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Tan XR, Wilson IM, Tay PKC, Win PPS, Song CF, Wee SL. Mapping of technological strategies for reducing social isolation in homebound older adults: A scoping review. Arch Gerontol Geriatr 2024; 125:105478. [PMID: 38776697 DOI: 10.1016/j.archger.2024.105478] [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: 11/23/2023] [Revised: 04/18/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Homebound older adults (HOAs) are particularly vulnerable to social isolation and loneliness, which engender a poorer physical and mental health, and greater cognitive decline. The purpose of this review is to map the literature to identify potential technological strategies that reduce social isolation in HOAs, and to understand facilitators and barriers for adoption and implementation. METHODS Six databases including PubMed (MEDLINE), Google Scholar, Cochrane Database, EBSCOHost, National Library ProQuest, Web of Science, and the Journal of Medical Internet Research were searched for relevant articles. Peer-reviewed literature published in English from Jan 2014 to Feb 2024 that employed technological strategies applicable to HOAs and assessed social isolation or connectedness as an outcome measure were included. RESULTS 107 studies were reviewed and classified into different technological categories based on their functions and features. A social technology framework encompassing delivery, hardware, software, content, training, and support was conceptualized with core characteristics identified from the reviewed technological strategies. Cost and complexity of technology, and resource commitment were identified as barriers while user-friendliness, content curation and a supportive ecosystem may facilitate the adoption of a technological strategy to address social isolation in HOAs. CONCLUSION There is a need for early and concerted effort to identify HOAs, provide technology training, and empower them to tap on the digital world to complement and/or supplement social interactions. Development of cost-effective and rapid-to-implement technology is vital for HOAs who are at highest risk to social isolation.
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Affiliation(s)
- Xiang Ren Tan
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ingrid M Wilson
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Latrobe University, Melbourne, Australia
| | - Peter Kay Chai Tay
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Phoo Pyae Sone Win
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Cai Feng Song
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Shiou-Liang Wee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Geriatric Education and Research Institute, Singapore
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Fettes L, Bayly J, Chukwusa E, Ashford S, Higginson I, Maddocks M. Predictors of increasing disability in activities of daily living among people with advanced respiratory disease: a multi-site prospective cohort study, England UK. Disabil Rehabil 2024; 46:4735-4744. [PMID: 38073190 DOI: 10.1080/09638288.2023.2288673] [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: 03/31/2023] [Revised: 11/12/2023] [Accepted: 11/23/2023] [Indexed: 01/14/2024]
Abstract
PURPOSE Disability in activities of daily living (ADL) is a common unmet need among people with advanced respiratory disease. Rehabilitation could help prolong independence, but indicators for timely intervention in this population are lacking. This study aimed to identify trajectories of disability in ADLs over time, and predicting factors, in advanced respiratory disease. METHOD Multi-site prospective cohort study in people with advanced non-small cell lung cancer (NSCLC), chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD), recruited from hospital or community services, throughout England. Disability in basic (Barthel Index) and instrumental (Lawton-Brody IADL Scale) ADLs were assessed monthly over six months. Visual graphical analysis determined individual trajectories. Multivariate logistic regression examined predictors of increasing disability in basic and instrumental ADLs. FINDINGS Between March 2020 and January 2021, we recruited participants with a diagnosis of NSCLC (n = 110), COPD (n = 72), and ILD (n = 19). 151 participants completed ≥3 timepoints and were included in the longitudinal analysis. Mobility limitation was an independent predictor of increasing disability in instrumental ADLs (odds ratio, 1⋅41 [CI: 1⋅14-1⋅74], p = 0⋅002). CONCLUSION Mobility limitation could be used as a simple referral criterion across people with advanced respiratory disease to ensure timely rehabilitation that targets independence in ADLs.
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Affiliation(s)
- Lucy Fettes
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Joanne Bayly
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Emeka Chukwusa
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Stephen Ashford
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Irene Higginson
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
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Hough KA, Tha SH, Perissinotto CM, Burnes P, Kotwal AA. A proactive phone intervention for older adults to address loneliness identified by a health plan. Ann N Y Acad Sci 2024. [PMID: 39315941 DOI: 10.1111/nyas.15223] [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] [Indexed: 09/25/2024]
Abstract
Social isolation and loneliness are associated with poor health and higher health care costs among older adults. Our objective was to determine if older adults identified as at risk for loneliness by a Medicare Advantage health plan could benefit from a proactive telephone support program. We conducted a mixed-methods pilot efficacy study of outbound calls from an established community-based telephone program to support older adults identified as at risk for loneliness. One hundred and twenty-one older adults were enrolled and completed surveys at baseline, 3 months, and 6 months. Outcomes included loneliness (3-item UCLA loneliness scale), depression (PHQ-2 screen), anxiety (GAD-2 screen), and unhealthy physical and mental health days (CDC Healthy Days Measure). Quantitative data were analyzed using multivariable mixed-effects logistic regression, and open-ended responses were analyzed thematically. Over 6 months, participants had reductions in loneliness (46% to 28%, p<0.001), depression (36% to 25%, p = 0.07), anxiety (63% to 43%, p = 0.004), unhealthy mental days (14 to 8, p<0.001), and unhealthy physical days (15 to 11, p<0.001). Participants reported high satisfaction with calls, and many felt the calls improved overall mood or health. Findings can inform trials to address loneliness through telephone support and partnerships between community-based organizations and payors.
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Affiliation(s)
- Katrina A Hough
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | - Soe Han Tha
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | - Carla M Perissinotto
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | | | - Ashwin A Kotwal
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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Nguyen AL, Polonijo AN, Galea JT, Yoo-Jeong M, Taylor J, Ruiz EL, Greene K, Lopez JL, Christenson C, Brown B. A community-academic partnered approach to designing a Virtual Village to address the needs of older adults living with HIV. AIDS Care 2024:1-9. [PMID: 39088383 DOI: 10.1080/09540121.2024.2383869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 07/18/2024] [Indexed: 08/03/2024]
Abstract
ABSTRACTMany older adults living with HIV face unique challenges, including comorbidities, loneliness, and isolation. This community-academic partnered study elicited viewpoints from older adults living with HIV about the characteristics of a digital environment ("Virtual Village") to combat against loneliness and isolation. We utilized Choice-Based Conjoint Analyses to determine preferred attributes of a Virtual Village. We also conducted focus groups and interviews with older adults living with HIV and used an iterative, data-driven approach to systematically identify emergent themes. Participants (N = 82) were aged 50-82 years and racially/ethnically diverse. The majority were men (78%), gay (66%), and lived with HIV for ≥15 years (83%). Cost was the factor that most drove participants' preference for joining a Virtual Village. Thematic concerns included lack of technological confidence, internet access, potential for harassment in digital environments, privacy, and preference for in-person interactions. Praises centered on convenience and making connections across geographic distances. Participants emphasized the need for purposive strategies to form a cohesive and supportive community for older adults living with HIV. A moderated environment was recommneded to create a safe, structured, and comfortable digital environment for older adults living with HIV. A Virtual Village should be viewed as a bridge to in-person interactions.
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Affiliation(s)
- Annie L Nguyen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA, United States
| | - Andrea N Polonijo
- Department of Sociology and the Health Sciences Research Institute, University of California, Merced, CA, United States
| | - Jerome T Galea
- College of Behavioral and Community Sciences, School of Social Work, University of South Florida, Tampa, FL, United States
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
| | - Moka Yoo-Jeong
- School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Jeff Taylor
- HIV+Aging Research Project-Palm Springs, Palm Springs, CA, United States
| | - Erik L Ruiz
- College of Public Health, University of South Florida, Tampa, FL, United States
| | - Karah Greene
- College of Behavioral and Community Sciences, School of Social Work, University of South Florida, Tampa, FL, United States
| | - Jasmine L Lopez
- Department of Psychology, University of California, Riverside, CA, United States
| | | | - Brandon Brown
- Riverside School of Medicine, Department of Social Medicine, Population and Public Health, University of California, San Diego, CA, United States
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Robertson MA, Petersen EE, Ross-White A, Camargo-Plazas P, Andrew M, Egan R. Residents' and spouses' experiences of loneliness and depression after separation due to long-term care placement: a qualitative systematic review. JBI Evid Synth 2024; 22:1536-1581. [PMID: 38632969 DOI: 10.11124/jbies-23-00334] [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: 04/19/2024]
Abstract
OBJECTIVE The objective of this review was to describe the experiences of loneliness and/or depression for residents and their spouses who have been separated by long-term care placement. INTRODUCTION Loneliness and depression have a pernicious influence on the overall health and well-being of older adults. Older adults' mental health is significantly affected by social relationships, including those between spouses. However, there is limited research pertaining to long-term care residents' and community-dwelling spouses' experiences of loneliness and/or depression after separation due to long-term care placement. INCLUSION CRITERIA This systematic review included studies that recruited community-dwelling spouses and long-term care residents over 50 years of age with living spouses from whom they are separated due to long-term care placement. Studies on the experiences of loneliness and/or depression due to spousal separation with one or both spouses living in long-term care were included in this review. METHODS Ovid MEDLINE(R) was used for the initial search. A full search strategy was developed for Ovid MEDLINE(R), CINAHL (EBSCOhost), Embase (Ovid), and PsycINFO (Ovid). The review was conducted using the JBI methodology for reviews of qualitative research, with 2 independent reviewers performing study selection, critical appraisal, data extraction, data synthesis, and assessment of confidence in the findings. RESULTS Eleven papers were included in this systematic review. Four synthesized findings were extracted from 10 categories and 42 findings: i) Loneliness and depression result from a lack of physical and social connection for separated long-term care residents and community-dwelling spouses; ii) Community-dwelling spouses feel unprepared and upset with spousal separation due to a lack of psychological support; iii) Behavioral strategies can prevent community-dwelling spouses and long-term care residents from developing loneliness and/or depression; and iv) Community-dwelling spouses have differing abilities to adapt and cope with feelings of loneliness and/or depression. CONCLUSION This review provides a comprehensive synthesis of the feelings of loneliness and/or depression in spouses who are separated due to long-term care placement. This review has demonstrated that there is a lack of literature inclusive of the voices and perspectives of all spouses affected by spousal separation in long-term care. The limitations of this review include the small number of included studies and the range of quality in included studies. Recommendations include additional research on the lived experience of spousal separation from the perspectives of long-term care residents and their community-dwelling spouses. Further, additional psychological support is needed for separated spouses, guided by the suggestions and experiences of long-term care residents and their community-dwelling spouses. REVIEW REGISTRATION PROSPERO CRD42022333014.
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Affiliation(s)
| | - Erika E Petersen
- Health Quality Programs, Queen's University, Kingston, ON, Canada
| | - Amanda Ross-White
- Queen's Collaboration for Healthcare Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
- Bracken Health Science Library, Queen's University, Kingston, ON, Canada
| | - Pilar Camargo-Plazas
- Queen's Collaboration for Healthcare Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
- School of Nursing, Queen's University, Kingston, ON, Canada
| | - Melissa Andrew
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Rylan Egan
- Health Quality Programs, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Healthcare Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
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Kaneko M, Shinoda S, Nakayama I, Xu J, Yagome S, Goto A. Usual source and better quality of primary care are associated with lower loneliness scores: a cross-sectional study. Fam Pract 2024; 41:312-320. [PMID: 37116200 PMCID: PMC11167986 DOI: 10.1093/fampra/cmad049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Loneliness is a global issue, and primary care physicians play an important role in assessing and intervening with loneliness. This study aimed to examine the association between having a usual source of care (USC) or a good quality of primary care, and loneliness. METHODS This cross-sectional study was conducted in Japan in 2022. A total of 6,000 residents were randomly sampled from the general population, aged 20-74 years. The outcome was the total score of the University of California, Los Angeles (UCLA) 3-item loneliness scale. The exposure included USC and the Person-Centered Primary Care Measure (PCPCM), which assesses the quality of primary care. We conducted a linear regression analysis to adjust for age, sex, educational status, annual household income, self-rated health, living status (whether alone or not), and the existence of physical health problems. RESULTS Of the 6,000 residents, 1,277 responded to the survey. The median score of the UCLA 3-item loneliness scale was 6.0 and the mean total score of the PCPCM was 2.62. Of the 1,277 individuals, 713 (55.8%) had USC. Having USC was significantly associated with lower scores on the UCLA 3-item loneliness scale; the coefficient was -0.34 (95% confidence interval (CI): -0.57 to -0.12). Also, the total PCPCM score was significantly associated with lower loneliness scores; the coefficient was -0.56 (P < 0.001, 95% CI: -0.78 to -0.35). CONCLUSIONS Having USC and a better quality primary care were associated with a lower loneliness score. The quality of primary care could be a factor to mitigate patient loneliness.
