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Tan XR, Wilson IM, Tay PKC, Win PPS, Song CF, Wee SL. Mapping of technological strategies for reducing social isolation in homebound older adults: A scoping review. Arch Gerontol Geriatr 2024; 125:105478. [PMID: 38776697 DOI: 10.1016/j.archger.2024.105478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/18/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Homebound older adults (HOAs) are particularly vulnerable to social isolation and loneliness, which engender a poorer physical and mental health, and greater cognitive decline. The purpose of this review is to map the literature to identify potential technological strategies that reduce social isolation in HOAs, and to understand facilitators and barriers for adoption and implementation. METHODS Six databases including PubMed (MEDLINE), Google Scholar, Cochrane Database, EBSCOHost, National Library ProQuest, Web of Science, and the Journal of Medical Internet Research were searched for relevant articles. Peer-reviewed literature published in English from Jan 2014 to Feb 2024 that employed technological strategies applicable to HOAs and assessed social isolation or connectedness as an outcome measure were included. RESULTS 107 studies were reviewed and classified into different technological categories based on their functions and features. A social technology framework encompassing delivery, hardware, software, content, training, and support was conceptualized with core characteristics identified from the reviewed technological strategies. Cost and complexity of technology, and resource commitment were identified as barriers while user-friendliness, content curation and a supportive ecosystem may facilitate the adoption of a technological strategy to address social isolation in HOAs. CONCLUSION There is a need for early and concerted effort to identify HOAs, provide technology training, and empower them to tap on the digital world to complement and/or supplement social interactions. Development of cost-effective and rapid-to-implement technology is vital for HOAs who are at highest risk to social isolation.
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Affiliation(s)
- Xiang Ren Tan
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ingrid M Wilson
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Latrobe University, Melbourne, Australia
| | - Peter Kay Chai Tay
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Phoo Pyae Sone Win
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Cai Feng Song
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Shiou-Liang Wee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Geriatric Education and Research Institute, Singapore
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Imai A, Matsuoka T, Nakayama C, Hashimoto N, Sano M, Narumoto J. Effectiveness of a Virtual Reality Open-Air Bath Program in Reducing Loneliness and Improving Brain Function for Dementia Prevention in Older Adults: Protocol for a Prospective Randomized Crossover Study. JMIR Res Protoc 2024; 13:e57101. [PMID: 39088243 DOI: 10.2196/57101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/23/2024] [Accepted: 07/09/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Older adults often face loneliness due to chronic illness or loss of close ones, a situation worsened by the COVID-19 pandemic. Increased loneliness heightens the risk of diseases, especially dementia, necessitating urgent action. OBJECTIVE This study aims to assess the impact of a virtual reality (VR)-based open-air bath program on depression and loneliness in older individuals with subjective cognitive decline/mild cognitive impairment attending the Dementia Medical Center in Kyoto, Japan. We further aim to evaluate the feasibility of the program (participant recruitment and adherence) and to measure program enjoyment and satisfaction. METHODS The study design is a crossover trial with a 1:1 ratio, wherein 12 participants will be randomly assigned to groups 1 and 2, with group 2 serving as a waitlist control and group 1 receiving the VR program from the onset for 6 months; the VR program will be conducted 6 times (monthly). Program completion for group 1 will be followed by an observation period from months 7 to 12. Group 2 will participate in the VR program from months 7 to 12, with an observation period from months 1 to 6. Cognitive tests, psychiatric assessments, and the University of California, Los Angeles Loneliness Scale will be conducted before the study, at 6 months, and at 12 months. Results will be analyzed using repeated-measures ANOVA. Head magnetic resonance imaging and single-photon emission computed tomography scans will be performed before and after the VR program to evaluate changes and effects on brain regions. RESULTS Recruitment began in September 2023 and data collection is expected to be completed by March 2025. Complete study results will be published by September 2025. CONCLUSIONS This study examines the preliminary effects of VR on loneliness in older adults with predementia through open-air bath simulations. VR experiences could benefit this population, particularly those with limited outdoor activities. Quantifying VR's impact will aid in determining the size for a larger clinical trial. Qualitative results will inform participation mechanisms and guide the implementation and design of future trials. TRIAL REGISTRATION University hospital Medical Information Network UMIN000052667; https://tinyurl.com/3yaccay5. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/57101.
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Affiliation(s)
- Ayu Imai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Psychiatry, National Hospital Organization Maizuru Medical Center, Maizuru, Japan
| | - Chikara Nakayama
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nana Hashimoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Mutsuo Sano
- Department of Information Science and Technology, Osaka Institute of Technology, Osaka, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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D’Cunha NM, Holloway H. A pilot study of an intergenerational program for people in residential aged care with cognitive impairment and children from a co-located early learning centre during COVID-19. DEMENTIA 2024; 23:927-948. [PMID: 38373711 PMCID: PMC11290022 DOI: 10.1177/14713012241235378] [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: 02/21/2024]
Abstract
Intergenerational programs in residential aged care may improve well-being and combat loneliness and social isolation in older people with cognitive impairment. This pilot study investigated the effects of a semi-structured intergenerational group, including children from a co-located early learning centre and people living in residential aged care with cognitive impairment. This 9-week study used a mixed methods pre- and post-program design. Sessions were designed and delivered once per week by Occupational Therapists and took into account residents' interests and children's developmental needs and interests, identified in pre-program interviews. Nine older people with cognitive impairment and 13 children participated. The program was well attended despite disruptions and complications caused by COVID-19 and weather conditions. Older people valued the opportunity to engage with the children. Children were observed to gain confidence in communicating and forming friendships with older people with different levels of ability. There did not appear to be any change in loneliness or neuropsychiatric symptoms. The intergenerational program benefited participants and received strong support from family members and staff of the early learning centre and aged care home.
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Affiliation(s)
- Nathan M D’Cunha
- Nathan M D’Cunha, School of Exercise and Rehabilitation Sciences, Faculty of Health, University of Canberra, 11 Kirinari St, Bruce, ACT 2617, Australia.
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LaVela SL, Motl RW, Berryman K, Wirth M, Bartle B, Aguina K, Solanki P, Bombardier CH. Facilitators to alleviate loneliness and social isolation as identified by individuals with spinal cord injuries and disorders: A qualitative study. Rehabil Psychol 2024; 69:264-274. [PMID: 38271018 PMCID: PMC11269529 DOI: 10.1037/rep0000540] [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: 01/27/2024]
Abstract
PURPOSE/OBJECTIVE Individuals with spinal cord injuries and disorders (SCI/D) are at increased risk for experiencing loneliness and social isolation. The aim is to describe facilitators identified by individuals living with SCI/D to alleviate loneliness and perceived social isolation. RESEARCH METHOD/DESIGN Descriptive qualitative design using in-depth interviews with veterans with SCI/D (n = 23). Descriptive statistics was used to calculate demographic and injury characteristics. Audio-recorded and transcribed verbatim transcripts were coded and analyzed using Braun and Clarke's (2006) six thematic analysis phases. RESULTS Participants were male (70%), white (78%), and not currently married (35%), with an average age of 66 years (42-88). Participants had paraplegia (61%), with traumatic etiology (65%) and were injured 14 years (1-45) on average. Eight themes were identified by participants living with SCI/D that described facilitators to alleviate loneliness and perceived social isolation. (a) Engage in/pursue interests; (b) Interact with/spend time with others; (c) Embrace acceptance; (d) Take part in reciprocity; (e) Find a purpose/accomplish goals; (f) Get out of residence, get outside; (g) Connect with SCI/D community/SCI/D peers; and (h) Seek help from (mental) healthcare professionals. CONCLUSIONS/IMPLICATIONS Individuals with SCI/D identified facilitators to alleviate loneliness that encompasses changes in ways of thinking, actions to expand participation in life, and efforts focused on involving others. Findings can be used to guide healthcare delivery and develop interventions to target feelings of loneliness and social isolation in persons with SCI/D, which may be particularly impactful if they involve reciprocal interactions with peers with SCI/D. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Sherri L. LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Robert W. Motl
- Department of Kinesiology and Nutrition, University of Illinois at Chicago
| | - Kelsey Berryman
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Marissa Wirth
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Brian Bartle
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Keith Aguina
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Pooja Solanki
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
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Askheim C, Engebretsen E, Haldar M. Living happily alone in Plato's cave? On loneliness, technology and the metaphysics of presence. MEDICAL HUMANITIES 2024:medhum-2024-012965. [PMID: 39084899 DOI: 10.1136/medhum-2024-012965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 08/02/2024]
Abstract
In a lot of research on loneliness and technology, there is an underlying premise that actual, physical presence is more real than 'virtual' presence. This premise is rarely explicit, yet it implies a hierarchy of reality, where the 'here and now' is always on top. In this theoretical paper, we examine this latent hierarchy and the understandings of presence and mediation it implies. We point towards potential consequences of this understanding for research on the role of technology in reducing loneliness and social isolation. To do this, we draw on the philosophical analysis made by Martin Heidegger and Jacques Derrida of what they called 'the metaphysics of presence'. This is the tendency to privilege presence as the only immediate and truthful access to reality, whereas all forms of mediations constitute mere approximations, derivations and second-rate realities with dubious truth value. First, we present their diagnosis, and then we show how it pertains to research on virtual presence and loneliness by analysing some examples from this research. Finally, we discuss some potential implications of the metaphysics of presence through a case story compiled from our empirical research. Our foundational assertion is that the question of whether anyone experiences loneliness is an empirical and not a metaphysical question. If we want to properly understand loneliness and the potential for alleviating it through the use of teletechnologies, we might get off on the wrong foot if we carry with us assumptions suggesting the existence of ascending levels of reality and presence.
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Affiliation(s)
- Clemet Askheim
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Oslo, Norway
| | - Eivind Engebretsen
- Sustainable Health Unit, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Marit Haldar
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Oslo, Norway
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Karpyn A, Kennedy N, Seibold M, Tracy T, Kim J, Larock J, Silberg T, Lennon J, Oluwadero J, Ratnayake M. Understanding benefits of a college student-homebound adult partnership program to support aging in place: An exploratory study. EVALUATION AND PROGRAM PLANNING 2024; 106:102464. [PMID: 39068774 DOI: 10.1016/j.evalprogplan.2024.102464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/28/2024] [Accepted: 07/08/2024] [Indexed: 07/30/2024]
Abstract
The need for effective approaches to support aging and homebound adults is recognized internationally and domestically. This exploratory study sought to understand the proximal benefits of an intergenerational program in Delaware, USA that connected homebound individuals with college students. The primary goal was to describe program impacts on home-bound community residents to inform future research, program planning, and implementation. Outcomes of interest included quality of life, well-being, and independence. Semi-structured interviews were conducted with 19 participants recruited from a nonprofit partner. Findings yielded seven unique themes: emotional fulfillment, special feelings of support from a rare "unconditional" relationship, assistance with tasks, close connection with someone not ordinarily met, intergenerational understanding, someone to talk to, and appreciation. Additionally, the research team applied the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, to contextualize the approach and findings. Results inform future evaluation efforts of homebound visiting programs, which may seek to incorporate outcome indicators aligned with these themes and serve as a foundation for future quantitative measures of impact.
