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Duffner LA, Janssen N, Deckers K, Schroyen S, de Vugt ME, Köhler S, Adam S, Verhey FRJ, Veenstra MY. Facing the Next "Geriatric Giant"-A Systematic Literature Review and Meta-Analysis of Interventions Tackling Loneliness and Social Isolation Among Older Adults. J Am Med Dir Assoc 2024; 25:105110. [PMID: 38945174 DOI: 10.1016/j.jamda.2024.105110] [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: 10/02/2023] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVES Loneliness and social isolation are associated with adverse health outcomes, especially within the older adult population, underlining the need for effective interventions. This systematic review and meta-analysis aims to summarize all available evidence regarding the effectiveness of interventions for loneliness and social isolation, to map out their working mechanisms, and to give implications for policy and practice. DESIGN Systematic literature review and meta-analysis. SETTING AND PARTICIPANTS Older adults (≥65 years). METHODS A systematic search was conducted in MEDLINE, PsycINFO, and CINAHL for studies quantitively or qualitatively assessing effects of interventions for loneliness and social isolation in older adults, following predefined selection criteria. Risk of bias as well as small study effects were assessed and, wherever appropriate, information about effect sizes of individual studies pooled using random-effects meta-analyses. Sources for between-study heterogeneity were explored using meta-regression. RESULTS Of n = 2223 identified articles, n = 67 were eventually included for narrative synthesis. Significant intervention effects were reported for a proportion of studies (55.9% and 50.0% for loneliness and social isolation, respectively) and 57.6% of studies including a follow-up measure (n = 29) reported sustained intervention effects. Meta-analysis of n = 27 studies, representing n = 1756 participants, suggested a medium overall effect of loneliness interventions (d = -0.47; 95% CI, -0.62 to -0.32). Between-study heterogeneity was substantial and could not be explained by differences in study design, year of publication, outcome measures, intervention length, participant demographics, setting, baseline level of loneliness, or geographic location. However, non-technology-based interventions reported larger effect sizes on average (Δd = -0.35; 95% CI, -0.66 to -0.04; P = .029) and were more often significant. Qualitative assessment of potential intervention mechanisms resulted in 3 clusters of effective components: "promoting social contact," "transferring knowledge and skills," and "addressing social cognition". CONCLUSIONS AND IMPLICATIONS Interventions for loneliness and social isolation can generally be effective, although some unexplained between-study heterogeneity remains. Further research is needed regarding the applicability of interventions across different settings and countries, also considering their cost-effectiveness.
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Affiliation(s)
- Lukas A Duffner
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Niels Janssen
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Kay Deckers
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sarah Schroyen
- Psychology of Aging Unit (UPsySen), Faculty of Psychology, University of Liege, Liege, Belgium
| | - Marjolein E de Vugt
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Stéphane Adam
- Psychology of Aging Unit (UPsySen), Faculty of Psychology, University of Liege, Liege, Belgium
| | - Frans R J Verhey
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Marja Y Veenstra
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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Jiang C, Chow JCC, Zhou L, Song H, Shi J. Community support, social isolation and older adults' life satisfaction: evidence from a national survey in China. Aging Ment Health 2024; 28:849-857. [PMID: 37921357 DOI: 10.1080/13607863.2023.2277871] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES Despite the recognized importance of community social service and community built facility for enhancing older adults' life satisfaction, the mechanisms underlying their relationship have not been thoroughly examined. This study aims to complement the existing knowledge by investigating the mediating role of social disconnectedness and loneliness in the association between community support and life satisfaction among older adults. METHODS Using data from the 2018 China Longitudinal Aging Social Survey, the study analyzes responses from 9,874 Chinese older adults (mean age = 71.30 years, SD = 7.30). We conducted descriptive statistics and Pearson's correlation to explore the variables. This study also used Mplus 8.0 to conduct a path analysis model that evaluated both the direct and indirect effects of community social service and built facility on life satisfaction. Social disconnectedness and loneliness were included as mediating variables in this model. RESULTS The present study results show that both community social service and community built facility are positively associated with life satisfaction among older adults, and community social service is more imporatant for enhancing the life satisfaction. In addition, these associations are mediated by social disconnectedness and loneliness. CONCLUSION Our research suggests that strengthening community social service programs and improving the built environment can reduce social disconnectedness and loneliness among older adults, ultimately enhancing their life satisfaction. Specifically, policymakers can invest in targeted interventions to enhance social connectedness and reduce loneliness, with the goal of improving the overall well-being of older adults.
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Affiliation(s)
- Chaoxin Jiang
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, China
- School of Social Welfare, University of California at Berkeley, Berkeley, CA, USA
| | | | - Leyi Zhou
- School of Social Welfare, University of California at Berkeley, Berkeley, CA, USA
| | - Hao Song
- School of Government, Nanjing University, Nanjing, China
| | - Jiaming Shi
- Department of Social Security, School of Public Administration, Southwestern University of Finance and Economics, Chengdu, China
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Smith L, López Sánchez GF, Soysal P, Veronese N, Gibson P, Pizzol D, Jacob L, Butler L, Barnett Y, Oh H, Shin JI, Koyanagi A. Association of handgrip strength with suicidal ideation among adults aged ≥50 years from low- and middle-income countries. Suicide Life Threat Behav 2024; 54:606-614. [PMID: 38469894 DOI: 10.1111/sltb.13071] [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: 08/03/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION This study aimed to investigate the association between handgrip strength and suicidal ideation in representative samples of adults aged ≥50 years from six LMICs (China, Ghana, India, Mexico, Russia, and South Africa). METHODS Cross-sectional, community-based data from the World Health Organization's Study on Global Aging and Adult Health were analyzed. Handgrip strength quintiles by sex were created based on the average value of two handgrip measurements of the dominant hand. Self-reported information on past 12-month suicidal ideation was collected. Multivariable logistic regression analysis was conducted to assess associations. RESULTS Data on 34,129 individuals were analyzed [mean (SD) age 62.4 (16.0) years; age range 50-114 years; 52.1% females]. After adjustment for potential confounders, in the overall sample, compared to the handgrip strength quintile with the highest values [Quintile 1 (Q1)], Q2, Q3, Q4, and Q5 were associated with significant 2.15 (95% CI = 1.05-4.39), 2.78 (95% CI = 1.06-7.32), 3.53 (95% CI = 1.68-7.42), and 6.79 (95% CI = 2.80-16.48) times higher odds for suicidal ideation. CONCLUSIONS Lower handgrip strength was significantly and dose-dependently associated with higher odds for suicidal ideation in adults aged ≥50 years from LMICs. Future longitudinal studies are needed to understand the underlying mechanisms, and whether increasing general muscular strength and physical function may lead to reduction in suicidal ideation.
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Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Poppy Gibson
- Faculty of Arts, Humanities, Education and Social Sciences, Anglia Ruskin University, Chelmsford, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
- AP-HP, Université Paris Cité, Lariboisière-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, Paris, France
- Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Université Paris Cité, Inserm U1153, Paris, France
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
- Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
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Shekelle PG, Miake-Lye IM, Begashaw MM, Booth MS, Myers B, Lowery N, Shrank WH. Interventions to Reduce Loneliness in Community-Living Older Adults: a Systematic Review and Meta-analysis. J Gen Intern Med 2024; 39:1015-1028. [PMID: 38200279 PMCID: PMC11074098 DOI: 10.1007/s11606-023-08517-5] [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: 06/27/2023] [Accepted: 10/26/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND The problem of loneliness has garnered increased attention from policymakers, payors, and providers due to higher rates during the pandemic, particularly among seniors. Prior systematic reviews have in general not been able to reach conclusions about effectiveness of interventions. METHODS Computerized databases were searched using broad terms such as "loneliness" or "lonely" or "social isolation" or "social support" from Jan 1, 2011 to June 23, 2021. We reference mined existing systematic reviews for additional and older studies. The Social Interventions Research & Evaluation Network database and Google were searched for gray literature on Feb 4, 2022. Eligible studies were RCTs and observational studies of interventions to reduce loneliness in community-living adults that used a validated loneliness scale; studies from low- or middle-income countries were excluded, and studies were excluded if restricted to populations where all persons had the same disease (such as loneliness in persons with dementia). RESULTS A total of 5971 titles were reviewed and 60 studies were included in the analysis, 36 RCTs and 24 observational studies. Eleven RCTs and 5 observational studies provided moderate certainty evidence that group-based treatment was associated with reduced loneliness (standardized mean difference for RCTs = - 0.27, 95% CI - 0.48, - 0.08). Five RCTs and 5 observational studies provided moderate certainty evidence that internet training was associated with reduced loneliness (standardized mean difference for RCTs = - 0.22, 95% CI - 0.30, - 0.14). Low certainty evidence suggested that group exercises may be associated with very small reductions in loneliness. Evidence was insufficient to reach conclusions about group-based activities, individual in-person interactions, internet-delivered interventions, and telephone-delivered interventions. DISCUSSION Low-to-moderate certainty evidence exists that group-based treatments, internet training, and possibly group exercises are associated with modest reductions in loneliness in community-living older adults. These findings can inform the design of supplemental benefits and the implementation of evidence-based interventions to address loneliness. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO ( CRD42021272305 ).
