Loneliness and mortality: The moderating effect of positive affect

The Role of Social Support in Enhancing Life Satisfaction Among Syrian Refugees in Türkiye During the COVID-19 Pandemic

PURPOSE

This study investigates the role of perceived social support from family and friends in enhancing life satisfaction among Syrian refugees in Türkiye during the COVID-19 pandemic.

MATERIALS AND METHODS

A cross-sectional survey was conducted among 636 Syrian refugees residing in Istanbul and Hatay provinces. The study used the Multidimensional Perceived Social Support Scale, the COVID-19 State Anxiety Sources Scale, and the Satisfaction With Life Scale. Structural equation modeling was applied to analyze the relationships between social support, COVID-19-related anxieties, and life satisfaction.

RESULTS

Both family and friend social support were positively associated with life satisfaction. Friend social support was negatively associated with COVID-19-related economic anxiety, daily routine change anxiety, and isolation anxiety. These anxieties mediated the relationship between friend social support and life satisfaction.

DISCUSSION

The results suggest that strengthening social support from families and friends can mitigate the adverse effects of economic and routine-related anxieties among refugees, with friend support playing a more crucial role.

CONCLUSION

Social support is vital for enhancing life satisfaction among Syrian refugees in Türkiye during public health crises. Policy interventions should aim to reinforce these systems to build resilient refugee communities.

Loneliness, Dementia Status, and Their Association with All-Cause Mortality Among Older US Adults

Background

Loneliness, dementia, and mortality are interconnected.

Objective

We aimed at understanding mediating pathways and interactions between loneliness and dementia in relation to mortality risk.

Methods

The study tested bi-directional relationships between dementia, loneliness, and mortality, by examining both interactions and mediating effects in a large sample of older US adults participating in the nationally representative Health and Retirement Study. Out of≤6,468 older participants selected in 2010, with mean baseline age of 78.3 years and a follow-up time up to the end of 2020, 3,298 died at a rate of 64 per 1,000 person-years (P-Y). Cox proportional hazards and four-way decomposition models were used.

Results

Algorithmically defined dementia status (yes versus no) was consistently linked with a more than two-fold increase in mortality risk. Dementia status and Ln(odds of dementia) were strongly related with mortality risk across tertiles of loneliness score. Loneliness z-score was also linked to an elevated risk of all-cause mortality regardless of age, sex, or race or ethnicity, and its total effect (TE) on mortality was partially mediated by Ln(odds of dementia), z-scored, (≤40% of the TE was a pure indirect effect). Conversely, a small proportion (<5%) of the TE of Ln(odds of dementia), z-scored, on mortality risk was explained by the loneliness z-score.

Conclusions

In sum, dementia was positively associated with all-cause mortality risk, in similar fashion across loneliness score tertiles, while loneliness was associated with mortality risk. TE of loneliness on mortality risk was partially mediated by dementia odds in reduced models.

A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality

The associations between social isolation, loneliness and the risk of mortality from all causes, cardiovascular disease (CVD) and cancer are controversial. We systematically reviewed prospective studies on the association between social isolation, loneliness and mortality outcomes in adults aged 18 years or older, as well as studies on these relationships in individuals with CVD or cancer, and conducted a meta-analysis. The study protocol was registered with PROSPERO (reg. no. CRD42022299959). A total of 90 prospective cohort studies including 2,205,199 individuals were included. Here we show that, in the general population, both social isolation and loneliness were significantly associated with an increased risk of all-cause mortality (pooled effect size for social isolation, 1.32; 95% confidence interval (CI), 1.26 to 1.39; P < 0.001; pooled effect size for loneliness, 1.14; 95% CI, 1.08 to 1.20; P < 0.001) and cancer mortality (pooled effect size for social isolation, 1.24; 95% CI, 1.19 to 1.28; P < 0.001; pooled effect size for loneliness, 1.09; 95% CI, 1.01 to 1.17; P = 0.030). Social isolation also increased the risk of CVD mortality (1.34; 95% CI, 1.25 to 1.44; P < 0.001). There was an increased risk of all-cause mortality in socially isolated individuals with CVD (1.28; 95% CI, 1.10 to 1.48; P = 0.001) or breast cancer (1.51; 95% CI, 1.34 to 1.70; P < 0.001), and individuals with breast cancer had a higher cancer-specific mortality owing to social isolation (1.33; 95% CI, 1.02 to 1.75; P = 0.038). Greater focus on social isolation and loneliness may help improve people's well-being and mortality risk.