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Affiliation(s)
- Allison Karpyn
- University of Delaware, Newark DE, United States of America, Pearson Hall, Room 104, 125 Academy Street, Newark, DE 19716, United States.
| | - Nicole Kennedy
- University of Delaware, Newark DE, United States of America, Pearson Hall, Room 104, 125 Academy Street, Newark, DE 19716, United States
| | - Mia Seibold
- University of Delaware, Newark DE, United States of America, Pearson Hall, Room 104, 125 Academy Street, Newark, DE 19716, United States
| | - Tara Tracy
- University of Delaware, Newark DE, United States of America, Pearson Hall, Room 104, 125 Academy Street, Newark, DE 19716, United States
| | - Joy Kim
- University of Delaware, Newark DE, United States of America, Pearson Hall, Room 104, 125 Academy Street, Newark, DE 19716, United States
| | - Julia Larock
- University of Delaware, Newark DE, United States of America, Pearson Hall, Room 104, 125 Academy Street, Newark, DE 19716, United States
| | - Tara Silberg
- University of Delaware, Newark DE, United States of America, Pearson Hall, Room 104, 125 Academy Street, Newark, DE 19716, United States
| | - Jayna Lennon
- Lori's Hands, Newark DE, United State of America, The Tower at STAR, 4th Floor, 100 Discovery Blvd, Newark, DE 19711, United States
| | - John Oluwadero
- University of Delaware, Newark DE, United States of America, Pearson Hall, Room 104, 125 Academy Street, Newark, DE 19716, United States
| | - Maggie Ratnayake
- Lori's Hands, Newark DE, United State of America, The Tower at STAR, 4th Floor, 100 Discovery Blvd, Newark, DE 19711, United States
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Swinkels JC, Abbing J, Broese van Groenou MI. Why is the composition of older adults' care network associated with psychological wellbeing: an application of the self-determination theory. Aging Ment Health 2024:1-9. [PMID: 38958434 DOI: 10.1080/13607863.2024.2373405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVES Older care recipients have different types of care networks, varying from spouse-only to large mixed care networks, that add to different levels of wellbeing. Applying Self-Determination Theory (SDT) to the care context, we argue that the care network composition may foster or hamper the three basic needs for wellbeing: relatedness, autonomy and competence. METHOD Data are from ten observations between 1992 and 2022 of the Longitudinal Aging Study Amsterdam (N = 18,434 observations from 4,837 older Dutch adults). Five care network types are used: no care, partner, informal, formal or privately paid care. Mixed-hybrid-multilevel regression analysis of depressive symptoms as measure of wellbeing is applied on care network type and loneliness, mastery and care sufficiency as indicators of the three basic needs for wellbeing. RESULTS Receiving care from a partner care network is, compared to the formal care network, the most negatively associated with depressive symptoms, followed by informal care and privately paid care. Differences in care network types existed in loneliness and care sufficiency, but not in mastery, and in part explained the association between care network types and depressive symptoms. Results of between and within effects are comparable. CONCLUSION Using a rich data set and advanced methodology support the hypotheses that formal care networks hamper wellbeing due to insufficient care and increased loneliness, in particular compared to partner and informal care. The role of mastery was less important, possibly because it does not measure care related level of control.
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Affiliation(s)
- J C Swinkels
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - J Abbing
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - M I Broese van Groenou
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Lee JJ, Park MK, Kim N, Kim L, Kim GS. Longitudinal Relationship Between Baseline Social Frailty and Cognitive Impairment in Older Adults: 14-Year Follow-Up Results From the Korean Longitudinal Study of Ageing. J Am Med Dir Assoc 2024; 25:105124. [PMID: 38968954 DOI: 10.1016/j.jamda.2024.105124] [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: 07/15/2023] [Revised: 05/25/2024] [Accepted: 05/29/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVES This study aimed to investigate the longitudinal relationship between social frailty and cognitive impairment among community-dwelling older adults. DESIGN This retrospective cohort study is based on the first to eighth waves of the Korean Longitudinal Study of Ageing (2006-2020). SETTING AND PARTICIPANTS The participants were 2106 community-dwelling older adults aged 65 years or older and without cognitive impairment in 2006. METHODS Social frailty was assessed with 5 items including social support, social activity, social network, loneliness, and living alone (0 = social nonfrailty, 1 = social prefrailty, 2 or more = social frailty). Cognitive function was assessed using the Korean Mini-Mental State Examination, and scores below 24 indicated cognitive impairment. We used the generalized estimating equation to assess the longitudinal relationship between social frailty and cognitive impairment. RESULTS Of the 2106 participants, 515 (24.4%) had social frailty, 669 (31.8%) had social prefrailty, and 922 (43.8%) were social nonfrailty based on the baseline assessments. Relative to the social nonfrailty group, the odds ratios of the social prefrailty and social frailty groups for cognitive impairment were 1.30 (95% CI 1.10-1.54) and 1.41 (95% CI 1.16-1.71), respectively, during the follow-up. Subgroup analysis showed that social inactivity and loneliness were significantly associated with cognitive impairment. CONCLUSIONS AND IMPLICATIONS These findings highlight the need for health care providers to introduce and use available social resources for older adults with social frailty to increase the relationships between individual and social context. Social inactivity and loneliness were the major domains associated with cognitive impairment, and loneliness can be resolved by participating in social activities. Therefore, health care providers especially provide opportunities for social activities, such as group-based programs in the community, to reduce social frailty and cognitive impairment.
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Affiliation(s)
- Jae Jun Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Min Kyung Park
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Namhee Kim
- Wonju College of Nursing, Yonsei University, Wonju, South Korea
| | - Layoung Kim
- College of Nursing, Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea
| | - Gwang Suk Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea.
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MacRitchie J, Breaden M, Taylor JR, Milne AJ. Exploring older adult needs and preferences for technology-assisted group music-making. A qualitative analysis of data collected during the participatory user-centred design process. Disabil Rehabil Assist Technol 2024; 19:1935-1944. [PMID: 35658719 DOI: 10.1080/17483107.2022.2077461] [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: 10/04/2021] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Engagement with arts, recreation and leisure is highly valued by older adults, with positive links to their continued wellbeing. Despite an availability of new music technology, these devices are rarely designed with older adults in mind. This project explores the needs and preferences of older adults in residential care as they interact with digital music interfaces in a group music-making context. MATERIALS AND METHODS Twenty participants at an Australian residential aged-care facility were involved in a user-centred design process (20 sessions across six months) to develop digital music interfaces suitable for group music-making. Participants' verbal comments were audio-recorded and transcribed, supported by further written observation notes made by the activity facilitators. RESULTS A hybrid inductive and deductive approach to thematic analysis revealed three main themes: individual music-making, ensemble music-making and social engagement. Our results suggest that when interfaces are designed with older adults in mind, technology-assisted group music-making can facilitate bringing together residents with different experiences and abilities. CONCLUSIONS These findings suggest implications for rehabilitation in developing a range of musical devices for older adults to account for required flexibility, whilst maintaining an appropriate and satisfyingly "rich" musical outcome.
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Affiliation(s)
- Jennifer MacRitchie
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, Australia
- Department of Music, The University of Sheffield, Sheffield, UK
| | - Matthew Breaden
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, Australia
| | - John R Taylor
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, Australia
| | - Andrew J Milne
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Penrith, Australia
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Autschbach D, Hagedorn A, Halek M. Addressing loneliness and social isolation through the involvement of primary and secondary informal caregivers in nursing homes: a scoping review. BMC Geriatr 2024; 24:552. [PMID: 38918689 PMCID: PMC11197341 DOI: 10.1186/s12877-024-05156-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 06/17/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVES To clarify the mechanisms of interventions addressing loneliness and social isolation in older adults living in nursing homes through the involvement of primary and secondary informal caregivers. METHODS This scoping review was performed by two independent reviewers, covering the period between 2011 and 2022 and the databases MEDLINE, CINAHL, PsycINFO and Scopus. It included terms related to (A) informal caregivers, (B) nursing homes, (C) psychosocial interventions, (D) involvement and (E) social isolation or loneliness. RESULTS Thirty-three studies met the inclusion criteria. Although there were various definitions and assessment tools related to social isolation and loneliness, the studies referred to three dimensions of these concepts in nursing home residents: the quantity of social interactions, the perception of these encounters and biographical changes in social relationships. Most studies did not explicate the mechanisms of these interventions. The review uncovered the following aspects of intervention mechanisms: increasing opportunities for social contact, creating meaningful encounters, maintaining existing relationships with primary informal caregivers and establishing new ones with secondary informal caregivers. CONCLUSION Studies reporting on interventions addressing loneliness and social isolation in nursing home residents need to clarify and detail their intervention mechanisms in order to foster more targeted interventions. In addition, there is a need for further research on large-scale programs or care philosophies in this field and the development of intervention designs, which allow for tailored intervention formats in order to respond to the individual perception of social relationships.
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Affiliation(s)
- Dominique Autschbach
- School of Nursing Science, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany.
| | - Anika Hagedorn
- School of Nursing Science, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany
| | - Margareta Halek
- School of Nursing Science, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany
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Nicoloro-SantaBarbara J, Lobel M. Loneliness and Its Predictors in Rare Versus Common Chronic Illnesses. Int J Behav Med 2024; 31:422-432. [PMID: 37845486 DOI: 10.1007/s12529-023-10231-9] [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] [Accepted: 10/04/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Loneliness is a growing public health concern associated with substantial negative mental and physical health outcomes. Loneliness is especially relevant for individuals with a chronic illness, perhaps more so if their illness is rare. Little is known about the psychosocial experience of individuals with a rare chronic illness, and whether and how it may differ from the experience of individuals with common chronic illnesses. We compared the magnitude of loneliness in persons with a rare or common chronic illness and examined theoretically guided predictors of loneliness as follows: stigma, illness intrusiveness, social comparison, social support, support from healthcare providers, and self-efficacy. METHOD Individuals with a chronic illness (common or rare) completed an anonymous online survey (N = 952). RESULTS Individuals with common chronic illnesses were as lonely as those with a rare chronic illness. Loneliness in both groups was higher than that in population norms. Regression analyses reveal that independent of other predictors, loneliness was especially high among people who feel stigmatized by others, those who have less social support available, and people whose functioning is more disrupted by their illness (all p values < 0.01). CONCLUSION The similarity of loneliness in these groups reinforces the value of further systematic research to identify the needs of individuals with any type of chronic illness. Study findings highlight the importance of examining internalized stigma and social support as possible targets of intervention to reduce loneliness among individuals with a chronic illness, recognizing some of the unique features and challenges of their disorders, whether common or rare.
