing the risk. Population with good social support showed low mortality and decreased rate of readmission. There are various prediction models, but the social determinants are not primarily included while calculating the algorithms. Although it has been proven in multiple studies that including the social determinants of health (SDOH) improves the accuracy of cardiovascular risk prediction models. Hence, the inclusion of SDOH should be highly encouraged.
Collapse
Affiliation(s)
- Mansi Singh
- Medicine, O.O. Bogomolets National Medical University, Kyiv, UKR
| | - Aiswarya Nag
- Internal Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Lovish Gupta
- Internal Medicine, Maulana Azad Medical College, New Delhi, IND
| | - Jingle Thomas
- Internal Medicine, Al-Ameen Medical College, Vijayapura, IND
| | | | - Binay K Panjiyar
- Department of Internal Medicine, Harvard Medical School, Boston, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| |
Collapse
|
15
|
Rosenberg D, Shiovitz-Ezra S, Ayalon L. Helps you, helps me? Provision of instrumental and personal care and loneliness among adults aged 50 years and older during the COVID-19 pandemic. Arch Gerontol Geriatr 2023; 113:105065. [PMID: 37224691 PMCID: PMC10199486 DOI: 10.1016/j.archger.2023.105065] [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: 03/01/2023] [Revised: 05/15/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE To examine the association between provision of instrumental and personal care, and loneliness in adults aged 50 years and older during the COVID-19 pandemic. Instrumental care referred to the provision of assistance with obtaining necessary or essential products and/or services, whereas personal care referred to the assistance with daily life activities or the provision of emotional support. Social capital and caregiver stress theories served as the study's theoretical framework. MATERIALS AND METHODS The data were obtained from the two COVID-19 waves of the Survey of Health, Ageing, and Retirement in Europe (SHARE) conducted in 2020 and 2021. The data were analyzed using logistic regression models. The analytical sample consisted of 48,722 adults in the abovementioned age bracket residing in Europe and Israel. RESULTS Providing instrumental care negatively related to loneliness. Providing instrumental care to a single category of people negatively related to loneliness, whereas providing personal care to multiple categories of people positively related to loneliness. Providing personal care to children positively related to loneliness. CONCLUSIONS The results suggest that different types of care provision correspond differently to the experience of loneliness while partially supporting both theoretical frameworks. Moreover, care indicators correspond differently to loneliness. The results imply that for a better understanding of the link between care provision and loneliness in later life, various parameters as well as various types of care provision should be examined.
Collapse
Affiliation(s)
- Dennis Rosenberg
- Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus 91905-IL, Jerusalem, Israel.
| | - Sharon Shiovitz-Ezra
- Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus 91905-IL, Jerusalem, Israel
| | - Liat Ayalon
- Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
16
|
Woodward SH, Jamison AL, Gala S, Lawlor C, Villasenor D, Tamayo G, Puckett M. Heart Rate During Sleep in PTSD Patients: Moderation by Contact with a Service Dog. Biol Psychol 2023; 180:108586. [PMID: 37187229 DOI: 10.1016/j.biopsycho.2023.108586] [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: 08/26/2022] [Revised: 04/12/2023] [Accepted: 05/12/2023] [Indexed: 05/17/2023]
Abstract
There is growing interest in the potential health benefits of dog ownership in both the lay and scientific communities. Large reductions in risk for cardiovascular disease and all-cause mortality in dog owners relative to non-owners have been observed in epidemiological samples. Persons diagnosed with posttraumatic stress disorder exhibit elevated risk for cardiovascular disease. The current study tested a sample of 45 U.S. military veterans with deployment-related posttraumatic stress disorder employing an intensive, longitudinal, within-subjects design contrasting sleep heart rate on nights with and without a service dog. As participants were engaged in residential psychiatric treatment, sleep opportunities, waking activities, meals, and medications, were consistently scheduled. The primary recording methodology, mattress actigraphy, enabled passive quantification of heart rate over a total sample of 1097 nights. Service dog contact was associated with reduced sleep heart rate especially in participants with more severe PTSD. Longer-term longitudinal studies will be needed to assess the durability and asymptotic magnitude of this effect. An unexpected effect of nights in study was associated with increased heart rate consistent with hospitalization-associated deconditioning.
Collapse
Affiliation(s)
- Steven H Woodward
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, 3801 Miranda Ave, Palo Alto, CA 94304.
| | - Andrea L Jamison
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, 3801 Miranda Ave, Palo Alto, CA 94304
| | - Sasha Gala
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, 3801 Miranda Ave, Palo Alto, CA 94304
| | - Catherine Lawlor
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, 3801 Miranda Ave, Palo Alto, CA 94304
| | - Diana Villasenor
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, 3801 Miranda Ave, Palo Alto, CA 94304
| | - Gisselle Tamayo
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, 3801 Miranda Ave, Palo Alto, CA 94304
| | - Melissa Puckett
- Trauma Recovery Programs and Recreation Service, VA Palo Alto Healthcare System. 3801 Miranda Ave, Palo Alto, CA 94304
| |
Collapse
|
17
|
Benjamin DG, Gummanur P. Loneliness - Cancer of the Mind. Indian J Palliat Care 2023; 29:212-216. [PMID: 37325265 PMCID: PMC10261937 DOI: 10.25259/ijpc_200_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 04/03/2023] [Indexed: 06/17/2023] Open
Abstract
World is greying as the proportion of the ageing population increases and the demography is changing both in the developing and developed world. Contact between people is the central part of everyone's life and the glue that holds communities and society together. Lack of social relations is considered to cause loneliness and isolation for the individual and, simultaneously, on a societal level, leads to marginalisation, social disintegration and diminishing trust between people. This has come to sharp focus during the corona pandemic. Meaningful social connections are central to the physical and mental health of human beings. Off late, the deleterious health implication of social isolation and loneliness has increasingly been noticed, with a higher risk of premature death and accelerated risks of coronary heart disease, stroke, depression, and dementia. Worldwide, there is an increasing awareness regarding the alarming consequences of loneliness, especially among older adults. In response, 2018 saw the launch of a UK loneliness strategy and the first minister for loneliness in the world appointed.
Collapse
Affiliation(s)
| | - Priyasha Gummanur
- Department of Geriatrics, Bangalore Baptist Hospital, Bengaluru, Karnataka, India
| |
Collapse
|
18
|
Shiovitz-Ezra S, Erlich B, Ayalon L. Short- and Medium-Term Effects of Ageism on Loneliness Experienced During the COVID-19 Pandemic. J Appl Gerontol 2023; 42:1255-1266. [PMID: 36809924 PMCID: PMC9947391 DOI: 10.1177/07334648231159372] [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: 02/24/2023] Open
Abstract
Loneliness, common in old age, may be partially attributed to ageism. The present study explored the short- and medium-term effect of ageism on loneliness experienced during the COVID-19 pandemic using prospective data derived from the Israeli sample of the Survey of Health, Aging and Retirement in Europe (SHARE) (N = 553). Ageism was measured before the COVID-19 outbreak and loneliness in the summer of 2020 and 2021 using a direct single question. We also tested for age differences in this association. In both the 2020 and 2021 models, ageism was related to increased loneliness. This association remained significant after adjusting for a host of demographic, health, and social variables. In the 2020 model, we also found that the positive association between ageism and loneliness was significant only in people aged 70+. We discussed the results with reference to the COVID-19 pandemic, which drew attention to two global social phenomena: loneliness and ageism.
Collapse
Affiliation(s)
- Sharon Shiovitz-Ezra
- Paul Baerwald School of Social Work
and Social Welfare, The Hebrew University of
Jerusalem, Jerusalem, ISRAEL,Sharon Shiovitz-Ezra, Paul Baerwald School
of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mt.Scopus
Campus, Jerusalem 91905, ISRAEL.
| | | | - Liat Ayalon
- Louis and Gabi Weisfeld School of
Social Work, Bar-Ilan University, Ramat Gan, ISRAEL
| |
Collapse
|
19
|
Lederman Z. Loneliness-a clinical primer. Br Med Bull 2023; 145:132-140. [PMID: 36752026 DOI: 10.1093/bmb/ldad003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/14/2023] [Accepted: 01/21/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION loneliness is prevalent worldwide. It is also associated with an increased risk for depression, high blood pressure, cardiovascular disease, stroke and early death. As such, loneliness is a major public health issue. This paper summarizes the salient points clinicians should know and encourages clinicians to assume an active part in the identification, mitigation and prevention of loneliness. SOURCES OF DATA white papers, academic publications. AREAS OF AGREEMENT loneliness is a distressful subjective experience, which does not always correlate with social isolation. Both internal (personal) and external (contextual, societal) factors determine whether an individual would feel lonely in a given situation. AREAS OF CONTROVERSY identifying loneliness in the clinic may be time consuming and challenging. There is a scarce robust evidence to support interventions. GROWING POINTS due to increased individualization and incidence of infectious diseases, loneliness is likely to become even more prevalent. AREAS TIMELY FOR DEVELOPING RESEARCH more research is needed to further elucidate the health impacts of loneliness as well as to find evidence-based interventions to prevent and mitigate loneliness that could then be implemented by policy-makers and clinicians.