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Affiliation(s)
- Paul G Shekelle
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA.
- Division of General Internal Medicine & Health Services Research, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- General Internal Medicine 111G, West Los Angeles VA Medical Center, Los Angeles, CA, USA.
| | - Isomi M Miake-Lye
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Meron M Begashaw
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA
| | - Marika S Booth
- RAND Corporation, Southern California Evidence-Based Practice Center, Santa Monica, CA, USA
| | - Bethany Myers
- Louise M. Darling Biomedical Library, University of California Los Angeles, Los Angeles, CA, USA
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Langergaard S, Evans R, Andreasen J, Petersen KS, Overgaard C. Targeting belongingness among older people through engagement in senior centres: intervention development study in Denmark. Health Promot Int 2024; 39:daae032. [PMID: 38610110 PMCID: PMC11015047 DOI: 10.1093/heapro/daae032] [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] [Indexed: 04/14/2024] Open
Abstract
Adults often experience a loss of social relations and sense of belonging in later life, leading to the risk of social isolation. Municipal senior centres offer a potential site for intervention, as they provide social communities targeting older people. However, not all older people find it easy to access these social communities due to experiencing physical and/or psychosocial frailties and could therefore continue to experience a decline in social relations and sense of belonging, which potentiates poor physical and psychosocial health and well-being. To date, there are limited evidence-based interventions in Denmark. The present article describes the development of an intervention to increase belongingness and decrease social isolation among older people with frailties who attend Danish municipal senior centres. The development process was conducted with reference to the INDEX (IdentifyiNg and assessing different approaches to DEveloping compleX intervention) guidance. The development process resulted in a 6-month supportive intervention, consisting of four elements: skills development workshops for all staff members; a start conversation including frailty screening; allocation of a 'buddy' among existing service users; and monthly follow-up conversations with staff members. This theory-informed approach can progress to feasibility testing and outcome evaluation in order to generate an evidence base. Concurrently, the article reflects on current guidance for intervention development and how it may be used and optimized to strengthen developmental processes in the future.
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Affiliation(s)
- Sofie Langergaard
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerloefs Vej 249, 9260 Gistrup, Aalborg, Denmark
| | - Rhiannon Evans
- DECIPHer, School of Social Sciences, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK
| | - Jane Andreasen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerloefs Vej 249, 9260 Gistrup, Aalborg, Denmark
- Aalborg Centre of Health and Rehabilitation, Aalborg Municipality, Teglgårds Plads 1, 9000 Aalborg, Denmark
| | - Kirsten Schultz Petersen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Selma Lagerloefs Vej 249, 9260 Gistrup, Aalborg, Denmark
| | - Charlotte Overgaard
- Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Degnevej 14, 6705 Esbjerg Ø, Denmark
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Adepoju OE, Ojinnaka CO, Pieratt J, Dobbins J. Racial and ethnic differences in predictors of participation in an intergenerational social connectedness intervention for older adults. BMC Geriatr 2024; 24:70. [PMID: 38233782 PMCID: PMC10795227 DOI: 10.1186/s12877-024-04679-x] [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: 05/24/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Social connectedness is a key determinant of health and interventions have been developed to prevent social isolation in older adults. However, these interventions have historically had a low participation rate amongst minority populations. Given the sustained isolation caused by the COVID-19 pandemic, it is even more important to understand what factors are associated with an individual's decision to participate in a social intervention. To achieve this, we used machine learning techniques to model the racial and ethnic differences in participation in social connectedness interventions. METHODS Data were obtained from a social connectedness intervention that paired college students with Houston-area community-dwelling older adults (> 65 yo) enrolled in Medicare Advantage plans. Eligible participants were contacted telephonically and asked to complete the 3-item UCLA Loneliness Scale. We used the following machine-learning methods to identify significant predictors of participation in the program: k-nearest neighbors, logistic regression, decision tree, gradient-boosted decision tree, and random forest. RESULTS The gradient-boosted decision tree models yielded the best parameters for all race/ethnicity groups (96.1% test accuracy, 0.739 AUROC). Among non-Hispanic White older adults, key features of the predictive model included Functional Comorbidity Index (FCI) score, Medicare prescription risk score, Medicare risk score, and depression and anxiety indicators within the FCI. Among non-Hispanic Black older adults, key features included disability, Medicare prescription risk score, FCI and Medicare risk scores. Among Hispanic older adults, key features included depression, FCI and Medicare risk scores. CONCLUSIONS These findings offer a substantial opportunity for the design of interventions that maximize engagement among minority groups at greater risk for adverse health outcomes.
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Affiliation(s)
- Omolola E Adepoju
- Humana Integrated Health Systems Sciences Institute, University of Houston, Houston, USA.
- Tilman J Fertitta Family College of Medicine, Department of Health Systems and Population Health Sciences, University of Houston, Houston, USA.
| | | | | | - Jessica Dobbins
- Tilman J Fertitta Family College of Medicine, Department of Health Systems and Population Health Sciences, University of Houston, Houston, USA
- Humana Inc, Louisville, USA
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Mosteiro Miguéns DG, Rodríguez Fernández A, Zapata Cachafeiro M, Vieito Pérez N, Represas Carrera FJ, Novío Mallón S. Community Activities in Primary Care: A Literature Review. J Prim Care Community Health 2024; 15:21501319231223362. [PMID: 38197384 PMCID: PMC10785739 DOI: 10.1177/21501319231223362] [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: 10/29/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/11/2024] Open
Abstract
Community health promotion activities are a useful tool for a proactive approach to healthy lifestyles. However, the implementation of these types of activities at health centers is not standardized. The aim of this review was to analyse the characteristics of community activities undertaken in the primary care setting and substantiate available evidence on their health impact. We conducted a bibliographic review until November 15th, 2023 in the TRIPDATABASE, MEDLINE, EMBASE, and DIALNET databases. We included original papers on interventions, community activities, and actions and/or social prescriptions which had been implemented in a Primary Care setting, included a group approach in at least one session, and described some type of evaluation of the intervention applied. Studies targeted at professionals and those without involvement of the primary care team were excluded. The search identified 1912 potential studies. We included a total of 30 studies, comprising 11 randomized clinical trials, 14 quasi-experimental studies, 1 cohort study, and 4 qualitative studies. The issues most frequently addressed in community activities were healthy habits, physical activity, cardiovascular diseases and diabetes. Community activities can improve the physical and psychological environment of their participants, as well as their level of knowledge about the issues addressed. That said, however, implementation of these types of interventions is not uniform. The existence of a professional community-activity liaison officer at health centers, who would help integrate the health system with the community sector, could serve to standardize implementation and maximize the health impact of these types of interventions.
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Affiliation(s)
| | - Almudena Rodríguez Fernández
- University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP) Instituto de Salud Carlos III, Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Maruxa Zapata Cachafeiro
- University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP) Instituto de Salud Carlos III, Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Natalia Vieito Pérez
- University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
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Yu J, Jin Y, Si H, Bian Y, Liu Q, Li Y, Wang C. Relationship between intrinsic capacity and health-related quality of life among community-dwelling older adults: the moderating role of social support. Qual Life Res 2024; 33:267-280. [PMID: 37845404 DOI: 10.1007/s11136-023-03520-z] [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] [Accepted: 09/18/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE To examine how social support might moderate the relationship between intrinsic capacity and health-related quality of life (HRQoL) based on the buffering model of social support. METHODS This was a cross-sectional study with a sample of 1181 Chinese community-dwelling older adults aged ≥ 60 years in 2016. Social support was assessed using the Social Support Rating Scale. Intrinsic capacity was assessed using the revised integrated care for older people screening tool. HRQoL was measured by the 12-item Short Form Health Survey. Hierarchical linear regression analysis was implemented to test the moderating effect of social support. RESULTS Support utilization attenuated the relationship between lower intrinsic capacity and poor physical HRQoL while subjective support attenuated the relationship between lower intrinsic capacity and poor mental HRQoL. However, objective support had no significant moderating effect on the relationship between intrinsic capacity and specific domains of HRQoL. CONCLUSION The moderating effects of social support on the association between intrinsic capacity and HRQoL vary by support types. Effective interventions should target the perception and utilization of available support among older adults with lower intrinsic capacity to maintain their physical and mental HRQoL.