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Affiliation(s)
- Jennifer Nicoloro-SantaBarbara
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, 02115, USA.
- Harvard Medical School, Boston, MA, 02115, USA.
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, USA
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12
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Leton N. Senescence Seclusion Syndrome: Appraising the Efficacy of Current Interventions. Cureus 2024; 16:e62684. [PMID: 39036158 PMCID: PMC11259019 DOI: 10.7759/cureus.62684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/23/2024] Open
Abstract
The proportion of senior citizens in the global population has been on a steady rise, and the current population is forecasted to double in a few decades. Against this backdrop, the prevalence of senescence seclusion syndrome, characterized by prolonged social isolation in the elderly, is increasing concurrently. Given the profound threats this syndrome poses to the mental, physical, and social well-being of this vulnerable demographic, implementing effective interventions is imperative to mitigate these threats and enhance the quality of life. This review aims to assess the efficacy of the interventional modalities critically. Studies were reviewed following comprehensive searches in databases such as PubMed, Scopus, and Google Scholar, and focusing on empirical studies from 2019 to 2024 that evaluated the efficacy of the major intervention categories - social, technological, psychological, and physical interventions. The findings indicate that initiatives that promote consistent social engagement, such as community-organized social events and structured group activities, significantly reduced loneliness and bolstered social connections. Furthermore, technological interventions, including artificial intelligence and virtual reality, have notably enhanced elderly connectivity with their communities. Additionally, psychological interventions, such as cognitive-behavioral therapy, have also been effective in alleviating symptoms of anxiety and depression associated with the syndrome, with group sessions enhancing social interaction and significantly diminishing isolation. Moreover, physical interventions involving group exercises and other activities have fostered improvements in the physical, mental, and social well-being of the elderly. This study underscores the importance of a multifaceted approach that is individualized according to preference and circumstance in addressing senescence seclusion syndrome.
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Affiliation(s)
- Noah Leton
- Department of Physiology, Neuroscience and Behavioral Sciences, St. George's University, St. George's, GRD
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13
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Mueller KE, Van Puymbroeck M, Brown C, Crowe BM, Davis N. Measuring older adults' wellbeing when transitioning into assisted living facilities: a confirmatory factor analysis of the Mueller assessment of transition (MAT). Aging Ment Health 2024; 28:936-942. [PMID: 38117221 DOI: 10.1080/13607863.2023.2293054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES Older adults' wellbeing during the transition into an assisted living facility (ALF) is not well understood and may influence their wellbeing. The Mueller Assessment of Transition (MAT) was created to measure the impact of transition on older adults' wellbeing. Early developmental testing of the MAT revealed a hypothesized model with two constructs (adjustment strategies and constraints to wellbeing). Therefore, the purpose of this study was to confirm the factor structure of the MAT with a representative sample of older adults transitioning into ALFs. METHODS In a nationwide sample, 108 older adult participants completed the MAT to measure wellbeing when relocating into ALFs. Confirmatory factor analysis (CFA) assessed the structural validity of the MAT. Internal consistency was evaluated, and chi-square tests of association for regional differences in MAT scores were also conducted. RESULTS The CFA produced strong fit indices to confirm the hypothesized 2-factor (constraints to wellbeing and adjustment strategies) model of the MAT. Cronbach's alpha for the internal consistency was 0.784 and chi-square test indicated no significant regional differences. CONCLUSION The MAT was established as a valid and reliable standardized assessment. Implications for using the MAT as a tool to measure older adults' wellbeing and future research are discussed.
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Affiliation(s)
- Kaitlin E Mueller
- School of Health Science and Human Performance, Catawba College, Salisbury, NC, USA
| | | | - Christy Brown
- Department of Education and Human Development, Clemson University, Clemson, SC, USA
| | - Brandi M Crowe
- Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC, USA
| | - Nicole Davis
- School of Nursing, Clemson University, Clemson, SC, USA
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14
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Fernández-Salido M, Alhambra-Borrás T, Garcés-Ferrer J. Implementation of a Comprehensive and Personalised Approach for Older People with Psychosocial Frailty in Valencia (Spain): Study Protocol for a Pre-Post Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:715. [PMID: 38928961 PMCID: PMC11203706 DOI: 10.3390/ijerph21060715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024]
Abstract
With ageing, the risk of frailty increases, becoming a common condition that exposes older people to an increased risk of multiple adverse health outcomes. In Valencia (Spain), the ValueCare project develops and applies a value-based care approach that addresses the multidimensional nature of frailty by implementing integrated and personalized care to tackle psychosocial frailty. A pre-post controlled design with a baseline measurement at inclusion, at the end of implementation and a follow-up measurement after 6 months of intervention. In Valencia (Spain), 120 participants over 65 years of age are recruited from primary care centres to receive the ValueCare comprehensive and personalised care plan according to the results and are compared with 120 participants receiving "usual care". An assessment questionnaire is designed using validated instruments, and a personalised care plan is developed specifically for each participant based on the results obtained. The study protocol has been registered under the ISRCTN registration number ISRCTN25089186. Addressing frailty as a multidimensional and multifactorial risk condition requires the development and implementation of comprehensive assessments and care. In this context, this study will provide new insights into the feasibility and effectiveness of a value-based methodology for integrated care supported by ICT for older people experiencing frailty.
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Affiliation(s)
- Mirian Fernández-Salido
- Research Institute on Social Welfare Policy (POLIBIENESTAR), University of Valencia, 46022 Valencia, Spain; (T.A.-B.); (J.G.-F.)
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15
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Oken BS, Kaplan J, Klee D, Gallegos AM. Contributions of loneliness to cognitive impairment and dementia in older adults are independent of other risk factors and Alzheimer's pathology: a narrative review. Front Hum Neurosci 2024; 18:1380002. [PMID: 38873650 PMCID: PMC11169707 DOI: 10.3389/fnhum.2024.1380002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/20/2024] [Indexed: 06/15/2024] Open
Abstract
Loneliness significantly contributes to cognitive impairment and dementia in older adults. Loneliness is a distressing feeling resulting from a perceived lack of social connection (i.e., a discrepancy between desired and actual social relationships), while social isolation is a related term that can be defined by number and type of social relationships. Importantly, loneliness is distinct from social isolation in that it is associated with a distressing self-perception. The primary focus of this narrative review is the impact of chronic loneliness on cognitive impairment and dementia among older adults. Loneliness has a significant association with many factors that are related to worse cognition, and therefore we include discussion on health, mental health, as well as the physiological effects of loneliness, neuropathology, and potential treatments. Loneliness has been shown to be related to development of dementia with a hazard ratio (HR) risk comparable to having a single APOE4 gene. The relationship of dementia to loneliness appears to be at least partially independent of other known dementia risk factors that are possibly associated with loneliness, such as depression, educational status, social isolation, and physical activity. Episodic memory is not consistently impacted by loneliness, which would be more typically impaired if the mild cognitive impairment (MCI) or dementia was due to Alzheimer's disease (AD) pathology. In addition, the several longitudinal studies that included neuropathology showed no evidence for a relationship between loneliness and AD neuropathology. Loneliness may decrease resilience, or produce greater cognitive change associated with the same level of AD neuropathology. Intervention strategies to decrease loneliness in older adults have been developed but need to consider key treatment targets beyond social isolation. Loneliness needs to be assessed in all studies of cognitive decline in elders, since it significantly contributes to the variance of cognitive function. It will be useful to better define the underlying mechanism of loneliness effects on cognition to determine if it is similar to other psychological factors related to excessive stress reactivity, such as neuroticism or even depression, which are also associated with cognitive decline. It is important from a health perspective to develop better strategies to decrease loneliness in older adults.
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Affiliation(s)
- Barry S. Oken
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States
| | - Josh Kaplan
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Daniel Klee
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Autumn M. Gallegos
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
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Horgan S, Prorok J, Ellis K, Mullaly L, Cassidy KL, Seitz D, Checkland C. Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:664. [PMID: 38928911 PMCID: PMC11203904 DOI: 10.3390/ijerph21060664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 06/28/2024]
Abstract
This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.
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Affiliation(s)
- Salinda Horgan
- Departments of Rehabilitation Therapy & Psychiatry, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Jeanette Prorok
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Katie Ellis
- Mental Health Commission of Canada, Ottawa, ON K1R 1A4, Canada; (K.E.); (L.M.)
| | - Laura Mullaly
- Mental Health Commission of Canada, Ottawa, ON K1R 1A4, Canada; (K.E.); (L.M.)
| | - Keri-Leigh Cassidy
- Department of Psychiatry, Dalhousie University, Dalhousie, NS B3H 2E2, Canada;
| | - Dallas Seitz
- Departments of Psychiatry & Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Claire Checkland
- Canadian Coalition for Seniors’ Mental Health, Markham, ON L3R 9X9, Canada;
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17
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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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18
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Lei J, Liang Y, Su Z, Dong P, Liang J, Lin L. Can Socially Assistive Robots Be Accepted by Older People Living Alone in the Community?: Empirical Findings from a Social Work Project in China. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-18. [PMID: 38682357 DOI: 10.1080/01634372.2024.2339992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 04/03/2024] [Indexed: 05/01/2024]
Abstract
A pilot study was undertaken between March 2019 and September 2021, loaning socially assistive robots (SARs) for a 7-day trial to older people living alone in China. Quantitative assessments of participants' acceptance of technology and loneliness were conducted before and after the intervention, supplemented with qualitative interviews. Unexpectedly, participants' intention to use SARs decreased significantly, largely due to emotional anxiety. Meanwhile, participants' level of loneliness remained unchanged. Follow-up interviews revealed anxious emotion, hesitant attitudes, unreal social presence, usability difficulties as contributing factors. The study provides social workers with valuable insights into introducing SARs into community care of older people.