Collapse
Affiliation(s)
- Zohar Lederman
- Medical Ethics and Hum anities Unit, Hong Kong University, Hong Kong.,Centre for Medical Ethics and Law, Hong Kong University, Hong Kong.,International Center of Health, Law, and Ethics, University of Haifa, Israel
| |
Collapse
|
20
|
Vallée A. Association between Social Isolation and Loneliness with Estimated Atherosclerotic Cardiovascular Disease Risk in a UK Biobank Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2869. [PMID: 36833566 PMCID: PMC9956863 DOI: 10.3390/ijerph20042869] [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: 12/22/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The association of cardiovascular (CV) risk with social isolation and loneliness remains poorly studied. The purpose of this cross-sectional study was to investigate the associations between social isolation and loneliness with estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk. METHODS Among 302,553 volunteers of the UK Biobank population, social isolation and loneliness were assessed with a questionnaire. Associations between social isolation and loneliness with ASCVD risk were estimated using multiple gender regressions. RESULTS Men presented a higher estimated 10-year ASCVD risk (8.63% vs. 2.65%, p < 0.001) and higher proportions of social isolation (9.13% vs. 8.45%, p < 0.001) and loneliness (6.16% vs. 5.57%, p < 0.001) than women. In all covariate-adjusted models, social isolation was associated with an increased ASCVD risk in men (B = 0.21 (0.16; 0.26), p < 0.001) and women (B = 0.12 (0.10; 0.14), p < 0.001). Loneliness was associated with an increased ASCVD risk in men (B = 0.08 (0.03; 0.14), p = 0.001) but not in women (p = 0.217). A significant interaction was observed between social isolation and loneliness with ASCVD risk in men (p = 0.009) and women (p = 0.016). After adjustment for all covariates, both social isolation and loneliness were significantly associated with ASCVD risk in men (B = 0.44 (0.28; 0.61), p < 0.001) and women (B = 0.20 (0.12; 0.29), p < 0.001). CONCLUSION Social isolation was associated with a higher estimated 10-year ASCVD risk in both genders but only loneliness among men. Social isolation and loneliness can be considered potential added risk factors for CV risk. Health policies should address these notions in prevention campaigns, in addition to traditional risk factors.
Collapse
Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch Hospital, 92150 Suresnes, France
| |
Collapse
|
21
|
Vasan S, Eikelis N, Lim MH, Lambert E. Evaluating the impact of loneliness and social isolation on health literacy and health-related factors in young adults. Front Psychol 2023; 14:996611. [PMID: 36777213 PMCID: PMC9911678 DOI: 10.3389/fpsyg.2023.996611] [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: 07/18/2022] [Accepted: 01/03/2023] [Indexed: 01/28/2023] Open
Abstract
Objectives In current study, we aim to extend previous research by investigating the unique impact of loneliness on health literacy and health-related factors of young adults, after controlling for social isolation, depressive symptomology, and social anxiety, as well as evaluate how social isolation and loneliness differ in their impact on health literacy, and health-related factors among young adults, after accounting for abovementioned concomitant variables. Methods Using a cross-sectional study design, 521 young adults completed an online survey in 2020, where they self-reported their loneliness, social isolation, health-related factors, and health literacy data. Results Increased loneliness was associated with decrease in several health literacy domains (e.g., poorer social support for health, lower appraisal of health information, among others) and increase in some health-related factors (e.g., higher perceived stress, higher negative affect), among young adults, even after controlling for social anxiety, depressive symptomology, and social isolation. Contrastingly, increase in social isolation was associated with changes in some health-related factors - more somatic health complaints, higher alcohol use, poorer cognitive and physical functioning, and lower scores for only one health literacy domain (i.e., social support for health) among young adults, after adjusting for the influence of social anxiety, depressive symptomology, and loneliness. Conclusion Even after accounting for the influence of several co-occurring social and mental health symptoms, higher loneliness was associated poorer health literacy and health-related factors in young adults. We also found loneliness and social isolation may differ in the mechanisms through which they impact health literacy and health-related factors in young adults.
Collapse
|
22
|
Löbel LM, Kröger H, Tibubos AN. How Migration Status Shapes Susceptibility of Individuals' Loneliness to Social Isolation. Int J Public Health 2022; 67:1604576. [PMID: 36561278 PMCID: PMC9763294 DOI: 10.3389/ijph.2022.1604576] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives: Our research provides competing hypotheses and empirical evidence how associations between objectively social isolation and subjective loneliness differ between host populations, migrants, and refugees. Methods: The analysis uses data of 25,171 participants from a random sample of the German population (SOEP v.35). We estimate regression models for the host population, migrants, and refugees and test five hypotheses on the association between social isolation and loneliness using a Bayesian approach in a multiverse framework. Results: We find the strongest relative support for an increased need for social inclusion among refugees, indicated by a higher Bayes factor compared to the hosts and migrants. However, all theoretically developed hypotheses perform poorly in explaining the major pattern in our data: The association of social isolation and loneliness is persistently lower for migrants (0.15 SD-0.29 SD), with similar sizes of associations for refugees and the host population (0.38 SD-0.67 SD). Conclusion: The migration history must be actively considered in health service provision and support programs to better cater to the needs of the different groups.
Collapse
Affiliation(s)
- Lea-Maria Löbel
- German Institute for Economic Research (DIW), Berlin, Germany,Berlin Graduate School of Social Sciences, Humboldt University of Berlin, Berlin, Germany,*Correspondence: Lea-Maria Löbel,
| | - Hannes Kröger
- German Institute for Economic Research (DIW), Berlin, Germany
| | | |
Collapse
|
23
|
Reynolds TA. Response to Commentaries: Variation in Women's Intrasexual Sociality by Life History Strategy, Patrilocal Legacy, and Polygyny. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3299-3310. [PMID: 35854162 DOI: 10.1007/s10508-022-02378-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Tania A Reynolds
- Department of Psychology, University of New Mexico, Logan Hall, MSC03-2220, Albuquerque, NM, 87131-0001, USA.
- The Kinsey Institute, Indiana University, Bloomington, USA.
| |
Collapse
|
24
|
Clifton K, Gao F, Jabbari J, Van Aman M, Dulle P, Hanson J, Wildes TM. Loneliness, social isolation, and social support in older adults with active cancer during the COVID-19 pandemic. J Geriatr Oncol 2022; 13:1122-1131. [PMID: 36041993 PMCID: PMC9385725 DOI: 10.1016/j.jgo.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 06/09/2022] [Accepted: 08/09/2022] [Indexed: 11/29/2022]
Abstract
Introduction The COVID-19 pandemic has had a considerable impact on mental health. The social distancing and stay-at-home orders have likely also impacted loneliness, social isolation, and social support. Older adults, particularly those with comorbidities such as cancer, have a greater potential to be impacted. Here we assessed loneliness, social isolation, and social support in older adults undergoing active cancer treatment during the pandemic. Materials and methods A mixed methods study in which quantitative data and qualitative response items were collected in parallel was conducted in 100 older adults with cancer. Participants completed a survey by telephone with a series of validated questionnaires to assess the domains of loneliness, social isolation, and social support as well as several open-ended questions. Baseline demographics and geriatric assessments were summarized using descriptive statistics. Bivariate associations between social isolation and loneliness and social support and loneliness were described using Spearman correlation coefficients. Conventional content analysis was performed on the open-ended questions. Results In a population of older adults with cancer, 3% were noted to be severely lonely, although 27% percent screened positive as having at least one indicator of loneliness by the University of California, Los Angeles (UCLA) Three Item Loneliness Scale. There was a significant positive correlation between loneliness and social isolation (r = +0.52, p < 0.05) as well as significant negative correlation between loneliness and social support (r = −0.49, p < 0.05). There was also a significant negative correlation between loneliness and emotional support (r = −0.43, p < 0.05). There was no significant association between loneliness and markers of geriatric impairments, including comorbidities, G8 score or cognition. Discussion Reassuringly, in this cohort we found relatively low rates of loneliness and social isolation and high rates of social support. Consistent with prior studies, loneliness, social isolation, and social support were found to be interrelated domains; however, they were not significantly associated with markers of geriatric impairments. Future studies are needed to study if cancer diagnosis and treatment may mediate changes in loneliness, social isolation, and social support in the context of the pandemic as well as beyond.
Collapse
Affiliation(s)
- Katherine Clifton
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, United States of America.
| | - Feng Gao
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, United States of America
| | - JoAnn Jabbari
- Goldfarb School of Nursing at Barnes-Jewish College, Saint Louis, MO, United States of America
| | - Mary Van Aman
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, United States of America
| | - Patricia Dulle
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, United States of America
| | - Janice Hanson
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, United States of America
| | - Tanya M Wildes
- Division of Hematology/Oncology, University of Nebraska Medical Center/Nebraska Medicine, Omaha NE, United States of America
| |
Collapse
|
25
|
Hilton DC, Canu WH, Jarrett MA. The importance of executive functioning for social skills in college students: a relative weights analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 35930391 DOI: 10.1080/07448481.2022.2109038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/13/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
STATEMENT OF RELEVANCE Social interaction is one of the most important things that humans do on a day-to-day basis, impacting both mental and physical wellness. College is a particularly important period where social interaction becomes increasingly important as well as complex. While there is no currently agreed upon cognitive basis of social interaction, the executive function (EF) system is believed to play a central role. The current study provides further evidence of the role of the EF system across different social skills in addition to highlighting the complexity of these relationships.
