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Balki E, Hayes N, Holland C. The Indirect Impact of Educational Attainment as a Distal Resource for Older Adults on Loneliness, Social Isolation, Psychological Resilience, and Technology Use During the COVID-19 Pandemic: Cross-Sectional Quantitative Study. JMIR Aging 2023; 6:e47729. [PMID: 37999938 DOI: 10.2196/47729] [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: 03/30/2023] [Revised: 06/11/2023] [Accepted: 10/10/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, government-mandated social distancing prevented the spread of the disease but potentially exacerbated social isolation and loneliness for older people, especially those already vulnerable to isolation. Older adults may have been able to draw from their personal resources such as psychological resilience (PR) and technology use (TU) to combat such effects. Educational attainment (EA) or early-life EA may potentially shape later-life personal resources and their impact on the effects of the pandemic lockdown on outcomes such as loneliness. The developmental adaptation model allows for the supposition that social isolation, TU, and PR may be affected by early EA in older adults. OBJECTIVE This study examined the indirect impact of EA on pandemic-linked loneliness in a sample of older adults. The developmental adaptation model was used as the conceptual framework to view EA as a distal influence on loneliness, social isolation, PR, and TU. We hypothesized that EA would predict TU and PR and have a moderating impact on social isolation and loneliness. We also hypothesized that PR and TU would mediate the effect of EA on loneliness. METHODS This was a cross-sectional observational study, in which data were gathered from 92 older adults aged ≥65 years in the United Kingdom from March 2020 to June 2021, when the country was under various pandemic-linked social mobility restrictions. The data captured demographic information including age, gender, ethnicity, and the highest degree of education achieved. The University of California Los Angeles Loneliness Scale, Connor-Davidson Resilience Scale, Lubben Social Network Index, and Technology Experience Questionnaire were used as standardized measures. Pearson correlation, moderation, and mediation regression analyses were conducted to investigate the hypotheses. RESULTS We found a higher prevalence of loneliness in older adults than in prepandemic norms. EA was correlated with greater TU and PR and moderated the impact of social isolation on loneliness. PR mediated and TU partially mediated the relationship between EA and loneliness. CONCLUSIONS Early-life EA was confirmed as a distal resource for older adults and played an indirect role in affecting loneliness levels during the pandemic. It has an impact on present-day personal resources, such as PR and TU, which affect loneliness and also moderate the impact of social isolation on loneliness. Policymakers should be aware that older adults with low levels of EA may be more vulnerable to the harmful impacts of loneliness when isolated by choice.
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Affiliation(s)
- Eric Balki
- Department of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Niall Hayes
- The Directorate, Nottingham Trent University, Nottingham, United Kingdom
| | - Carol Holland
- Department of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
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Pollak C, Verghese J, Blumen H. Loneliness and Functional Decline in Aging: A Systematic Review. Res Gerontol Nurs 2023; 16:202-212. [PMID: 37159388 PMCID: PMC10926714 DOI: 10.3928/19404921-20230503-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Loneliness is prevalent in adults aged ≥65 years in the United States and is associated with functional decline. The purpose of the current review was to synthesize evidence on the relationship between loneliness and functional decline using Roy's Adaptation Model as a theoretical framework. A comprehensive review of PubMed, Medline, and Embase databases was performed. Inclusion criteria were samples including adults primarily aged >60 years, peer-reviewed, published in the English language, and included a measure for loneliness and function. A total of 47 studies were analyzed. Most studies examined correlates, risk factors, and predictors of loneliness, rather than the relationship between loneliness and function. Evidence suggests there is bidirectionality in the relationship between loneliness and functional decline. Loneliness is associated with functional decline in aging via multiple possible pathways. Further studies are needed to determine causality and biological mechanisms underlying the relationship. [Research in Gerontological Nursing, 16(4), 202-212.].