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Affiliation(s)
- Jie Lei
- School of Social & Behavioral Sciences, Nanjing University, Nanjing, China
| | - Yucheng Liang
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Zhenhao Su
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Peixing Dong
- Qichuang Social Work Service Centre, Guangzhou, China
| | - Jianling Liang
- School of Politics and Law, Wuyi University, Jiangmen, China
| | - Lin Lin
- Qichuang Social Work Service Centre, Guangzhou, China
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19
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Misiak MM, Bethell J, Chapman H, Sommerlad A. How can care home activities facilitate social connection in residents? A qualitative study. Aging Ment Health 2024:1-10. [PMID: 38669150 DOI: 10.1080/13607863.2024.2345130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/13/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Good social connection is associated with better physical and mental health but care home residents experience barriers to social connection. Activities present a potential avenue for improving social connection in care homes but residents often experience loneliness despite access to activity programmes. We therefore aimed to identify what aspects of activities facilitate social connection in care home residents. METHOD Qualitative study using semi-structured interviews that were analysed using Thematic Analysis. A purposive sample of 35 participants, including 12 residents, 10 family caregivers, nine care home staff and four clinicians, recruited from UK care homes. RESULTS We found four main themes describing features of activities important for facilitating social connection: (1) personalisation with respect to residents' interests, social preferences, and cognitive ability; (2) activities which foster a sense of community; (3) finding and emphasising things in common that residents share; and (4) facilitating a sense of involvement with others. CONCLUSION We identified the key aspects of activities which facilitate social connection in care homes. These findings can be applied to a range of existing and newly designed activities in care homes and inform the development and testing of psychosocial interventions aiming to improve social connection.
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Affiliation(s)
| | - Jennifer Bethell
- KITE Research Institute, Toronto Rehabilitation Institute,University Health Network, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | | | - Andrew Sommerlad
- Division of Psychiatry, University College London, UK
- Division of Psychiatry, Camden and Islington NHS Foundation Trust, London, UK
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20
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Cole S, Hua C, Peng S, Wang W. Exploring the Relationship of Leisure Travel with Loneliness, Depression, and Cognitive Function in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:498. [PMID: 38673409 PMCID: PMC11050658 DOI: 10.3390/ijerph21040498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
Loneliness, depression, and cognitive decline are pressing concerns among older adults. This study examines the association between leisure travel participation and these health outcomes in older adults, aiming to provide further evidence of the benefits of leisure travel. Using nationally representative historical data from the 2006 household survey of the Health and Retirement Study, this study conducted a series of regression analyses to investigate the relationship between traveling and the three health outcomes, adjusting for age, sex, race, marital status, education, total wealth, annual income, and difficulty with daily activities. The results reveal that travel patterns in terms of distance are significantly associated with loneliness, depression, and cognitive function. Long-distance travel is positively related to higher cognitive function and a reduction in depressive symptoms, along with lower levels of loneliness, reinforcing the notion that leisure travel can potentially act as a catalyst for improved cognitive and mental health by offering opportunities for enhancing social connections and forming new relationships. The findings on the relationships between participation in leisure travel and mental and cognitive health contribute to the body of evidence supporting the therapeutic value of leisure travel in promoting healthy aging and enhancing the overall well-being in older adults.
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Affiliation(s)
- Shu Cole
- Department of Health and Wellness Design, Indiana University School of Public Health—Bloomington, Bloomington, IN 47405, USA; (C.H.); (W.W.)
| | - Chenggang Hua
- Department of Health and Wellness Design, Indiana University School of Public Health—Bloomington, Bloomington, IN 47405, USA; (C.H.); (W.W.)
| | - Siyun Peng
- Department of Sociology, Indiana University—Bloomington, Bloomington, IN 47405, USA;
| | - Weixuan Wang
- Department of Health and Wellness Design, Indiana University School of Public Health—Bloomington, Bloomington, IN 47405, USA; (C.H.); (W.W.)
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21
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O'Rourke HM. The global crisis of loneliness: a call for contextualised, mechanistic research. THE LANCET. HEALTHY LONGEVITY 2024; 5:e241-e242. [PMID: 38490236 DOI: 10.1016/s2666-7568(24)00030-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/17/2024] Open
Affiliation(s)
- Hannah M O'Rourke
- College of Health Sciences, Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB T6G 1C9, Canada.
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22
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Ingelson B, Dahlke S, O'Rourke H, Low G. A Scoping Review on Nurse's Pain Management of Older Patients with Dementia in a Hospital Environment. Pain Manag Nurs 2024; 25:104-112. [PMID: 37968142 DOI: 10.1016/j.pmn.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 09/18/2023] [Accepted: 10/16/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVES Hospitalized persons living with dementia often experience unrelieved pain. Unmanaged pain during hospitalization has a significant negative effect on quality of life for persons living with dementia. Despite the central role of nurses in pain management, little is known about how nurses manage pain in this patient population in the hospital environment. DESIGN A scoping review explored the nurses' pain management practices when caring for persons living with dementia in a hospital setting. DATA SOURCES AND REVIEW/ANALYSIS METHODS After an extensive search for all available evidence on how nurses manage pain in hospitalized persons living with dementia, data were extracted on pain management methods that included assessment, intervention, effectiveness of pain management, and the barriers nurses encountered when managing pain. A descriptive content analysis was used to extract data from qualitative studies. RESULTS Six articles published between 2016 and 2021 met the inclusion criteria; four utilized qualitative methods, and the others used mixed-methods and quantitative study designs. A narrative description of the findings was summarized after data were categorized into pain management data elements and barriers nurses encountered when managing pain. Barriers were grouped into the subcategories of communication challenges (nurse to patient), information sharing (nurse to nurse), lack of knowledge, time constraints, and nursing stressors. CONCLUSION We identified six articles that met our inclusion criteria, highlighting a noticeable gap in the literature. Managing pain in this population is complex and lacks organizational support. Review findings indicate that pain management methods lack consistency and standardization, making it difficult to assess their effectiveness. Nurses also described knowledge deficits resulting in practice gaps that, when combined with barriers and challenges, result in underrecognized and undermanaged pain.
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Affiliation(s)
| | | | | | - Gail Low
- University of Alberta, Edmonton, Alberta, Canada.
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23
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Kikuchi M, Ikeda A, Hirano M. Development of Older Adults' Perceptions on Community-based Connectedness with People Scale: Reliability and validity evaluation. Jpn J Nurs Sci 2024; 21:e12583. [PMID: 38216981 DOI: 10.1111/jjns.12583] [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: 08/22/2023] [Revised: 12/02/2023] [Accepted: 12/12/2023] [Indexed: 01/14/2024]
Abstract
AIM We developed a self-assessment scale-Older Adults' Perceptions of Community-based Connectedness with People-to assess older adults' comprehensive perceptions of their connectedness with others in the community. A specific aim of this study is to evaluate the reliability and validity of this scale. METHODS Participants consisted of 1000 men and women aged 65 years or older, living in Sapporo, Hokkaido, Japan. Factorial validity was assessed using exploratory and confirmatory factor analysis, while concurrent validity was assessed using correlation analysis. Reliability was confirmed by Cronbach's α coefficient using the internal consistency method, and the stability coefficient was confirmed using the test-retest method. RESULTS Responses were received from 380 participants, and 358 participants who responded to all items were included in the analysis. The developed scale comprised 22 items with three factors: "Perception of Inclusion" (α = .947), "Perception of Reciprocity through Reception" (α = .937), and "Perception of Reciprocity through Provision" (α = .910). Correlation analyses indicated that concurrent scales were positively correlated with Ikigai and negatively correlated with loneliness on the total scale. The model fit was comparative fit index = 0.933, goodness-of-fit index = 0.854, adjusted goodness-of-fit index = 0.818, and root mean square of approximation = 0.081. The stability coefficient of the total scale scores was 0.875 (95% CI: [0.830, 0.908]). CONCLUSIONS The developed scale had adequate reliability and validity. The perceptions of connectedness measured using this scale can be used by public health and nursing care professionals to prevent loneliness and isolation among older adults living in the community.
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Affiliation(s)
- Mami Kikuchi
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Atsuko Ikeda
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Michiyo Hirano
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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24
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Gasteiger C, Collens P, du Preez E. Community-based support to improve mental health and wellbeing in older sexually and gender diverse people: a scoping review. Aging Ment Health 2024; 28:692-700. [PMID: 37855436 DOI: 10.1080/13607863.2023.2269097] [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: 06/16/2022] [Accepted: 10/05/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES This scoping review seeks to identify what community-based support is used by older sexually and gender diverse (SGD) people, that aims to improve mental health/wellbeing. METHODS A scoping review was conducted using the Arksey and O'Malley framework. APA PsycInfo, Embase, MEDLINE, PubMed, and Scopus were searched. Key information was extracted and entered into a structured coding sheet before being summarized. RESULTS Seventeen studies were included (41% observational qualitative and 35% observational quantitative). The most commonly used community-based support was lesbian, gay, bisexual and transgender (LGBT) social groups. A range of practices were reported in five studies, including in SGD affirming religious congregations and mind-body practices. Two studies reported the use of formal programmes, with one based on a group initiative. Positive outcomes included feeling connected, improved social support and mental health, and coping with illness. Five studies reported null or negative findings, including a lack of acceptance. Most studies used categories for sex and gender inaccurately, and lacked detail when describing community-based support. CONCLUSION The use of community-based support by older SGD people is underexplored. More interventions designed for and by this community are needed, along with experimental research to draw conclusions on effectiveness to improve mental health or wellbeing.
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Affiliation(s)
- Chiara Gasteiger
- School of Clinical Sciences, AUT University, Auckland, New Zealand
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Paula Collens
- School of Clinical Sciences, AUT University, Auckland, New Zealand
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25
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Pohl JS, Fleury J. Behavioral activation for family caregiver connectedness: Adaptation of an evidenced based intervention. Geriatr Nurs 2024; 56:285-290. [PMID: 38412635 DOI: 10.1016/j.gerinurse.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/29/2024]
Abstract
Informal caregivers of older adults with chronic illness have unique barriers to social connection. As the older adult population increases, individualized interventions are urgently needed to address the social disconnection experienced across generations of informal caregivers. Adapting an evidenced-based intervention to target social connectedness and leverage technology-mediated communication may be a promising approach. This article describes the adaptation of the Brief Behavioral Activation Treatment for Depression-Revised intervention using elements of the Framework for Reporting Adaptations and Modifications-Enhanced. Facilitating the comprehensive documentation of modifications made, we discuss the (a) rationale for modifications, (b) timing and approach to modifications, (c) nature of context and content modifications, and (d) fidelity in modifications. The Behavioral Activation for Family Caregiver Connectedness intervention addresses unique barriers to caregiver social connection with individualized value-based plans. Modifications to content and delivery reflect the goal of improving intervention fit in the context of social connectedness experienced by informal caregivers.