Collapse
Affiliation(s)
- Dane C Hilton
- Department of Psychology, Wofford College, Spartanburg, South Carolina, USA
| | - Will H Canu
- Department of Psychology, Appalachian State University, Boone, North Carolina, USA
| | - Matthew A Jarrett
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
| |
Collapse
|
26
|
Prevalence of loneliness and social isolation among older adults during the COVID-19 pandemic: A systematic review and meta-analysis. Int Psychogeriatr 2022; 35:229-241. [PMID: 35357280 DOI: 10.1017/s1041610222000199] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Pandemics and their public health control measures have generally substantially increased the level of loneliness and social isolation in the general population. Because of the circumstances of aging, older adults are more likely to experience social isolation and loneliness during pandemics. However, no systematic review has been conducted or published on the prevalence of loneliness and/or social isolation among the older population. This systematic review and meta-analysis aims to provide up-to-date pooled estimates of the prevalence of social isolation and loneliness among older adults during the COVID-19 pandemic and other pandemics in the last two decades. DESIGN EMBASE, PsychoINFO, Medline, and Web of Science were searched for relevant studies from January 1, 2000 to November 31, 2021 published in a variety of languages. Only studies conducted during the COVID-19 pandemic were selected in the review. RESULTS A total of 30 studies including 28,050 participants met the inclusion criteria. Overall, the pooled period prevalence of loneliness among older adults was 28.6% (95% CI: 22.9-35.0%) and 31.2% for social isolation (95% CI: 20.2-44.9%). Prevalence estimates were significantly higher for those studies conducted post 3-month from the start of the COVID-19 pandemic compared to those conducted within the first 3 months of the pandemic. CONCLUSIONS This review identifies the need for good quality longitudinal studies to examine the long-term impact of pandemics on loneliness and social isolation among older populations. Health policymaking and healthcare systems should proactively address the rising demand for appropriate psychological services among older adults.
Collapse
|
27
|
Klusek J, Thurman AJ, Abbeduo L. Maternal Pragmatic Language Difficulties in the FMR1 Premutation and the Broad Autism Phenotype: Associations with Individual and Family Outcomes. J Autism Dev Disord 2022; 52:835-851. [PMID: 33813684 PMCID: PMC8488060 DOI: 10.1007/s10803-021-04980-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 02/03/2023]
Abstract
Broader phenotypes associated with genetic liability, including mild difficulties with pragmatic language skills, have been documented in mothers of children with autism spectrum disorder (ASD) and mothers of children with fragile X syndrome (FXS). This study investigated the relationship between pragmatic difficulties and indicators of maternal well-being and family functioning. Pragmatic difficulty was associated with loneliness in mothers of children with ASD or FXS, and with depression, decreased life satisfaction, and poorer family relationship quality in mothers of children with FXS only. Results inform subtle maternal pragmatic language difficulties as a risk factor that that may contribute to reduced health and well-being, informing tailored support services to better meet the unique needs of families of children with ASD or FXS.
Collapse
Affiliation(s)
- Jessica Klusek
- Department of Communication Sciences and Disorders, 1705 College Street, University of South Carolina, Columbia SC 29208, USA
| | - Angela John Thurman
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis Health, 2825 50th Street, Room 2335, Sacramento, CA 95817, USA
| | - Leonard Abbeduo
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis Health, 2825 50th Street, Room 2335, Sacramento, CA 95817, USA
| |
Collapse
|
28
|
Golaszewski NM, LaCroix AZ, Godino JG, Allison MA, Manson JE, King JJ, Weitlauf JC, Bea JW, Garcia L, Kroenke CH, Saquib N, Cannell B, Nguyen S, Bellettiere J. Evaluation of Social Isolation, Loneliness, and Cardiovascular Disease Among Older Women in the US. JAMA Netw Open 2022; 5:e2146461. [PMID: 35107574 PMCID: PMC8811637 DOI: 10.1001/jamanetworkopen.2021.46461] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
IMPORTANCE Social isolation and loneliness are increasing public health concerns and have been associated with increased risk of cardiovascular disease (CVD) among older adults. OBJECTIVE To examine the associations of social isolation and loneliness with incident CVD in a large cohort of postmenopausal women and whether social support moderated these associations. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study, conducted from March 2011 through March 2019, included community-living US women aged 65 to 99 years from the Women's Health Initiative Extension Study II who had no history of myocardial infarction, stroke, or coronary heart disease. EXPOSURES Social isolation and loneliness were ascertained using validated questionnaires. MAIN OUTCOMES AND MEASURES The main outcome was major CVD, which was physician adjudicated using medical records and included coronary heart disease, stroke, and death from CVD. Continuous scores of social isolation and loneliness were analyzed. Hazard ratios (HRs) and 95% CIs for CVD were calculated for women with high social isolation and loneliness scores (midpoint of the upper half of the distribution) vs those with low scores (midpoint of the lower half of the distribution) using multivariable Cox proportional hazards regression models adjusting for age, race and ethnicity, educational level, and depression and then adding relevant health behavior and health status variables. Questionnaire-assessed social support was tested as a potential effect modifier. RESULTS Among 57 825 women (mean [SD] age, 79.0 [6.1] years; 89.1% White), 1599 major CVD events occurred over 186 762 person-years. The HR for the association of high vs low social isolation scores with CVD was 1.18 (95% CI, 1.13-1.23), and the HR for the association of high vs low loneliness scores with CVD was 1.14 (95% CI, 1.10-1.18). The HRs after additional adjustment for health behaviors and health status were 1.08 (95% CI, 1.03-1.12; 8.0% higher risk) for social isolation and 1.05 (95% CI, 1.01-1.09; 5.0% higher risk) for loneliness. Women with both high social isolation and high loneliness scores had a 13.0% to 27.0% higher risk of incident CVD than did women with low social isolation and low loneliness scores. Social support was not a significant effect modifier of the associations (social isolation × social support: r, -0.18; P = .86; loneliness × social support: r, 0.78; P = .48). CONCLUSIONS AND RELEVANCE In this cohort study, social isolation and loneliness were independently associated with modestly higher risk of CVD among postmenopausal women in the US, and women with both social isolation and loneliness had greater CVD risk than did those with either exposure alone. The findings suggest that these prevalent psychosocial processes merit increased attention for prevention of CVD in older women, particularly in the era of COVID-19.
Collapse
Affiliation(s)
- Natalie M. Golaszewski
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| | - Andrea Z. LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| | - Job G. Godino
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
- Laura Rodriguez Research Institute, Family Health Centers of San Diego, San Diego, California
- Center for Wireless and Population Health Systems, University of California, San Diego
- Exercise and Physical Activity Resource Center, University of California, San Diego
| | - Matthew A. Allison
- Division of Preventive Medicine, Department of Family Medicine, University of California, San Diego
| | - JoAnn E. Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jennifer J. King
- Department of Health Promotion Sciences, University of Arizona Cancer Center, Tucson, Arizona
| | - Julie C. Weitlauf
- Veterans Affairs Palo Alto Health Care System, Stanford University School of Medicine, Stanford, California
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Jennifer W. Bea
- Department of Health Promotion Sciences, University of Arizona Cancer Center, Tucson, Arizona
| | - Lorena Garcia
- University of California Davis School of Medicine, Davis
| | | | - Nazmus Saquib
- Department of Clinical Sciences, College of Medicine, Sulaiman Al Rajhi University, Al Bukayriyah, Saudi Arabia
| | - Brad Cannell
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health–Dallas Campus
| | - Steve Nguyen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| | - John Bellettiere
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| |
Collapse
|
29
|
Low-Density Lipoprotein Cholesterol Is a Possible Blood Biomarker of Schizoid Personality Traits among Females. J Pers Med 2022; 12:jpm12020131. [PMID: 35207620 PMCID: PMC8875671 DOI: 10.3390/jpm12020131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/01/2022] [Accepted: 01/10/2022] [Indexed: 01/27/2023] Open
Abstract
Lower serum levels of low-density lipoprotein cholesterol (LDL-C) have been suggested to indicate higher suicide risk and various psychiatric symptoms. Previously, we reported that lower serum LDL-C levels are associated with loneliness, social phobia, isolated life with little social support, and lower trust in others among young non-clinical females. Thus, we hypothesize that schizoid personality traits may be associated with lower serum LDL-C. We here verified this hypothesis using non-clinical data and clinical data with schizophrenia. Using the database from the Midlife in Japan (MIDJA), a cohort of residents living in Tokyo, we analyzed whether schizoid-related interpersonal characteristics were associated with LDL-C. In addition, we assessed the association between blood biomarkers including LDL-C and schizoid personality traits in 101 adult non-clinical volunteers. Finally, we evaluated the interaction between LDL-C and social decision making of patients with schizophrenia. In female non-clinical volunteers, serum LDL-C level was a predictive factor and negatively correlated with schizoid personality traits. Female patients with schizophrenia, whose serum LDL-C levels were lower, tended not to trust other females. The present findings suggest that LDL-C may influence schizoid personality traits in females, which provide a basis for further investigation into the biological aspects of schizoid personality disorder.