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Affiliation(s)
- Makoto Kaneko
- Department of Health Data Science, Yokohama City University, Yokohama, Japan
| | - Satoru Shinoda
- Department of Biostatistics, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Izumi Nakayama
- Unit of Public Health and Preventive Medicine, School of Medicine, Yokohama, Japan
| | - Juan Xu
- Department of Endocrinology and Metabolism, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | | | - Atsushi Goto
- Department of Health Data Science, Yokohama City University, Yokohama, Japan
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Hong JH, Nakamura JS, Sahakari SS, Chopik WJ, Shiba K, VanderWeele TJ, Kim ES. The silent epidemic of loneliness: identifying the antecedents of loneliness using a lagged exposure-wide approach. Psychol Med 2024; 54:1519-1532. [PMID: 38497115 DOI: 10.1017/s0033291723002581] [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] [Indexed: 03/19/2024]
Abstract
BACKGROUND A large and accumulating body of evidence shows that loneliness is detrimental for various health and well-being outcomes. However, less is known about potentially modifiable factors that lead to decreased loneliness. METHODS We used data from the Health and Retirement Study to prospectively evaluate a wide array of candidate predictors of subsequent loneliness. Importantly, we examined if changes in 69 physical-, behavioral-, and psychosocial-health factors (from t0;2006/2008 to t1;2010/2012) were associated with subsequent loneliness 4 years later (t2;2014/2016). RESULTS Adjusting for a large range of covariates, changes in certain health behaviors (e.g. increased physical activity), physical health factors (e.g. fewer functioning limitations), psychological factors (e.g. increased purpose in life, decreased depression), and social factors (e.g. greater number of close friends) were associated with less subsequent loneliness. CONCLUSIONS Our findings suggest that subjective ratings of physical and psychological health and perceived social environment (e.g. chronic pain, self-rated health, purpose in life, anxiety, neighborhood cohesion) are more strongly associated with subsequent loneliness. Yet, objective ratings (e.g. specific chronic health conditions, living status) show less evidence of associations with subsequent loneliness. The current study identified potentially modifiable predictors of subsequent loneliness that may be important targets for interventions aimed at reducing loneliness.
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Affiliation(s)
- Joanna H Hong
- Department of Psychology, University of British Columbia, Vancouver, Canada
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | - Julia S Nakamura
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Sakshi S Sahakari
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - William J Chopik
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Koichiro Shiba
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tyler J VanderWeele
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric S Kim
- Department of Psychology, University of British Columbia, Vancouver, Canada
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Horgan S, Prorok J, Conn D, Checkland C, Saunders J, Watson-Borg B, Tinley L. Can 'What Is Known' about Social Isolation and Loneliness Interventions Sufficiently Inform the Clinical Practice of Health Care and Social Service Professionals Who Work with Older Adults? Exploring Knowledge-to-Practice Gaps. Healthcare (Basel) 2024; 12:1111. [PMID: 38891186 PMCID: PMC11171656 DOI: 10.3390/healthcare12111111] [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: 04/18/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Establishing intervention effectiveness is an important component of a broader knowledge translation (KT) process. However, mobilizing the implementation of these interventions into practice is perhaps the most important aspect of the KT cycle. The purpose of the current study was to conduct an umbrella review to (a) identify promising interventions for SI&L in older adults, (b) interpret (translate) the findings to inform clinical knowledge and practice interventions in different settings and contexts, and (c) highlight research gaps that may hinder the uptake of these interventions in practice. The broader purpose of this study was to inform evidence-based clinical practice guidelines on SI&L for HCSSPs. In line with other reviews, our study noted variations in methods and intervention designs that prohibit definitive statements about intervention effectiveness. Perhaps, the most significant contribution of the current review was in identifying knowledge-to-practice gaps that inhibit the implementation of interventions into practice-based realities.
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Affiliation(s)
- Salinda Horgan
- Department of Psychiatry, School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Jeanette Prorok
- Department of Psychiatry, School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - David Conn
- Department of Psychiatry, Baycrest Centre, Toronto, ON M6A 2E1, Canada;
| | - Claire Checkland
- Canadian Coalition of Seniors’ Mental Health, Markham, ON L3R 9X9, Canada; (C.C.); (J.S.); (B.W.-B.); (L.T.)
| | - John Saunders
- Canadian Coalition of Seniors’ Mental Health, Markham, ON L3R 9X9, Canada; (C.C.); (J.S.); (B.W.-B.); (L.T.)
| | - Bette Watson-Borg
- Canadian Coalition of Seniors’ Mental Health, Markham, ON L3R 9X9, Canada; (C.C.); (J.S.); (B.W.-B.); (L.T.)
| | - Lisa Tinley
- Canadian Coalition of Seniors’ Mental Health, Markham, ON L3R 9X9, Canada; (C.C.); (J.S.); (B.W.-B.); (L.T.)
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Devita M, Marescalco E, Bordignon A, Trevisan C, Sergi G, Coin A. Social interaction level modulates the impact of frailty on cognitive decline: a longitudinal study. Aging Ment Health 2024; 28:652-657. [PMID: 37602456 DOI: 10.1080/13607863.2023.2247349] [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: 02/12/2023] [Accepted: 08/08/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVES This study evaluates whether social interaction level modifies the association between frailty and cognitive decline in older adults. METHODS A total of 2701 adults aged ≥65 years enrolled in the Progetto Veneto Anziani (Pro.V.A.), participated in the study. At baseline, participants were classified as having low, moderate, or high social interactions based on: cohabiting status, frequency of contacts with relatives/friends or involvement in childcare activities, and frequency of participation in social or community activities. Baseline frailty was defined as the presence of ≥3 criteria among: weight loss, weakness, slowness, low physical activity, and exhaustion. Cognitive function was assessed through the Mini-Mental State Examination (MMSE) at baseline and after 4.4 and 7 years. The association between frailty and MMSE changes over time was evaluated through linear mixed models. Interaction and subgroup analyses explored the modifying effect of social interaction level on the above association. RESULTS The mean age of participants was 76.1 years, and 59.1% were women. Frail individuals had a steeper annual MMSE decline than their non-frail counterparts (ß=-0.40, 95%CI: -0.59, -0.20). When stratifying participants by social interaction level, we found that the association between frailty and MMSE changes over time was stronger in those with low social interactions (ß=-0.74, 95%CI: -1.33, -0.15) while attenuated in those with moderate (ß=-0.42, 95%CI: -0.74, -0.11) or high social interaction level (ß=-0.29, 95%CI: -0.58, 0.01). CONCLUSION Maintaining frequent social interactions might mitigate the negative impact of frailty on older people's cognitive functions.
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Affiliation(s)
- Maria Devita
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, Padua, Italy
- Department of General Psychology (DPG), University of Padua, Padua, Italy
| | - Eleonora Marescalco
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Alessandra Bordignon
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Trevisan
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, Padua, Italy
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giuseppe Sergi
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Alessandra Coin
- Geriatrics Division, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Gunnes M, Løe IC, Kalseth J. Exploring the impact of information and communication technologies on loneliness and social isolation in community-dwelling older adults: a scoping review of reviews. BMC Geriatr 2024; 24:215. [PMID: 38431561 PMCID: PMC10908002 DOI: 10.1186/s12877-024-04837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Recognizing the escalating public health concerns of loneliness and social isolation in aging populations, this study seeks to comprehensively explore the potential of information and communication technology (ICT)-based interventions to address these issues among older adults. This scoping review of reviews aims to map and synthesize existing evidence on the effectiveness and scope of ICT interventions targeting loneliness and social isolation in community-dwelling older adults, elucidating types of technology, impacts, facilitators, barriers, and research gaps. METHODS Following the Joanna Briggs Institute framework, we systematically searched eight diverse databases identifying relevant published reviews. We included English-written, peer-reviewed reviews of all types, with no limits regarding time of publication about ICTs targeting loneliness and/or social isolation for community-dwelling older adults. Eligible reviews were analysed and summarized, offering a holistic narrative of the reported types of ICTs and their impact, the identified facilitators and barriers influencing the implementation and adoption of ICT interventions, and the research gaps identified in the literature. RESULTS The review included 39 publications published between 2012 and 2024, spanning systematic, scoping, and reviews of reviews. Various ICTs were reported, primarily social media virtual communities, followed by video-mediated friendly visits, conversational agents, social robots, exergames and online gameplay. Predominantly positive impacts on mitigating social isolation and loneliness were evident for these ICTs, although methodological diversity and contradictory findings complicated definite conclusions. Facilitators and barriers encompassed individual competencies, access and usage, and intervention design and implementation. Research gaps involved targeting specific subgroups, exploring innovative technologies, incorporating diverse study designs, improving research methodologies, and addressing usability and accessibility. Future research should focus on identifying elderly individuals who can benefit the most from ICT use, exploring novel technologies, using a wider range of study designs, and enhancing usability and accessibility considerations. CONCLUSIONS This review sheds light on the diverse range of ICTs, their impact, and the facilitators and barriers associated with their use. Future investigations should prioritize refining outcome measures, addressing gender differences, and enhancing the usability and accessibility of interventions. The involvement of older adults in the design process and the exploration of technological training interventions hold promise in overcoming barriers.
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Affiliation(s)
- Mari Gunnes
- Department of Health Research, SINTEF Digital, Trondheim, Norway.
| | - Ida-Camilla Løe
- Department of Technology Management, SINTEF Digital, Steinkjer, Norway
| | - Jorid Kalseth
- Department of Health Research, SINTEF Digital, Trondheim, Norway
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Jabbari J, Roll S, McQueen A, Ridenour N. Increased experiences of loneliness during the COVID-19 pandemic, emotional distress and changes in perceived physical and mental health: A structural equation model. Nurs Open 2024; 11:e2125. [PMID: 38429914 PMCID: PMC10907826 DOI: 10.1002/nop2.2125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/30/2023] [Accepted: 02/07/2024] [Indexed: 03/03/2024] Open
Abstract
AIM To explore how experiences of increased loneliness during the COVID-19 pandemic affected emotional distress and changes in perceptions of physical and mental health. DESIGN Cross-sectional study. METHODS Data from the Socio-Economic Impacts of Covid-19 Survey, a national survey administered to 5033 adults in August and September 2020 in the United States, was utilized in this study. Structural equation modelling was used to analyse the associations between increased experiences of loneliness during the pandemic, emotional distress and changes in perceptions of physical and mental health. RESULTS Among the 47% of participants who reported increased experiences of loneliness during the pandemic, 31% reported a poorer perceived change in mental health and 12% reported a poorer perceived change in physical health. Increased experiences of loneliness during the pandemic were significantly associated with emotional distress and poorer perceived mental and physical health changes. Emotional distress significantly mediated the effect between increased experiences of loneliness during the pandemic and poorer perceived mental and physical health changes. These findings highlight the importance of producing preventative actions to combat increased loneliness and emotional distress during and after future pandemics in order to improve health perceptions, which can result in negative health outcomes over time.
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Affiliation(s)
- JoAnn Jabbari
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
- Goldfarb School of Nursing, Barnes‐Jewish CollegeSt. LouisMissouriUSA
| | - Stephen Roll
- George Warren Brown School of Social WorkWashington University in St. LouisSt. LouisMissouriUSA
| | - Amy McQueen
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | - Nancy Ridenour
- Goldfarb School of Nursing, Barnes‐Jewish CollegeSt. LouisMissouriUSA
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12
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Zhang Y, Liu M, Zhou C, Ye Z, Zhang Y, Yang S, He P, Gan X, Qin X. Social isolation, loneliness, and the risk of incident type 2 diabetes mellitus by glycemic status. DIABETES & METABOLISM 2024; 50:101517. [PMID: 38253174 DOI: 10.1016/j.diabet.2024.101517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/26/2023] [Accepted: 01/07/2024] [Indexed: 01/24/2024]
Abstract
AIM The modifying effect of prediabetic status on the association of social isolation and loneliness with the risk of type 2 diabetes mellitus (T2DM) remains uncertain. We aimed to explore whether prediabetic status modifies the association of social isolation and loneliness with incident T2DM. METHODS 358,951 participants with random blood glucose < 11.1 mmol/l, hemoglobin A1c < 6.5 % and without diagnosis of diabetes from the UK Biobank were included. Prediabetes was defined by hemoglobin A1c level at 5.7-6.4 %. Social isolation and loneliness were assessed using self-reported questionnaires. The study outcome was incident T2DM. RESULTS During a median follow-up of 12.5 years, 13,213 (3.7 %) incident T2DM cases were documented. Social isolation and loneliness in subjects with normoglycemia (adjusted HR [95 %CI]: social isolation: 1.14 [1.07;1.23]; loneliness: 1.33 [1.20;1.47]) were more strongly associated with increased risk of T2DM than in those with prediabetes (adjusted HR [95 %CI]: social isolation: 0.97 [0.91;1.03]; loneliness: 1.04 [0.95;1.13]) (Both P for interaction < 0.001). Among individuals with prediabetes, alcoholic consumption (30.9 %), household income (23.3 %), healthy sleep (17.1 %), loneliness (14.9 %), and physical activity (12.6 %) mediated most of the variance in the association between social isolation and incident T2DM, while body mass index (17.9 %) and healthy sleep (17.6 %) mediated most of the variance in the association between loneliness and incident T2DM. CONCLUSION Social isolation and loneliness were independently associated with a higher risk of T2DM among individuals without prediabetes. Among those with prediabetes, the association of social isolation and loneliness with incident T2DM were mainly mediated by some socioeconomic and lifestyle factors.