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Affiliation(s)
- Janet S Pohl
- Arizona State University, Edson College of Nursing and Health Innovation, 500 N 3rd Street, Phoenix, AZ 85004, United States.
| | - Julie Fleury
- Arizona State University, Edson College of Nursing and Health Innovation, 500 N 3rd Street, Phoenix, AZ 85004, United States
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26
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Dworschak C, Heim E, Kuhn N, Schwager J, Tröster A, Maercker A. User-centered development of an internet-based CBT intervention for the treatment of loneliness in older individuals. Internet Interv 2024; 35:100720. [PMID: 38328277 PMCID: PMC10847952 DOI: 10.1016/j.invent.2024.100720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/18/2023] [Accepted: 01/30/2024] [Indexed: 02/09/2024] Open
Abstract
Background Loneliness is a widespread phenomenon associated with a number of negative health outcomes. Older individuals may constitute one important target group with a need for effective interventions. However, despite evidence showing that addressing maladaptive social cognition (e.g., via cognitive behavioral therapy [CBT]) is the most effective intervention strategy for reducing loneliness, most existing programs aimed at older individuals do not use that method. Further, in terms of mental health service use, older individuals have been found to be an extremely undertreated population. When developing interventions, active involvement of end users in the development process is essential to increase later uptake. Objective The aim of the present study was to develop an internet-based CBT intervention for loneliness in older individuals (i.e., aged ≥65 years) applying a user-centered design. The present report provides an in-depth description of the development process. Methods Two phases of qualitative data collection were conducted in parallel with intervention development using a sample of N = 12 participants including both potential end users (i.e., older adults) as well as experts (i.e., psychotherapists). Measures included semi-structured interviews and usability testing. Results In Phase 1 interviews, participants indicated that they were predominantly positive about the idea of an internet-based program for loneliness targeting older individuals. Individualization and interactivity were named as crucial features. In Phase 2, usability testing of a prototype program provided important insights into technical barriers to intervention use. Further, participants reported that they were missing content on philosophy/theology and the role of descendants/relatives. Valuable insights from Phase 1 and Phase 2 were incorporated into the intervention program resulting in a 7-module internet-based self-help CBT intervention. Discussion Findings of this study highlight the significance of including relevant stakeholders in the development process of an intervention. Additionally, results emphasize the high acceptance of internet-based interventions in this population, but also underline the need for considering age-specific aspects when developing treatments.
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Affiliation(s)
- Christine Dworschak
- University of Zurich, Department of Psychology, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Switzerland
| | - Eva Heim
- University of Lausanne, Department of Psychology, Quartier UNIL-Mouline, 1015 Lausanne, Switzerland
| | - Nadine Kuhn
- University of Zurich, Department of Psychology, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
| | - Jessica Schwager
- University of Zurich, Department of Psychology, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
| | - Alicia Tröster
- University of Zurich, Department of Psychology, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
| | - Andreas Maercker
- University of Zurich, Department of Psychology, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Switzerland
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Smith S, Lally P, Steptoe A, Chavez-Ugalde Y, Beeken RJ, Fisher A. Prevalence of loneliness and associations with health behaviours and body mass index in 5835 people living with and beyond cancer: a cross-sectional study. BMC Public Health 2024; 24:635. [PMID: 38419011 PMCID: PMC10903019 DOI: 10.1186/s12889-024-17797-3] [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: 10/19/2023] [Accepted: 01/17/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND A cancer diagnosis and its treatment may be an especially isolating experience. Despite evidence that positive health behaviours can improve outcomes for people living with and beyond cancer (LWBC), no studies have examined associations between loneliness and different health behaviours in this population. This study aimed to describe the prevalence of loneliness in a large sample of UK adults LWBC and to explore whether loneliness was associated with multiple health behaviours. METHODS Participants were adults (aged ≥ 18 years) diagnosed with breast, prostate or colorectal cancer who completed the Health and Lifestyle After Cancer Survey. Loneliness was reported using the UCLA loneliness score, dichotomised into higher (≥ 6) versus lower (< 6) loneliness. Engagement in moderate-to-vigorous physical activity, dietary intake, smoking status, alcohol use, and self-reported height and weight were recorded. Behaviours were coded to reflect meeting or not meeting the World Cancer Research Fund recommendations for people LWBC. Logistic regression analyses explored associations between loneliness and health behaviours. Covariates were age, sex, ethnicity, education, marital status, living situation, cancer type, spread and treatment, time since treatment, time since diagnosis and number of comorbid conditions. Multiple imputation was used to account for missing data. RESULTS 5835 participants, mean age 67.4 (standard deviation = 11.8) years, completed the survey. 56% were female (n = 3266) and 44% (n = 2553) male, and 48% (n = 2786) were living with or beyond breast cancer, 32% (n = 1839) prostate, and 21% (n = 1210) colorectal. Of 5485 who completed the loneliness scale, 81% (n = 4423) of participants reported lower and 19% (n = 1035) higher loneliness. After adjustment for confounders, those reporting higher levels of loneliness had lower odds of meeting the WCRF recommendations for moderate-to-vigorous physical activity (Odds Ratio [OR] 0.78, 95% Confidence Internal [CI], 0.67, 0.97, p =.028), fruit and vegetable intake (OR 0.81, CI 0.67, 1.00, p =.046), and smoking (OR 0.62, 0.46, 0.84, p =.003). No association was observed between loneliness and the other dietary behaviours, alcohol, or body mass index. CONCLUSIONS Loneliness is relatively common in people LWBC and may represent an unmet need. People LWBC who experience higher levels of loneliness may need additional support to improve their health behaviours.
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Affiliation(s)
- Susan Smith
- Department of Behavioural Science and Health, University College London, Gower Street, WC1E 6BT, London, UK
| | - Phillippa Lally
- Department of Psychological Sciences, University of Surrey, GU2 7XH, Guildford, Surrey, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, Gower Street, WC1E 6BT, London, UK
| | - Yanaina Chavez-Ugalde
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, CB2 0QQ, Cambridge, Box 285, UK
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, LS2 9JT, Leeds, UK
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, Gower Street, WC1E 6BT, London, UK.
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Tyner CE, Boulton AJ, Slotkin J, Cohen ML, Weintraub S, Gershon RC, Tulsky DS. Exploring symptom clusters in mild cognitive impairment and dementia with the NIH Toolbox. J Int Neuropsychol Soc 2024:1-12. [PMID: 38361424 DOI: 10.1017/s1355617724000055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE Symptom clustering research provides a unique opportunity for understanding complex medical conditions. The objective of this study was to apply a variable-centered analytic approach to understand how symptoms may cluster together, within and across domains of functioning in mild cognitive impairment (MCI) and dementia, to better understand these conditions and potential etiological, prevention, and intervention considerations. METHOD Cognitive, motor, sensory, emotional, and social measures from the NIH Toolbox were analyzed using exploratory factor analysis (EFA) from a dataset of 165 individuals with a research diagnosis of either amnestic MCI or dementia of the Alzheimer's type. RESULTS The six-factor EFA solution described here primarily replicated the intended structure of the NIH Toolbox with a few deviations, notably sensory and motor scores loading onto factors with measures of cognition, emotional, and social health. These findings suggest the presence of cross-domain symptom clusters in these populations. In particular, negative affect, stress, loneliness, and pain formed one unique symptom cluster that bridged the NIH Toolbox domains of physical, social, and emotional health. Olfaction and dexterity formed a second unique cluster with measures of executive functioning, working memory, episodic memory, and processing speed. A third novel cluster was detected for mobility, strength, and vision, which was considered to reflect a physical functioning factor. Somewhat unexpectedly, the hearing test included did not load strongly onto any factor. CONCLUSION This research presents a preliminary effort to detect symptom clusters in amnestic MCI and dementia using an existing dataset of outcome measures from the NIH Toolbox.
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Affiliation(s)
- Callie E Tyner
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
| | - Aaron J Boulton
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
| | - Jerry Slotkin
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
| | - Matthew L Cohen
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
- Department of Communication Sciences & Disorders, University of Delaware, Newark, DE, USA
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark, DE, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Richard C Gershon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David S Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
- Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
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Zhu D, Al Mahmud A, Liu W. Examining behaviour change techniques (BCTs) in technology-based interventions for enhancing social participation in people with mild cognitive impairment (MCI) or dementia: a scoping review protocol. BMJ Open 2024; 14:e078188. [PMID: 38341213 PMCID: PMC10862279 DOI: 10.1136/bmjopen-2023-078188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Technology-based interventions have improved the social participation of older adults with mild cognitive impairment (MCI) or dementia. Nevertheless, how these interventions modify social participation remains to be seen, and what efficient behaviour change techniques (BCTs) have been used. As such, this study aims to conduct a scoping review, identifying the features and BCTs behind technology-based interventions that improve social participation for individuals with MCI or dementia. METHODS AND ANALYSIS The scoping review method will be used to search journal articles from electronic databases, such as PsycINFO, PubMed, MEDLINE, Web of Science, Scopus and reference lists. Following the population, concept and context structure, this study focuses on adults over 60 diagnosed with MCI or dementia. It delves into technology-based interventions, specifically focusing on BCTs, features and overall effectiveness for improving social participation. The research considers contextual factors, exploring the diverse settings where these interventions are used, including homes, healthcare facilities and community centres. This approach aims to provide nuanced insights into the impact of technology-based interventions on social participation in the targeted demographic. Two authors will independently screen titles, abstracts and full texts using Covidence software. Disagreements will be resolved through consensus or a third reviewer, and reasons for exclusion will be documented. We will conduct a detailed analysis of BCTs to pinpoint effective strategies applicable to future technology-based intervention designs. Through this scoping review, we aim to provide valuable insights that guide the direction of future research. Specifically, we seek to inform the development of effective technology-based interventions tailored to support social participation for people with MCI or dementia. ETHICS AND DISSEMINATION Ethical approval is not necessary, as this review will use available articles from electronic databases. The outcome of the study will be published in a peer-reviewed journal. PROTOCOL REGISTRATION NUMBER: https://osf.io/tkzuf/.