Collapse
|
30
|
Van Bogart K, Engeland CG, Sliwinski MJ, Harrington KD, Knight EL, Zhaoyang R, Scott SB, Graham-Engeland JE. The Association Between Loneliness and Inflammation: Findings From an Older Adult Sample. Front Behav Neurosci 2022; 15:801746. [PMID: 35087386 PMCID: PMC8787084 DOI: 10.3389/fnbeh.2021.801746] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/17/2021] [Indexed: 11/20/2022] Open
Abstract
Loneliness has been linked to poor mental and physical health outcomes. Past research suggests that inflammation is a potential pathway linking loneliness and health, but little is known about how loneliness assessed in daily life links with inflammation, or about linkages between loneliness and inflammation among older adults specifically. As part of a larger investigation, we examined the cross-sectional associations between loneliness and a panel of both basal and LPS-stimulated inflammatory markers. Participants were 222 socioeconomically and racially diverse older adults (aged 70-90 years; 38% Black; 13% Hispanic) systematically recruited from the Bronx, NY. Loneliness was measured in two ways, with a retrospective trait measure (the UCLA Three Item Loneliness Scale) and an aggregated momentary measure assessed via ecological momentary assessment (EMA) across 14 days. Inflammatory markers included both basal levels of C-reactive protein (CRP) and cytokines (IL-1β, IL-4, IL-6, IL-8, IL-10, TNF-α) and LPS-stimulated levels of the same cytokines. Multiple regression analyses controlled for age, body-mass index, race, and depressive symptoms. Moderation by gender and race were also explored. Both higher trait loneliness and aggregated momentary measures of loneliness were associated with higher levels of CRP (β = 0.16, p = 0.02; β = 0.15, p = 0.03, respectively). There were no significant associations between loneliness and basal or stimulated cytokines and neither gender nor race were significant moderators. Results extend prior research linking loneliness with systemic inflammation in several ways, including by examining this connection among a sample of older adults and using a measure of aggregated momentary loneliness.
Collapse
Affiliation(s)
- Karina Van Bogart
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States
| | - Christopher G. Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, United States
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA, United States
| | - Martin J. Sliwinski
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
| | - Karra D. Harrington
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
| | - Erik L. Knight
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Ruixue Zhaoyang
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, United States
| | - Stacey B. Scott
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | | |
Collapse
|
31
|
The impact of threats to belonging on health, peripheral physiology, and social behavior. ADVANCES IN EXPERIMENTAL SOCIAL PSYCHOLOGY 2022. [DOI: 10.1016/bs.aesp.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
32
|
Abshire DA, Graves JM, Amiri S, Williams-Gilbert W. Differences in Loneliness Across the Rural-Urban Continuum Among Adults Living in Washington State. J Rural Health 2022; 38:187-193. [PMID: 33180354 PMCID: PMC8674765 DOI: 10.1111/jrh.12535] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE Rural residents may be at higher risk for loneliness than urban residents due to factors such as social isolation, poorer health, and socioeconomic disadvantage. To date, there have been few studies examining rural-urban differences in loneliness among adults in the United States. We examined differences in loneliness across the rural-urban continuum among adult residents living in Washington State. METHODS Stratified random sampling was used to select 2,575 adults from small rural, large rural, suburban, and urban areas who were invited to complete a survey on factors affecting health. Data were obtained from 616 adults (278 from small rural, 100 from large rural, 98 from suburban, and 140 from urban areas) from June 2018 through October 2019. Loneliness was measured using the UCLA Loneliness Scale (3rd version). Multivariable linear and logistic regressions were used to examine geographic differences in loneliness (measured continuously and dichotomously). FINDINGS Mean unadjusted loneliness scores were lower in suburban compared to urban areas (35.06 vs 38.57, P = .03). The prevalence of loneliness was 50.7%, 59.0%, 40.8%, and 54.3% in small rural, large rural, suburban, and urban areas, respectively. Suburban living was associated with lower odds for being lonely compared to urban living (unadjusted OR = 0.58; 95% CI = 0.34-0.98), but this association was not statistically significant in the adjusted model (OR = 0.63; 95% CI = 0.33-1.19). CONCLUSION Loneliness is a prevalent health issue across the rural-urban continuum among Washington State adults.
Collapse
Affiliation(s)
| | - Janessa M. Graves
- College of Nursing, Washington State University, Spokane, Washington
| | - Solmaz Amiri
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | | |
Collapse
|
33
|
Sharma T, Padala PR, Mehta JL. Loneliness and Social Isolation: Determinants of Cardiovascular Outcomes. Curr Cardiol Rev 2021; 17:e051121190873. [PMID: 33511946 PMCID: PMC8950500 DOI: 10.2174/1573403x17666210129101845] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/21/2020] [Accepted: 12/31/2020] [Indexed: 12/30/2022] Open
Abstract
One in three Americans report experiencing loneliness in everyday life, a number that has grown exponentially over the last few decades. As we respond to the SARS-COV2 pandemic with quarantine and social distancing, social isolation and feelings of loneliness are increasing among people of all ages. This presents as an opportune time to recognize the public health impact of these important psychosocial determinants. Loneliness and social isolation are associated with a higher incidence of CVD, higher healthcare utilization and worse outcomes even after controlling for conventional risk factors of CVD. In this review, we discuss loneliness and social isolation as determinants of cardiovascular outcomes, the pathophysiology of this association, and its implications in clinical practice. We discuss some of the shortcomings in the assessment of loneliness and social isolation while identifying the most commonly used rating scales for the same. Finally, we suggest modifications to interventions for loneliness and social isolation during the COVID-19 pandemic.
Collapse
Affiliation(s)
| | | | - Jawahar L. Mehta
- Department of Internal Medicine, Central Arkansas Veterans Healthcare System and the University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; Tel: 501-296-1426, E-mail:
| |
Collapse
|
34
|
Freak-Poli R, Ryan J, Neumann JT, Tonkin A, Reid CM, Woods RL, Nelson M, Stocks N, Berk M, McNeil JJ, Britt C, Owen AJ. Social isolation, social support and loneliness as predictors of cardiovascular disease incidence and mortality. BMC Geriatr 2021; 21:711. [PMID: 34922471 PMCID: PMC8684069 DOI: 10.1186/s12877-021-02602-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 10/18/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Poor social health is associated with increased risk of cardiovascular disease (CVD). Recent research suggests that different social health domains should be considered separately as the implications for health and possible interventions may differ. AIM To assess social isolation, low social support and loneliness as predictors of CVD. METHODS Secondary analysis of 11,486 community-dwelling, Australians, aged 70 years and over, free of CVD, dementia, or significant physical disability, from the ASPirin in Reducing Events in the Elderly (ASPREE) trial. Social isolation, social support (Revised Lubben Social Network Scale), and loneliness were assessed as predictors of CVD using Cox proportional-hazard regression. CVD events included fatal CVD, heart failure hospitalization, myocardial infarction and stroke. Analyses were adjusted for established CVD risk factors. RESULTS Individuals with poor social health were 42 % more likely to develop CVD (p = 0.01) and twice as likely to die from CVD (p = 0.02) over a median 4.5 years follow-up. Interaction effects indicated that poorer social health more strongly predicted CVD in smokers (HR 4.83, p = 0.001, p-interaction = 0.01), major city dwellers (HR 1.94, p < 0.001, p-interaction=0.03), and younger older adults (70-75 years; HR 2.12, p < 0.001, p-interaction = 0.01). Social isolation (HR 1.66, p = 0.04) and low social support (HR 2.05, p = 0.002), but not loneliness (HR 1.4, p = 0.1), predicted incident CVD. All measures of poor social health predicted ischemic stroke (HR 1.73 to 3.16). CONCLUSIONS Among healthy older adults, social isolation and low social support may be more important than loneliness as cardiovascular risk factors. Social health domains should be considered in future CVD risk prediction models.