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Affiliation(s)
- Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, China; National Clinical Research Center for Kidney Disease, China; State Key Laboratory of Organ Failure Research, China; Guangdong Provincial Institute of Nephrology, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, China; National Clinical Research Center for Kidney Disease, China; State Key Laboratory of Organ Failure Research, China; Guangdong Provincial Institute of Nephrology, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, China; National Clinical Research Center for Kidney Disease, China; State Key Laboratory of Organ Failure Research, China; Guangdong Provincial Institute of Nephrology, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, China; National Clinical Research Center for Kidney Disease, China; State Key Laboratory of Organ Failure Research, China; Guangdong Provincial Institute of Nephrology, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, China; National Clinical Research Center for Kidney Disease, China; State Key Laboratory of Organ Failure Research, China; Guangdong Provincial Institute of Nephrology, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, China; National Clinical Research Center for Kidney Disease, China; State Key Laboratory of Organ Failure Research, China; Guangdong Provincial Institute of Nephrology, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, China; National Clinical Research Center for Kidney Disease, China; State Key Laboratory of Organ Failure Research, China; Guangdong Provincial Institute of Nephrology, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Xiaoqin Gan
- Division of Nephrology, Nanfang Hospital, Southern Medical University, China; National Clinical Research Center for Kidney Disease, China; State Key Laboratory of Organ Failure Research, China; Guangdong Provincial Institute of Nephrology, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, China; National Clinical Research Center for Kidney Disease, China; State Key Laboratory of Organ Failure Research, China; Guangdong Provincial Institute of Nephrology, China; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.
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13
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Jones VK, Yan C, Shade MY, Boron JB, Yan Z, Heselton HJ, Johnson K, Dube V. Reducing Loneliness and Improving Social Support among Older Adults through Different Modalities of Personal Voice Assistants. Geriatrics (Basel) 2024; 9:22. [PMID: 38525739 PMCID: PMC10961806 DOI: 10.3390/geriatrics9020022] [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: 11/13/2023] [Revised: 01/16/2024] [Accepted: 02/05/2024] [Indexed: 03/26/2024] Open
Abstract
This study examines the potential of AI-powered personal voice assistants (PVAs) in reducing loneliness and increasing social support among older adults. With the aging population rapidly expanding, innovative solutions are essential. Prior research has indicated the effectiveness of various interactive communication technologies (ICTs) in mitigating loneliness, but studies focusing on PVAs, particularly considering their modality (audio vs. video), are limited. This research aims to fill this gap by evaluating how voice assistants, in both audio and video formats, influence perceived loneliness and social support. This study examined the impact of voice assistant technology (VAT) interventions, both audio-based (A-VAT) and video-based (V-VAT), on perceived loneliness and social support among 34 older adults living alone. Over three months, participants engaged with Amazon Alexa™ PVA through daily routines for at least 30 min. Using a hybrid natural language processing framework, interactions were analyzed. The results showed reductions in loneliness (Z = -2.99, p < 0.01; pre-study loneliness mean = 1.85, SD = 0.61; post-study loneliness mean = 1.65, SD = 0.57), increases in social support post intervention (Z = -2.23, p < 0.05; pre-study social support mean = 5.44, SD = 1.05; post-study loneliness mean = 5.65, SD = 1.20), and a correlation between increased social support and loneliness reduction when the two conditions are combined (ρ = -0.39, p < 0.05). In addition, V-VAT was more effective than A-VAT in reducing loneliness (U = 85.50, p < 0.05) and increasing social support (U = 95, p < 0.05). However, no significant correlation between changes in perceived social support and changes in perceived loneliness was observed in either intervention condition (V-VAT condition: ρ = -0.24, p = 0.37; A-VAT condition: ρ = -0.46, p = 0.06). This study's findings could significantly contribute to developing targeted interventions for improving the well-being of aging adults, addressing a critical global issue.
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Affiliation(s)
- Valerie K. Jones
- College of Journalism and Mass Communications, University of Nebraska-Lincoln, Lincoln, NE 68588, USA;
| | - Changmin Yan
- College of Journalism and Mass Communications, University of Nebraska-Lincoln, Lincoln, NE 68588, USA;
| | - Marcia Y. Shade
- College of Nursing, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Julie Blaskewicz Boron
- Department of Gerontology, University of Nebraska-Omaha, Omaha, NE 68182, USA; (J.B.B.); (H.J.H.); (V.D.)
| | - Zhengxu Yan
- College of Computing, Data Science, and Society, University of California-Berkeley, Berkeley, CA 94720, USA;
| | - Hyeon Jung Heselton
- Department of Gerontology, University of Nebraska-Omaha, Omaha, NE 68182, USA; (J.B.B.); (H.J.H.); (V.D.)
| | - Kate Johnson
- College of Law, University of Nebraska-Lincoln, Lincoln, NE 68588, USA;
| | - Victoria Dube
- Department of Gerontology, University of Nebraska-Omaha, Omaha, NE 68182, USA; (J.B.B.); (H.J.H.); (V.D.)
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Zhang Y, Liu M, Ye Z, Yang S, Zhou C, He P, Zhang Y, Gan X, Qin X. Social isolation, loneliness, and the risk of incident acute kidney injury in middle-aged and older adults: A prospective cohort study. J Psychosom Res 2024; 177:111587. [PMID: 38181549 DOI: 10.1016/j.jpsychores.2023.111587] [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: 10/08/2023] [Revised: 12/03/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024]
Abstract
OBJECTIVE The relationships of social isolation and loneliness with acute kidney injury (AKI) risk remained uncertain. We aimed to investigate the associations of social isolation and loneliness with incident AKI. METHODS 450,868 participants without prior AKI were included from the UK Biobank. The social isolation index was constructed based on living alone, social contact, and participation in social activities. Loneliness was assessed by asking about "Do you often feel lonely?". The study outcome was incident AKI. RESULTS During a median follow-up of 12.0 years, 18,679 (4.1%) participants developed AKI, including 18,428 participants ascertained by hospital admission records with a median duration of hospitalization of 3 (25th-75th, 1-8) days. The hazard ratio for incident AKI for social isolation compared with no social isolation was 1.50 (95% CI: 1.44-1.55) after adjusting for age and race (minimally adjusted), and was 1.10 (95% CI: 1.06-1.14) after further adjusting for socioeconomic factors, health behaviors, biological and health-related factors, psychologic factors, and loneliness (fully adjusted). The minimally adjusted and fully adjusted hazard ratios for incident AKI for loneliness compared with no loneliness was 1.57 (95% CI: 1.52-1.62), and 1.10 (95% CI: 1.06-1.15), respectively. In the fully adjusted models, the highest risk of AKI was found in those with both social isolation and loneliness. Living alone and less social contact, rather than less participation in social activities, were significantly associated with a higher risk of incident AKI. CONCLUSIONS Both social isolation and loneliness were independently and significantly associated with a higher risk of incident AKI.
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Affiliation(s)
- Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Xiaoqin Gan
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.
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15
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Stara V, Maranesi E, Möller J, Palmier C, Ogawa T, Browne R, Luc M, Wieching R, Boudy J, Bevilacqua R. Technology-Enabled Senior Living: A Preliminary Report on Stakeholder Perspectives. Healthcare (Basel) 2024; 12:381. [PMID: 38338266 PMCID: PMC10855261 DOI: 10.3390/healthcare12030381] [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: 12/04/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The integration of stakeholders is crucial in developing smart living technologies to support the autonomy of elderly populations. Despite the clear benefits of these technologies, there remains a significant gap in comprehensive research. METHODS This study presents the viewpoints of 19 stakeholders from Europe and Japan, focusing on the sustainability of smart living solutions for Active and Healthy Ageing (AHA). Data were gathered through qualitative semi-structured interviews and analysed using a Framework Analysis approach. RESULTS Analysis of the interviews revealed six key sustainability categories: addressing the unmet needs of older adults, functionalities of the smart living coach, integration within organizations, identified barriers, financial considerations, and the social role of the smart living coach. CONCLUSIONS This research underscores the importance of evaluating user needs through the involvement of various stakeholders, including the elderly, their caregivers, professionals, technicians, service providers, and government bodies. Collaborative efforts are essential to generate new evidence demonstrating the value of smart living solutions in facilitating Active and Healthy Ageing.
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Affiliation(s)
- Vera Stara
- Scientific Direction, IRCCS INRCA, 60124 Ancona, Italy; (V.S.); (R.B.)
| | - Elvira Maranesi
- Scientific Direction, IRCCS INRCA, 60124 Ancona, Italy; (V.S.); (R.B.)
| | - Johanna Möller
- Diocesan Caritas Association for the Archdiocese of Cologne, D-50668 Cologne, Germany;
| | - Cecilia Palmier
- Service de Gériatrie 1&2, AP-HP, Hôpital Broca, 75013 Paris, France;
| | - Toshimi Ogawa
- Smart-Aging Research Center, Tohoku University, Sendai 980-8575, Japan; (T.O.); (R.B.)
| | - Ryan Browne
- Smart-Aging Research Center, Tohoku University, Sendai 980-8575, Japan; (T.O.); (R.B.)
| | - Marine Luc
- AGE Platform Europe, 1150 Brussels, Belgium;
| | - Rainer Wieching
- Institute for New Media and Information Systems, University Siegen, D-57072 Siegen, Germany;
| | - Jerome Boudy
- Institut Mines-Telecom, Telecom SudParis, SAMOVAR IP Paris, 91011 Evry, France;
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16
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Thangavel G, Memedi M, Hedström K. Information and Communication Technology for Managing Social Isolation and Loneliness Among People Living With Parkinson Disease: Qualitative Study of Barriers and Facilitators. J Med Internet Res 2024; 26:e48175. [PMID: 38231548 PMCID: PMC10831595 DOI: 10.2196/48175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/17/2023] [Accepted: 11/20/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Parkinson disease (PD) is a complex, noncurable, and progressive neurological disease affecting different areas of the human nervous system. PD is associated with both motor and nonmotor symptoms, which negatively affect patients' quality of life and may cause changes in socialization such as intentional social withdrawal. This may further lead to social isolation and loneliness. The use of information and communication technology (ICT) plays an important role in managing social isolation and loneliness. Currently, there is a lack of research focusing on designing and developing ICT solutions that specifically address social isolation and loneliness among people living with PD. OBJECTIVE This study addresses this gap by investigating barriers and social needs in the context of social isolation, loneliness, and technology use among people living with PD. The insights gained can inform the development of effective ICT solutions, which can address social isolation and loneliness and improve the quality of life for people living with PD. METHODS A qualitative study with 2 phases of data collection were conducted. During the first phase, 9 health care professionals and 16 people living with PD were interviewed to understand how PD affects social life and technology use. During the second phase, 2 focus groups were conducted with 4 people living with PD in each group to gather insights into their needs and identify ways to manage social isolation and loneliness. Thematic analysis was used to analyze both data sets and identify key themes. RESULTS The results showed that the barriers experienced by people living with PD due to PD such as "fatigue," "psychological conditions," "social stigma," and "medication side effects" affect their social life. People living with PD also experience difficulties using a keyboard and mouse, remembering passwords, and navigating complex applications due to their PD-related physical and cognitive limitations. To manage their social isolation and loneliness, people living with PD suggested having a simple and easy-to-use solution, allowing them to participate in a digital community based on their interests, communicate with others, and receive recommendations for social events. CONCLUSIONS The new ICT solutions focusing on social isolation and loneliness among people living with PD should consider the barriers restricting user's social activities and technology use. Given the wide range of needs and barriers experienced by people living with PD, it is more suitable to adopt user-centered design approaches that emphasize the active participation of end users in the design process. Importantly, any ICT solution designed for people living with PD should not encourage internet addiction, which will further contribute to the person's withdrawal from society.