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Affiliation(s)
- Di Zhu
- Centre for Design Innovation, Swinburne University of Technology, Melbourne, Victoria, Australia
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Centre for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Abdullah Al Mahmud
- Centre for Design Innovation, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Wei Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Centre for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
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Park NS, Jang Y, Chung S, Chiriboga DA, Haley WE. Relationship of Living and Eating Arrangements to Mental Distress Among Older Korean Immigrants: Gender Difference in the Mediating Role of Loneliness. Res Aging 2024; 46:153-166. [PMID: 37820385 DOI: 10.1177/01640275231206482] [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] [Indexed: 10/13/2023]
Abstract
This study examined how different living/eating arrangements were associated with loneliness and depressive symptoms among older Korean immigrants. We examined gender differences considering: (1) patterns of living/eating arrangements and their relations with loneliness and mental distress and (2) indirect effect of living/eating arrangements on mental distress through feeling lonely. Data were drawn from the Study of Older Korean Americans that surveyed older; Korean immigrants during 2017-2018 (N = 2150). Living/eating arrangements were classified in the combination of four categores. Using the PROCESS macro, we tested gender differences in the mediation effect of loneliness on the relationship between living/eating arrangements and mental distress while controlling for background/health characteristics and social connectedness-related variables. The mediating role of loneliness was manifested differentially between men and women. By administering simple measures of living/eating arrangements, practitioners could potentially identify key targets to improve social and mental well-being, particularly among older immigrants with limited resources.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, California, CA, USA
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, FL, USA
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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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Xu J, Liu G, Li H, Jiang X, Zhou S, Wang J, Pang M, Li S, Kong F. Association between social integration and loneliness among the female migrant older adults with children: the mediating effect of social support. BMC Geriatr 2024; 24:4. [PMID: 38172722 PMCID: PMC10763376 DOI: 10.1186/s12877-023-04569-8] [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: 10/14/2022] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The number of migrant older adults with children (MOAC) in China has been increasing in recent years, and most of them are women. This study aimed to explore the mediating effect of social support between social integration and loneliness among the female MOAC in Jinan, China. METHODS In this study, 418 female MOAC were selected using multi-stage cluster random sampling in Jinan, Shandong Province, China. Loneliness was measured by the eight-item version of the University of California Los Angeles Loneliness Scale (ULS-8), and social support was measured by The Social Support Rating Scale (SSRS). Descriptive analyses, t-tests, ANOVA, and structural equation modeling (SEM) were used to illustrate the relationship between social integration, social support, and loneliness. RESULTS The average scores of ULS-8 and SSRS were 12.9 ± 4.0 and 39.4 ± 5.9 among female MOAC in this study. Social integration and social support were found to be negatively related to loneliness, and the standardized direct effect was -0.20 [95% CI: -0.343 to -0.068] and -0.39 [95% CI: -0.230 to -0.033], respectively. Social support mediated the relationship between social integration and loneliness, and the indirect effect was -0.16 [95% CI: -0.252 to -0.100]. CONCLUSION The female MOAC's loneliness was at a relatively lower level in this study. It was found that social integration was negatively associated with loneliness, and social support mediated the relationship between them. Helping female MOAC integrate into the inflow city and improving their social support could be beneficial for alleviating their loneliness.
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Affiliation(s)
- Jing Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Department of Medical Administration, The First Affiliated Hospital of Anhui Medical University, Hefei, 230000, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Guangwen Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Hexian Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Xiaoxu Jiang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Shengyu Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Mingli Pang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
- Institute of Health and Elderly Care, Shandong University, Jinan, China.
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Nguyen LT, Prophater LE, Fazio S, Hülür G, Tate R, Sherwin K, Shatzer J, Peterson LJ, Haley WE. Project VITAL at Home: Impact of Technology on Loneliness and Well-Being of Family Caregivers of People with Dementia. Clin Gerontol 2024; 47:149-160. [PMID: 36111824 DOI: 10.1080/07317115.2022.2123726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Project VITAL At Home aimed to combat social isolation and loneliness in family caregivers of people with dementia through purposeful engagement and connection. This project examined the effects of technology on caregiver loneliness and well-being, as well as their technology experiences, during the COVID-19 pandemic. METHODS Family caregivers were provided iN2L tablets and access to Alzheimer's Association supportive programs. Caregivers (n = 124) completed online surveys at pre and post evaluation points (average 7 months apart) to assess loneliness, subjective well-being (affect), supportive program usage, and tablet experiences. RESULTS Family caregivers had positive perceptions of the tablets for both themselves and their family members. Tablets had positive effects on caregiver well-being, including giving them an additional caregiver tool, alleviating stress, increasing satisfaction with quiet time, and improving access to supportive programs. Caregiver positive affect decreased, but no changes were observed for negative affect or loneliness. CONCLUSIONS Family caregivers found value in the tablets and showed improvements in some aspects of well-being. Randomized trials are needed to more fully assess the benefits of the intervention. CLINICAL IMPLICATIONS Pairing tablets with caregiving supports is a promising intervention to improve caregivers' access to vital resources and services and to improve their well-being.
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Affiliation(s)
- Lydia T Nguyen
- Product Management, iN2L, Greenwood Village, Colorado, USA
| | | | - Sam Fazio
- Care & Support, Alzheimer's Association, Chicago, Illinois, USA
| | - Gizem Hülür
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Rio Tate
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Kasia Sherwin
- Care & Support, Alzheimer's Association, Chicago, Illinois, USA
| | - Julie Shatzer
- Care & Support, Alzheimer's Association, Chicago, Illinois, USA
| | - Lindsay J Peterson
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
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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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O'Rourke HM, Jeffery N, Walsh B, Quark S, Sidani S. Understanding Acceptability of Group Leisure Activities Used to Address Loneliness Among People Living With Dementia: An Exploratory Mixed-Methods Study. Can J Aging 2023; 42:565-575. [PMID: 37492945 DOI: 10.1017/s0714980823000314] [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: 07/27/2023] Open
Abstract
This mixed-methods complementarity study explored family members', friends', and health care providers' perspectives of acceptability of group leisure activities as an intervention for loneliness experienced by older adults living with dementia. A sample of 25 family members, friends, and health care providers of people living with dementia in ON rated the acceptability of group leisure activities (adapted Treatment Perception and Preference questionnaire) and discussed their ratings in an interview. Quantitative (descriptive statistics) and qualitative (conventional content analysis) results were integrated to understand acceptability. Participants viewed group leisure activities as effective, logical, and suitable for use with people living with dementia. Participants described the need for flexible programs, careful facilitation, and attention to activity selection. Group leisure activities were seen as low risk, but stigmas related to dementia could prevent participation. The findings inform the design of acceptable group leisure activities, promoting their use to address loneliness in people living with dementia.
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Affiliation(s)
- Hannah M O'Rourke
- Faculty of Nursing, University of Alberta Level 3, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Nicole Jeffery
- School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
| | - Brittany Walsh
- Faculty of Nursing, University of Alberta Level 3, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Sheylenne Quark
- Faculty of Nursing, University of Alberta Level 3, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Souraya Sidani
- School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
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Eliacin J, Patterson SM, Mendez DM, Burgess DJ, Traylor MH, Borden MY, Slaven JE, Matthias MS. Findings from a Peer-Facilitated, Social Isolation Intervention in the Veterans Health Administration Healthcare System: A Mixed-Methods, Pilot Feasibility Study. J Gen Intern Med 2023; 38:3460-3471. [PMID: 37723366 PMCID: PMC10713941 DOI: 10.1007/s11606-023-08387-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/21/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Social isolation is a global public health threat. Veterans are particularly at risk for social isolation due to high rates of comorbid physical and mental health problems. Yet, effective interventions are limited. OBJECTIVES Our primary objective was to assess the feasibility and acceptability of CONNECTED, a novel, transdiagnostic intervention to reduce social isolation that includes individual and group components and is delivered by peers via telehealth. Secondary objectives were to identify appropriate outcome measures and explore preliminary intervention effects. METHODS This was a two-phase study. In Phase 1, to evaluate study feasibility, we surveyed 200 veterans to assess prevalence of social isolation and their interest in social connectedness interventions. In Phase 2, we employed a mixed-methods, pre-post study design in which we piloted CONNECTED with 19 veterans through 2 successive cohorts to further assess feasibility, to evaluate acceptability, and to explore preliminary effectiveness. Quantitative analyses involved descriptive and bivariate analyses as well as multivariate modeling. Qualitative interviews were analyzed using thematic analysis. RESULTS For Phase 1, 39% of veterans surveyed were socially isolated. Participants who were ≤ 55 years old, caregivers, and those who experienced unmet social needs were more likely to report social isolation. Over 61% expressed interest in VA programs to reduce social isolation. For Phase 2, the pilot intervention, recruitment rate was 88% and the enrollment rate was 86%. Retention rates for the two cohorts were 80% and 50%, respectively, and satisfaction rates among intervention completers were 100%. Results also showed statistically significant improvements in social isolation (+ 5.91, SD = 4.99; p = .0028), social support (+ 0.74, SD = 1.09; p = .03), anxiety (-3.92, SD = 3.73; p = .003), and depression (-3.83, SD = 3.13; p = .001). Results for the other measures were not statistically significant. CONCLUSION CONNECTED is a feasible and acceptable intervention and is likely to be an effective tool to intervene on social isolation among veterans.
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Affiliation(s)
- Johanne Eliacin
- Department of Veterans Affairs, VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
- Regenstrief Institute, Indianapolis, IN, USA.
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Scott M Patterson
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Diana M Mendez
- Department of Psychiatry, Orlando VA Healthcare System, Orlando, FL, USA
| | - Diana J Burgess
- Center for Care Delivery and Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Morgan H Traylor
- Department of Veterans Affairs, VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Maria Y Borden
- Department of Veterans Affairs, VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - James E Slaven
- Deparmtent of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Marianne S Matthias
- Department of Veterans Affairs, VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
- Regenstrief Institute, Indianapolis, IN, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Weldrick R, Dunn JR, Andrews GJ, Ploeg J. Friendly Visiting Programs for Older People Experiencing Social Isolation: A Realist Review of what Works, for whom, and under what Conditions. Can J Aging 2023; 42:538-550. [PMID: 37551541 DOI: 10.1017/s0714980823000302] [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] [Indexed: 08/09/2023] Open
Abstract
Many social interventions have been developed with the hopes of reducing and preventing social isolation among older people (e.g., recreation, arts-based programs and social prescription). Friendly visiting programs, also known as befriending schemes, have been a mainstay in this area for decades and are largely thought to be effective at reconnecting older people (≥ 60 years of age) experiencing isolation. Research and evaluations have yet to determine, however, how and why these programs may be most successful, and under what conditions. This article presents the findings of a realist synthesis aimed at identifying the critical mechanisms and contextual factors that lead to successful outcomes in friendly visiting programs. Seven studies are synthesized to inform a friendly visiting program theory accounting for key mechanisms (e.g., provision of informal support) and underlying contexts (e.g., training of volunteers) that can be used to inform future programs. Recommendations for future research are also presented.