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Affiliation(s)
- Jiaqi Yu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yaru Jin
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Huaxin Si
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yanhui Bian
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Qinqin Liu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yanyan Li
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Cuili Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Pecchinenda A, Yankouskaya A, Boccia M, Piccardi L, Guariglia C, Giannini AM. Exploring the relationship between perceived loneliness and subjective cognitive decline in older individuals. Aging Ment Health 2024; 28:73-82. [PMID: 37540497 DOI: 10.1080/13607863.2023.2242291] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/12/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE Loneliness has been associated to a greater risk of cognitive decline and dementia in older individuals. However, evidence on whether this association also exists for older individuals who complain of cognitive problems is limited. We conducted a survey to examine the association between subjective cognitive decline in the working memory domain, perceived loneliness, depression, anxiety, and stress in older individuals with different profiles. METHODS A total of 302 healthy, old individuals completed 3 questionnaires to assess subjective cognitive problems in attention, executive functions, storage, depression, anxiety, stress, and perceived loneliness. RESULTS We conducted a cluster analysis and 3 clusters of individuals with different profiles emerged. Individuals with greater subjective cognitive problems (cluster 1) in the attention and storage domains, reported higher perceived loneliness and stress but not depression. In contrast, individuals with the least subjective cognitive problems (cluster 3) in the storage domain, reported lower perceived loneliness. CONCLUSIONS Individuals with higher subjective cognitive decline also report higher levels of perceived loneliness but not more depression than their peers. However, this correlation is present only for individuals with mild subjective cognitive decline (cluster 2). The implications for future research and interventions are discussed.
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Affiliation(s)
- Anna Pecchinenda
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Maddalena Boccia
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia, Rome, Italy
| | - Laura Piccardi
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- San Raffaele Cassino Hospital, Cassino, FR, Italy
| | - Cecilia Guariglia
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia, Rome, Italy
| | - Anna Maria Giannini
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia, Rome, Italy
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Laidlaw RJ, McGrath R, Adams C, Kumar S, Murray CM. Improved Mental Health, Social Connections and Sense of Self: A Mixed Methods Systematic Review Exploring the Impact and Experience of Community Reminiscence Programs. J Multidiscip Healthc 2023; 16:4111-4132. [PMID: 38116304 PMCID: PMC10729907 DOI: 10.2147/jmdh.s438730] [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: 09/05/2023] [Accepted: 11/15/2023] [Indexed: 12/21/2023] Open
Abstract
Older people can experience health and social challenges such as loneliness, depression, and lack of social connectedness. One initiative that has been trialed to address these challenges is reminiscence programs. These programs can include music, art, photographs, sports, and general discussion to stimulate memories. This review aimed to systematically search for literature that explored the impact and experience of reminiscence programs for older people living in the community for the purposes of informing community programming. The PICOS framework was used to develop the review parameters and search strategy. Qualitative and quantitative research focused on community-based reminiscence programs were included. Commercially produced databases and grey literature were searched. The Critical Appraisal Skills Program qualitative critical appraisal tool and McMaster quantitative critical appraisal tool were used to assess the methodological quality of the included studies. Quantitative data were descriptively synthesized, and qualitative data were thematically analyzed, with each reported separately. Twenty-seven studies were included in the review. All quantitative studies (n = 17) provided clear information regarding the purpose, sample size, and justification. The measures adopted were reliable and valid. All studies reported clear data collection/analysis information and statistically significant findings. All qualitative studies (n = 10) clearly articulated a purpose with nine clearly describing recruitment, data collection, and researcher relationship. Synthesis of quantitative data demonstrated positive findings through a reduction in depression, anxiety, and loneliness and improvements in quality of life and mastery. These findings were supported and broadened by qualitative findings with three key themes identified: program processes, program ingredients, and program benefits. Providing opportunities for older adults to come together to tell stories about their past experiences may positively contribute to social outcomes. As reminiscence programs gain popularity, their implementation in practice should be underpinned by clear and reproducible practices.
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Affiliation(s)
- Robert John Laidlaw
- Allied Health and Human Performance, IIMPACT in Health, University of South Australia, Adelaide, South Australia, 5001, Australia
| | - Richard McGrath
- Allied Health and Human Performance, IIMPACT in Health, University of South Australia, Adelaide, South Australia, 5001, Australia
| | - Caroline Adams
- Allied Health and Human Performance, IIMPACT in Health, University of South Australia, Adelaide, South Australia, 5001, Australia
| | - Saravana Kumar
- Allied Health and Human Performance, IIMPACT in Health, University of South Australia, Adelaide, South Australia, 5001, Australia
| | - Carolyn M Murray
- Allied Health and Human Performance, IIMPACT in Health, University of South Australia, Adelaide, South Australia, 5001, Australia
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Wang Y, Li X, Yao L, Ren T, Wang T. Effectiveness of social support programmes on loneliness in community-dwelling older adults: study protocol for a meta-analysis of randomised controlled trials. BMJ Open 2023; 13:e073739. [PMID: 38072487 PMCID: PMC10729098 DOI: 10.1136/bmjopen-2023-073739] [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: 03/18/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The prevalence of loneliness among older adults is of great importance in the field of public health. Numerous studies have provided evidence supporting the effectiveness of social support as a powerful intervention for reducing loneliness in older individuals. However, the specific types of social support that yield positive results are yet to be determined. Therefore, this study aims to conduct a comprehensive review to compare and analyse the effectiveness of different support mechanisms in alleviating loneliness among community-dwelling older adults. METHODS AND ANALYSIS A thorough search will be conducted on various electronic databases, including EMBASE, PubMed, the Cochrane Library, Web of Science, PsycINFO, Scopus, Google Scholar, China National Knowledge Infrastructure Library, China Science and Technology Journal Database (Weipu), WanFang Database, and China Biology Medicine Disc. The search will include randomised controlled trials published in English or Chinese that focus on interventions for loneliness in older individuals, with loneliness as the primary measure of interest. The selection and choice of articles will be the responsibility of both reviewers. The JBI Critical Appraisal Checklist for Randomised Controlled Trials will be used to assess the methodological quality of the included trials. When sufficient data are obtained and the study is relatively homogeneous, a random-effects or fixed-effects model will be employed to conduct a meta-analysis, yielding a descriptive synthesis of the findings. ETHICS AND DISSEMINATION Ethics approval will not be sought for this systematic review as it will exclusively focus on published papers. The review findings will be showcased at a conference dedicated to this specific field and published in an appropriate journal that undergoes peer evaluation. PROSPERO REGISTRATION NUMBER CRD42020226523.
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Affiliation(s)
- Yinhua Wang
- The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | | | - Li Yao
- The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Tingting Ren
- The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Tingshu Wang
- Guizhou Medical University, Guiyang, Guizhou, China
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Bridi L, Kaki DA, Behnam R, Khan X, Albahsahli B, Bencheikh N, Aljenabi R, Ahmadi N, Dajani R, Al-Rousan T. Attitudes toward dementia and cognitive aging among Syrian refugees resettled in Jordan: a qualitative study. BMC Public Health 2023; 23:2307. [PMID: 37990313 PMCID: PMC10664261 DOI: 10.1186/s12889-023-17183-5] [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: 04/12/2023] [Accepted: 11/08/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Mounting evidence is revealing disparities in cognitive function and heightened dementia risk among refugees, yet research in this area remains scant. Despite bearing most of the world's refugee burden, limited-resource countries like Jordan are facing challenges when dealing with refugee health. There is a lack of research on the attitudes toward dementia and the cognitive healthcare gaps among refugees in Jordan. METHODS 32 older (≥ 55 years) Syrian refugees resettled in Jordan were recruited through a local community-based organization and interviewed in four focus groups (2 female and 2 male groups). Interviews were transcribed and translated, then coded using inductive thematic analysis. RESULTS Mean age of the sample was 60.1 years and 53.1% were female. Only 34.4% rated their memory as good or excellent. Themes were organized using the socioecological model: 1) At the individual level, participants believed high levels of stress, including low socioeconomic status, poor health, and traumatic history from their refugee experience increased their dementia risk. 2) Interpersonally, there is a fear of dementia due to the possible impact and burden on loved ones, particularly with the stigma surrounding dementia. 3) At the community level, participants noted that resettlement in Jordan - with a shared language, religion, and culture - offered protective effects due to facilitated access to social connection, information, and mental health self-care. 4) At the institution and policy level, participants believed older refugees faced restrictive policies for economic aid, healthcare, and employment, presenting a significant barrier to healthy aging. CONCLUSIONS Findings from this study are the first to examine the attitudes of Syrian refugees in Jordan toward dementia and cognitive aging. These results could provide essential data inclusive of refugees as Jordan develops its National Dementia Plan. Investing in dementia awareness interventions and age-friendly neighborhoods may benefit aging refugees in limited-resources settings.