Effects and mechanisms of an online short-term audio-based mindfulness program on positive affect: A randomized controlled trial including exploratory moderator analyses

This study investigated the effects and mechanisms of an online short-term audio-based mindfulness (SAM) intervention program on positive affect and explored how well-being and negative affect influenced these effects and mechanisms. Participants (N = 100) were randomized into an intervention group (n = 50) and a control group (n = 50). Those in the mindfulness group underwent 3 weeks of an online SAM program and completed the online measures four times, while those in the control group completed the measures twice. Participants completed measures including the World Health Organization Well-Being Index, the Freiburg Mindfulness Inventory, and the Positive and Negative Affect Schedule. The effects of measures in both groups were compared. Parallel process latent growth curve modeling analysis was used to explore the longitudinal moderated mediation effects. The results showed that SAM was effective at improving positive affect, mindfulness, well-being, and reducing negative affect. Mindfulness growth speed during the intervention period mediated the relationship between SAM and positive affect improvement speed. The moderation effects of baseline well-being and negative effect on mediation effects were found to be significant. The SAM program was effective for the general public and was more beneficial for those with medium/high well-being and low/medium negative affect.

Loneliness and social networks of older adults in rural communities: a narrative synthesis systematic review

Introduction

Loneliness has significant impacts on the health of older adults. Social networks help to improve psychosocial and quality of life outcomes among older adults. A fifth of older adults live in rural communities, where geographic isolation poses challenges to health. The dynamics of social networks of older adults in rural communities has not been explored.

Objective

To synthesize the literature related to loneliness and social networks of older adults in rural settings.

Methods

A mixed-methods systematic review was conducted through searching six bibliographic databases to retrieve peer-reviewed literature with no time limits. We performed a methodological assessment of each study using a mixed method quality assessment tool. Findings are synthesized thematically.

Results

A total of 50 studies (32 quantitative, 15 qualitative, and 3 mixed methods) were included in this review. Studies were conducted in 17 different countries, the majority from China (n = 12), the UK (n = 9), and USA (n = 9). Findings revealed that social networks of older adults consist of family, friends and neighbors and continue to be developed through participation in various physical and social activities such as walking groups and participation in religious events. Social networks offer informational, functional, psychological and social support to older adults. Through their social networks, older adults feel socially connected and cared for. Successful interventions to improve social networks and address loneliness were those developed in groups or one-on-one with the older adults. The key ingredient to the positive impact of these interventions on reducing social isolation and loneliness was the formation of a social connection and regular engagement with the older adults. However, the review did not find any explicitly reported theory or model on which these interventions are based.

Conclusion

The prevalence of loneliness among older adults in rural areas needs urgent attention. Social network theory and methods can help in developing interventions to address social isolation and loneliness among older adults in rural communities.

Loneliness predicts physical and mental health-related quality of life over 9 months among patients with coronary heart disease

This study investigated whether loneliness would predict physical and mental health-related quality of life (HRQoL) over 9 months and examined whether medical adherence would mediate their associations in patients with coronary heart disease (CHD). The overall design is a three-wave longitudinal study. A sample of 255 outpatients with CHD was recruited from a community-based cardiac rehabilitation programme. Participants, with a mean age of 63 years, completed measures assessing loneliness, depression and physical and mental HRQoL at baseline. Medical adherence was assessed at 3 months, and physical and mental HRQoL were reassessed at 9 months. A total of 88% of participants reported moderate or high loneliness. Baseline loneliness predicted physical and mental HRQoL at 9 months after adjusting for baseline physical and mental HRQoL, respectively. The effects remained significant when depression was also adjusted. Medical adherence at 3 months partially mediated the associations of baseline loneliness with 9-month physical and mental HRQoL. Findings underline the necessity of assessing loneliness for CHD patients to promote long-term medical adherence and further improve physical and mental HRQoL.

Understanding and overcoming challenges in times of personal or global crisis-Editorial on the Special Issue on Loneliness and Health

The ever-present interest in loneliness has increased during the last decade. Although loneliness is generally not as prevalent as other topics and not among the top 5 most read papers in the journal Applied Psychology: Health and Well-Being, it is closely connected to topics therein, such as well-being and health. Conceptualizing loneliness as indicator of risk, it may function as a cue for action. Accordingly, understanding loneliness, its development, prevalence, effects, and how to support individuals to prevent or overcome loneliness is key and the main aim of this special issue. Therefore, theories and models are reviewed in this paper and synthesized together with other aspects relating to the field of loneliness research and intervention. Accordingly, we propose an agenda including key determinants (e.g., risk groups), how to proceed (various research methods), intervention components (e.g., behavior change techniques, SDGs), and how to perform dissemination (open science practices, co-creative approaches, etc.). The original studies in this special issue provide stimulating examples. Moreover, the commentaries give new insights and inspiring ideas. Overall, this special issue aims to give readers a lens with which to re-examine their own research, enable innovation, and empower addressing loneliness and its interconnection synergistically.