Collapse
Affiliation(s)
- Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Johannes T. Neumann
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
- Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel, Lübeck, Germany
| | - Andrew Tonkin
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Christopher M. Reid
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
- School of Public Health, Curtin University, 6102 Perth, WA Australia
| | - Robyn L. Woods
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Mark Nelson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
- Menzies Institute for Medical Research, University of Tasmania, 7000 Hobart, TAS Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, 5005 Adelaide, SA Australia
| | - Michael Berk
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
- IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Department of Psychiatry, Florey Institute for Neuroscience and Centre for Mental Health, University of Melbourne, Parkville, Victoria Australia
| | - John J. McNeil
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Carlene Britt
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| | - Alice J. Owen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, 3004 Melbourne, Victoria, VIC Australia
| |
Collapse
|
35
|
Stokes AC, Xie W, Lundberg DJ, Glei DA, Weinstein MA. Loneliness, social isolation, and all-cause mortality in the United States. SSM - MENTAL HEALTH 2021; 1:100014. [PMID: 36936717 PMCID: PMC10019099 DOI: 10.1016/j.ssmmh.2021.100014] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Social isolation and loneliness are both established risk factors for mortality, but it remains unclear how these two conditions interact with each other. We used data from 3975 adults aged 25-74 years who completed self-administered questionnaires (SAQs) for the Midlife in the United States (MIDUS) National Study Wave 2 (2004-2006). Loneliness was measured by asking participants how often they felt lonely. A shortened version of the Berkman-Syme Social Network Index that captured partnerships, friends/family, religious participation, and other forms of social connection was used to assess social isolation. Follow-up for all-cause mortality was censored at the end of 2016. We used progressively adjusted Cox proportional hazard models to examine the mortality risks of loneliness, social isolation, the components of social isolation, and combinations of loneliness and isolation. We adjusted for sociodemographic characteristics in our first models and then added health behaviors and physical and mental health conditions in subsequent models. In the minimally adjusted model, loneliness was associated with higher mortality risk (HR, 1.34; 95% CI, 1.22-1.47), but the association was not significant in the fully adjusted model. Social isolation was significantly associated with mortality in the minimally adjusted model (HR, 1.24; 95% CI, 1.15-1.34) and the fully adjusted model (HR, 1.13; 95% CI, 1.04-1.23). Having infrequent contact with family or friends was the component of isolation that had the strongest association with mortality. Contrary to prior literature, which has found either no interaction or a synergistic interaction between isolation and loneliness, we identified a significant, negative interaction between the two measures, indicating that loneliness and social isolation may partially substitute for one another as risk factors for mortality. Both are associated with a similar increased risk of mortality relative to those who express neither; we find no evidence that the combined effect is worse than experiencing either by itself.
Collapse
Affiliation(s)
- Andrew C. Stokes
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
- Corresponding author. Boston University School of Public Health, 801 Massachusetts Ave. 3rd Floor, 362, Boston, MA, 02118, USA. (A.C. Stokes)
| | - Wubin Xie
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Dielle J. Lundberg
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Dana A. Glei
- Center for Population and Health, Georgetown University, Washington, D.C, USA
| | - Maxine A. Weinstein
- Center for Population and Health, Georgetown University, Washington, D.C, USA
| |
Collapse
|
36
|
Singh R, Javed Z, Yahya T, Valero-Elizondo J, Acquah I, Hyder AA, Maqsood MH, Amin Z, Al-Kindi S, Cainzos-Achirica M, Nasir K. Community and Social Context: An Important Social Determinant of Cardiovascular Disease. Methodist Debakey Cardiovasc J 2021; 17:15-27. [PMID: 34824678 PMCID: PMC8588761 DOI: 10.14797/mdcvj.846] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/18/2021] [Indexed: 12/21/2022] Open
Abstract
Disease prevention frameworks and clinical practice guidelines in the United States (US) have traditionally ignored upstream social determinants of health (SDOH), which are critical for reducing disparities in cardiovascular disease (CVD)-the leading cause of death in the US. Existing evidence demonstrates a protective effect of social support, social cohesion, and community engagement on overall health and wellbeing. Increasing community and social support is a major objective of the Healthy People 2030 initiative, with special provisions for vulnerable populations. However, to date, existing evidence of the association between community and social context (CSC)-an integral SDOH domain-and CVD has not been reviewed extensively. In particular, the individual and cumulative impact of CSC on CVD risk and the pathways linking CSC to cardiovascular outcomes are not well understood. In this review, we critically appraise current knowledge of the association between CSC and CVD, describe potential pathways linking CSC to CVD, and identify opportunities for evidence-based policy and practice interventions to improve CVD outcomes.
Collapse
Affiliation(s)
- Rahul Singh
- Department of Cardiology, University of Minnesota, Minnesota, US
| | - Zulqarnain Javed
- Division of Health Equity & Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, Texas, US
| | - Tamer Yahya
- Center for Outcomes Research, Houston Methodist, Houston, Texas, US
| | - Javier Valero-Elizondo
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.,Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist, Houston, Texas, US
| | - Isaac Acquah
- Center for Outcomes Research, Houston Methodist, Houston, Texas, US
| | | | | | - Zahir Amin
- University of Houston, Houston, Texas, US
| | - Sadeer Al-Kindi
- Case Western Reserve University School of Medicine, Cleveland, Ohio, US
| | - Miguel Cainzos-Achirica
- Center for Outcomes Research, Houston Methodist, Houston, Texas, US.,Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.,Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist, Houston, Texas, US
| | - Khurram Nasir
- Center for Outcomes Research, Houston Methodist, Houston, Texas, US.,Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.,Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist, Houston, Texas, US
| |
Collapse
|
37
|
Jeste DV, Di Somma S, Lee EE, Nguyen TT, Scalcione M, Biaggi A, Daly R, Liu J, Tu X, Ziedonis D, Glorioso D, Antonini P, Brenner D. Study of loneliness and wisdom in 482 middle-aged and oldest-old adults: a comparison between people in Cilento, Italy and San Diego, USA. Aging Ment Health 2021; 25:2149-2159. [PMID: 33000647 PMCID: PMC8012404 DOI: 10.1080/13607863.2020.1821170] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES There has been growing research interest in loneliness and wisdom in recent decades, but no cross-cultural comparisons of these constructs using standardized rating measures in older adults, especially the oldest-old. This was a cross-sectional study of loneliness and wisdom comparing middle-aged and oldest-old adults in Cilento, Italy and San Diego, United States. METHOD We examined loneliness and wisdom, using the UCLA Loneliness Scale Version 3 (UCLA-3) and San Diego Wisdom Scale (SD-WISE), respectively, in four subject groups: adults aged 50-65 and those ≥90 years from Cilento, Italy (N = 212 and 47, respectively) and San Diego, California, USA (N = 138 and 85, respectively). RESULTS After controlling for education, there were no significant group differences in levels of loneliness, while on SD-WISE the Cilento ≥90 group had lower scores compared to the other three groups. There was a strong inverse correlation between loneliness and wisdom in each of the four subject groups. Loneliness was negatively associated while wisdom was positively associated with general health, sleep quality, and happiness in most groups, with varying levels of significance. CONCLUSION These results largely support cross-cultural validity of the constructs of loneliness and wisdom, and extend previous findings of strong inverse correlations between these two entities. Loneliness has become a growing public health problem, and the results of our study suggest that wisdom could be a protective factor against loneliness, although alternative explanations are also possible. Research on interventions to reduce loneliness by enhancing wisdom in older adults is needed.
Collapse
Affiliation(s)
- Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, USA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, USA,Department of Neurosciences, University of California San Diego, USA
| | - Salvatore Di Somma
- Department of Medical-Surgery Sciences and Translational Medicine, University of Rome La Sapienza, Rome, Italy,Great Network, Italy
| | - Ellen E. Lee
- Department of Psychiatry, University of California San Diego, USA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, USA,VA San Diego Healthcare System, San Diego, CA, USA
| | - Tanya T. Nguyen
- Department of Psychiatry, University of California San Diego, USA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, USA
| | - Mara Scalcione
- Great Network, Italy,University of Rome La Sapienza School of Medicine, Rome, Italy
| | - Alice Biaggi
- Great Network, Italy,University of Rome La Sapienza School of Medicine, Rome, Italy
| | - Rebecca Daly
- Department of Psychiatry, University of California San Diego, USA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, USA
| | - Jinyuan Liu
- Department of Psychiatry, University of California San Diego, USA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, USA,Department of Family Medicine and Public Health, University of California San Diego, USA
| | - Xin Tu
- Department of Psychiatry, University of California San Diego, USA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, USA,Department of Family Medicine and Public Health, University of California San Diego, USA
| | - Douglas Ziedonis
- Department of Psychiatry, University of California San Diego, USA,School of Medicine, University of California San Diego, USA
| | - Danielle Glorioso
- Department of Psychiatry, University of California San Diego, USA,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, USA
| | | | - David Brenner
- School of Medicine, University of California San Diego, USA
| |
Collapse
|
38
|
Abstract
PURPOSE OF REVIEW Social isolation and loneliness have long been identified as risk factors for poorer physical and mental health and increased mortality. These factors have also been shown to impact dietary behavior and physical activity which play a role in precipitating and maintaining obesity. Less is known about the impact of social isolation resulting from the COVID-19 pandemic in which social distancing is a major component of public health initiatives. This narrative review will examine the existing literature on the relationships between social isolation, loneliness, mental health, and weight as they relate to the COVID-19 pandemic. RECENT FINDINGS Individuals with obesity are at very high risk for worsening course of COVID-19, hospitalization, and death. This population may also be more significantly impacted by the dietary and physical activity consequences resulting from lockdown, social distancing, and isolation. The pandemic has led to significant lifestyle disruptions. However, early studies have largely relied upon cross-sectional studies or convenience samples. Future research will need to study the impact more rigorously, particularly among populations at greatest risk.