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Affiliation(s)
- Gomathi Thangavel
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
| | - Mevludin Memedi
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
- College of Business, Alfaisal University, Riyadh, Saudi Arabia
| | - Karin Hedström
- Centre for Empirical Research on Information Systems, Örebro University School of Business, Örebro, Sweden
- Department of Communication, Quality Management and Information Systems, Mid Sweden University, Sundsvall, Sweden
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Hashimoto K, Takeuchi T, Ihara K, Obuchi S, Kawai H, Hirano H, Fujiwara Y, Hunkyung K, Watanabe Y, Hashizume M. Association Between Ego-Resilience and Social Isolation Among Urban Older People. Gerontol Geriatr Med 2024; 10:23337214241238069. [PMID: 38487274 PMCID: PMC10938606 DOI: 10.1177/23337214241238069] [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: 11/07/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/17/2024] Open
Abstract
Social isolation among older adults affects their physical and mental health. Ego-resilience is associated with flexible adaptation to various environments and acceptable behaviors. However, its association with social isolation among older people is unclear. Therefore, a health survey was conducted with 510 adults aged 65 years or older to assess social isolation, its associated factors, and ego resilience. The results showed that the social isolation group had a lower median ego-resiliency scale score (42.0) compared to the non-social isolation group (38.0). The social isolation group were mostly males without spouses, took time to move, had more depressive moods, and poorer subjective health status. The non-social isolated group had faster maximum walking speed. Low ego-resilience was newly identified as a factor associated with social isolation among older people, as were being male, having no spouse, and depressive symptoms. Mediation analysis revealed that ego-resilience affected social isolation and was partially mediated by depressive symptoms.
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Affiliation(s)
- Kazuaki Hashimoto
- Toho University Faculty of Medicine, Tokyo, Japan
- Hirosaki University Graduate School of Medicine, Aomori, Japan
| | | | - Kazushige Ihara
- Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kim Hunkyung
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yutaka Watanabe
- Hokkaido University Faculty of Dental Medicine, Sapporo, Japan
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Suen AO, Iyer AS, Cenzer I, Farrand E, White DB, Singer J, Sudore R, Kotwal A. National Prevalence of Social Isolation and Loneliness in Adults with Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 2023; 20:1709-1717. [PMID: 37463307 PMCID: PMC10704233 DOI: 10.1513/annalsats.202304-288oc] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/17/2023] [Indexed: 07/20/2023] Open
Abstract
Rationale: Social isolation and loneliness are gaining recognition for their role in health outcomes, yet they have not been defined in people with chronic obstructive pulmonary disease (COPD). Objective: To determine the national prevalence of and characteristics associated with social isolation and loneliness in people with COPD. Methods: This is a cross-sectional study of community-dwelling adults aged ⩾50 years in the nationally representative HRS (Health and Retirement Study) (2016-2018). Participants self-reported COPD and supplemental oxygen use and were categorized into three groups: 1) no COPD; 2) COPD; and 3) COPD on oxygen. Social isolation was defined using a nine-item scale indicating minimal household contacts, social network interaction, and community engagement. Loneliness was measured using the 3-Item UCLA Loneliness Scale. Multivariable logistic regression defined prevalence and associated characteristics for both. Results: Participants (n = 10,384) were on average 68 years old (standard deviation, ±10.5), 54% female, 10% Black, 11% self-reported COPD, and 2% self-reported supplemental oxygen. Overall, 12% were socially isolated, 12% lonely, and 3% both socially isolated and lonely. People with COPD had a higher adjusted prevalence of social isolation (no COPD: 11%; COPD: 16%; COPD on oxygen: 20%; P < 0.05) and loneliness (no COPD: 11%; COPD: 18%; COPD on oxygen: 22%; P < 0.001). In those with COPD, characteristics associated with social isolation (P < 0.05) included sex (men: 22%; women: 13%), non-Hispanic White ethnicity (White: 19%; Black: 7%), low net worth (<$6,000: 32%; $81,001-$239,000: 10%), depression (depression: 24%; no depression: 14%), having difficulty with one or more activities of daily living (one or more difficulty: 22%; no difficulty: 14%), and current cigarette use (current: 24%; never: 13%). Characteristics associated with loneliness (P < 0.05) included younger age (50-64 yr: 22%; 75-84 yr: 12%), being single (single: 32%; married: 12%), depression (depression: 36%; no depression: 13%), having difficulty with one or more activities of daily living (one or more difficulty: 29%; no difficulty: 15%), diabetes (diabetes: 26%; no diabetes: 17%), and heart disease (heart disease 23%; no heart disease: 17%). Conclusions: Nearly one in six adults with COPD experience social isolation, and one in five experience loneliness, with almost twice the prevalence among those on supplemental oxygen compared with the general population. Demographic and clinical characteristics identify those at highest risk to guide clinical and policy interventions.
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Affiliation(s)
- Angela O. Suen
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | - Anand S. Iyer
- Division of Pulmonary, Allergy, and Critical Care Medicine, Center for Palliative and Supportive Care, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama; and
| | - Irena Cenzer
- Division of Geriatrics, and
- Division of Palliative Care Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Erica Farrand
- Division of Pulmonary, Allergy, and Critical Care Medicine
| | - Douglas B. White
- Program on Ethics and Decision Making in Critical Illness, Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Rebecca Sudore
- Division of Geriatrics, and
- Division of Palliative Care Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Ashwin Kotwal
- Division of Geriatrics, and
- Division of Palliative Care Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California
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19
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Esmaeilzadeh P. Older Adults' Perceptions About Using Intelligent Toilet Seats Beyond Traditional Care: Web-Based Interview Survey. JMIR Mhealth Uhealth 2023; 11:e46430. [PMID: 38039065 PMCID: PMC10724815 DOI: 10.2196/46430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 10/19/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND In contemporary society, age tech (age technology) represents a significant advancement in health care aimed at enhancing patient engagement, ensuring sustained independence, and promoting quality of life for older people. One innovative form of age tech is the intelligent toilet seat, which is designed to collect, analyze, and provide insights based on toileting logs and excreta data. Understanding how older people perceive and interact with such technology can offer invaluable insights to researchers, technology developers, and vendors. OBJECTIVE This study examined older adults' perspectives regarding the use of intelligent toilet seats. Through a qualitative methodology, this research aims to unearth the nuances of older people's opinions, shedding light on their preferences, concerns, and potential barriers to adoption. METHODS Data were collected using a web-based interview survey distributed on Amazon Mechanical Turk. The analyzed data set comprised 174 US-based individuals aged ≥65 years who voluntarily participated in this study. The qualitative data were carefully analyzed using NVivo (Lumivero) based on detailed content analysis, ensuring that emerging themes were coded and classified based on the conceptual similarities in the respondents' narratives. RESULTS The analysis revealed 5 dominant themes encompassing the opinions of aging adults. The perceived benefits and advantages of using the intelligent toilet seat were grouped into 3 primary themes: health-related benefits including the potential for early disease detection, continuous health monitoring, and seamless connection to health care insights. Technology-related advantages include the noninvasive nature of smart toilet seats and leveraging unique and innovative data collection and analysis technology. Use-related benefits include ease of use, potential for multiple users, and cost reduction owing to the reduced need for frequent clinical visits. Conversely, the concerns and perceived risks were classified into 2 significant themes: psychological concerns, which included concerns about embarrassment and aging-related stereotypes, and the potential emotional impact of constant health monitoring. Technical performance risks include concerns centered on privacy and security, device reliability, data accuracy, potential malfunctions, and the implications of false positives or negatives. CONCLUSIONS The decision of older adults to incorporate intelligent toilet seats into their daily lives depends on myriad factors. Although the potential health and technological benefits are evident, valid concerns that need to be addressed remain. To foster widespread adoption, it is imperative to enhance the advantages while simultaneously addressing and mitigating the identified risks. This balanced approach will pave the way for a more holistic integration of smart health care devices into the routines of the older population, ensuring that they reap the full benefits of age tech advancements.
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Affiliation(s)
- Pouyan Esmaeilzadeh
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, United States
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20
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Lwi SJ, Larsen J, Jenkins M, Swick D. The Association Between Loneliness and Maladaptive Moods and Beliefs: A Pilot Study in U.S. Veterans. Mil Med 2023; 188:e3343-e3348. [PMID: 36377771 DOI: 10.1093/milmed/usac341] [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: 08/09/2022] [Revised: 10/13/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2023] Open
Abstract
INTRODUCTION Loneliness is a powerful predictor of several medical and psychiatric conditions that are highly prevalent in Veterans, including depression and PTSD. Despite this, few studies have examined loneliness in Veterans or how best to intervene upon Veteran loneliness. Additional empirical research is needed in these areas in order to define clear intervention targets and improve Veteran care. MATERIALS AND METHODS In this pilot study, we used 62 Veterans' self-reported loneliness and symptoms of post-traumatic stress to examine whether specific symptom clusters of post-traumatic stress were associated with greater loneliness. Post-traumatic stress was measured using the PTSD Checklist for DSM-5, and responses were further parsed into four symptom clusters: intrusions, avoidance, negative alterations in mood and cognition (excluding the social withdrawal item), and alterations in arousal and reactivity. RESULTS Results revealed that only the negative alterations in mood and cognition symptom cluster was associated with increased Veteran loneliness, even after adjusting for sociodemographic factors, social isolation, and symptoms of depression. These analyses were also repeated using a subset of our sample (n = 29) who completed repeated measures of the PTSD Checklist. Results again revealed that the same symptom cluster predicted Veteran loneliness over 1 year later. CONCLUSIONS This pilot study demonstrates the value of a publicly available PTSD measure for identifying lonely Veterans and highlights how reducing negative alterations in mood and cognition may serve as a potentially critical target for future Veteran loneliness interventions.
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Affiliation(s)
- Sandy J Lwi
- VA Northern California Health Care System, Martinez, CA 94553, USA
| | - Jary Larsen
- VA Northern California Health Care System, Martinez, CA 94553, USA
| | - Mark Jenkins
- VA Northern California Health Care System, Martinez, CA 94553, USA
| | - Diane Swick
- VA Northern California Health Care System, Martinez, CA 94553, USA
- Department of Neurology, University of California, Davis, CA 95616, USA
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21
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McDaniels B, Pontone GM, Keener AM, Subramanian I. A Prescription for Wellness in Early PD: Just What the Doctor Ordered. J Geriatr Psychiatry Neurol 2023; 36:461-469. [PMID: 36911924 DOI: 10.1177/08919887231164358] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
BACKGROUND Being diagnosed with a neurodegenerative disease is a life-changing event and a critical time to help patients cope and move forward in a proactive way. Historically, the main focus of Parkinson's disease (PD) treatment has been on the motor features with limited attention given to non-motor and mental health sequelae, which have the most impact on quality of life. Although depression and anxiety have been described at the time of PD diagnosis, demoralization, intolerance of uncertainty, decreased self-efficacy, stigma and loneliness can also present and have negative effects on the trajectory of the disease. Hence, understanding the psychological impact of the diagnosis and how to provide better counselling at this critical time point may be the key to a better long-term trajectory and quality of life. FOCUS There has been a paradigm shift in the treatment of chronic illness moving beyond the medical model, which focuses on fighting illness with the physician being in charge of the treatment process and the patient being the passive recipient, toward a more holistic (i.e., physical, psychological, social, and spiritual health) biopsychosocial approach that emphasizes behavioral factors with the patient being an active collaborator in their treatment. Hence, we propose that fostering resilience, social support, and psychological flexibility offer promise toward attenuating negative reactions and improving overall well-being. CONCLUSION Through a proactive wellness approach incorporating lifestyle choices, people with PD (PwP) can not only achieve improved states of health, well-being, and quality of life, but actually thrive.
