Loneliness, Social Isolation, and Objectively Measured Physical Activity in Rural-Living Older Adults

Relationship between objectively measured conversation time and social behavior in community-dwelling older adults

Background

Social isolation is a significant public health concern in aging societies. The association between conversation time and social behavior remains unclear. This study examines whether objective conversation time is associated with social activity frequency in older adults.

Methods

This prospective cohort study enrolled 855 older adults (538 women; mean age, 73.8 years) aged 65 and older, who were followed from 2015 to 2019. All participants wore a wristband sensor to measure conversation time for at least 9 days and an average of 31.3 days per year. Social behaviors were assessed through interviews, and the frequency of engagement in community activities, outings, lessons, or classes and contact frequency were assessed using a self-report questionnaire. The association between conversation time and social behavior was evaluated using multi-linear regression analysis.

Results

Conversation time was significantly associated with the frequency of engagement in community activities and lessons or classes after adjusting for several covariates (β = 0.181, 95% confidence interval: 0.107-0.254, p < 0.001; β = 0.11, 95% confidence interval: 0.04-0.179, p = 0.002).

Conclusion

Objectively measured conversation time using a wearable sensor is associated with social behavior and may be a valuable parameter for social isolation in older adults.

Leisure activities as reserve mediators of the relationship between loneliness and cognition in aging

Previous studies have found that loneliness affects cognitive functions in older persons. However, the influence of loneliness on different cognitive fields and the internal mechanism of the relationship are unclear. A total of 4772 older persons aged above 50 years (Mean = 65.31, SD = 6.96, 57.7% female) were included in this study. All the participants completed the characteristics scale, as well as the loneliness scale, leisure activity scale, and cognitive function tests in six domains. The results showed that 17.6% of participants had high loneliness, while 16.7% of participants had low loneliness. Associations were observed between higher levels of loneliness and lower scores in general cognitive ability, memory, and executive functions. Mediation analysis suggested that leisure activities, encompassing mental, physical, and social activities, were associated with cognitive functions in the context of loneliness. These results indicate that leisure activities may play a significant role in the relationship between loneliness and cognitive functions in older adults. The study highlights the importance of considering leisure activities in this demographic to potentially mitigate the adverse cognitive effects associated with loneliness.

Factors that promote resilience for older adults and their informal caregivers during the COVID-19 pandemic

OBJECTIVES

The aim of this cross-sectional, descriptive study was to characterize the impact of modifiable activities on older adult mental health during the COVID-19 pandemic and to understand the interaction between older adult behaviors and the mental health of their informal caregivers.

METHODS

This study leveraged the National Health and Aging Trends Study and associated Family and Friends survey completed 2020-2021. Participants included 3,257 community dwelling older adults and 2,062 associated unpaid caregivers, weighted sample sizes 26,074,143 and 21,871,408, respectively.

RESULTS

Older adult engagement in volunteering, religious, or group activities was associated with decreased older adult depression, as was increased walking or vigorous activity. However, online compared to in-person participation correlated with greater loneliness in older adults and anxiety for their caregivers. Finally, increased appreciation by the care recipient correlated with decreased caregiver depression.

CONCLUSION

Overall, a close interaction exists between caregiver and older adult behavior and psychiatric symptoms. Online activities are not an equivalent substitute for in-person activities during required social isolation; however, they remain superior to no participation. Further, increased walking and caregiver appreciation may ameliorate some of the harms of isolation. Health care providers should continue to promote engagement, exercise, and appreciation as ways to improve older adult and informal caregiver mental health.

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

Introduction

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

Objective

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

Methods

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

Results

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

Conclusion

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

Sensor-based assessment of social isolation in community-dwelling older adults: a scoping review

Social isolation (SI) is a state of low social interaction with peers associated with various adverse health consequences in older adults living in the community. SI is most often assessed through retrospective self-reports, which can be prone to recall or self-report biases and influenced by stigma. Ambient and wearable sensors have been explored to objectively assess SI based on interactions of a person within the environment and physiological data. However, because this field is in its infancy, there is a lack of clarity regarding the application of sensors and their data in assessing SI and the methods to develop these assessments. To understand the current state of research in sensor-based assessment of SI in older adults living in the community and to make recommendations for the field moving forward, we conducted a scoping review. The aims of the scoping review were to (i) map the types of sensors (and their associated data) that have been used for objective SI assessment, and (ii) identify the methodological approaches used to develop the SI assessment. Using an established scoping review methodology, we identified eight relevant articles. Data from motion sensors and actigraph were commonly applied and compared and correlated with self-report measures in developing objective SI assessments. Variability exists in defining SI, feature extraction and the use of sensors and self-report assessments. Inconsistent definitions and use of various self-report scales for measuring SI create barriers to studying the concept and extracting features to build predictive models. Recommendations include establishing a consistent definition of SI for sensor-based assessment research and development and consider capturing its complexity through innovative domain-specific features.