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Christoffersen LA, Helenius D, Schwinn M, Erikstrup C, Hjalgrim H, Nissen J, Banasik K, Nielsen K, Kaspersen KA, Dinh KM, Bruun MT, Ostrowski SR, Sækmose S, Hansen TF, Werge T, Didriksen M, Pedersen OB. Experience of loneliness during the COVID-19 pandemic: a cross-sectional study of 50 968 adult Danes. BMJ Open 2023; 13:e064033. [PMID: 37185636 PMCID: PMC10151242 DOI: 10.1136/bmjopen-2022-064033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES To examine the level of loneliness experienced during the COVID-19 pandemic in Denmark and to identify associated behavioural patterns and demographic factors. DESIGN Cross-sectional cohort study. SETTING Includes Danish active and former blood donors. PARTICIPANTS A questionnaire was sent to 124 307 active and former blood donors, of these a total of 50 968 participants completed the study questionnaire (response rate=41%). PRIMARY AND SECONDARY OUTCOME MEASURES Subjective experience of loneliness was measured using the 3-item University of California, Los Angeles Loneliness Scale (UCLA-3). Besides the UCLA-3, the respondents answered items on sociodemographic and economic characteristics, items on precautionary measures taken to avoid COVID-19 infection as well as on COVID-19 anxiety. RESULTS The participants indicated their experienced level of loneliness both before and during the pandemic. Comparing the two reports yielded a mean increase in loneliness scores of 14.1% (p<0.001). Exploratory factor analysis identified the factor well-being, which comprised three questionnaire items related to emotional heath, physical health and happiness. A high score on the factor well-being was associated with reduced levels of loneliness (coefficient=-0.47, 95% CI -0.49 to -0.46)). Furthermore, women were more likely than men to have experienced increased levels of loneliness during the pandemic (coefficient=0.27, 95% CI 0.25 to 0.29). Furthermore, a negative correlation between higher age and change in loneliness score was observed. CONCLUSIONS The findings document an increase in the level of experienced loneliness during the COVID-19 pandemic, particularly affecting individuals with low well-being, women and younger individuals.
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Affiliation(s)
- Lea An Christoffersen
- Institute of Biological Psychiatry, Mental Health Services Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dorte Helenius
- Institute of Biological Psychiatry, Mental Health Services Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael Schwinn
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Hjalgrim
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Janna Nissen
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Kaspar Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Kathrine A Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus, Denmark
| | - Khoa M Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Mie T Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Sækmose
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Thomas F Hansen
- Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
- Department of Neurology, NeuroGenomic Group, Rigshospitalet, Glostrup, Denmark
| | - Thomas Werge
- Institute of Biological Psychiatry, Mental Health Services Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
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Khan MSR, Yuktadatta P, Kadoya Y. Who Became Lonely during the COVID-19 Pandemic? An Investigation of the Socioeconomic Aspects of Loneliness in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106242. [PMID: 35627778 PMCID: PMC9140939 DOI: 10.3390/ijerph19106242] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/15/2022] [Accepted: 05/19/2022] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has impacted social and economic aspects of people’s lives in different ways, causing them to experience different levels of loneliness. This study examines the extent of loneliness among men and women of various ages in Japan during the pandemic and attempts to determine the underlying causes. We used data from Hiroshima University’s nationwide survey conducted before and during the pandemic in Japan. The sample consists of 3755 participants, of which 67% are men and 33% are women with an average age of 51 years (SD = 13.64). Using mean comparison tests and probit regression models, we show that loneliness is a common occurrence among the Japanese population and that a significant number of people became lonely for the first time during the pandemic. In general, loneliness was greater among younger respondents, but older people became lonelier during the pandemic. Simultaneously, we observed significant differences in loneliness across age and gender subsamples. Although depression and subjective health status contributed to loneliness, we found no single explanation for the loneliness experienced by people during the pandemic; rather, subsample analysis revealed that the causes of loneliness for each group differed. Nevertheless, we discovered that older people are at a higher risk of developing loneliness during the pandemic due to a variety of socioeconomic and behavioral factors. The findings of this study suggest that health authorities should not generalize cases of loneliness, but rather intervene individually in each group to avoid further complications.
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Gronewold J, Engels M. The Lonely Brain – Associations Between Social Isolation and (Cerebro-) Vascular Disease From the Perspective of Social Neuroscience. Front Integr Neurosci 2022; 16:729621. [PMID: 35153690 PMCID: PMC8834536 DOI: 10.3389/fnint.2022.729621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
The current COVID-19 pandemic led to a considerable reduction in in-person social contacts all over the world. In most individuals, reduced social contacts lead to the perception of social isolation causing feelings of loneliness, which are experienced as stressful. Experiencing social distress due to actual or perceived social isolation has been associated with negative health outcomes such as depression, (cerebro-) vascular disease and mortality. Concrete mechanisms behind this association are still a matter of debate. A group of researchers around Hugo Critchley with special contributions of Sarah Garfinkel and Lisa Quadt proposes a framework for the underlying brain-body interactions including elements from models of social homeostasis and interoceptive predictive processing that provides important insights and testable pathways. While in a previous publication, we reviewed literature on the observed association between social isolation and stroke and coronary heart disease, we now extent this review by presenting a comprehensive model to explain underlying pathomechanisms from the perspective of social neuroscience. Further, we discuss how neurodivergent people, e.g. autistic individuals or persons with attention deficit disorders, might differ in these pathomechanisms and why they are especially vulnerable to social isolation. Finally, we discuss clinical implications for the prevention and therapy of (cerebro-) vascular diseases.
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Affiliation(s)
- Janine Gronewold
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- *Correspondence: Janine Gronewold,
| | - Miriam Engels
- Institute of Medical Sociology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Miriam Engels,
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