Collapse
Affiliation(s)
- Leslie J Heinberg
- Cleveland Clinic Lerner College of Medicine, 9500 Euclid Ave./M61, Cleveland, OH, 44195, USA.
| | - Kristine Steffen
- North Dakota State University, Sanford Center for Bio-Behavioral Research, Fargo, ND, USA
| |
Collapse
|
39
|
Berger K, Riedel-Heller S, Pabst A, Rietschel M, Richter D. [Loneliness during the first wave of the SARS-CoV-2 pandemic-results of the German National Cohort (NAKO)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:1157-1164. [PMID: 34327541 PMCID: PMC8320420 DOI: 10.1007/s00103-021-03393-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/05/2021] [Indexed: 12/04/2022]
Abstract
Hintergrund Mit Beginn der SARS-CoV-2-Pandemie und der nachfolgenden Maßnahmen zu ihrer Eindämmung im Frühjahr 2020 ist rasch die Frage nach Auswirkungen der Beschränkung sozialer Kontakte auf die psychische Gesundheit der Bevölkerung aufgekommen. Einsamkeit beschreibt eine wahrgenommene Qualität der eigenen Kontakte und Beziehungen zu anderen Menschen. Zahlreiche Studien haben einen Zusammenhang von Einsamkeit mit somatischen und psychischen Erkrankungen aufgezeigt. Ziel Auswertung der Häufigkeit von Einsamkeit und ihrer Beziehung zu Angst- und Depressionssymptomen in der ersten Welle der Pandemie im Mai 2020. Methoden Zwischen 2014 und 2019 hat die NAKO-Gesundheitsstudie 205.000 Personen im Alter zwischen 20 und 69 Jahren in 18 Studienzentren in Deutschland rekrutiert und untersucht. Die nachfolgende Zweituntersuchung musste aufgrund der Pandemie im Frühjahr 2020 unterbrochen werden. In dieser Zeit wurde ein COVID-19-bezogener Fragebogen entwickelt und an alle Teilnehmenden verschickt. Ausgewertet wurden die 113.928 Fragebögen, die innerhalb der ersten 30 Tage zurückgeschickt wurden. Einsamkeit wurde mit der 3‑Item UCLA Loneliness Scale, Angst und Depression mit den PHQ-9- und GAD-7-Skalen des Patient Health Questionnaire erhoben. Ergebnisse Im Mai 2020 nahmen sich 31,7 % der NAKO-Teilnehmenden als einsam wahr. Frauen und junge Menschen waren häufiger als Männer und ältere Personen betroffen. Mit steigender Wahrnehmung von Einsamkeit nahm der Schweregrad von Depressions- und Angstsymptomen stetig zu. Einsame Personen während der Pandemie hatten bereits zur NAKO-Basisuntersuchung mehr depressive und Angstsymptome angegeben als NAKO-Teilnehmende, die sich in der Pandemie nicht einsam fühlten. Schlussfolgerung In der NAKO-Gesundheitsstudie zeigte sich während der ersten Phase der Pandemie eine Zunahme von Einsamkeit und ihr deutlicher Zusammenhang mit schlechterer, psychischer Gesundheit.
Collapse
Affiliation(s)
- Klaus Berger
- Institut für Epidemiologie und Sozialmedizin, Universität Münster, Domagkstr. 3, 48149, Münster, Deutschland.
| | - Steffi Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
| | - Alexander Pabst
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland
| | - Marcella Rietschel
- Abteilung Genetische Epidemiologie in der Psychiatrie, Zentralinstitut für seelische Gesundheit, Mannheim, Deutschland
| | - Dirk Richter
- Zentrum Psychiatrische Rehabilitation, Universitäre Psychiatrische Dienste Bern, Bern, Schweiz
- Universitätsklinik für Psychiatrie und Psychotherapie, Universität Bern, Bern, Schweiz
- Departement Gesundheit, Berner Fachhochschule, Bern, Schweiz
| |
Collapse
|
40
|
Lee A, McArthur C, Veroniki AA, Kastner M, Ioannidis G, Griffith LE, Thabane L, Adachi JD, Papaioannou A. Management of social isolation and loneliness in community-dwelling older adults: protocol for a network meta-analysis of randomised controlled trials. BMJ Open 2021; 11:e042828. [PMID: 34226209 PMCID: PMC8258567 DOI: 10.1136/bmjopen-2020-042828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 05/07/2021] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Social isolation and loneliness in older adults are significant public health issues. Various interventions such as exercise programmes or social activities are used in the management of social isolation and loneliness in older adults. Network meta-analysis (NMA) provides effect estimates for all comparisons by considering the relative efficacy of multiple intervention alternatives. Therefore, this study will determine the comparative efficacy of intervention to alleviate social isolation and loneliness of older adults in community dwelling by comparing direct and indirect interventions through systematic review and NMA. METHODS AND ANALYSIS We will include all relevant randomised controlled trials for interventions of social isolation and loneliness in older adults written in English without any limitation of publication date through electronic databases: MEDLINE via OVID, EMBASE, Cochrane Central Registry of Controlled Trials (CENTRAL), PsycINFO and CINAHL. Independent teams of reviewers will screen trial eligibility, collect data, identify duplication and assess risk of bias, by using the Cochrane revised risk of bias tool. The interventions for the management of social isolation and loneliness will be included. The primary outcome is social isolation. The secondary outcomes are loneliness and health-related quality of life. We will conduct an NMA through a Bayesian hierarchical model, by testing assumption (ie, transitivity) for NMA. We will also estimate the ranking probabilities for all interventions at each possible rank for each intervention. For estimation of each intervention efficacy, we will assess the certainty and credibility using the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION Ethics approval will not be obtained for this systematic review as it will be conducted with published papers. The review results will be presented at a field-specific conference and published in a relevant peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42020155789.
Collapse
Affiliation(s)
- Ahreum Lee
- Health Research Methods, Evidence, and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
- GERAS Centre for Aging Research, Hamilton, Ontario, Canada
| | - Caitlin McArthur
- GERAS Centre for Aging Research, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Areti Angeliki Veroniki
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Epirus, Greece
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Institute of Reproductive and Development Biology, Department of Surgery & Cancer, Faculty of Medicine, Imperial College, London, UK
| | - Monika Kastner
- Knowledge Translation and Implementation, Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
- Health Service Research, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - George Ioannidis
- GERAS Centre for Aging Research, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Lauren E Griffith
- Health Research Methods, Evidence, and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Health Research Methods, Evidence, and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Jonathan D Adachi
- Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Alexandra Papaioannou
- Health Research Methods, Evidence, and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
- GERAS Centre for Aging Research, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| |
Collapse
|
41
|
Lin S, Falbo T, Qu W, Wang Y, Feng X. Chinese only children and loneliness: Stereotypes and realities. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2021; 91:531-544. [PMID: 34166053 PMCID: PMC8454259 DOI: 10.1037/ort0000554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Popular media has aroused concern that Chinese only children are growing up lonely owing to their lack of sibling interaction Mu et al. (2007). However, little research has been directed at determining whether Chinese adults believe in the only-child-as-lonely stereotype and whether Chinese only children actually suffer more loneliness than their peers with siblings. Three studies were conducted to examine belief in the only-child-as-lonely stereotype and determine whether only children report greater loneliness than children with siblings. With the first study, the prevalence of the only-child-as-lonely stereotype among young adults from six cities (Study 1, N = 588) was examined. The results showed that belief in this stereotypical perception was common among young Chinese adults, particularly those who had siblings. We then examined the validity of this stereotype by analyzing data from three samples, consisting of Chinese emerging adults (Study 2, N = 699) and late adolescents (Studies 3.1 and 3.2, N = 345 and 210, respectively). Results from Studies 2 and 3 consistently showed that, contrary to the stereotype, Chinese only children reported lower levels of loneliness than their counterparts with siblings. Additionally, open-ended responses from the adolescent participants in Study 3 provided hints about the situations that provoke their loneliness. The results are explained in terms of the two theoretical approaches to loneliness. In sum, our research suggests that belief in the loneliness of only children is widespread in Chinese society, but the evidence indicates that reports of loneliness are greater for those who grew up with siblings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Shengjie Lin
- Department of Educational Psychology, The University of Texas at Austin
| | - Toni Falbo
- Department of Educational Psychology, The University of Texas at Austin
| | - Wen Qu
- Department of Psychology, University of Notre Dame
| | - Yidan Wang
- Department of Educational Psychology, The University of Texas at Austin
| | - Xiaotian Feng
- Department of Sociology and Social Work, Guangxi Normal University
| |
Collapse
|
42
|
Rentscher KE, Zhou X, Small BJ, Cohen HJ, Dilawari AA, Patel SK, Bethea TN, Van Dyk KM, Nakamura ZM, Ahn J, Zhai W, Ahles TA, Jim HSL, McDonald BC, Saykin AJ, Root JC, Graham DMA, Carroll JE, Mandelblatt JS. Loneliness and mental health during the COVID-19 pandemic in older breast cancer survivors and noncancer controls. Cancer 2021; 127:3671-3679. [PMID: 34161601 PMCID: PMC8419003 DOI: 10.1002/cncr.33687] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/17/2021] [Accepted: 05/28/2021] [Indexed: 12/31/2022]
Abstract
Background The coronavirus disease 2019 (COVID‐19) pandemic has had wide‐ranging health effects and increased isolation. Older with cancer patients might be especially vulnerable to loneliness and poor mental health during the pandemic. Methods The authors included active participants enrolled in the longitudinal Thinking and Living With Cancer study of nonmetastatic breast cancer survivors aged 60 to 89 years (n = 262) and matched controls (n = 165) from 5 US regions. Participants completed questionnaires at parent study enrollment and then annually, including a web‐based or telephone COVID‐19 survey, between May 27 and September 11, 2020. Mixed‐effects models were used to examine changes in loneliness (a single item on the Center for Epidemiologic Studies–Depression [CES‐D] scale) from before to during the pandemic in survivors versus controls and to test survivor‐control differences in the associations between changes in loneliness and changes in mental health, including depression (CES‐D, excluding the loneliness item), anxiety (the State‐Trait Anxiety Inventory), and perceived stress (the Perceived Stress Scale). Models were adjusted for age, race, county COVID‐19 death rates, and time between assessments. Results Loneliness increased from before to during the pandemic (0.211; P = .001), with no survivor‐control differences. Increased loneliness was associated with worsening depression (3.958; P < .001) and anxiety (3.242; P < .001) symptoms and higher stress (1.172; P < .001) during the pandemic, also with no survivor‐control differences. Conclusions Cancer survivors reported changes in loneliness and mental health similar to those reported by women without cancer. However, both groups reported increased loneliness from before to during the pandemic that was related to worsening mental health, suggesting that screening for loneliness during medical care interactions will be important for identifying all older women at risk for adverse mental health effects of the pandemic. Older breast cancer survivors and matched noncancer controls experienced similar increases in loneliness from before to during the COVID‐19 pandemic. Women who reported increased loneliness also experienced worsening depression and anxiety symptoms and higher stress during the pandemic.