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Affiliation(s)
- Bradley McDaniels
- Department of Rehabilitation and Health Services, University of North Texas, Denton, TX, USA
| | - Gregory M Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Adrienne M Keener
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
- Parkinson's Disease Research, Education, and Clinical Center (PADRECC), Veterans Administration Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Indu Subramanian
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
- Parkinson's Disease Research, Education, and Clinical Center (PADRECC), Veterans Administration Greater Los Angeles Health Care System, Los Angeles, CA, USA
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22
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Hsu KY, Cenzer I, Harrison KL, Ritchie CS, Waite L, Kotwal A. In sickness and in health: Loneliness, depression, and the role of marital quality among spouses of persons with dementia. J Am Geriatr Soc 2023; 71:3538-3545. [PMID: 37539784 PMCID: PMC10838362 DOI: 10.1111/jgs.18520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/06/2023] [Accepted: 07/01/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Older adults married to persons living with dementia (PLwD) may be at risk for loneliness and depression. We assessed the prevalence of loneliness and depressive symptoms among spouses of PLwD or cognitive impairment not dementia (CIND), and the role of marital quality in mediating these outcomes. METHODS We used a US population-based sample of 4071 couples enrolled in the Health and Retirement Study (2014 and 2016). We included older adults married to PLwD (N = 227), married to persons with CIND (N = 885), or married to persons with no cognitive impairment (NCI) (N = 2959). We determined the prevalence of loneliness (UCLA 3-item scale), depressive symptoms (CESD-8 scale), and both, using multivariable logistic regression adjusting for sociodemographic and health-related characteristics. We then tested for interaction terms between marital quality (4-item scale) and degree of spousal cognitive impairment for each outcome of loneliness and depressive symptoms. RESULTS The sample was 55% women and on average 67-years-old (range: 50-97). After adjustment, spouses of persons with cognitive impairment were more likely to be lonely (NCI: 20%, CIND: 23%, PLwD: 29%; p = 0.04), depressed (NCI: 8%, CIND: 15%, PLwD: 14%; p < 0.01), and both (NCI: 4%, CIND: 9%, PLwD: 7%; p < 0.01). The association between cognition and loneliness, but not depression, differed by marital quality (interaction p-value = 0.03). Among couples with high marital quality, spousal cognitive impairment was associated with higher likelihood of loneliness (p < 0.05). In contrast, no association existed between spousal cognition and loneliness among couples with lower marital quality (p = 0.37). CONCLUSIONS One in six spouses of persons with CIND or more advanced disease (PLwD) experienced depressive symptoms, and loneliness among spouses of PLwD was experienced at a twofold rate. By identifying and managing both, and facilitating interventions that promote high-quality social connection, clinical teams might improve the lives of older couples facing dementia.
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Affiliation(s)
- Kristie Y. Hsu
- Division of Internal Medicine, University of California, San Francisco, CA
| | - Irena Cenzer
- Division of Geriatrics, University of California, San Francisco, CA
| | - Krista L. Harrison
- Division of Geriatrics, University of California, San Francisco, CA
- Global Brain Health Institute, University of California, San Francisco, CA
| | - Christine S. Ritchie
- Massachusetts General Hospital Division of Palliative Care and Geriatric Medicine and Harvard Medical School, Boston, MA
- The Mongan Institute Center for Aging and Serious Illness, Massachusetts General Hospital, Boston, MA
| | - Linda Waite
- Department of Sociology, University of Chicago, Chicago, IL
| | - Ashwin Kotwal
- Division of Geriatrics, University of California, San Francisco, CA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs, San Francisco, CA
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23
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Luo MS, Li LW. Trajectories of social isolation and depressive symptoms in mid- and later life: a parallel process latent growth curve analysis. Aging Ment Health 2023; 27:2211-2219. [PMID: 37212635 DOI: 10.1080/13607863.2023.2214099] [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: 06/16/2022] [Accepted: 05/10/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES Social isolation has subjective and objective dimensions. This study explored the change trajectories of both dimensions of isolation and depressive symptoms and their interrelationships in terms of levels and changes over time. METHODS Data were drawn from the 2006-2018 Health and Retirement Study, involving a nationally representative sample of middle-aged and older adults (N = 7890). Parallel process latent growth curve models were used. RESULTS Over time, objective isolation displayed a non-linear upward trend, subjective isolation displayed a non-linear downward trend, and depressive symptoms remained relatively stable. More objectively isolated people experienced smaller increases in objective isolation and more subjectively isolated people experienced smaller decreases in subjective isolation. Such negative intercept-slope associations were not observed for depressive symptoms. Net of sociodemographic characteristics, physical disabilities, functional limitations, and chronic diseases, each isolation dimension was associated with the level of depressive symptoms. But only the rate of change in subjective isolation was positively associated with that of depressive symptoms. CONCLUSION The initial level of objective isolation may be one of the common origins of subjective isolation and depressive symptoms. Recognition of such shared origins is important in mitigating the synergistic and deleterious effects of loneliness and depression in middle-aged and older adults.
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Affiliation(s)
- Meng Sha Luo
- Department of Sociology, Zhejiang University, Hangzhou, China
| | - Lydia W Li
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
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24
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Stara V, Soraci L, Takano E, Kondo I, Möller J, Maranesi E, Luzi R, Riccardi GR, Browne R, Dacunha S, Palmier C, Wieching R, Ogawa T, Bevilacqua R. Intrinsic Capacity and Active and Healthy Aging Domains Supported by Personalized Digital Coaching: Survey Study Among Geriatricians in Europe and Japan on eHealth Opportunities for Older Adults. J Med Internet Res 2023; 25:e41035. [PMID: 37824183 PMCID: PMC10603559 DOI: 10.2196/41035] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/03/2022] [Accepted: 07/14/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND The worldwide aging trend requires conceptually new prevention, care, and innovative living solutions to support human-based care using smart technology, and this concerns the whole world. Enabling access to active and healthy aging through personalized digital coaching services like physical activity coaching, cognitive training, emotional well-being, and social connection for older adults in real life could offer valuable advantages to both individuals and societies. A starting point might be the analysis of the perspectives of different professionals (eg, geriatricians) on such technologies. The perspectives of experts in the sector may allow the individualization of areas of improvement of clinical interventions, supporting the positive perspective pointed out by the intrinsic capacity framework. OBJECTIVE The overall aim of this study was to explore the cross-national perspectives and experiences of different professionals in the field of intrinsic capacity, and how it can be supported by eHealth interventions. To our knowledge, this is the first study to explore geriatric care providers' perspectives about technology-based interventions to support intrinsic capacity. METHODS A survey involving 20 geriatricians or clinical experts in the fields of intrinsic capacity and active and healthy aging was conducted in Italy, France, Germany, and Japan between August and September 2021. RESULTS The qualitative findings pointed out relevant domains for eHealth interventions and provided examples for successful practices that support subjective well-being under the intrinsic capacity framework (the benefits offered by personalized interventions, especially by promoting health literacy but avoiding intrusiveness). Moreover, eHealth interventions could be used as a bridge that facilitates and enables social engagement; an instrument that facilitates communication between doctors and patients; and a tool to enrich the monitoring actions of medical staff. CONCLUSIONS There is an unexplored and significant role for such geriatric perspectives to help the development process and evaluate the evidence-based results on the effectiveness of technologies for older people. This is possible only when clinicians collaborate with data scientists, engineers, and developers in order to match the complex daily needs of older adults.
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Affiliation(s)
- Vera Stara
- Medical Direction, IRCCS, INRCA, Ancona, Italy
| | - Luca Soraci
- Unit of Geriatric Medicine, IRCCS, INRCA, Cosenza, Italy
| | - Eiko Takano
- National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Izumi Kondo
- National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Johanna Möller
- Diocesan Caritas Association for the Archdiocese of Cologne, Cologne, Germany
| | | | | | | | - Ryan Browne
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
| | | | - Cecilia Palmier
- Service de gériatrie 1&2, AP-HP, Hôpital Broca, Paris, France
| | - Rainer Wieching
- Institute for New Media & Information Systems, University of Siegen, Siegen, Germany
| | - Toshimi Ogawa
- Smart-Aging Research Center, Tohoku University, Sendai, Japan
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25
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Thompson C, Halcomb E, Masso M. The contribution of primary care practitioners to interventions reducing loneliness and social isolation in older people-An integrative review. Scand J Caring Sci 2023; 37:611-627. [PMID: 36732897 DOI: 10.1111/scs.13151] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/22/2022] [Accepted: 01/14/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Social connection is a fundamental human need. Its absence can lead to loneliness and social isolation, adversely impacting health and well-being. Given their regular contact and trusted relationships with older people, practitioners delivering community-based primary care are well-positioned to address this issue. However, their contribution to addressing loneliness and social isolation is unclear. AIM This integrative review explores the contribution of the primary care workforce to interventions aimed at reducing loneliness and social isolation in community-dwelling older people. METHOD Using an integrative review method, Scopus, Web of Science, CINAHL and PubMed were searched for original research published between 2000 and 2022. Fourteen papers reporting 13 primary studies were appraised for methodological quality and included in the review. Data were extracted into a summary table and analysed using thematic analysis. RESULTS Included studies came from over six countries. Internationally, primary care services have diverse structures, funding and workforces influencing their response to loneliness and social isolation. All but one intervention was multi-component, with ten studies including a group-based activity and three providing primarily individual-level activities. Only six studies reported reductions in loneliness following the intervention. Three themes were identified: characteristics of interventions; implementation context, barriers and facilitators; and differing contributions of primary care practitioners in addressing loneliness and social isolation of older people. CONCLUSION There is increasing demand and scope for primary care practitioners to assist lonely and socially isolated older people. It is important to understand how to equip and incentivise these practitioners to routinely identify, assess and respond to lonely and socially isolated older people despite varying implementation contexts. There is a need for further research that explores how the primary care team can be better utilised to deliver effective interventions that reduce the health impacts of loneliness and social isolation.
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Affiliation(s)
- Cristina Thompson
- Australian Health Services Research Institute, University of Wollongong, New South Wales, Wollongong, Australia
- School of Nursing, University of Wollongong, New South Wales, Wollongong, Australia
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, New South Wales, Wollongong, Australia
| | - Malcolm Masso
- Australian Health Services Research Institute, University of Wollongong, New South Wales, Wollongong, Australia
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26
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Arnoldy FL, Garrido M, Wong A, Pratt S, Braddish T, Brown G, Reblin M, Rizzo D, Gramling R. Protocol for a Scalable StoryListening Intervention for Grief-Related Loneliness During COVID-19. Palliat Med Rep 2023; 4:208-213. [PMID: 37637761 PMCID: PMC10457646 DOI: 10.1089/pmr.2023.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/29/2023] Open
Abstract
Background Social distancing during the COVID-19 pandemic limited how family, friends, and clinicians physically interacted with people who were dying and decreased communal opportunities for processing grief. These barriers can cause or exacerbate suffering due to loneliness while grieving. Purpose In this article, we describe the protocol for a brief storytelling intervention designed to reduce loneliness among families, friends, and clinicians grieving the death of a person during the time of COVID-19. Methods We trained four StoryListening doulas (SLDs) to hold a welcoming space and listen to stories with curiosity and openness. The intervention included a video StoryListening session and two brief questionnaires, filled out before and two weeks after the encounter, assessing loneliness and quality of life. During sessions, SLDs invited participants to share their story of loss in their own words and in as much detail as preferred. When participants felt a sense of story completion, SLDs shared validating statements and expressed gratitude to the participant for sharing. The video and audio for each participant's StoryListening encounter were recorded and the participant was offered an audio copy of their session.
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Affiliation(s)
| | - Matilda Garrido
- Professional and Clinical Education, University of Vermont, Burlington, Vermont, USA
| | - Ann Wong
- University of Vermont Honor's College, Burlington, Vermont, USA
| | - Susanna Pratt
- Office of Clinical Trials, University of Vermont, Burlington, Vermont, USA
| | - Tess Braddish
- Department of Family Medicine, University of Vermont, Burlington, Vermont, USA
| | - Greg Brown
- Professional and Clinical Education, University of Vermont, Burlington, Vermont, USA
| | - Maija Reblin
- Department of Family Medicine, University of Vermont, Burlington, Vermont, USA
| | - Donna Rizzo
- Department of Civil and Environmental Engineering, University of Vermont, Burlington, Vermont, USA
| | - Robert Gramling
- Department of Family Medicine, University of Vermont, Burlington, Vermont, USA
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27
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Ritchie CS, Kotwal AA. Loneliness and Social Isolation in Palliative Care: A Call to Action. J Palliat Med 2023; 26:1032-1034. [PMID: 37579234 PMCID: PMC11079500 DOI: 10.1089/jpm.2023.0425] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Affiliation(s)
- Christine S. Ritchie
- Massachusetts General Hospital Division of Palliative Care and Geriatric Medicine and Harvard Medical School, Boston, Massachusetts, USA
- The Mongan Institute Center for Aging and Serious Illness, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ashwin A. Kotwal
- Division of Geriatrics, University of California, San Francisco, California, USA
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs, San Francisco, California, USA
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28
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Kuang K, Huisingh-Scheetz M, Miller MJ, Waite L, Kotwal AA. The association of gait speed and self-reported difficulty walking with social isolation: A nationally-representative study. J Am Geriatr Soc 2023; 71:2549-2556. [PMID: 37000466 PMCID: PMC10524495 DOI: 10.1111/jgs.18348] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/21/2023] [Accepted: 03/07/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Mobility assessments are commonly used among older adults as risk stratification for falls, preoperative function, frailty, and mortality. We determined if gait speed and self-reported difficulty walking are similarly associated with social isolation and loneliness, which are key markers of social well-being and linked to health outcomes. METHODS We used 2015-2016 data from the National Social life Health and Aging Project (NSHAP), an in-person nationally-representative survey of 2640 community-dwelling adults ≥65 years old. We measured gait speed (timed 3-m walk: unable to walk, ≥5.7 s, and <5.7 s), and self-reported difficulty walking one block or across the room (unable, "much," "some," or "no" difficulty). Social measures included loneliness (3-item UCLA scale), social isolation (12-item scale), and individual social activities (frequency socializing, religious participation, community participation, and volunteering). We used logistic regression to determine the adjusted probability of each social measure by gait speed and difficulty walking, adjusting for sociodemographic and health characteristics, and tested for interaction terms with age. RESULTS Participants were on average 75 years old (SD = 7.1), 54% female, 9% Black/African American, and 6% Hispanic. Difficulty walking one block was associated with (p < 0.05): social isolation (much difficulty: 26% vs no difficulty: 18%), low socializing (33% vs 19%), low volunteering (67% vs 53%), low community participation (54% vs 43%), low religious participation (51% vs 46%), and loneliness (25% vs 14%). Difficulty walking across the room was similarly strongly associated with social isolation and individual activities. The association between self-reported difficulty walking and social isolation was stronger at older ages (p-value of interaction <0.001). CONCLUSIONS Self-reported mobility difficulty is a widely used clinical assessment that is strongly associated with loneliness and social isolation, particularly at older ages. Among persons with limited mobility, clinicians should consider a careful social history to identify social needs and interventions addressing mobility to enhance social connections.