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Affiliation(s)
- Lana Bridi
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Dahlia A Kaki
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Rawnaq Behnam
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
| | - Xara Khan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
- School of Social Sciences, University of California, San Diego, San Diego, CA, USA
| | - Behnan Albahsahli
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
| | - Nissma Bencheikh
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Raghad Aljenabi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
- School of Social Sciences, University of California, San Diego, San Diego, CA, USA
| | - Nargis Ahmadi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
| | - Rana Dajani
- Department of Biology and Biotechnology, The Hashemite University, Zarqa, Jordan
| | - Tala Al-Rousan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA.
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Ebner NC, Pehlivanoglu D, Shoenfelt A. Financial Fraud and Deception in Aging. ADVANCES IN GERIATRIC MEDICINE AND RESEARCH 2023; 5:e230007. [PMID: 37990708 PMCID: PMC10662792 DOI: 10.20900/agmr20230007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Financial exploitation among older adults is a significant concern with often devastating consequences for individuals and society. Deception plays a critical role in financial exploitation, and detecting deception is challenging, especially for older adults. Susceptibility to deception in older adults is heightened by age-related changes in cognition, such as declines in processing speed and working memory, as well as socioemotional factors, including positive affect and social isolation. Additionally, neurobiological changes with age, such as reduced cortical volume and altered functional connectivity, are associated with declining deception detection and increased risk for financial exploitation among older adults. Furthermore, characteristics of deceptive messages, such as personal relevance and framing, as well as visual cues such as faces, can influence deception detection. Understanding the multifaceted factors that contribute to deception risk in aging is crucial for developing interventions and strategies to protect older adults from financial exploitation. Tailored approaches, including age-specific warnings and harmonizing artificial intelligence as well as human-centered approaches, can help mitigate the risks and protect older adults from fraud.
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Affiliation(s)
- Natalie C. Ebner
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA
- Florida Institute for Cybersecurity Research, University of Florida, Gainesville, FL 32611, USA
- Florida Institute for National Security, University of Florida, Gainesville, FL 32611, USA
- Institute on Aging, University of Florida, Gainesville, FL 32611, USA
- Center for Cognitive Aging and Memory, University of Florida, Gainesville, FL 32610, USA
| | - Didem Pehlivanoglu
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA
- Florida Institute for Cybersecurity Research, University of Florida, Gainesville, FL 32611, USA
- Florida Institute for National Security, University of Florida, Gainesville, FL 32611, USA
| | - Alayna Shoenfelt
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA
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Santos C, Fernandes CS, Bastos C, Cruz MA, Costa S, Lima L. Older person's experience of PT4Ageing-A programme on self-management «support» in chronic illness. ENFERMERIA CLINICA (ENGLISH EDITION) 2023; 33:346-352. [PMID: 37714461 DOI: 10.1016/j.enfcle.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/30/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE This study sought to describe the experience of a group of older adults who participated in a chronic illness self-management program. METHODS The study employed a qualitative phenomenological approach. Participants were eight elders and data collected using semi-structured interviews Data was analysed using thematic analysis. RESULTS Five themes emerged from the analysis: (1) Tips to improve our daily lives, (2) I was always motivated, (3) Sharing and mutual help, (4) They made us believe we were capable (5). It would be great if it did not end here. Globally, the participants of the program described their experience as very positive. They identified gains from participating in the program, such as learning strategies to help them cope with their health problems, improving their ability to manage their illnesses more autonomously and building social support, that even persisted after the conclusion of the intervention. CONCLUSION The findings of this study provide insight into how older adults experience a program for the self-management of chronic illness. For the development of future programs, support building must be considered. Older adults who participate in self-management programmes exhibit improved self-efficacy in relation to the management their chronic illnesses and greater autonomy in self-care.
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Affiliation(s)
- Célia Santos
- Escuela de Enfermería de Oporto, Porto, Portugal; lCINTESIS@RISE Research, Porto, Portugal
| | - Carla Silvia Fernandes
- Escuela de Enfermería de Oporto, Porto, Portugal; lCINTESIS@RISE Research, Porto, Portugal.
| | - Celeste Bastos
- Escuela de Enfermería de Oporto, Porto, Portugal; lCINTESIS@RISE Research, Porto, Portugal
| | | | - Sandra Costa
- lCINTESIS@RISE Research, Porto, Portugal; Instituto de Ciencias Biomédicas Abel Salazar, Universidad de Oporto, Porto, Portugal; ACES Grande Porto I - Santo Tirso/Trofa, ARS Norte Administración Sanitaria del Norte, I.P., Porto, Portugal
| | - Lígia Lima
- Escuela de Enfermería de Oporto, Porto, Portugal; lCINTESIS@RISE Research, Porto, Portugal
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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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Douglas NF, Archer B, Azios JH, Strong KA, Simmons-Mackie N, Worrall L. A scoping review of friendship intervention for older adults: lessons for designing intervention for people with aphasia. Disabil Rehabil 2023; 45:3012-3031. [PMID: 36170126 DOI: 10.1080/09638288.2022.2117866] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Map the landscape of friendship interventions/programs for older adults to guide intervention/program development inclusive of the unique needs of older people with aphasia (PWA). METHODS A search query of multiple databases was completed for articles published before 4 January 2021. Studies included all the following: (1) participants aged 55 years or older; (2) addressed an intervention/program designed to prevent social isolation and/or friendship loss; (3) used an outcome variable related to social isolation and/or friendship; and (4) published in a peer-reviewed journal. Title and abstract screening were conducted using Covidence software, which tracked disagreements across the study team. All studies included in the full-text review were identified as relevant by a minimum of two study authors, and a consensus was reached on all full-text reviews. Data were extracted according to (1) theoretical frameworks used; (2) interventionist and discipline; (3) participant characteristics; (4) intervention/program replicability; (5) format of intervention/program; (6) measures used in the intervention/programs; (7) and, reported effects of intervention/programs on individuals. RESULTS A total of 40 articles with 42 intervention/programs were included and represented 4584 intervention/program participants ranging in age from 40 to 104 years. Intervention/programs involved a wide range of theoretical frameworks (e.g., theories of loneliness, feminist theory, positive psychology). Disciplines such as psychology and exercise science informed intervention/programs. Interventionists included many types of individuals like therapists, volunteers and home health aides. Intervention/programs often lacked adequate description for replication and included individual and group formats, most commonly delievered in the participants homes. Outcomes usually included self-report measures of loneliness, social networks, or well-being, and intervention/programming was primarily educational, activity-based, or networking-based in nature. CONCLUSIONS The intervention/programs reviewed yield important lessons to support innovation in developing friendship intervention/programs for older PWA as most yielded positive results and were acceptable to participants.IMPLICATIONS FOR REHABILITATIONPeople with aphasia want their friendships addressed as part of their rehabilitation; however, the research literature has little guidance in this area.Studies reviewed of friendship intervention/programs for older adults yielded helpful lessons for consideration in developing this type of intervention/programming for people with aphasia.Interprofessional teams made up of rehabilitation professionals should address friendship for people with aphasia in both research and clinical practice.