Profiles of Loneliness and Social Isolation in Physically Active and Inactive Older Adults in Rural England

Objective: Loneliness and social isolation are associated with higher risk of morbidity and mortality and physical inactivity in older age. This study explored the socioecological context in which both physically active and inactive older adults experience loneliness and/or social isolation in a UK rural setting. Design: A mixed-methods design employed semi structured interviews and accelerometer-measured moderate-to-vigorous physical activity (MVPA). Interviews explored the personal, social and environmental factors influencing engagement with physical activities, guided by an adapted-socioecological model of physical activity behaviour. Findings: Twenty-four older adults (Mean Age = 73 (5.8 SD); 12 women) were interviewed. Transcripts were thematically analysed and seven profiles of physical activity, social isolation and loneliness were identified. The high-MVPA group had established PA habits, reported several sources of social contact and evaluated their physical environment as activity friendly. The low MVPA group had diverse experiences of past engagement in social activities. Similar to the high MVPA, they reported a range of sources of social contact but they did not perceive the physical environment as activity friendly. Conclusions: Loneliness and/or social isolation was reported by both physically active and inactive older adults. There is wide diversity and complexity in types and intensity of PA, loneliness and social isolation profiles and personal, social and environmental contexts.

Association of living arrangements with happiness attributes among older adults

Background

In Korea, along with the rapid aging of the population, older adults’ living arrangements have changed in various ways. In particularly, the happiness of older adults living alone warrants attention because they are more vulnerable to unhappiness than those living with families are. This study reports on the level of happiness among older adults in Korean and examines the potential mediating roles of depressive symptoms, present health status, socio-physical environment, social support networks, and social activities, and happiness in three different living arrangements, older adults living alone, with their spouse, or with their family.

Method

Data for this study were extracted from the secondary data from the 2017 Korean Community Health Survey, a non-experimental, cross-sectional survey conducted among Korean individuals that were aged 65 and above (n = 14,687). The chi-square test, one-way ANOVA, and Logistic regression were used to explore the related factors of happiness among the three groups.

Results

Findings revealed a significant difference in the happiness index among older adults living alone (6.22 ± 2.11), older adults living with their spouse (6.76 ± 1.99), and older adults living with their family (6.46 ± 1.94) (F = 88.69, p < .001). As the result of logistic regression, older adults living alone (odds ratio (OR) = 0.75, 95% confidence interval (CI) = 0.57–0.99) and those living with their family (OR = 0.80, 95% CI = 0.65–0.99) demonstrated greater happiness as the frequency of contact with their family increased. Older adults living with their spouse indicated an increase in happiness when their contact with friends was higher (OR = 0.69, 95% CI = 0.56–0.84).

Conclusion

It was recognized that factors influencing happiness differed according to older adults’ living arrangements, thus suggesting that older adults’ happiness could be facilitated through interventions that consider their circumstances, including living arrangements.

Big smile, small self: Awe walks promote prosocial positive emotions in older adults

Aging into later life is often accompanied by social disconnection, anxiety, and sadness. Negative emotions are self-focused states with detrimental effects on aging and longevity. Awe-a positive emotion elicited when in the presence of vast things not immediately understood-reduces self-focus, promotes social connection, and fosters prosocial actions by encouraging a "small self." We investigated the emotional benefits of a novel "awe walk" intervention in healthy older adults. Sixty participants took weekly 15-min outdoor walks for 8 weeks; participants were randomly assigned to an awe walk group, which oriented them to experience awe during their walks, or to a control walk group. Participants took photographs of themselves during each walk and rated their emotional experience. Each day, they reported on their daily emotional experience outside of the walk context. Participants also completed pre- and postintervention measures of anxiety, depression, and life satisfaction. Compared with participants who took control walks, those who took awe walks experienced greater awe during their walks and exhibited an increasingly "small self" in their photographs over time. They reported greater joy and prosocial positive emotions during their walks and displayed increasing smile intensity over the study. Outside of the walk context, participants who took awe walks reported greater increases in daily prosocial positive emotions and greater decreases in daily distress over time. Postintervention anxiety, depression, and life satisfaction did not change from baseline in either group. These results suggest cultivating awe enhances positive emotions that foster social connection and diminishes negative emotions that hasten decline. (PsycInfo Database Record (c) 2020 APA, all rights reserved).