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Affiliation(s)
- Kathy Kuang
- University of Arizona College of Medicine – Tucson, Tucson, AZ
| | - Megan Huisingh-Scheetz
- Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, IL
| | - Matthew J. Miller
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA
| | - Linda Waite
- Department of Sociology, University of Chicago, Chicago, IL
| | - Ashwin A. Kotwal
- Division of Geriatrics, Department of Medicine, University of California, San Francisco
- Geriatrics, Palliative, and Extended Care Service Line, San Francisco Veterans Affairs Medical Center
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29
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Erratum. Br J Community Nurs 2023; 28:317. [PMID: 37369441 DOI: 10.12968/bjcn.2023.28.7.317a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
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30
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Griffiths J. Integrated care systems: a potential for improving care of housebound older adults. Br J Community Nurs 2023; 28:317. [PMID: 37369431 DOI: 10.12968/bjcn.2023.28.7.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Affiliation(s)
- Jane Griffiths
- Division of Nursing, Midwifery and Social Work, University of Manchester
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31
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Prell T, Schönenberg A, Heimrich KG. The impact of loneliness on quality of life in people with Parkinson's disease: results from the Survey of Health, Ageing and Retirement in Europe. Front Med (Lausanne) 2023; 10:1183289. [PMID: 37425329 PMCID: PMC10326722 DOI: 10.3389/fmed.2023.1183289] [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: 03/09/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background Loneliness is a growing issue for public health in an aging society. However, there is a lack of research on loneliness in people with Parkinson's disease (PwPD). Methods We analyzed cross-sectional and longitudinal data from wave 5 (N = 559 PwPD) and 6 (N = 442 PwPD) from the Survey of Health, Ageing and Retirement in Europe (SHARE). Loneliness was assessed using the three-item version of the Revised UCLA Loneliness Scale. Descriptive statistics, group comparisons, multiple linear regressions, and generalized estimating equation analysis were performed to explore loneliness prevalence, its relationship with other factors, and its impact on Quality of Life (QoL) in PwPD. Results Depending on the used cut-off, the prevalence of loneliness in PwPD ranged from 24.1 to 53.8%. These prevalences were higher compared to people without PD. Loneliness was mainly linked to decreased functional abilities, weaker grip strength, more symptoms of depression, and country of residence. Loneliness was also associated with current QoL and predicts future QoL in PwPD, highlighting its impact on well-being. Conclusion Addressing loneliness could potentially improve QoL for PwPD, making it a modifiable risk factor that clinicians and policy-makers should consider.
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Affiliation(s)
- Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany
- Department of Neurology, Jena University Hospital, Jena, Germany
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Moshtagh M, Mirlashari J, Brown H. Experiences of women with cancer living in the rural areas of Iran during the COVID-19 pandemic: a qualitative study. Support Care Cancer 2023; 31:376. [PMID: 37273068 DOI: 10.1007/s00520-023-07847-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 05/27/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE This study aimed to explore the challenges of access to treatment and quality of life in female cancer survivors living in rural areas of Iran within the global pandemic context (COVID-19). METHODS We conducted a qualitative exploratory study where we recruited nine female-identifying individuals diagnosed with cancer, 23 family members, and five healthcare providers from a hospital affiliated with the Birjand University of Medical Sciences in Iran. Data was collected using semi-structured interviews and analyzed using Braun and Clarke's reflective thematic analysis. RESULTS The three themes constructed were lack of strength from fighting on two fronts (subthemes: (i) fear related to longevity and life span, (ii) disruption of emotional relationships and family functioning, (iii) loneliness and fear of the future, (iv) village culture and double whammy, and (v) isolation and rejection in a rural community); changes during treatment (subthemes: (i) confusion related to treatment and (ii) the hope found during treatment "bottlenecks"); and spiritual growth and clarifying values (subthemes: (i) patience and resilience and (ii) clarifying life values and opportunities when facing uncertainty about the future). CONCLUSION This study highlights the importance of further evaluating interventions to mitigate barriers to supportive care for female cancer survivors living in rural areas with low-resource contexts during the COVID-19 pandemic.
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Affiliation(s)
- Mozhgan Moshtagh
- Social Determinants of Health Research Center, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran.
| | | | - Helen Brown
- University of British Columbia, School of Nursing, Vancouver, Canada
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Gagne-Henderson R, Holland C, Walshe C. Sense of Coherence at End of Life in Older People: An Interpretive Description. J Hosp Palliat Nurs 2023; 25:165-172. [PMID: 37081670 DOI: 10.1097/njh.0000000000000948] [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: 04/22/2023]
Abstract
As people age, losses accumulate (ie, the death of family and friends, the loss of agility, and the loss of independence). Such losses have an impact on one's Sense of Coherence, that is, one's ability to see the world as comprehensible, manageable, and meaningful. Antonovsky deemed Sense of Coherence as a mostly stable state by the age of 30 years. Until now, there has not been an investigation into how serial loss of resources affects older people as they near the end of life. Sense of Coherence was used as the theoretical framework for this study to answer the question of how older people maintain or regain a Sense of Coherence in the presence of serious illness as they near death. Data were gathered using semistructured interviews and guided by interpretive description. This investigation found new concepts that contribute to Antonovsky's midlevel theory of salutogenesis and the construct of Sense of Coherence. Those are Incomprehensibility and Serial Loss of General Resistance Resources. The results indicate that the crux of a strong Sense of Coherence for this population is excellent communication and a coherent "big-picture" conversation.
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Greene-Higgs L, Jordan A, Sheehan J, Berinstein J, Admon AJ, Waljee AK, Riehl M, Piette J, Resnicow K, Higgins PD, Cohen-Mekelburg S. Social Network Diversity and the Daily Burden of Inflammatory Bowel Disease. Clin Transl Gastroenterol 2023; 14:e00572. [PMID: 36854057 PMCID: PMC10208714 DOI: 10.14309/ctg.0000000000000572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
INTRODUCTION To examine the association between social network, daily inflammatory bowel disease (IBD) burden, and related cognitive factors such as loneliness and psychological well-being. METHODS Using survey data, we compared the relationship between social network diversity and daily IBD burden with multivariable linear regression. RESULTS Patients with IBD with higher social network diversity reported a lower daily IBD burden. This association was more common among those who reported a higher degree of loneliness than those with a low degree of loneliness. DISCUSSION We should consider diverse social connections as an indicator of risk for higher IBD burden, especially among lonely patients.
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Affiliation(s)
- LaVana Greene-Higgs
- Department of Internal Medicine, University of Michigan Medicine, Ann Arbor, Michigan, USA
| | - Ariel Jordan
- Department of Internal Medicine, University of Michigan Medicine, Ann Arbor, Michigan, USA
| | - Jessica Sheehan
- Division of Gastroenterology & Hepatology, University of Michigan Medicine, Ann Arbor, Michigan, USA
| | - Jeffrey Berinstein
- Division of Gastroenterology & Hepatology, University of Michigan Medicine, Ann Arbor, Michigan, USA
| | - Andrew J. Admon
- Division of Pulmonary and Critical Care Medicine, University of Michigan Medicine, Ann Arbor, Michigan, USA
- VA Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, Michigan, USA
| | - Akbar K. Waljee
- Division of Gastroenterology & Hepatology, University of Michigan Medicine, Ann Arbor, Michigan, USA
- VA Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, Michigan, USA
| | - Megan Riehl
- Division of Gastroenterology & Hepatology, University of Michigan Medicine, Ann Arbor, Michigan, USA
| | - John Piette
- VA Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, Michigan, USA
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kenneth Resnicow
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Peter D. Higgins
- Division of Gastroenterology & Hepatology, University of Michigan Medicine, Ann Arbor, Michigan, USA
| | - Shirley Cohen-Mekelburg
- Division of Gastroenterology & Hepatology, University of Michigan Medicine, Ann Arbor, Michigan, USA
- VA Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, Michigan, USA
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Zarling A, Kim J, Russell D, Cutrona C. Online acceptance and commitment therapy as treatment for loneliness among older adults: Report of a pilot study. J Am Geriatr Soc 2023. [PMID: 36970989 DOI: 10.1111/jgs.18345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Loneliness has been linked to cognitive decline, cardiovascular risk, and risk of mortality among older adults. Creative approaches are needed to increase access for older adults to evidence-based intervention programs. One possible approach is acceptance and commitment therapy (ACT). The aim of this study was to pilot test a novel ACT-based online intervention to decrease loneliness in older adults living in the community. METHODS A self-paced online ACT program consisting of eight interactive modules designed to teach participants skills to address common contributors to loneliness was evaluated. It was delivered to a sample of 529 men and women, aged 65 or over, who were assessed pre-intervention, postintervention, and at a one-month follow-up, with a short 10-item version of the UCLA Loneliness Scale. RESULTS For participants who completed all eight modules of the intervention, average levels of loneliness significantly decreased from pre- to posttreatment, b = -0.013, t (385) = -4.69, p < 0.001 (Cohen's d = 0.30). The improvement in loneliness was maintained at the one-month follow-up assessment. These improvements were particularly robust for individuals who were lonely at outset (Cohen's d = 0.73). The change in loneliness among these individuals was significantly greater than that observed in members of a "hold-out" group of lonely individuals that did not participate in the intervention (Cohen's d = 0.24). CONCLUSIONS This pilot investigation suggests the feasibility of this program for decreasing loneliness in older adults. Future controlled investigations with long-term follow-up assessments are needed to confirm the effectiveness and sustained benefits of the program.
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Affiliation(s)
- Amie Zarling
- Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
| | - Joseph Kim
- Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
| | - Dan Russell
- Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
| | - Carolyn Cutrona
- Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
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Kelsall-Foreman I, Bucks RS, Weinborn M, Badcock JC. Loneliness and objective social isolation are differentially associated with anomalous perceptions in community-dwelling older adults. Cogn Neuropsychiatry 2023; 28:130-146. [PMID: 36744805 DOI: 10.1080/13546805.2023.2174841] [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] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Anomalous perceptions are characterised by the subjective experience of a range of distorted and/or hallucinatory percepts. Whilst considerable attention has been paid to the neurocognitive processes contributing to anomalous perceptions amongst older adults, less is known about the social factors (e.g. social isolation, loneliness). Furthermore, it is unknown whether loneliness and social isolation are associated with different types of anomalous perceptions, including anomalous body-centred self-experiences and anomalous external experiences. METHODS This study examined the cross-sectional relationships between loneliness, objective social isolation, and anomalous perceptions in a sample of community-dwelling older adults (N = 242, Mage = 71.87 ± 7.73, range = 52-91, 67.8% female) using structural equation modelling. RESULTS Higher levels of loneliness were associated with more anomalous body-centred self-experiences and anomalous external experiences. Those reporting more loneliness also reported higher levels of anxiety and depression; however, the relationship between loneliness and anomalous perceptions was not mediated by these factors. Social disconnection from a religious group was associated with more anomalous external experiences and being married/living with a partner was associated with more anomalous body-centred self-experiences. CONCLUSIONS These findings suggest that loneliness and social isolation have differential associations with anomalous perceptions in older adults and provide additional evidence that attending to loneliness in older adults is important.