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Affiliation(s)
- Natalie F Douglas
- Department of Communication Sciences and Disorders, Central Michigan University, Mount Pleasant, MI, USA
| | - Brent Archer
- Department of Communication Sciences & Disorders, Bowling Green State University, Bowling Green, OH, USA
| | - Jamie H Azios
- Department of Speech & Hearing Sciences, Lamar University, Beaumont, TX, USA
| | - Katie A Strong
- Department of Communication Sciences and Disorders, Central Michigan University, Mount Pleasant, MI, USA
| | - Nina Simmons-Mackie
- Department of Health & Human Sciences, Southeastern Louisiana University, Hammond, LA, USA
| | - Linda Worrall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Welch V, Pottie K, Gaudet C, Thuku M, Mallard R, Spenceley S, Amjed N, Wadhwani A, Ghogomu E, Scott C, Dahrouge S. Realist review of community coalitions and outreach interventions to increase access to primary care for vulnerable populations: a realist review. Arch Public Health 2023; 81:115. [PMID: 37353828 DOI: 10.1186/s13690-023-01105-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/09/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND There are meaningful gaps in equitable access to Primary Health Care (PHC), especially for vulnerable populations after widespread reforms in Western countries. The Innovative Models Promoting Access-to-Care Transformation (IMPACT) research program is a Canadian-Australian collaboration that aims to improve access to PHC for vulnerable populations. Relationships were developed with stakeholders in six regions across Canada and Australia where access-related needs could be identified. The most promising interventions would be implemented and tested to address the needs identified. This realist review was conducted to understand how community coalition and outreach (e.g., mobile or pop-up) services improve access for underserved vulnerable residents. OBJECTIVE To inform the development and delivery of an innovative intervention to increase access to PHC for vulnerable populations. METHODS A realist review was conducted in collaboration with the Local Innovative Partnership (LIP) research team and the IMPACT research members who conducted the review. We performed an initial comprehensive systematic search using MEDLINE, EMBASE, PsycINFO, and the Cochrane Library up to October 19, 2015, and updated it on August 8, 2020. Studies were included if they focused on interventions to improve access to PHC using community coalition, outreach services or mobile delivery methods. We included Randomized Controlled Trials (RCTs), and systematic reviews. Studies were screened by two independent reviewers and the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used for data extraction and framework analysis to obtain themes. The LIP research team was also allowed to suggest additional papers not included at screening. RESULTS We included 43 records, comprising 31 RCTs, 11 systematic reviews, and 1 case control study that was added by the LIP research team. We identified three main themes of PHC interventions to promote access for vulnerable residents, including: 1) tailoring of materials and services decreases barriers to primary health care, 2) services offered where vulnerable populations gather increases the "reach" of the interventions, 3) partnerships and collaborations lead to positive health outcomes. In addition, implementation designs and reporting elements should be considered. CONCLUSION Realist reviews can help guide the development of locally adapted primary health care interventions.
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Affiliation(s)
- Vivian Welch
- Bruyère Research Institute, Methods Centre, 85 Primrose, Ottawa, ON, K1R 7G5, Canada.
| | - Kevin Pottie
- Bruyère Research Institute, C.T. Lamont Primary Health Care Research Centre (CTLC), 85 Primrose, Ottawa, ON, K1R 7G5, Canada
| | - Caroline Gaudet
- Bruyère Research Institute, Methods Centre, 85 Primrose, Ottawa, ON, K1R 7G5, Canada
| | - Micere Thuku
- Bruyère Research Institute, C.T. Lamont Primary Health Care Research Centre (CTLC), 85 Primrose, Ottawa, ON, K1R 7G5, Canada
| | - Ryan Mallard
- University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Shannon Spenceley
- University of Lethbridge, 4401 University Dr W, Lethbridge, AB, T1K 6T5, Canada
| | - Nida Amjed
- Lakehead University, 955 Oliver Road, Thunder Bay, ON, P7B 5E1, Canada
| | - Arpana Wadhwani
- Bruyère Research Institute, Methods Centre, 85 Primrose, Ottawa, ON, K1R 7G5, Canada
| | - Elizabeth Ghogomu
- Bruyère Research Institute, Methods Centre, 85 Primrose, Ottawa, ON, K1R 7G5, Canada
| | - Cathie Scott
- PolicyWise for Children & Families, #1000, 9925 109 Street, Edmonton, AB, T5K 2J8, Canada
| | - Simone Dahrouge
- Bruyère Research Institute, C.T. Lamont Primary Health Care Research Centre (CTLC), 85 Primrose, Ottawa, ON, K1R 7G5, Canada
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Mizuta S, Uchida K, Sawa R, Nakamura J, Encho H, Akisue T, Ono R. Context of walking and loneliness among community-dwelling older adults: a cross-sectional study. BMC Geriatr 2023; 23:326. [PMID: 37231334 DOI: 10.1186/s12877-023-04043-5] [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: 03/16/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Older adults are more likely to experience loneliness than younger people. Moreover, greater loneliness in older adults is associated with poor mental health and increased risk of cardiovascular disease and mortality. Physical activity is an effective intervention for reducing loneliness among older adults. Among physical activities, walking is suitable for older adults, because it is easy and safe to incorporate into daily life. We hypothesized that the association between walking and loneliness depends on the presence of others and the number of people present. The aim of this study is to investigate the association between the context of walking (the number of walkers) and loneliness among community-dwelling older adults. METHODS This cross-sectional study included 173 community-dwelling older adults aged 65 or older. Context of walking was classified as non-walking, walking alone (days of walking alone > days of walking with someone), and walking with someone (days of walking alone ≤ days of walking with someone). Loneliness was measured using the Japanese version of the University of California Los Angeles Loneliness Scale. A linear regression model was used to investigate the relationship between context of walking and loneliness, adjusted for age, sex, living situation, social participation, and physical activity excluding walking. RESULTS Data from 171 community-dwelling older adults (mean age = 78.0 years, 59.6% women) were analyzed. After adjustment, walking with someone was associated with lower loneliness than non-walking (adjusted β: -0.51, 95% confidence interval: -1.00, -0.01). CONCLUSIONS The study's findings suggest that walking with a companion may effectively prevent or reduce loneliness among older adults.
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Affiliation(s)
- Sachiko Mizuta
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Kazuaki Uchida
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ryuichi Sawa
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Junya Nakamura
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
- Department of Dentistry and Oral Surgery, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Haruhi Encho
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Rei Ono
- National Institute of Health and Nutrition, Health and Nutrition, National Institutes of Biomedical Innovation, KENTO Innovation Park NK Bldg., 3-17, Senriokashinmachi, Settu, Osaka, 566-0002, Japan.
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Yu DSF, Li PWC, Lin RSY, Kee F, Chiu A, Wu W. Effects of non-pharmacological interventions on loneliness among community-dwelling older adults: A systematic review, network meta-analysis, and meta-regression. Int J Nurs Stud 2023; 144:104524. [PMID: 37295285 DOI: 10.1016/j.ijnurstu.2023.104524] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND The highly prevalent late-life loneliness, together with its deleterious health impacts, calls for increasing attention to the need for effective interventions targeting on this growing public health problem. With the increasing evidence on interventions for combating loneliness, it is timely to identify their comparative effectiveness. OBJECTIVE This systematic review, meta-analysis and network meta-analysis was to identify and compare the effects of various non-pharmacological interventions on loneliness in community-dwelling older adults. METHODS Systematic search was conducted in nine electronic databases from inception to 30th March 2023 for studies investigating the effects of non-pharmacological interventions on loneliness among community-dwelling older adults. The interventions were categorized according to the nature and purpose of use. Pairwise meta-analysis and network meta-analyses were sequentially performed to identify the effects of each category of interventions and their comparative intervention effectiveness, respectively. Meta-regression was performed to examine any influence of study design and participants' characteristics on the intervention effectiveness. The study protocol was registered at PROSPERO (CRD42022307621). RESULTS A total of 60 studies with 13,295 participants were included. The interventions were categorized as psychological interventions, social support interventions (by digital and non-digital means), behavioral activation, exercise intervention with and without social engagement, multi-component intervention and health promotion. Pairwise meta-analysis identified the positive effect of psychological interventions (Hedges' g = -2.33; 95%CI [-4.40, -0.25]; Z = -2.20, p = 0.003), non-digital social support interventions (Hedges' g = -0.63; 95%CI [-1.16, -0.10]; Z = 2.33, p = 0.02) and multi-component interventions (Hedges' g = -0.28 95%CI [-0.54, -0.03]; Z = -2.15, p = 0.03) on reducing loneliness. Subgroup analysis provided additional insights: i) social support and exercise interventions which integrated active strategies to optimize the social engagement demonstrated more promising intervention effects; ii) behavioral activation and multicomponent interventions worked better for older adults who were male or reported loneliness, respectively, and iii) counseling-based psychological interventions was more effective than mind-body practice. Network meta-analysis consistently pointed to the greatest therapeutic benefits of psychological interventions, and this was followed by exercise-based interventions, non-digital social support interventions and behavioral activation. Meta-regression further suggested that the therapeutic effects of the tested interventions were independent of the various factors relating to study design and participants' characteristics. CONCLUSIONS This review highlights the more superior effects of psychological interventions in improving loneliness among older adults. Interventions which have an attribute to optimize social dynamic and connectivity may also be effective. TWEETABLE ABSTRACT Psychological intervention is the best to beat late-life loneliness, but increasing social dynamic and connectivity may add an impact.
