Association between social participation and cognitive function among community-dwelling older adults living alone: Analysis of a nationally representative survey

Aging wisely: The impact of Internet use on older adults' mental health

This study aims to explore the impact of Internet use on the mental health of older adults and its pathway mechanisms and to provide a theoretical basis and practical guidance for improving the mental health of older adults and better realizing active aging. Using cross-sectional data from the 2020 China Health and Retirement Longitudinal Survey, 6722 older adults over 60 were finally included. We conducted descriptive and correlation analyses of the data; we analyzed the correlation of Internet use on the depression level and cognitive ability of older adults using seemingly unrelated regression; we further explored the mediating role of socialization frequency in the relationship between Internet use and the depression level and cognitive ability of older adults and its differences through mediation analysis. The results showed that the mean age of older adults in this study was (68.52 ± 5.97), the mean Internet use score was (1.12 ± 1.63), the mean depression score was (8.44 ± 6.31), and the mean cognitive score was (12.17 ± 3.27). Internet use had a positive impact on the mental health of older adults, including lowering depression (β = -0.275, P < 0.05) and improving cognition (β = 0.300, P < 0.05). Socialization frequency mediated the relationship between Internet use and depression/cognitive ability (95 % CI = -0.034 to -0.008, 95 % CI = 0.007-0.022). Therefore, it is essential to encourage older adults to use the Internet, actively integrate into the digital society, promote wise aging, share the fruits of technological development, and utilize the Internet to maintain the mental health of older adults.

Social participation classification and activities in association with health outcomes among older adults: Results from a scoping review

AIMS

The aim of this study is to summarize the characteristics of social participation classification and examine the association between activities and health outcomes among older adults.

DESIGN

Scoping review.

DATA SOURCES

Eight databases (Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Embase, ProQuest, Psychological Information Database, PubMed, Scopus and Web of Science) were searched. Reference lists of relevant social participation reviews were also considered.

METHODS

This study applied a five-stage methodological framework. A narrative synthesis summarized social participation classification and activities and their associations with health outcomes among older adults (≥65 years) living at home, in the community or in nursing residences.

RESULTS

Forty-two articles published between 1975 and 2022 were selected. Four classification criteria of social participation were extracted and summarized from these studies. Based on the depth and breadth of social interactions, this review proposed a four-level classification schema. A lower risk of mortality and less visual impairment were associated with participation in level-one, level-three or level-four activities, whereas less depression, less pain and better cognitive function were linked to participation in level-three or level-four activities.

CONCLUSION

Future studies should provide a clear definition, establish classification criteria for participation and properly select activity forms while considering both subjective and objective dimensions.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

The results could provide data for designing targeted social participation interventions to improve specific health outcomes among older adults.

IMPACT

This review could help researchers examine the role of social participation activities in specific health outcomes. Moreover, a proposed classification of social participation activities would benefit researchers and community nurses in discerning the similarities and differences among activities.

REPORTING METHOD

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews guideline.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Eight-year trajectories and predictors of cognitive function in community-dwelling Korean older adults with cardiovascular diseases

PURPOSE

This study aims to identify longitudinal patterns and predictors of cognitive function trajectories among Korean older adults with cardiovascular diseases.

DESIGN

This study is a longitudinal panel analysis based on secondary data. Data from the the Korean Longitudinal Study of Ageing (KLoSA) were used for analysis.

METHODS

The KLoSA is a representative panel survey of older Koreans. We analyzed responses from 301 participants aged ≥65 years who completed the same survey more than three times out of five waves between 2012 and 2020.

FINDINGS

Latent class growth modeling identified two trajectories of cognitive function in older people with cardiovascular diseases: "low and declining" (n = 81, 26.9%) and "high and declining" (n = 220, 73.1%). Participants in "the low and declining trajectory group" were more likely to have a low educational level, weak handgrip strength, depression, and low social participation at baseline than those in "the high and declining trajectory group."