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Affiliation(s)
- Rachel Weldrick
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
- School of Urban and Regional Planning, Toronto Metropolitan University, Toronto, ON, Canada
| | - James R Dunn
- Department of Health, Aging & Society, McMaster University, Hamilton, ON, Canada
| | - Gavin J Andrews
- Department of Health, Aging & Society, McMaster University, Hamilton, ON, Canada
| | - Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, ON, Canada
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Ruan J, Zheng W, Zhuang Y. Everyday life experiences of Chinese community-dwelling oldest old who live alone at home. Int J Qual Stud Health Well-being 2023; 18:2253937. [PMID: 37667880 PMCID: PMC10481758 DOI: 10.1080/17482631.2023.2253937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/28/2023] [Indexed: 09/06/2023] Open
Abstract
PURPOSE Older adults aged ≥ 80 years living alone at home are more likely to experience challenges. Daily life experiences regarding living alone are still limited in the Asian context. This study explored the everyday life experiences of older Chinese residents living alone at home. Research questions included: (1) How do Chinese community-dwelling old people describe everyday life experiences related to living alone? (2) What kind of difficulties and needs do Chinese community-dwelling older people living alone face in everyday lives? (3) How do Chinese community-dwelling older people cope with challenges faced in their everyday lives related to living alone? METHODS This was qualitative descriptive research. Purposive sampling was adopted to recruit 13 participants aged 80-92 years of age from communities and one hospital. Semi-structured interviews were conducted to collect data which was analysed by conventional content analysis. RESULTS Three themes were identified: theme 1-difficulty in finding a sense of belonging, theme 2-striving to maintain independence, theme 3-hard to gain a sense of control. CONCLUSIONS This study provided novel insights into understanding the difficulties and needs of Chinese older people living alone at home. Three key challenges and associated strategies they used to cope with in daily lives were presented.
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Affiliation(s)
- Jiayin Ruan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, China
| | - Weina Zheng
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yiyu Zhuang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Xie X, Huang C, Sitar S, Qiao X. Community engagement and loneliness in older adults in China: mediation effects of social support in the wake of COVID-19. Front Public Health 2023; 11:1199577. [PMID: 38106887 PMCID: PMC10722421 DOI: 10.3389/fpubh.2023.1199577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/13/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Loneliness is a key indicator of well-being in older adults. Drawing from the ecological model of aging, the active aging perspective, and the convoy model of social relations, this study investigates the extent community engagement influences loneliness and whether the relationship is mediated by social support during the COVID-19 pandemic. Methods Data was collected from 1,067 retired older adults in a cross-sectional design in Chengdu, China in 2022. Structural equation modeling was conducted to examine the direct and indirect effects of community engagement on loneliness through the hypothesized mediator of social support. Results The results show community engagement was positively associated with social support (β = 0.26, p < 0.001) and social support was negatively related to loneliness (β = -0.41, p < 0.001). Social support fully mediated the relationship between community engagement and loneliness. Additionally, community engagement had an indirect effect on loneliness via social support (β = -0.11, p < 0.001). Discussion The findings from the moderation analysis suggests community engagement and social support are likely to have large effects on loneliness for older adults over the age of 70 and who have low educational attainment. The findings suggest community engagement could be an important factor for improving social support and reducing loneliness amongst retired, older adults in China, especially in the wake of the COVID-19 pandemic where millions of individuals were isolated for extended periods of time.
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Affiliation(s)
- Xiaoxia Xie
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
| | - Chienchung Huang
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Sophie Sitar
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Xingyong Qiao
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
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Thibault D, Whynot TD, Swindle J, Lee H, O'Rourke HM. Acceptability of a Personal Contact Intervention among People Living with Dementia: Might Baseline Contact Matter? Can J Aging 2023; 42:761-770. [PMID: 37580984 DOI: 10.1017/s071498082300034x] [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] [Indexed: 08/16/2023] Open
Abstract
Our study aimed to explore how perceived baseline contact may influence acceptability of Connecting Today, a personal contact intervention, among people living with dementia. We aimed to generate hypotheses for testing in future studies. This was a sub-group analysis of pilot study data. Fifteen people living with mild to moderate dementia participated in Connecting Today. We explored how perceptions of intervention acceptability may differ in groups reporting weekly contact (n = 8) compared with groups reporting monthly/unknown (n = 7) contact at baseline. Measures of acceptability included a treatment perceptions and preferences questionnaire, and the number of and reasons for non-consent, missing data, and study withdrawal. We used descriptive statistics and content analysis. In visits one and two, a larger proportion (85.7-100%) of low baseline contact participants reported feeling better, and indicated that the visits helped them and were easy "mostly" or "a lot", compared with the high baseline contact group (37.5-62.5%). Most missing data (71%) and all study withdrawals occurred in the high baseline contact group. Scheduled in-person visits with family, friends, or a volunteer may appeal to residents in care homes who have few existing opportunities for routine, one-on-one visits with others. Hypotheses generated should be tested in future studies.
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Affiliation(s)
| | | | | | - Heunjung Lee
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Welch V, Ghogomu ET, Barbeau VI, Dowling S, Doyle R, Beveridge E, Boulton E, Desai P, Huang J, Elmestekawy N, Hussain T, Wadhwani A, Boutin S, Haitas N, Kneale D, Salzwedel DM, Simard R, Hébert P, Mikton C. Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1369. [PMID: 38024780 PMCID: PMC10681039 DOI: 10.1002/cl2.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background Social isolation and loneliness are more common in older adults and are associated with a serious impact on their well-being, mental health, physical health, and longevity. They are a public health concern highlighted by the COVID-19 pandemic restrictions, hence the need for digital technology tools to enable remotely delivered interventions to alleviate the impact of social isolation and loneliness during the COVID-19 restrictions. Objectives To map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings. Search Methods We searched the following databases from inception to May 16, 2021, with no language restrictions. Ovid MEDLINE, Embase, APA PsycInfo via Ovid, CINAHL via EBSCO, Web of Science via Clarivate, ProQuest (all databases), International Bibliography of the Social Sciences (IBSS) via ProQuest, EBSCO (all databases except CINAHL), Global Index Medicus, and Epistemonikos. Selection Criteria Titles and abstracts and full text of potentially eligible articles were independently screened in duplicate following the eligibility criteria. Data Collection and Analysis We developed and pilot tested a data extraction code set in Eppi-Reviewer and data were individually extracted and coded based on an intervention-outcome framework which was also used to define the dimensions of the evidence and gap map. Main Results We included 200 articles (103 primary studies and 97 systematic reviews) that assessed the effects of digital interventions to reduce social isolation and/or loneliness in older adults. Most of the systematic reviews (72%) were classified as critically low quality, only 2% as high quality and 25% were published since the COVID-19 pandemic. The evidence is unevenly distributed with clusters predominantly in high-income countries and none in low-income countries. The most common interventions identified are digital interventions to enhance social interactions with family and friends and the community via videoconferencing and telephone calls. Digital interventions to enhance social support, particularly socially assistive robots, and virtual pets were also common. Most interventions focused on reducing loneliness and depression and improving quality of life of older adults. Major gaps were identified in community level outcomes and process indicators. No included studies or reviews assessed affordability or digital divide although the value of accessibility and barriers caused by digital divide were discussed in three primary studies and three reviews. Adverse effects were reported in only two studies and six reviews. No study or review included participants from the LGBTQIA2S+ community and only one study restricted participants to 80 years and older. Very few described how at-risk populations were recruited or conducted any equity analysis to assess differences in effects for populations experiencing inequities across PROGRESS-Plus categories. Authors' Conclusions The restrictions placed on people during the pandemic have shone a spotlight onto social isolation and loneliness, particularly for older adults. This evidence and gap map shows available evidence on the effectiveness of digital interventions for reducing social isolation or loneliness in older adults. Although the evidence is relatively large and recent, it is unevenly distributed and there is need for more high-quality research. This map can guide researchers and funders to consider areas of major gaps as priorities for further research.
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Affiliation(s)
- Vivian Welch
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Sierra Dowling
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | - Ella Beveridge
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Elisabeth Boulton
- School of Health Sciences, Division of Nursing, Midwifery and Social WorkUniversity of ManchesterManchesterUK
| | - Payaam Desai
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | - Jimmy Huang
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Arpana Wadhwani
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
| | | | | | - Dylan Kneale
- Social Science Research Unit, EPPI‐Centre, UCL Institute of EducationUniversity College LondonLondonUK
| | - Douglas M. Salzwedel
- Department of Anesthesiology, Pharmacology and TherapeuticsUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Paul Hébert
- Bruyère Research InstituteUniversity of OttawaOttawaOntarioCanada
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O’Rourke HM. Connecting Today: Feasibility and acceptability of a remote visiting program for people living with dementia in long-term care homes. DEMENTIA 2023; 22:1321-1347. [PMID: 37341515 PMCID: PMC10521164 DOI: 10.1177/14713012231176858] [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: 06/22/2023]
Abstract
OBJECTIVES Social isolation and loneliness affect the quality of life of people living with dementia, yet few interventions have been developed for this population. The purpose of this study was to assess the feasibility and acceptability of 'Connecting Today', a remote visiting program designed for use with care home residents living with dementia. METHODS This was a feasibility study to assess whether Connecting Today can be delivered in care homes, and was acceptable to family and friends and people living with dementia. We used a single-group before/after design and included residents ≥ 65 years old with a dementia diagnosis from two care homes in Alberta, Canada. Connecting Today involved up to 60 min per week of facilitated remote visits for 6 weeks. To understand feasibility, we assessed rates and reasons for non-enrollment, withdrawal and missing data. We assessed acceptability with the Observed Emotion Rating Scale (residents) and a Treatment Perception and Preferences Questionnaire (family and friends). Data were analyzed with descriptive statistics. RESULTS Of 122 eligible residents, 19.7% (n = 24) enrolled (mean age = 87.9 years, 70.8% females). Three residents withdrew from the study before the first week of calls. Among 21 remaining residents, 62%-90% completed at least 1 call each week. All the calls were completed by videoconference, rather than by phone. Alertness and pleasure were observed for ≥92% of residents during calls. The 24 contacts rated Connecting Today as logical, effective and low risk. CONCLUSIONS Facilitated, remote visits are feasible and highly acceptable to residents and their family and friend contacts. Connecting Today shows promise to address social isolation and loneliness for people living with moderate to severe dementia because it can promote positive engagement in meaningful interactions with their family and friends while they are living in a care home. Future studies will test effectiveness of Connecting Today in a large sample.