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Affiliation(s)
- Doris Sau-Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong.
| | - Polly Wai-Chi Li
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Rose Sin-Yi Lin
- School of Nursing, University of Rochester, United States of America
| | - Frank Kee
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Alice Chiu
- Improving Health Outcomes Together Team, Alberta Health Services, Calgary, Alberta, Canada
| | - Wendy Wu
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
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Su Q, Wang H, Fan L. The impact of home and community care services pilot program on healthy aging: A difference-in-difference with propensity score matching analysis from China. Arch Gerontol Geriatr 2023; 110:104970. [PMID: 36842402 DOI: 10.1016/j.archger.2023.104970] [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: 10/17/2022] [Revised: 02/05/2023] [Accepted: 02/19/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Home and community care service (HACCS) is an important policy response worldwide to the growing and unmet care needs of the aging population. In China, the government also started to implement a HACCS pilot program in 2016. This study aims to evaluate the association of HACCS utilization with healthy aging in Chinese older adults. METHODS This study followed a quasi-experimental design and derived data from the nationwide China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018. We employed the propensity score matching with difference-in-difference approach (PSM-DID) to examine the association between HACCS and healthy aging indicators. RESULTS A total of 8345 older adults were incorporated for a final sample. The results indicated that HACCS utilization was associated with significantly reduced functional limitations (β for BADL=-0.124, β for IADL=-0.210; P<0.01) and depression (β=-0.386, P<0.05) as well as improved cognitive function (β=0.609, P<0.001), life satisfaction (β=0.083, P<0.01) and social participation (β=0.105, P<0.01) in older people, although its association with reduced disability was non-significant (β=-0.005, P = 0.676). The heterogeneous tests further found that rural older adults and older adults aged<80 were more likely than their counterparts to benefit from the HACCS utilization in specific healthy aging indicators such as cognitive function. CONCLUSIONS The implementation of the HACCS program benefited a range of healthy aging domains among older adults in China. Policymakers are encouraged to further expand the program implementation and also continue to improve the services list and care quality of HACCS.
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Affiliation(s)
- Qing Su
- School of Public Health, Southeast University, No.87 Dingjiaqiao, Nanjing 210009, China.
| | - Hang Wang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
| | - Lijun Fan
- School of Public Health, Southeast University, No.87 Dingjiaqiao, Nanjing 210009, China.
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21
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A Systematic Literature Review of Loneliness in Community Dwelling Older Adults. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci12010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Research on loneliness is extensive. This paper presents a systematic review of intervention studies, outlining the antecedents to, and consequences of loneliness in community-dwelling older people. Using PRISMA methodology, a systematic literature review was conducted between January and August 2021 resulting in 49 useable articles. Papers were included if they: (a) investigated older people (+50); (b) were living in community dwellings; (c) had been published in English; (d) had titles or abstracts available and, (e) were published between 2016 and 2021. This study found the antecedents and consequences of social, emotional and existential loneliness differ, however, the vast majority of research has not examined the unique types of loneliness and instead kept loneliness as a generic term, despite the acceptance that various types of loneliness exist. In addition, the findings of intervention studies identified through this review have yielded mixed results. Those interventions focused on improving personal and psycho-social resources for older people fared better outcomes than those focused on technological and social connections alone. This paper reports important implications for the future of research conducted on loneliness and interventions accordingly.
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22
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Puustinen J, Kangasniemi M, Pasanen M, Turjamaa R. Recognising older people's individual resources and home‐care‐specific tasks in home care in Finland: A document analysis of care and service plans. Scand J Caring Sci 2022; 37:507-523. [PMID: 36464860 DOI: 10.1111/scs.13135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/27/2022] [Accepted: 11/06/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND AND RATIONALE Comprehensive care and service planning in home care is tailored to older people's individual needs and resources in order to support them living at home. However, little is known about how these individual resources and home-care-specific tasks are recognised in older people's care and service plans. AIMS To describe the content of care and service plans in older people's home care with special attention to their individual resources and home-care-specific tasks. DESIGN This was a document-based cross-sectional study with mixed-methods analysis, carried out in Eastern Finland during Spring 2018. METHODS A document analysis using the deductive Finnish Care Classification (FinCC), and an inductively developed framework of older people's care and service plans (n = 71). The data were analysed with descriptive statistical methods. RESULTS Altogether, 1718 notes were relevant to the FinCC main categories: 707 (41%) focused on older people's needs and 1011 (59%) on nursing interventions. We identified 1104 notes based on the 26 inductively developed main categories: the majority (n = 628, 57%) focused on individual resources and the remainder (n = 476, 43%) on home-care-specific tasks. Increasing age resulted in fewer notes on safety and sensory functions. There were fewer notes on resources related to sleeping and wakefulness after longer care and service periods. An increased number of home visits resulted in more documentation on tasks related to pharmaceutical issues, including repeat prescriptions. DISCUSSION Individual resources for older people were documented, to some extent, in their care and service plans. It is necessary to review these alongside home-care-specific tasks that support older people's independence and safety at home. CONCLUSION Individual resources need to be recognised in order to enable home-care professionals to provide tailored, high-quality home care services. Home-care-specific tasks should be supported by documentation with updated, sensitive home care classifications.
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Affiliation(s)
- Jonna Puustinen
- Department of Nursing Science, Faculty of Medicine University of Turku Turku Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine University of Turku Turku Finland
| | - Miko Pasanen
- Department of Nursing Science, Faculty of Medicine University of Turku Turku Finland
| | - Riitta Turjamaa
- Unit of Continuous Learning Savonia University of Applied Sciences Kuopio Finland
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23
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Mistur EJ, Scalora SC, Crete AA, Anderson MR, Athan AM, Chapman AL, Miller LJ. Inner Peace in a Global Crisis: A Case Study of Supported Spiritual Individuation in Acute Onset Phase of COVID-19. EMERGING ADULTHOOD (PRINT) 2022; 10:1543-1560. [PMID: 38603365 PMCID: PMC9253523 DOI: 10.1177/21676968221111965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Emerging-adult undergraduates (ages 18-25) are at increased risk for mental illness, exacerbated by the COVID-19 pandemic. Simultaneously, emerging adults face developmental tasks including identity development, finding meaning and purpose, and spiritual individuation. A case study approach is used to elucidate processes of undergraduates coping with collective trauma as a potential pathway to trauma-related spiritual growth via Awakened Awareness for Adolescents (AA-A) and emerging adults, a spiritual-mind-body wellness intervention. Awakened Awareness for Adolescents fosters enhanced spiritual perception to support spiritual individuation for improved mental health and well-being. Processes of spiritual individuation supported by AA-A during the COVID-19 pandemic from February to May 2020 are presented using students' qualitative data and self-report measures of psychopathology, spiritual well-being, emotional regulation, and cognition. Shared cohort (N = 15) themes and one in-depth case (1) reveal ideographic processes of personal transformation and spiritual growth, (2) generate hypotheses around pathways of trauma-related spiritual growth and spiritual individuation for future research.
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Affiliation(s)
- Elisabeth J. Mistur
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY, USA
| | - Suza C. Scalora
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY, USA
| | - Abigail A. Crete
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY, USA
| | - Micheline R. Anderson
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY, USA
| | - Aurélie M. Athan
- Department of Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Amy L. Chapman
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY, USA
| | - Lisa J. Miller
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY, USA
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24
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Astell-Burt T, Hartig T, Putra IGNE, Walsan R, Dendup T, Feng X. Green space and loneliness: A systematic review with theoretical and methodological guidance for future research. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 847:157521. [PMID: 35878853 DOI: 10.1016/j.scitotenv.2022.157521] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/08/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
Persistent loneliness troubles people across the life span, with prevalence as high as 61 % in some groups. Urban greening may help to reduce the population health impacts of loneliness and its concomitants, such as hopelessness and despair. However, the literature lacks both a critical appraisal of extant evidence and a conceptual model to explain how green space would work as a structural intervention. Both are needed to guide decision making and further research. We conducted a systematic review of quantitative studies testing associations between green space and loneliness, searching seven databases. Twenty two studies were identified by 25/01/2022. Most of the studies were conducted in high-income countries and fifteen (68 %) had cross-sectional designs. Green space was measured inconsistently using either objective or subjective indicators. Few studies examined specific green space types or qualities. The majority of studies measured general loneliness (e.g. using the UCLA loneliness scale). Different types of loneliness (social, emotional, existential) were not analysed. Of 132 associations, 88 (66.6 %) indicated potential protection from green space against loneliness, with 44 (33.3 %) reaching statistical significance (p < 0.05). We integrated these findings with evidence from qualitative studies to elaborate and extend the existing pathway domain model linking green space and health. These elaborations and extensions acknowledge the following: (a) different types of green space have implications for different types of loneliness; (b) multilevel circumstances influence the likelihood a person will benefit or suffer harm from green space; (c) personal, relational, and collective processes operate within different domains of pathways linking green space with loneliness and its concomitants; (d) loneliness and its concomitants are explicitly positioned as mediators within the broader causal system that links green space with health and wellbeing. This review and model provide guidance for decision making and further epidemiological research on green space and loneliness.