CONCLUSIONS

Our results indicate a need to develop community-based tailored interventions for improving handgrip strength, mental health, and social participation in delaying cognitive decline in older people with cardiovascular diseases considering their educational level.

CLINICAL RELEVANCE

Healthcare providers should be more concerned about older people with a weaker handgrip, depression, and low social activities as a high-risk group for cognitive decline over time in cardiovascular care. Therefore, it is necessary to evaluate them early with standardized tools and make subsequent strategies for the older population with cardiovascular diseases.

The role of social and intellectual activity participation in older adults' cognitive function

THEORETICAL BACKGROUND

A challenge of the ageing of the population is cognitive performance, given its association to optimal ageing. Documented predictors of cognition have included socio-demographics, education or physical factors. However, the association of social and intellectual activity participation to cognition has been less studied.

AIM

This study presents a predictive model of cognitive functioning including these alternative factors as well as more seminal ones to explain cognition in old age.

MATERIALS AND METHODS

The sample was composed by 45475 older adult participants in the 8th Wave of the Survey of Health, Aging and Retirement in Europe, that took place between 2019 and 2020. A correlational design was specified to test the effects of age, gender, years of education, physical inactivity, number of chronic diseases, social activity participation and intellectual activity participation on temporal orientation, numeracy, verbal fluency and memory. A completely a priori Structural Equation Model with latent variables was tested.

RESULTS

The sample had an average of 70 years of age, was well-educated and physically active and engaged in reading. There was a higher proportion of females. The model showed an optimal fit to the data, explaining 8.7%-36.0% of the different cognitive components' variance. Age, years of education and intellectual activity displayed the largest effects across the cognitive domains.

CONCLUSIONS

Findings suggest that social and intellectual activity participation are of relative importance to predict cognition in old age, even when considering other well-documented factors affecting older adults' cognitive functioning.

'I eat to not die': Diet and exercise experiences of older adults living alone

INTRODUCTION

Living alone is a critical health risk factor among older adults. Regular exercise and a balanced diet are important for maintaining an independent and healthy life. However, it can be more difficult for older adults living alone to maintain healthy exercise and dietary habits due to their lack of social support. This study aimed to explore the life changes that accompany living alone and their needs, focussing on exercise and diet.

METHODS

This was a qualitative descriptive study. Purposeful sampling was conducted to recruit community-dwelling older adults living alone. Thematic analyses were applied to analyse the qualitative data collected from semistructured interviews.

RESULTS

Fifteen subjects, including 5 men and 10 women, participated in the interviews. The median age was 77 years, ranging from 66 to 88, and the median duration of living alone was 16 years, ranging from 3 to 35. Six main themes were developed, namely unavoidable difficulties of living alone: lack of someone to depend on and loneliness, just eating 'to not die', exercise that is good for health but hard to do consistently, conflict between maintaining independence and dependence on others, coping with available resources, and resources needed for regular exercise and a balanced diet.

CONCLUSION

Living alone leads to poor dietary habits, such as skipping meals or insufficient food intake. Food security should be ensured through the reinforcement of social support, financial assistance and the operation of public cafeterias. In addition, an individually tailored group exercise programme that can meet the need for social interaction and improve self-efficacy would help older adults living alone maintain regular exercise habits.

The impact of home and community care services pilot program on healthy aging: A difference-in-difference with propensity score matching analysis from China

BACKGROUND

Home and community care service (HACCS) is an important policy response worldwide to the growing and unmet care needs of the aging population. In China, the government also started to implement a HACCS pilot program in 2016. This study aims to evaluate the association of HACCS utilization with healthy aging in Chinese older adults.

METHODS

This study followed a quasi-experimental design and derived data from the nationwide China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018. We employed the propensity score matching with difference-in-difference approach (PSM-DID) to examine the association between HACCS and healthy aging indicators.