Collapse
Affiliation(s)
- Kelly E Rentscher
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, California.,Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Xingtao Zhou
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, Florida
| | - Harvey J Cohen
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina
| | - Asma A Dilawari
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia
| | - Sunita K Patel
- Outcomes Division, Population Sciences, City of Hope National Medical Center, Los Angeles, California
| | - Traci N Bethea
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia
| | - Kathleen M Van Dyk
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Zev M Nakamura
- Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, District of Columbia
| | - Wanting Zhai
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Brenna C McDonald
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Deena M A Graham
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey
| | - Judith E Carroll
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, California.,Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California
| | - Jeanne S Mandelblatt
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia
| |
Collapse
|
43
|
van Zutphen EM, Kok AAL, Rijnhart JJM, Rhebergen D, Huisman M, Beekman ATF. An examination of reciprocal effects between cardiovascular morbidity, depressive symptoms and loneliness over time in a longitudinal cohort of Dutch older adults. J Affect Disord 2021; 288:122-128. [PMID: 33864961 DOI: 10.1016/j.jad.2021.03.081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Unidirectional studies suggest that the effects between cardiovascular disease, depressive symptoms and loneliness are reciprocal, but this has not been tested empirically. The aim was to study how cardiovascular morbidity, depressive symptoms and loneliness influence each other longitudinally. METHODS Data from 2979 older adults from the Longitudinal Aging Study Amsterdam were analysed. Depressive symptoms (≥16 points on the Center for Epidemiologic Studies Depression Scale), loneliness (≥3 points on the De Jong Gierveld Loneliness Scale) and cardiovascular morbidity were measured five times during 13-year follow-up. With structural equation modelling, a full cross-lagged panel model was compared to nine nested models reflecting different sets of temporal effects. RESULTS The best-fitting cross-lagged panel model showed reciprocal risk increasing effects between depressive symptoms and loneliness and a risk increasing effect of cardiovascular morbidity on depressive symptoms. LIMITATIONS A cross-lagged panel model has technical limitations, such as that the chosen time lag may not be appropriate for each effect. In addition, differential loss to follow-up and collider bias may have led to an underestimation of the effects. CONCLUSIONS Reciprocal effects tend to occur only between depressive symptoms and loneliness. Their interplay with cardiovascular morbidity seems more complex and mostly indirect, highlighting the potential of interventions to reduce depressive symptoms, loneliness and cardiovascular morbidity in concert to improve health at old age.
Collapse
Affiliation(s)
- Elisabeth M van Zutphen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Almar A L Kok
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | | | - Didi Rhebergen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands; Mental Health Care Institute GGZ Centraal, Amersfoort, the Netherlands
| | - Martijn Huisman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Department of Sociology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| |
Collapse
|
44
|
Nghiem N, Wilson N. Potential impact of COVID-19 related unemployment on increased cardiovascular disease in a high-income country: Modeling health loss, cost and equity. PLoS One 2021; 16:e0246053. [PMID: 34043626 PMCID: PMC8159004 DOI: 10.1371/journal.pone.0246053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/03/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of health loss and health sector economic burdens in high-income countries. Unemployment is associated with increased risk of CVD, and so there is concern that the economic downturn associated with the COVID-19 pandemic will increase the CVD burden. AIMS This modeling study aimed to quantify potential health loss, health cost burden and health inequities among people with CVD due to additional unemployment caused by COVID-19 pandemic-related economic disruption in one high-income country: New Zealand (NZ). METHODS We adapted an established and validated multi-state life-table model for CVD in the national NZ population. We modeled indirect effects (ie, higher CVD incidence due to high unemployment rates) for various scenarios of pandemic-related unemployment projections from the NZ Treasury. RESULTS We estimated the potential CVD-related heath loss in NZ to range from 23,300 to 36,900 health-adjusted life years (HALYs) for the different unemployment scenarios. Health inequities would be increased with the per capita health loss for Māori (Indigenous population) estimated to be 3.7 times greater than for non-Māori (49.9 vs 13.5 HALYs lost per 1000 people). The estimated additional health system costs ranged between (NZ$303 million [m] to 503m in 2019 values; or US$209m to 346m). CONCLUSIONS AND POLICY IMPLICATIONS Unemployment due to the COVID-19 pandemic could cause significant health loss, increase health inequities from CVD, and impose additional health system costs in this high-income country. Prevention measures should be considered by governments to reduce this risk, including additional job creation programs and measures directed towards the primary prevention of CVD.
Collapse
Affiliation(s)
- Nhung Nghiem
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
| |
Collapse
|
45
|
Leslie-Miller CJ, Waugh CE, Cole VT. Coping With COVID-19: The Benefits of Anticipating Future Positive Events and Maintaining Optimism. Front Psychol 2021; 12:646047. [PMID: 33897550 PMCID: PMC8062780 DOI: 10.3389/fpsyg.2021.646047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/09/2021] [Indexed: 01/01/2023] Open
Abstract
In early 2020, the COVID-19 pandemic forced a large portion of the world into quarantine, leading to an extensive period of stress making it necessary to explore regulatory techniques that are effective at stimulating long-lasting positive emotion. Previous research has demonstrated that anticipating positive events produces increases in positive emotion during discrete stressors. We hypothesized that state and trait positive anticipation during the COVID-19 pandemic would be associated with increased positive emotions. We assessed how often participants thought about a future positive/negative/neutral event, activity, or goal through a daily reconstruction method that represented a "day in the life" of people in the United States during the early stages of the COVID-19 pandemic. The results of multi-level modeling and mediational analyses demonstrated that higher optimism, one form of trait positive anticipation, was related to higher state positive anticipation, which was in turn related to higher positive emotions during the current episode, which persisted to the next episode. In addition, both optimism and state positive anticipation were related to adaptive responses to the pandemic. These findings suggest that anticipation of future emotional experiences and hopefulness for the future can be a powerful predictor of positive emotions during global pandemics and perhaps other similar chronic stressors.