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Affiliation(s)
- Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, Australia.
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden
| | - I Gusti Ngurah Edi Putra
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Ramya Walsan
- Centre of Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Tashi Dendup
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; Save the Children, Bhutan Office, Thimphu, Bhutan
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, Faculty of Arts, Social Sciences, and Humanities, University of Wollongong, Wollongong, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
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25
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Research on the Relationship between Chinese Elderly Health Status, Social Security, and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127496. [PMID: 35742744 PMCID: PMC9223444 DOI: 10.3390/ijerph19127496] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/05/2022] [Accepted: 06/16/2022] [Indexed: 12/01/2022]
Abstract
(1) Background: To explore the relationship between health status, social security status, and the occurrence of depression in older adults and provide a basis for mental health care services for the elderly population; (2) Methods: This study used the 2018 China Health and Senior Care Tracking Survey (CHARLS) data to select 8383 older people aged over 60 years old as the research subjects. The two-category Logistic model was used to analyze the research problem; (3) Results: Older adults with depressive tendencies accounted for 34.1% of the total older adults. The incidence of depression among female older adults reached 41.51%. The risk of depression in the elderly population was 40.3% lower in males than in females (OR = 0.597, 95% CI: 0.539−0.662). Self-rated health status, physical disability, and receipt of pensions affected the incidence of depression in older adults (all p < 0.05); (4) Conclusions: Focus on and intervene in the mental status of elderly females and disabled elderly people. Provide mental and economic support and mental health care services to the elderly at the family and social levels. Promote the healthy development of the mental health of the elderly and promote active aging.
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26
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Herrmann WJ, Oeser P, Buspavanich P, Lech S, Berger M, Gellert P. Loneliness and depressive symptoms differ by sexual orientation and gender identity during physical distancing measures in response to COVID-19 pandemic in Germany. Appl Psychol Health Well Being 2022; 15:80-96. [PMID: 35666060 PMCID: PMC9348355 DOI: 10.1111/aphw.12376] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 05/14/2022] [Indexed: 11/28/2022]
Abstract
During the COVID-19 pandemic, physical distancing measures to prevent transmission of the virus have been implemented. The effect of physical distancing measures on loneliness especially for vulnerable groups remained unclear. Thus, we aimed to investigate loneliness in relation with depressive symptoms among lesbian, gay, bisexual, trans, inter, asexual, and queer (LGBT) persons compared with cis-heterosexual persons during the pandemic. We conducted an online survey during the first two waves of the COVID-19 pandemic in Germany. The survey contained self-categorizations regarding sexual orientation and gender identity, questions on loneliness, social contacts, depressive symptoms, and healthcare. Descriptive and regression analysis and propensity score matching across cohorts was conducted using R; 2641 participants took part in first wave of the survey and 4143 participants in the second wave. The proportion of lonely people was higher in the second wave compared with the first wave. LGBT persons were more lonely than cis-heterosexual persons. In both waves, being LGBT was associated with depressive symptoms, but loneliness mediated the effect, even when adjusting for social contacts. Psychologists and other practitioners should be aware that LGBT clients might have an increased risk for loneliness and depressive symptoms and of the potential burden of the pandemic measures.
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Affiliation(s)
- Wolfram J. Herrmann
- Institute of General PracticeCharité ‐ Universitätsmedizin BerlinBerlinGermany,Münster School of HealthFH MünsterMünsterGermany
| | - Philip Oeser
- Institute of General PracticeCharité ‐ Universitätsmedizin BerlinBerlinGermany
| | - Pichit Buspavanich
- Gender in Medicine (GiM)Charité ‐ Universitätsmedizin BerlinBerlinGermany,Department of Psychiatry, Psychotherapy and PsychosomaticsBrandenburg Medical School Theodor FontaneNeuruppinGermany,Department of Psychiatry and PsychotherapyCharité ‐ Universitätsmedizin BerlinBerlinGermany,Institute of Sexology and Sexual MedicineCharité – Universitätsmedizin BerlinBerlinGermany,Faculty of Health Sciences BrandenburgJoint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus‐Senftenberg and Brandenburg Medical SchoolPotsdamGermany
| | - Sonia Lech
- Department of Psychiatry, Psychotherapy and PsychosomaticsBrandenburg Medical School Theodor FontaneNeuruppinGermany,Department of Psychiatry and PsychotherapyCharité ‐ Universitätsmedizin BerlinBerlinGermany,Institute of Medical Sociology and Rehabilitation ScienceCharité ‐ Universitätsmedizin BerlinBerlinGermany
| | - Maximilian Berger
- Department of Psychiatry, Psychotherapy and PsychosomaticsBrandenburg Medical School Theodor FontaneNeuruppinGermany,Department of Psychiatry and PsychotherapyCharité ‐ Universitätsmedizin BerlinBerlinGermany
| | - Paul Gellert
- Institute of Medical Sociology and Rehabilitation ScienceCharité ‐ Universitätsmedizin BerlinBerlinGermany
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27
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Zagic D, Wuthrich VM, Rapee RM, Wolters N. Interventions to improve social connections: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2022; 57:885-906. [PMID: 34796368 DOI: 10.1007/s00127-021-02191-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 10/31/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE The importance of both frequent and high-quality social connections is widely recognised. Previous reviews of interventions for promoting social connections found mixed results due to the inclusion of uncontrolled studies and merging of objective and subjective dimensions of social connections. This study aimed to compare the effectiveness of interventions designed to promote 'objective social contact' and the 'quality of social connections'; and compare the effectiveness of interventions from different theoretical orientations on these social dimensions through a systematic review and meta-analysis of controlled trials. METHODS A systematic search of electronic databases Medline, Embase, PsycINFO and PubMed was conducted to identify randomised controlled trials of interventions for social isolation, loneliness, social participation and/or social connectedness in adults. Data were analysed using Stata V.16.0. RESULTS Fifty-eight studies met inclusion criteria (mean age = 62 years). Overall, interventions led to significant improvements in objective social contact (Hedges' g = 0.43) and perceived quality of social connections (Hedges' g = - 0.33). Increasing access to other people was the most effective strategy for promoting objective social contact (Hedges' g = 0.67). Providing adults with skills to manage maladaptive attributional biases, fear-related avoidance of social situations, and barriers to social contact, was the most effective strategy for addressing deficits in perceived quality of social connections (Hedges' g = - 0.53). CONCLUSION In summary, different interventions had differential effects on the frequency and quality of social relationships and associated emotional distress. Psychological interventions hold the most promise for increasing meaningful social connections and reducing distress.
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Affiliation(s)
- Dino Zagic
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia. .,Department of Psychology, Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, Australia.
| | - Viviana M Wuthrich
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.,Department of Psychology, Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, Australia
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Nine Wolters
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.,Faculty of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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28
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The Effectiveness of a Thanks, Sorry, Love, and Farewell Board Game in Older People in Taiwan: A Quasi-Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053146. [PMID: 35270838 PMCID: PMC8910523 DOI: 10.3390/ijerph19053146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/28/2022] [Accepted: 03/04/2022] [Indexed: 02/05/2023]
Abstract
The objective of this study is to examine the effectiveness of the four themes of life ("thanks, sorry, love, and farewell") board game to enhance interpersonal communication, interpersonal relationships, and self-efficacy; and decrease loneliness. The participants were a convenience sample of 91 older people recruited from two community activity centers in Taiwan. Using a quasi-experimental method, participants from one of the community activity centers were enrolled as the experimental group, and participants from the other center were enrolled as the control group. The experimental group played the four themes of life board game for 4 weeks. The control group participated in routine community center activities. Compared to the control group, the experimental group had statistically significantly larger improvements in scores on interpersonal communication, self-efficacy, and loneliness at 3 months after the end of the intervention. This study provides a reference for the design interventions for promoting health in older people.