RESULTS

A total of 8345 older adults were incorporated for a final sample. The results indicated that HACCS utilization was associated with significantly reduced functional limitations (β for BADL=-0.124, β for IADL=-0.210; P<0.01) and depression (β=-0.386, P<0.05) as well as improved cognitive function (β=0.609, P<0.001), life satisfaction (β=0.083, P<0.01) and social participation (β=0.105, P<0.01) in older people, although its association with reduced disability was non-significant (β=-0.005, P = 0.676). The heterogeneous tests further found that rural older adults and older adults aged<80 were more likely than their counterparts to benefit from the HACCS utilization in specific healthy aging indicators such as cognitive function.

CONCLUSIONS

The implementation of the HACCS program benefited a range of healthy aging domains among older adults in China. Policymakers are encouraged to further expand the program implementation and also continue to improve the services list and care quality of HACCS.

The Role of Social Engagement in Older Adults' Health

The purpose of the current study was to explore the association between social engagement and the health status, cognition, and perceived well-being of older adults using data from the National Health and Aging Trends Study. Descriptive statistics, clustering, and regression modeling were performed to analyze the data. We used the regression model to identify statistically significant relationships between the representative variables and the extent to which participants participated in social activities. The most representative variable for each of the three clusters was selected and fitted to the regression model, which consists of (1) acute health problems and events, (2) cognitive and communication barriers, and (3) chronic conditions contributing to long-term health status. A regression model found that two factors-cognitive and communication barriers and chronic conditions contributing to long-term health status-were statistically significant in determining social engagement in older adults. Health care providers should consider various factors in planning and implementing social programs that can positively engage older adults. [Research in Gerontological Nursing, xx(x), xx-xx.].

Relationship between frailty and cognitive decline in Chinese older patients with Alzheimer's disease: The mediating role of social contact

This study aimed to evaluate the effects of frailty and social contact on cognitive decline among Chinese older patients with Alzheimer's disease (AD), and examine the mediating role of social contact between frailty and cognitive decline. A total of 205 eligible participants were recruited from a tertiary A hospital in Anhui province, China. A structural equation modeling was conducted to test the hypothetical mediating model. Frailty and cognitive decline were significantly and negatively correlated with social contact. Meanwhile, frailty exerted a significant positive effect on cognitive decline. The indirect effect of frailty on the cognitive decline through social contact was 0.401. Social contact could exert a partial mediating effect on the relationship between frailty and cognitive decline in this population. These findings could help guide effective interventions to improve the cognitive abilities of AD patients, thereby reducing the burden of this population on their caregivers.

The evolution trend of availability of China's community-based care services and its impact on the cognitive function of elderly people: 2008-2018

Background

To address the challenge of the aging population, community-based care services (CBCS) have been developed rapidly in China as a new way of satisfying the needs of elderly people. Few studies have described the evolution trend of availability of CBCS in rural and urban areas and evaluated their effectiveness. This study aims to show the availability of China’s CBCS and further analyze the effect of the CBCS on the cognitive function of elderly people.

Methods

Longitudinal analysis was performed using data from the 2008 to 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 23937 observations from 8421 elderly people were included in the study. The Chinese version of the Mini-Mental State Examination (MMSE) was used to assess cognitive function. We aggregated similar CBCS to generate three binary variable categories (daily life support, emotional comfort and entertainment services, medical support and health services) indicating the availability of CBCS (1 = yes, 0 = no). Multilevel growth models were employed to estimate the association between CBCS and cognitive function while adjusting for many demographic and socioeconomic characteristics.

Results

The availability of CBCS increased a lot from 2008 to 2018 in China. Although the availability of CBCS in urban areas was higher than that in rural areas in 2008, by 2018 the gap narrowed significantly. Emotional comfort and entertainment services (B = 0.331, 95% CI = 0.090 to 0.572) and medical support and health services (B = 1.041, 95% CI = 0.854 to 1.228) were significantly and positively associated with cognitive function after adjusting for the covariates.

Conclusion

There was a significant increase in the availability of CBCS from 2008 to 2018 in China. This study sheds light on the positive correlation between CBCS and cognitive function among Chinese elderly individuals. The results suggest that policymakers should pay more attention to the development of CBCS and the equity of the supply of CBCS in urban and rural areas.