Collapse
Affiliation(s)
| | - Christian E Waugh
- Department of Psychology, Wake Forest University, Winston-Salem, NC, United States
| | - Veronica T Cole
- Department of Psychology, Wake Forest University, Winston-Salem, NC, United States
| |
Collapse
|
46
|
Hearing impairment and loneliness in older adults in Shandong, China: the modifying effect of living arrangement. Aging Clin Exp Res 2021; 33:1015-1021. [PMID: 32557333 DOI: 10.1007/s40520-020-01594-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Hearing impairment is a highly prevalent condition and potential risk factor of loneliness in older adults. There is little evidence on whether living arrangement modifies the effects of hearing impairment on loneliness in older adults. AIMS (1) Explore the relationship between hearing impairment and loneliness in old adults; (2) investigate the modifying effect of living arrangement on the association between hearing impairment and loneliness. METHODS A cross-sectional analysis was conducted of 7070 participants (aged 60-101) in Shandong province of China. Hearing impairment was measured by a single self-reported question. Variables about social demography and physical functioning were assessed using self-administered questionnaires, and loneliness using short-form UCLA Loneliness Scale. Linear regression models were performed to evaluate the association between hearing impairment and loneliness and possible effect modified by living arrangement. RESULTS After controlling variables, older adults with hearing impairment reported significantly higher levels of loneliness than those with normal hearing (β = 0.024; P < 0.001). Living arrangement has a significant modifying effect on association between hearing impairment and loneliness. CONCLUSIONS Our results underscored the potential impact of hearing impairment on loneliness in older adults, and also suggested that having adult children in the same village/community may play a protective role in reducing the loneliness of older adults with hearing impairment.
Collapse
|
47
|
Mavroudis CL, Landau S, Brooks E, Bergmark R, Berlin NL, Blumenthal B, Cooper Z, Hwang EK, Lancaster E, Waljee J, Wick E, Yeo H, Wirtalla C, Kelz RR. The Relationship Between Surgeon Gender and Stress During the Covid-19 Pandemic. Ann Surg 2021; 273:625-629. [PMID: 33491977 PMCID: PMC7959864 DOI: 10.1097/sla.0000000000004762] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the relationship between surgeon gender and stress during the Covid-19 pandemic. BACKGROUND Although female surgeons face difficulties integrating work and home in the best of times, the Covid-19 pandemic has presented new challenges. The implications for the female surgical workforce are unknown. METHODS This cross-sectional, multi-center telephone survey study of surgeons was conducted across 5 academic institutions (May 15-June 5, 2020). The primary outcome was maximum stress level, measured using the validated Stress Numerical Rating Scale-11. Mixed-effects generalized linear models were used to estimate the relationship between surgeon stress level and gender. RESULTS Of 529 surgeons contacted, 337 surgeons responded and 335 surveys were complete (response rate 63.7%). The majority of female respondents were housestaff (58.1%), and the majority of male respondents were faculty (56.8%) (P = 0.008). A greater proportion of male surgeons (50.3%) than female surgeons (36.8%) had children ≤18 years (P = 0.015). The mean maximum stress level for female surgeons was 7.51 (SD 1.49) and for male surgeons was 6.71 (SD 2.15) (P < 0.001). After adjusting for the presence of children and training status, female gender was associated with a significantly higher maximum stress level (P < 0.001). CONCLUSIONS Our findings that women experienced more stress than men during the Covid-19 pandemic, regardless of parental status, suggest that there is more to the gendered differences in the stress experience of the pandemic than the added demands of childcare. Deliberate interventions are needed to promote and support the female surgical workforce during the pandemic.
Collapse
Affiliation(s)
| | - Sarah Landau
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ezra Brooks
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Regan Bergmark
- Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | - Zara Cooper
- Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | | | | | - Heather Yeo
- Weill Cornell Medical College, New York, New York
| | | | - Rachel R Kelz
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
48
|
Bevilacqua G, D'Angelo S, Ntani G, Syddall HE, Harris EC, Linaker C, Stevens M, Cooper C, Walker-Bone K. Older working adults in the HEAF study are more likely to report loneliness after two years of follow-up if they have negative perceptions of their work quality. BMC Public Health 2021; 21:574. [PMID: 33757464 PMCID: PMC7988922 DOI: 10.1186/s12889-021-10610-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/09/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Loneliness is an important public health issue associated with mortality and morbidity. Often researched amongst older people, less is known about risk factors for loneliness among adults aged 50-64 years who are in work. We investigated (a) if exit from the workforce increases the odds of loneliness; (b) whether adverse psychosocial work factors are associated with increased odds of loneliness over 2 years of follow-up; and (c) whether the association is stronger among subjects still working compared with those who have exited the workforce. METHODS Data came from the Health and Employment After Fifty (HEAF) study, a large population cohort who provided questionnaire information about work and health at baseline and 2 annual follow-ups. Logistic regression was used to explore the association between psychosocial risk factors and loneliness at follow-up 2, with adjustment for loneliness at baseline, sex, age, self-rated health, living alone, and mental health diagnosis. RESULTS Of the initial 8134 participants, 4521 were working at baseline and provided data for this analysis. Of those, 507 (11.2%) were defined as lonely at 2 years' follow-up. Exiting the workforce was not significantly associated with loneliness (OR = 1.1, 95%CI: 0.7-1.7). However, negative psychosocial work factors predicted loneliness at follow-up. After mutual adjustment, lack of choice at work (OR: 1.5, 95%CI: 1.1-1.9), often lying awake worrying about work (OR: 1.4, 95%CI: 1.0-1.9) and perceived not coping with physical demands of the job (OR: 1.3, 95%CI: 1.0-1.7) were independent predictors, with associations robust to adjustment for demographic factors and health. Associations were only slightly altered when we restricted the sample to those who remained in work until the end of follow-up. CONCLUSIONS Loneliness amongst middle-aged working adults is not predicted by permanent work exit but is predicted by individuals' perceptions about their work. Provision of good-quality work, matched to the capacity of the older worker, could prevent loneliness.
Collapse
Affiliation(s)
- Gregorio Bevilacqua
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Georgia Ntani
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Holly Emma Syddall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Elizabeth Clare Harris
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Cathy Linaker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Martin Stevens
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Karen Walker-Bone
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England.
| |
Collapse
|
49
|
Griffin SC, Mladen SN, Williams AB, Dautovich ND, Lageman SK, Dzierzewski JM, Perrin PB, Rybarczyk BD. Sleep Disturbance Mediates the Association Between Loneliness and Health in Older Americans. Int J Behav Med 2021; 28:64-72. [PMID: 32445188 DOI: 10.1007/s12529-020-09897-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND As the research documenting loneliness as a risk factor for morbidity and mortality continues to grow, it becomes increasingly critical to understand the mechanics of this relationship. This study assessed whether sleep disturbance mediates the relationship between loneliness and health. METHOD Data came from the 2006, 2010, and 2014 waves of the Health and Retirement Study, a longitudinal study of older Americans; participants ≥ 65 who completed the Psychosocial and Lifestyle Questionnaire in 2006 were included (n = 5067). Measures include the Hughes loneliness scales, a modified version of the Jenkins sleep scale, and self-reported health. Cross-lagged mediation models (i.e., path analysis) were used to model the relationships between loneliness, sleep disturbance, and self-reported health over the 8-year span. RESULTS Loneliness predicted subsequent sleep disturbance, which in turn predicted subsequent self-reported health. Moreover, there was evidence of both direct and indirect effects (via sleep disturbance) of loneliness on self-reported health. These effects remained after controlling for demographics, isolation, and depression. CONCLUSION Sleep disturbance partially mediates the relationship between loneliness and self-reported health over 8 years. These findings are not attributable to isolation or depression. Further research is necessary to develop and assess a more comprehensive model of how loneliness shapes health. This study indicates that targeting sleep disturbance may mitigate the health risks of loneliness in older Americans.
Collapse
Affiliation(s)
- Sarah C Griffin
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Richmond, VA, 23223, USA. .,Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.
| | - Samantha N Mladen
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Richmond, VA, 23223, USA
| | - Allison Baylor Williams
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Richmond, VA, 23223, USA
| | - Natalie D Dautovich
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Richmond, VA, 23223, USA
| | - Sarah K Lageman
- Parkinson's & Movement Disorders Center at Neuroscience, Orthopaedic and Wellness Center, Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
| | - Joseph M Dzierzewski
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Richmond, VA, 23223, USA
| | - Paul B Perrin
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Richmond, VA, 23223, USA
| | - Bruce D Rybarczyk
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Richmond, VA, 23223, USA
| |
Collapse
|
50
|
O’Neal CW, Wickrama K(K. The Contribution of Stressful Marital Interactions to Loneliness and Health across Mid-life and Later Adulthood. JOURNAL OF FAMILY ISSUES 2021; 42:553-570. [PMID: 34504384 PMCID: PMC8425179 DOI: 10.1177/0192513x20921927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Although past research has noted longitudinal, and sometimes bi-directional, associations between marital interactions, loneliness, and physical health, previous work has not identified long-term associations and differential associations over life-course stages (i.e., mid-life and later adulthood). Utilizing a life-course stress process perspective and a sample of 250 couples in enduring marriages over 17 years (2001-2017), a structural equation model within a dyadic framework assessed the unique influences of stressful marital interactions on loneliness and physical health and the variation in bi-directional influences of loneliness and physical health over time. Marital interactions were relatively stable across life stages, yet marital interactions appear to influence loneliness and physical health. Notable distinctions were evident across life stages (from mid-life to later adulthood and then within later adulthood). Findings are discussed with an emphasis on the implications for health promotion and prevention programs targeting couples' quality of life in later years.
Collapse
Affiliation(s)
- Catherine Walker O’Neal
- Department of Human Development and Family Science, The University of Georgia, Athens, GA, USA
| | | |
Collapse
|