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Affiliation(s)
- India Kelsall-Foreman
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Romola S Bucks
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Michael Weinborn
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Johanna C Badcock
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
- Perth Voices Clinic, Murdoch, Australia
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Luo M, Li LW. Within-Person Dynamics of Objective and Subjective Social Isolation in Midlife and Later Life. J Aging Health 2023; 35:182-190. [PMID: 35945654 DOI: 10.1177/08982643221118449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ObjectivesTo investigate the within-person dynamics of objective and subjective social isolation among U.S. middle-aged and older adults and to explore gender differences in this relationship. Methods: Four waves of data from the Health and Retirement Study (HRS, 2006-2018, N = 5437) and the multiple group random intercept cross-lagged panel model were used. Results: Within-person deviation in expected subjective isolation predicted deviation in expected objective isolation years later. No corresponding cross-lagged effect of objective isolation on subjective isolation was found. Gender differences were detected: the within-person cross-lagged positive effect of subjective isolation on objective isolation was significant for men but not for women. Discussion: This study provides evidence for a unidirectional relationship between subjective and objective isolation at the within-person level: higher than expected increase in subjective isolation predicts higher than expected increase in subsequent objective isolation. This within-person process is more salient in men than in women.
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Affiliation(s)
- Mengsha Luo
- Department of Sociology, 12377Zhejiang University, Hangzhou, China
| | - Lydia W Li
- School of Social Work, 1259University of Michigan, Ann Arbor, MI, USA
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Abstract
Late-life depression is common but underrecognized and undertreated leading to significant morbidity and mortality, including from suicide. The presence of comorbidities necessitates screening followed by a careful history in order to make the diagnosis of depression. Because older adults tend to take longer to respond to treatment and have higher relapse rates than younger patients, they benefit most from persistent, attentive therapy. Although both pharmacotherapy and psychosocial treatments, or a combination of the two, are considered as the first-line therapy for late-life depression, most data support a combined, biopsychosocial treatment approach provided by an interdisciplinary team.
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Affiliation(s)
- Elizabeth Gundersen
- University of Colorado School of Medicine, Mail Stop B178 Academic Office One, 12631 E. 17th Avenue, Aurora, CO 80045, USA.
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Profiles of socially isolated community-dwelling older adults during the COVID-19 pandemic: A latent class analysis. Maturitas 2023; 171:1-6. [PMID: 36863186 PMCID: PMC9941310 DOI: 10.1016/j.maturitas.2023.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/08/2023] [Accepted: 02/10/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVE To identify different profiles of socially isolated older adults during the first wave of COVID-19 in Quebec, Canada. STUDY DESIGN Cross-sectional data were obtained through a telehealth socio-geriatric risk assessment tool, ESOGER, administered to adults aged 70 years or more between April and July 2020 in Montreal, Canada. MEASURES Those living alone with no social contacts in the last few days were considered socially isolated. Latent class analysis was performed to identify profiles of socially isolated older adults based on: age, sex, polypharmacy, use of home care, use of a walking aid, recall of current year/month, anxiety level (scale 0-10), and need for follow-up from a healthcare provider. RESULTS Three-hundred and eighty (380) older adults identified as socially isolated were analyzed, of whom 75.5 % were female and 56.6 % were over 85. Three classes were identified: Class 1 ("physically frail older females") had the highest proportion of polypharmacy, walking aid, and home care use. Class 2 ("anxious, relatively younger males") were predominantly males who used the least home care but had the highest anxiety levels. Class 3 ("seemingly well older females") had the highest proportion of females, lowest proportion of polypharmacy, lowest anxiety level, and none used a walking aid. Recall of current year/month was similar across the three classes. CONCLUSIONS This study found heterogeneity among socially isolated older adults during the first wave of the COVID-19 pandemic with varying levels of physical and mental health. Our findings may contribute to the development of targeted interventions to support this vulnerable population during and after the pandemic.
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Aalto UL, Bonin-Guillaume S. Editorial: Loneliness among Older People Exacerbated by the COVID-19 Pandemic. J Nutr Health Aging 2023; 27:617-618. [PMID: 37702333 DOI: 10.1007/s12603-023-1968-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 09/14/2023]
Affiliation(s)
- U L Aalto
- Ulla L. Aalto, Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland,
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A Faith-Based Intervention to Address Social Isolation and Loneliness in Older Adults. J Christ Nurs 2023; 40:28-35. [PMID: 36469874 DOI: 10.1097/cnj.0000000000001023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
ABSTRACT The goal of this quality improvement project was to determine if virtually offered faith-based resources for socially isolated older adults could reduce loneliness and improve quality of life. A nurse-developed program of virtual spiritual and religious interventions, including mindfulness, prayer, Scripture meditation, gratitude practices, and online church services, was offered by local ministers to older adults at risk of social isolation or loneliness. A sample of 16 adults over age 55 from local communities participated in the 12-week intervention and follow-up. The intervention resulted in a significant decrease in perception of social loneliness and improved physical health quality of life.
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Lennon JC, Hantke N, Mattek N, Wu CY, Dodge H, Wall R, Beattie Z, Kaye J, Silbert L. Mood and activity changes during the COVID-19 pandemic in rural and urban Veterans and their cohabitants. Clin Gerontol 2023; 46:759-766. [PMID: 36208222 PMCID: PMC10132474 DOI: 10.1080/07317115.2022.2130123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES We aimed to examine the impact of COVID-19 pandemic-related stay-at-home orders on weekly reports of mood and activity before and during COVID-19 in a sample of older Veterans and their cohabitants. METHODS Urban and rural Veterans and their cohabitants living in the Pacific Northwest ≥62 years old were enrolled as part of the Collaborative Aging Research Using Technology initiative (n = 100, age = 71.2 ± 6.5, 41% women). Participants reported frequency of social activities (e.g., travel away), physical illness, and mood (blue mood and loneliness) via weekly online health forms. RESULTS A total of 2,441 weekly online health forms (OHFs) were collected from 100 participants. During the COVID-19 pandemic, blue mood (OR = 4.4, p < .0001) and loneliness (OR = 7.2, p < .0001) were significantly higher than before the pandemic, and travel away from home was significantly lower (OR = 0.5, p < .0001). Prevalence of blue mood and loneliness were not associated with rurality. CONCLUSIONS The current study established that blue mood and loneliness were significantly more prevalent in older Veterans following COVID-19 stay-at-home orders regardless of rurality. CLINICAL IMPLICATIONS The COVID-19 pandemic associated health precautions, while necessary to curb acute health risks, have created a unique situation that places vulnerable populations at increased risk of low mood.
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Affiliation(s)
- Jack C. Lennon
- Division of Mental Health & Clinical Neurosciences, Veterans Affairs Portland Health Care System, Portland, OR USA
| | - Nathan Hantke
- Division of Mental Health & Clinical Neurosciences, Veterans Affairs Portland Health Care System, Portland, OR USA
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
| | - Nora Mattek
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Chao-Yi Wu
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Hiroko Dodge
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Rachel Wall
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Zachary Beattie
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Jeffrey Kaye
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
| | - Lisa Silbert
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
- NIA-Layton Aging & Alzheimer’s Disease Research Center, Portland, OR USA
- Oregon Center for Aging & Technology (ORCATECH), Portland, OR USA
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Stara V, Rampioni M, Moșoi AA, Kristaly DM, Moraru SA, Paciaroni L, Paolini S, Raccichini A, Felici E, Rossi L, Vizitiu C, Nistorescu A, Marin M, Tónay G, Tóth A, Pilissy T, Fazekas G. A Technology-Based Intervention to Support Older Adults in Living Independently: Protocol for a Cross-National Feasibility Pilot. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16604. [PMID: 36554485 PMCID: PMC9779466 DOI: 10.3390/ijerph192416604] [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: 11/23/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
Innovative technologies can support older adults with or without disabilities, allowing them to live independently in their environment whilst monitoring their health and safety conditions and thereby reducing the significant burden on caregivers, whether family or professional. This paper discusses the design of a study protocol to evaluate the acceptance, usability, and efficiency of the SAVE system, a custom-developed information technology-based elderly care system. The study will involve older adults (aged 65 or older), professional and lay caregivers, and care service decision-makers representing all types of users in a care service scenario. The SAVE environmental sensors, smartwatches, smartphones, and Web service application will be evaluated in people's homes situated in Romania, Italy, and Hungary with a total of 165 users of the three types (cares, elderly, and admin). The study design follows the mixed method approach, using standardized tests and questionnaires with open-ended questions and logging all the data for evaluation. The trial is registered to the platform ClinicalTrials.gov with the registration number NCT05626556. This protocol not only guides the participating countries but can be a feasibility protocol suitable for evaluating the usability and quality of similar systems.
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Affiliation(s)
- Vera Stara
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy
| | - Margherita Rampioni
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy
| | - Adrian Alexandru Moșoi
- Department of Psychology, Education and Teacher Training, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brasov, Romania
| | - Dominic M. Kristaly
- Department of Automatics and Information Technology, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brasov, Romania
| | - Sorin-Aurel Moraru
- Department of Automatics and Information Technology, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brasov, Romania
| | - Lucia Paciaroni
- Neurology Department, IRCCS INRCA-National Institute of Health and Science on Aging, Via della Montagnola 81, 60100 Ancona, Italy
| | - Susy Paolini
- Neurology Department, IRCCS INRCA-National Institute of Health and Science on Aging, Via della Montagnola 81, 60100 Ancona, Italy
| | - Alessandra Raccichini
- Neurology Department, IRCCS INRCA-National Institute of Health and Science on Aging, Via della Montagnola 81, 60100 Ancona, Italy
| | - Elisa Felici
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy
| | - Lorena Rossi
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy
| | - Cristian Vizitiu
- Institute of Space Science, Atomistilor Str. 409, 077125 Magurele, Romania
| | | | - Mihaela Marin
- Institute of Space Science, Atomistilor Str. 409, 077125 Magurele, Romania
| | - Gabriella Tónay
- National Institute of Locomotor Diseases and Disabilities, National Institute for Medical Rehabilitation, Szanatórium utca 19, 1121 Budapest, Hungary
| | - András Tóth
- National Institute of Locomotor Diseases and Disabilities, National Institute for Medical Rehabilitation, Szanatórium utca 19, 1121 Budapest, Hungary
- Department of Manufacturing Science and Engineering, Faculty of Mechanical Engineering, Budapest University of Technology and Economics, Muegyetem rkp 3., 1111 Budapest, Hungary
| | - Tamás Pilissy
- National Institute of Locomotor Diseases and Disabilities, National Institute for Medical Rehabilitation, Szanatórium utca 19, 1121 Budapest, Hungary
- Department of Manufacturing Science and Engineering, Faculty of Mechanical Engineering, Budapest University of Technology and Economics, Muegyetem rkp 3., 1111 Budapest, Hungary
| | - Gábor Fazekas
- National Institute of Locomotor Diseases and Disabilities, National Institute for Medical Rehabilitation, Szanatórium utca 19, 1121 Budapest, Hungary
- Department of Rehabilitation Medicine, University of Szeged, Dugonics Square 13, 6720 Szeged, Hungary
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Steiner JF, Ross C, Stiefel M, Mosen D, Banegas MP, Wall AE, Martin C, Kelly TS, Paolino AR, Zeng C. Association between changes in loneliness identified through screening and changes in depression or anxiety in older adults. J Am Geriatr Soc 2022; 70:3458-3468. [PMID: 36053977 DOI: 10.1111/jgs.18012] [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: 03/07/2022] [Revised: 07/09/2022] [Accepted: 07/21/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Changes in loneliness are associated with corresponding changes in depression, anxiety, and general health in population surveys, but few studies have assessed these associations through repeated screening in clinical settings. METHODS Retrospective cohort study among individuals ≥age 65 in an integrated health care system who completed loneliness screening before two annual wellness visits, separated by a mean of 12.9 (SD 2.0) months, between 2013 and 2018. Their responses identified four subgroups: individuals who were persistently lonely; not lonely; experienced an increase (recently lonely); or decrease (previously lonely) in loneliness. Loneliness was assessed with a single item. Depression was assessed with the Patient Health Questionnaire-2. Anxiety was assessed with the Generalized Anxiety Disorder-2. Fair/poor general health was assessed by a single item. Linear mixed effects models assessed changes in outcomes after covariate adjustment. RESULTS The cohort comprised 24,666 individuals (19.2% of older adults in the system). Mean age was 73.7 years (SD 6.4); 54.6% were female, and 11.6% were members of racial and ethnic minority groups. Of these individuals, 1936 (7.8%) were persistently lonely, 1687 (6.8%) were recently lonely, 1551 (6.3%) were previously lonely, and 19,492 (79.0%) were not lonely at either time point. After adjustment for sociodemographic, clinical and social variables, recent loneliness was associated with increases in depression (adjusted odds ratio [aOR] 1.76, 95% confidence interval [CI] 1.41-2.19) and anxiety (aOR 1.67, 95% CI 1.32-2.10). Previous loneliness was associated with decreases in depression (aOR, 0.46, 95% CI 0.36-0.58) and anxiety (aOR 0.69, 95% CI 0.54-0.90). Changes in loneliness were not associated with changes in general health. CONCLUSIONS Changes in loneliness identified through screening were associated with corresponding changes in depression and anxiety. These findings support the potential value of identifying social risk factors in clinical settings among older adults.