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29
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Galvez-Hernandez P, González-de Paz L, Muntaner C. Primary care-based interventions addressing social isolation and loneliness in older people: a scoping review. BMJ Open 2022; 12:e057729. [PMID: 35121608 PMCID: PMC8819903 DOI: 10.1136/bmjopen-2021-057729] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Primary care is well positioned to identify and address loneliness and social isolation in older adults, given its gatekeeper function in many healthcare systems. We aimed to identify and characterise loneliness and social isolation interventions and detect factors influencing implementation in primary care. DESIGN Scoping review using the five-step Arksey and O'Malley Framework. DATA SOURCES MEDLINE, CINAHL, EMBASE, COCHRANE databases and grey literature were searched from inception to June 2021. ELIGIBILITY CRITERIA Empirical studies in English and Spanish focusing on interventions addressing social isolation and loneliness in older adults involving primary care services or professionals. DATA EXTRACTION AND SYNTHESIS We extracted data on loneliness and social isolation identification strategies and the professionals involved, networks and characteristics of the interventions and barriers to and facilitators of implementation. We conducted a thematic content analysis to integrate the information extracted. RESULTS 32 documents were included in the review. Only seven articles (22%) reported primary care professionals screening of older adults' loneliness or social isolation, mainly through questionnaires. Several interventions showed networks between primary care, health and non-healthcare sectors, with a dominance of referral pathways (n=17). Two-thirds of reports did not provide clear theoretical frameworks, and one-third described lengths under 6 months. Workload, lack of interest and ageing-related barriers affected implementation outcomes. In contrast, well-defined pathways, collaborative designs, long-lasting and accessible interventions acted as facilitators. CONCLUSIONS There is an apparent lack of consistency in strategies to identify lonely and socially isolated older adults. This might lead to conflicts between intervention content and participant needs. We also identified a predominance of schemes linking primary care and non-healthcare sectors. However, although professionals and participants reported the need for long-lasting interventions to create meaningful social networks, durable interventions were scarce. Sustainability should be a core outcome when implementing loneliness and social isolation interventions in primary care.
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Affiliation(s)
- Pablo Galvez-Hernandez
- Lawrence S. Bloomberg Faculty of Nursing & Health Services and Policy Research Collaborative Specialization, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Luis González-de Paz
- Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), IDIBAPS, Barcelona, Spain
- Escola Superior d'Infermeria del Mar (ESIMar), Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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30
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Yang L, Wang L, Di X, Dai X. Utilisation of community care services and self-rated health among elderly population in China: a survey-based analysis with propensity score matching method. BMC Public Health 2021; 21:1936. [PMID: 34696767 PMCID: PMC8546940 DOI: 10.1186/s12889-021-11989-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Elderly care and elderly health are the enormous challenges in such an aging society as China. Community care services have been developing rapidly in recent years in China as an increasingly mainstream care resource to promote elderly health. The purpose of this study is to examine the association between using community care services and self-rated health among Chinese elderly. Methods A cross-sectional survey was conducted in 2019 and 612 elderly people from China’s Shaanxi province were enrolled. The binary logistic regression was first employed to explore the association between community care services utilisation and elderly health. Given the potential selection bias issue, the propensity score matching method was hired to generate comparable samples between participants who used these services and participants who didn’t, and further examine the health benefits of using four types of services. Results The results of the binary logistic regression showed that the use of community care services predicted a better health status of elderly individuals. Overall, the results of the propensity score matching method showed the similar results. Specifically, with the nearest neighbors matching algorithm, using daily care services was significantly associated with a 0.246 increase in the self-rated health of the elderly (T = 1.83). For medical care services, the mean of self-rated health of elderly individuals who used these services was 3.542, significantly higher than those who didn’t (T = 2.15). For spiritual comfort services, elderly individuals using these services showed a significant increase by 0.280 in the self-rated health (T = 1.82). For social and recreational services, the result of the nearest neighbor matching method was not statistically significant, while the results of kernel matching method and the mahalanobis matching method showed a significant increase in the self-rated health among elderly individuals using these services (T = 2.03, T = 2.03, respectively). All the estimated results passed the Rosenbaum bounds analysis and were not sensitive to hidden bias. Conclusions Using community care services improved the self-rated health of the elderly. More effective measures may be implemented to increase access to care resources for senior citizens, and further improve their health status. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11989-x.
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Affiliation(s)
- Liu Yang
- School of Public Policy and Administration, Xi'an Jiaotong University, People's Republic of China, No 28 West Road, Xi'an, Xianning, 710049, Shaanxi, China
| | - Lijian Wang
- School of Public Policy and Administration, Xi'an Jiaotong University, People's Republic of China, No 28 West Road, Xi'an, Xianning, 710049, Shaanxi, China.
| | - Xiaodong Di
- School of Public Policy and Administration, Xi'an Jiaotong University, People's Republic of China, No 28 West Road, Xi'an, Xianning, 710049, Shaanxi, China
| | - Xiuliang Dai
- School of Public Policy and Administration, Xi'an Jiaotong University, People's Republic of China, No 28 West Road, Xi'an, Xianning, 710049, Shaanxi, China
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Saini GK, Haseeb SB, Taghi-Zada Z, Ng JY. The effects of meditation on individuals facing loneliness: a scoping review. BMC Psychol 2021; 9:88. [PMID: 34022961 PMCID: PMC8140565 DOI: 10.1186/s40359-021-00585-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 05/10/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Meditation is defined as a mind and body practice focused on interactions between the brain, mind, body, and behaviour, containing four key elements: a quiet location with little distractions, a comfortable posture, a focus of attention, and an open attitude. We sought to review the benefits of meditation on the alleviation of loneliness. METHODS A scoping review was conducted based on Arksey and O'Malley's five-stage framework. Eligibility criteria included primary studies of any type that investigated the effects of meditation on loneliness. Search strategies were developed and conducted on MEDLINE, EMBASE, AMED, and CINAHL. The National Center for Complementary and Integrative Health, and American Psychological Association websites were also searched. Articles meeting the inclusion criteria were critically reviewed using a descriptive-analytical narrative method. RESULTS Thirteen studies met our inclusion criteria and were published between 2012 and 2020 across 10 countries. Eleven studies reported improvements in relation to loneliness. Of the remaining two studies (15%), one mentioned the alleviation of loneliness, but only looked primarily at social closeness in lonely individuals. The other study found a correlation between loneliness and nuclear factor (NF)-κB levels, which was the measured outcome; however, the direct effects of meditation on loneliness were unclear. Three main themes emerged from our analysis, as follows: 1) positive results across all studies, 2) relatively small randomized control trials conducted over the last decade, and 3) lack of diverse demographic information. CONCLUSIONS While a small number of studies exist at this intersection, given all included studies indicated positive findings, the effects of meditation in alleviating loneliness are promising. Future research should be directed at understanding how meditation mitigates loneliness and how this intervention can impact practice for healthcare professionals.
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Affiliation(s)
- Gurleen K. Saini
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Saud B. Haseeb
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Zhala Taghi-Zada
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - Jeremy Y. Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
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Yang L, Wang L, Dai X. Rural-urban and gender differences in the association between community care services and elderly individuals' mental health: a case from Shaanxi Province, China. BMC Health Serv Res 2021; 21:106. [PMID: 33516212 PMCID: PMC7847576 DOI: 10.1186/s12913-021-06113-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/24/2021] [Indexed: 11/21/2022] Open
Abstract
Background While community care services have been developing rapidly as a new way to meet the growing demands of elderly individuals in China, their health benefits are virtually unknown. Thus, the aim of this study was to examine the Chinese elderly individuals’ utilisation of community care services and its association with the mental health with comparing rural-urban and gender differences. Methods For this 2019 cross-sectional study, 687 elderly people from 7 counties (districts) of China’s Shaanxi province were enrolled. Respondents’ mental health level was assessed using a self-reported mental health measure. Four categories of community care services utilisation were examined: daily care services, medical care services, social and recreational services and spiritual comfort services. The binary logistic regression model was used in examining the association between community care services utilisation and mental health. Results Our results showed that there was a noted difference in mental health level between the male and female groups. Utilisation of medical care services and social and recreational services was significantly higher in the rural group than that in the urban group. Regression analysis showed that utilisation of daily care services (β = 0.809, p = 0.008) and social and recreational service (β = 0.526, p = 0.035) was significantly and positively associated with elderly individuals’ mental health level. Specifically, daily care services utilisation predicted a better mental health of the rural elderly (β = 1.051, p = 0.036) and the male elderly (β = 1.133, p = 0.053), while social and recreational services utilisation predicted a better mental health of the urban elderly (β = 0.927, p = 0.008) and the female elderly (β = 0.864, p = 0.007). Conclusions Our findings indicated varied levels of community care services utilisation and mental health are common among the elderly people in China. Community care services utilisation has a positive, albeit selective, association with elderly individuals’ mental health. Further policies should strengthen the equitable development of high-quality community care services in urban and rural areas to improve the mental health of elderly individuals, and focus more on gender differences in terms of community care services needs. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06113-z.
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Affiliation(s)
- Liu Yang
- School of Public Policy and Administration, Xi'an Jiaotong University, No 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
| | - Lijian Wang
- School of Public Policy and Administration, Xi'an Jiaotong University, No 28 Xianning West Road, Xi'an, 710049, Shaanxi, China.
| | - Xiuliang Dai
- School of Public Policy and Administration, Xi'an Jiaotong University, No 28 Xianning West Road, Xi'an, 710049, Shaanxi, China
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