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Affiliation(s)
- John F Steiner
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA
| | - Colleen Ross
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA
| | - Matthew Stiefel
- Social Health Practice, Kaiser Permanente, Oakland, California, USA
| | - David Mosen
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Matthew P Banegas
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.,Department of Radiation Medicine and Applied Sciences, University of California, San Diego, California, USA
| | - Alena E Wall
- Social Health Practice, Kaiser Permanente, Oakland, California, USA
| | - Cally Martin
- Social Health Practice, Kaiser Permanente, Oakland, California, USA
| | - Tammy S Kelly
- Quality, Risk & Patient Safety Department, Kaiser Permanente Colorado, Denver, Colorado, USA
| | - Andrea R Paolino
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA
| | - Chan Zeng
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA
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Long EM. The effect of letter writing on a long-term care resident with loneliness. Geriatr Nurs 2022; 50:260-261. [PMID: 36446660 PMCID: PMC9700208 DOI: 10.1016/j.gerinurse.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Older adults living in long term care (LTC) facilities may experience increased isolation and loneliness. This was compounded with the Coronavirus Disease 2019 (COVID-19) pandemic. Loneliness and isolation increase the risk for physical, psychological, and social decline. This case report discusses the effect of a letter writing initiative on feelings of loneliness and connection in a long-term care resident. Personalized care is the standard in the long-term care setting and letter writing between two people can contribute to personalized meaningful care as evidenced by the example provided. Further research is needed to explore social connection and loneliness and methods to combat these issues with a personalized approach for different populations within LTC facilities.
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Buczkowska M, Górski M, Domagalska J, Buczkowski K, Nowak P. Type D Personality and Health Behaviors in People Living with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14650. [PMID: 36429364 PMCID: PMC9690440 DOI: 10.3390/ijerph192214650] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Considering that health behaviors and personality traits play an important role in the formation of health attitudes, the main objective of this study was to evaluate the relations that occur between type D personality and health behaviors in a group of obese patients. METHODS 443 adult patients with BMI ≥ 30 kg/m2, who had been hospitalized in selected hospital facilities in the Silesian Voivodeship (Poland), participated in the study. Respondents completed three standardized questionnaires-the Multidimensional Health Locus of Control Scale, version A (MHLC-A), the Inventory of Health Behaviors (IZZ), and the Type D Scale (DS-14). RESULTS Patients with type D personality were characterized by the least effective mental attitudes and preventive behaviors, and differed significantly from the other personality types (intermediate and non-type D). Type D personality increased the risk of initiating improper health behaviors by more than five times. Regarding the sense of health control, patients with type D personality had significantly lower scores for the Internal Dimension subscale (21.3 ± 3.1) and higher for the Powerful Others Dimension subscale (24.0 ± 2.6), compared to patients with intermediate and non-type D personality. Proper health behaviors correlated with an internal sense of health control; the strongest correlation, defined as a medium, was with Preventive Behaviors (R = 0.42; p < 0.0001). CONCLUSIONS Type D personality was associated with poorer attitudes towards health. Among obese respondents with a type D personality, there was a significantly higher prevalence of those who believed that their health status was a consequence of chance events.
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Affiliation(s)
- Marta Buczkowska
- Department of Toxicology and Health Protection, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41-902 Katowice, Poland
| | - Michał Górski
- Doctoral School of the Medical University of Silesia in Katowice, Faculty of Health Sciences in Bytom, Medical University of Silesia, 40-055 Katowice, Poland
| | - Joanna Domagalska
- Department of Environmental Health, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41-902 Katowice, Poland
| | - Krzysztof Buczkowski
- Department of General and Oncological Surgery, City Hospital, 41-100 Siemianowice Slaskie, Poland
| | - Przemysław Nowak
- Department of Pharmacology, Faculty of Medicine, University of Opole, 45-052 Opole, Poland
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Bradley N, Dowrick C, Lloyd-Williams M. Feasibility of Patient Reported Outcome Measures in Psychosocial Palliative Care: Observational Cohort Study of Hospice Day Care and Social Support Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13258. [PMID: 36293835 PMCID: PMC9603547 DOI: 10.3390/ijerph192013258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/08/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Palliative care patients can be at risk of social isolation or loneliness. Interventions that can provide effective social support, and particularly emotional support, could facilitate healthy coping that bolsters quality of life and reduces depression in palliative care patients. This is an observational cohort study which recruited thirty patients (n = 30) from the day services of four independent hospices in England. Participants completed patient reported outcome measures in perceived social support, loneliness, and depression, at up to three time points. Age range was 56-91 years, males and females were equally represented, and the sample was 93% white British. In participants that provided two or more timepoints, perceived social support increased, and loneliness and depression decreased. Largest changes with the least variation between participants was in emotional support (p = 0.165) and loneliness (p = 0.104). These results suggest that the psychosocial patient reported outcome measures used (MOS-SS, UCLA, BEDS) could be sensitive to change aligned with the goals of this intervention in palliative care. Participants in this study were observed to derive psychosocial benefit from attending the hospice day service.
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Affiliation(s)
- Natasha Bradley
- Centre for Health & Clinical Research, University of the West of England, Bristol BS16 1DD, UK
| | - Christopher Dowrick
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool L69 3BX, UK
| | - Mari Lloyd-Williams
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool L69 3BX, UK
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Döring N, Conde M, Brandenburg K, Broll W, Gross HM, Werner S, Raake A. Can Communication Technologies Reduce Loneliness and Social Isolation in Older People? A Scoping Review of Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11310. [PMID: 36141581 PMCID: PMC9517063 DOI: 10.3390/ijerph191811310] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/31/2022] [Accepted: 09/03/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND Loneliness and social isolation in older age are considered major public health concerns and research on technology-based solutions is growing rapidly. This scoping review of reviews aims to summarize the communication technologies (CTs) (review question RQ1), theoretical frameworks (RQ2), study designs (RQ3), and positive effects of technology use (RQ4) present in the research field. METHODS A comprehensive multi-disciplinary, multi-database literature search was conducted. Identified reviews were analyzed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. A total of N = 28 research reviews that cover 248 primary studies spanning 50 years were included. RESULTS The majority of the included reviews addressed general internet and computer use (82% each) (RQ1). Of the 28 reviews, only one (4%) worked with a theoretical framework (RQ2) and 26 (93%) covered primary studies with quantitative-experimental designs (RQ3). The positive effects of technology use were shown in 55% of the outcome measures for loneliness and 44% of the outcome measures for social isolation (RQ4). CONCLUSION While research reviews show that CTs can reduce loneliness and social isolation in older people, causal evidence is limited and insights on innovative technologies such as augmented reality systems are scarce.
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Affiliation(s)
- Nicola Döring
- Media Psychology and Media Design Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Melisa Conde
- Media Psychology and Media Design Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Karlheinz Brandenburg
- Electronic Media Technology Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Wolfgang Broll
- Virtual Worlds and Digital Games Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Horst-Michael Gross
- Neuroinformatics and Cognitive Robotics Lab, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Stephan Werner
- Electronic Media Technology Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
| | - Alexander Raake
- Audiovisual Technology Group, Technische Universität Ilmenau, 98693 Ilmenau, Germany
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Powell VD, Kumar N, Galecki AT, Kabeto M, Clauw DJ, Williams DA, Hassett A, Silveira MJ. Bad company: Loneliness longitudinally predicts the symptom cluster of pain, fatigue, and depression in older adults. J Am Geriatr Soc 2022; 70:2225-2234. [PMID: 35415848 PMCID: PMC9378441 DOI: 10.1111/jgs.17796] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/10/2022] [Accepted: 03/11/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Pain, fatigue, and depression frequently co-occur as a symptom cluster. While commonly occurring in those with cancer and autoimmune disease, the cluster is also found in the absence of systemic illness or inflammation. Loneliness is a common psychosocial stressor associated with the cluster cross-sectionally. We investigated whether loneliness predicted the development of pain, fatigue, depression, and the symptom cluster over time. METHODS Data from the Health and Retirement Study were used. We included self-respondents ≥50 year-old who had at least two measurements of loneliness and the symptom cluster from 2006-2016 (n = 5974). Time-varying loneliness was used to predict pain, fatigue, depression, and the symptom cluster in the subsequent wave(s) using generalized estimating equations (GEE) and adjusting for sociodemographic covariates, living arrangement, and the presence of the symptom(s) at baseline. RESULTS Loneliness increased the odds of subsequently reporting pain (aOR 1.22, 95% CI 1.08, 1.37), fatigue (aOR 1.47, 95% CI 1.32, 1.65), depression (aOR 2.33, 95% CI 2.02, 2.68), as well as the symptom cluster (aOR 2.15, 95% CI 1.74, 2.67). The median time between the baseline and final follow-up measurement was 7.6 years (IQR 4.1, 8.2). CONCLUSIONS Loneliness strongly predicts the development of pain, fatigue, and depression as well as the cluster of all three symptoms several years later in a large, nonclinical sample of older American adults. Future studies should examine the multiple pathways through which loneliness may produce this cluster, as well as examine whether other psychosocial stressors also increase risk. It is possible that interventions which address loneliness in older adults may prevent or mitigate the cluster of pain, fatigue, and depression.
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Affiliation(s)
- Victoria D. Powell
- Division of Geriatric and Palliative MedicineUniversity of MichiganAnn ArborMichiganUSA
- Geriatric Research, Education, and Clinical CenterLTC Charles S. Kettles VA Medical CenterAnn ArborMichiganUSA
| | - Navasuja Kumar
- Division of Geriatric and Palliative MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Andrzej T. Galecki
- Division of Geriatric and Palliative MedicineUniversity of MichiganAnn ArborMichiganUSA
- Department of Biostatistics, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Mohammed Kabeto
- Division of Geriatric and Palliative MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Daniel J. Clauw
- Department of AnesthesiologyUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - David A. Williams
- Department of AnesthesiologyUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Afton Hassett
- Department of AnesthesiologyUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Maria J. Silveira
- Division of Geriatric and Palliative MedicineUniversity of MichiganAnn ArborMichiganUSA
- Geriatric Research, Education, and Clinical CenterLTC Charles S. Kettles VA Medical CenterAnn ArborMichiganUSA
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50
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Freak-Poli R, Ryan J, Tran T, Owen A, McHugh Power J, Berk M, Stocks N, Gonzalez-Chica D, Lowthian JA, Fisher J, Byles J. Social isolation, social support and loneliness as independent concepts, and their relationship with health-related quality of life among older women. Aging Ment Health 2022; 26:1335-1344. [PMID: 34219569 DOI: 10.1080/13607863.2021.1940097] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives: To assess whether social isolation, social support, and loneliness are independently associated with health-related quality of life (HRQoL).Method: Retrospective analysis including 10,517 women aged 70-75 years from the Australian Longitudinal Study on Women's Health (ALSWH). Social isolation, social support (Duke Social Support Index), and loneliness (single item) were investigated for their association with standardised HRQoL (physical [PCS] and mental [MCS] components of the SF-36® questionnaire). Analyses were adjusted for sociodemographic variables and number of medical conditions.Results: Only 3% reported being socially isolated, having low social support and being lonely, and 34% reported being not socially isolated, high social support and not being lonely. Each construct was independently associated with HRQoL, with loneliness having the strongest inverse association (PCS: isolation -0.98, low support -2.01, loneliness -2.03; MCS: isolation -1.97, low support -4.79, loneliness -10.20; p-value < 0.001 for each). Women who were not isolated or lonely and with high social support had the greatest HRQoL (compared to isolated, low social support and lonely; MCS: 17 to 18 points higher, PCS: 5 to 8 points higher). Other combinations of social isolation, social support and loneliness varied in their associations with HRQoL.Conclusion: Ageing populations face the challenge of supporting older people to maintain longer, healthy, meaningful and community-dwelling lives. Among older women, social isolation, low social support and loneliness are distinct, partially overlapping yet interconnected concepts that coexist and are each adversely associated with HRQoL. Findings should be replicated in other cohorts to ensure generalisability across other age groups and men.
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Affiliation(s)
- Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Thach Tran
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Alice Owen
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Michael Berk
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Nigel Stocks
- Discipline of General Practice, The University of Adelaide, Adelaide, Australia
| | - David Gonzalez-Chica
- Discipline of General Practice, The University of Adelaide, Adelaide, Australia.,Adelaide Rural Clinical School, The University of Adelaide, Adelaide, Australia
| | - Judy A Lowthian
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,Bolton Clarke Research Institute, Bolton Clarke, Melbourne, Australia.,Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Jane Fisher
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Julie Byles
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, Australia
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