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Affiliation(s)
- Hannah M O’Rourke
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Gumikiriza-Onoria JL, Nakigudde J, Kaddu Mukasa M, Tibasiima I, Mayega R, Nakasujja N. Reflections of ageing among older adults in a Ugandan community: A qualitative analysis into the benefits and pains of ageing. JOURNAL OF MENTAL HEALTH AND AGING 2023; 7:171. [PMID: 38288055 PMCID: PMC10824533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Background The way societies comprehend and interpret aging has been in constant flux, mainly as life expectancy benchmarks increase and worldwide dynamics transform. Similar to many other nations, Uganda is experiencing this demographic shift. People aged 60 and above, who form a mere 2.7% of Uganda's population, are gradually emerging as a segment worth attention. This surge in life expectancy, which has increased from 50 to 63 years over the last decade, indicates a significant transformation in healthcare, lifestyles, and societal structures. Given this backdrop, there is a pressing need to delve deeper into the perceptions and experiences of this age cohort, especially in Central Uganda. This area mirrors the national trends. Methods This study adopted a rigorous methodological approach. Individuals aged 60 years and above were selected through purposive sampling, which aimed to draw out rich and diverse narratives. These participants participated in seven in-depth Focus Group Discussions (FGDs) held in Wakiso District. To ensure accuracy in representation, all discussions were first transcribed in Luganda, the local dialect, before careful translation to English. Results The participants presented a broad age spectrum from 62 to 90 years. The demographic data revealed a majority of female participants (54%), and a noteworthy statistic was that over half (51%) lacked a steady income source. Meticulous thematic analysis uncovered three themes. First, the journey of ageing encompasses physical, psychological, and social shifts, such as diminishing mobility, deteriorating health, and mounting social isolation. Second, the brighter side of ageing manifests in intangibles such as accumulated wisdom and a profound sense of life's accomplishments. The third theme echoed the harsher realities of aging, highlighting struggles with maintaining independence, looming financial challenges, and the sting of social exclusion.
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Affiliation(s)
- JL Gumikiriza-Onoria
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - J Nakigudde
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - M Kaddu Mukasa
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - I Tibasiima
- College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
| | - R Mayega
- School of Public Health, Makerere University, Kampala, Uganda
| | - N Nakasujja
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Pudur R, Mpofu E, Prybutok G, Meier N, Ingman S. Social Connectedness Resource Preferences of Older Adults in Assisted Living: A Scoping Review Based on the WHO-ICF Framework. J Gerontol Nurs 2023; 49:35-42. [PMID: 37650849 DOI: 10.3928/00989134-20230816-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The current scoping review identified emerging evidence on social connectedness resource preferences of older adults in assisted living facilities (ALFs) and the community. A literature search was performed using several databases. We included review articles published between January 2000 and September 2022 in English and related to social connectedness resources in ALFs and the community. Of 134 titles and abstracts, eight studies were included. Study participants comprised 2,482 older adults from 233 ALFs in the United States. Themes were framed using the World Health Organization's International Classification of Functioning, Disability, and Health. For social activities, older adults preferred facility-based recreation and leisure resources. For community social connectedness, residents preferred participation in civic life activities. Participants of older age preferred facility resources, whereas those of younger age preferred more demanding physical activities. Those from larger enrollment facilities preferred facility-based resources compared to community resources. For moderately and less active residents, participation was limited to less demanding activities. Older adults' preferences varied based on age, physical limitations, and size and location of the facility. Findings suggest opportunities for further research on developing ALF- and community-based resources for older adults' social well-being and quality of life. [Journal of Gerontological Nursing, 49(9), 35-42.].
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Welch V, Tanjong Ghogomu E, Dowling S, Choo WY, Yunus RM, Mohd TAMT, Haitas N, Bomze S, Dahrouge S, Garcia E, Holt‐Lunstad J, Lasgaard M, Lim MH, Mulligan K, Salzwedel DM, Qualter P, Hébert PC, Mikton C. PROTOCOL: In-person interventions to reduce social isolation and loneliness: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1340. [PMID: 37361556 PMCID: PMC10286723 DOI: 10.1002/cl2.1340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
This is the protocol for an evidence and gap map. The objectives are as follows: This EGM aims to map available evidence on the effects of in-person interventions to reduce social isolation and/or loneliness across all age groups in all settings.
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Affiliation(s)
| | | | | | - Wan Yuen Choo
- Department of Social & Preventive Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Raudah M. Yunus
- Public Health MedicineUniversiti Teknologi MARASungai BulohMalaysia
| | | | | | - Sivan Bomze
- Canadian Red CrossMississaugaCanada
- Canadian Red CrossMississaugaCanada
| | | | - Edward Garcia
- Foundation for Social ConnectionWashingtonDistrict of ColumbiaUSA
| | | | - Mathias Lasgaard
- DEFACTUM ‐ Public Health and Health Services ResearchCentral Denmark RegionAarhus NDenmark
| | - Michelle H. Lim
- University of Sydney, School of Public HealthSydneyAustralia
- Ending Loneliness TogetherMelbourneAustralia
| | - Kate Mulligan
- University of Toronto, Dalla Lana School of Public HealthTorontoCanada
| | - Douglas M. Salzwedel
- Department of Anesthesiology, Pharmacology and TherapeuticsUniversity of British ColumbiaVancouverCanada
| | - Pamela Qualter
- University of Manchester, Mancehster Institute of EducationManchesterUK
| | - Paul C. Hébert
- Bruyere Research InstitutePalliative Care University of OttawaOttawaCanada
| | - Christopher Mikton
- World Health Organization, Department of Social Determinants of HealthGenevaSwitzerland
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Pentikäinen E, Kimppa L, Pitkäniemi A, Lahti O, Särkämö T. Longitudinal effects of choir singing on aging cognition and wellbeing: a two-year follow-up study. Front Hum Neurosci 2023; 17:1174574. [PMID: 37545597 PMCID: PMC10398963 DOI: 10.3389/fnhum.2023.1174574] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction While increasing evidence points toward the benefits of musical activities in promoting cognitive and emotional well-being in older adults, more longitudinal studies are needed to establish their long-term effects and uncover the mechanisms through which musical activities affect well-being. Most previous research has focused on instrumental musical activities, but little is currently known about the long-term effects of singing, even though neuroimaging evidence suggests that it is a versatile activity for the brain, involving a multitude of neural processes that are potentially beneficial for well-being. Methods We conducted a 2-year follow-up study to assess aging-related changes in cognitive functioning and emotional and social well-being with self-report questionnaires and standardized tests in 107 older adult choir singers and 62 demographically matched non-singers. Data were collected at baseline (T1), and at 1-year (T2) and 2-year (T3) follow-ups using questionnaires on subjective cognitive functioning, depression, social engagement, and quality of life (QOL) in all participants and neuropsychological tests in a subgroup of participants (45 choir singers and 41 non-singers). Results The results of linear mixed model analysis showed that in verbal flexibility (phonemic fluency task), the choir singers had higher scores already at T1 and showed no change over time, whereas the non-singers showed enhancement from T1 to T3. Furthermore, active retrieval of word knowledge (WAIS-IV Vocabulary task) showed significantly different changes from T1 to T2 between the groups (enhancement in choir singers and decline in non-singers), however lacking significant change within groups. Similar opposite trajectories of QOL related to social inclusion and safety of the environment (WHOQOL-Bref Environmental subscale) were significant from T1 to T3, but these changes were not significant within groups or at each timepoint. Within the choir singers, shorter experience in choir singing was associated with greater improvement in the vocabulary task over the follow-up period, suggesting that initiation of choir singing at older age induces some verbal benefits. There were no group differences in any other questionnaire or neuropsychological measure over time. Discussion In conclusion, our results suggest that choir singing at older age is associated with a sustained enhancement of phonemic fluency, while the effects on other verbal skills and quality of life are less clear.
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Affiliation(s)
- Emmi Pentikäinen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Centre of Excellence in Music, Mind, Body, and Brain, University of Helsinki, Helsinki, Finland
| | - Lilli Kimppa
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anni Pitkäniemi
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Centre of Excellence in Music, Mind, Body, and Brain, University of Helsinki, Helsinki, Finland
| | - Outi Lahti
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Seinäjoki Central Hospital, Geriatric Outpatient Clinic, Rehabilitation Analysis Clinic, Seinäjoki, Finland
| | - Teppo Särkämö
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Centre of Excellence in Music, Mind, Body, and Brain, University of Helsinki, Helsinki, Finland
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Li M, Rao W, Su Y, Sul Y, Caron G, D'Arcy C, Fleury MJ, Meng X. Psychological interventions for loneliness and social isolation among older adults during medical pandemics: a systematic review and meta-analysis. Age Ageing 2023; 52:7192245. [PMID: 37290121 DOI: 10.1093/ageing/afad076] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVES There is little research conducted to systematically synthesize the evidence on psychological interventions for social isolation and loneliness among older adults during medical pandemics. This systematic review aims to address this information gap and provides guidance for planning and implementing interventions to prevent and reduce loneliness and social isolation for older adults, especially during medical pandemics. METHODS Four electronic databases (EMBASE, PsychoInfo, Medline and Web of Science) and grey literature from 1 January 2000 to 13 September 2022 were searched for eligible studies on loneliness and social isolation. Data extraction and methodological quality assessment on key study characteristics were conducted independently by two researchers. Both qualitative synthesis and meta-analysis were used. RESULTS The initial search yielded 3,116 titles. Of the 215 full texts reviewed, 12 intervention articles targeting loneliness during the COVID-19 pandemic met the inclusion criteria. No studies were found concerning intervention with respect to social isolation. Overall, interventions targeting social skills and the elimination of negativities effectively alleviated the feelings of loneliness in the older population. However, they had only short-term effects. CONCLUSION This review systematically summarised the key characteristics and the effectiveness of existing interventions addressing loneliness in older adults during the COVID-19 pandemic. Future interventions should focus on social skills and eliminating negativities and be tailored to the needs and characteristics of older people. Repeated larger-scale randomized controlled trials and long-term effectiveness evaluations on this topic are warranted.
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Affiliation(s)
- Muzi Li
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec H3A1A1, Canada
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
| | - Wenwang Rao
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec H3A1A1, Canada
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China
| | - Yingying Su
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec H3A1A1, Canada
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
| | - Youngjoo Sul
- Department of Anatomy & Cell Biology, McGill University, Montreal, Quebec H3A0G4, Canada
| | - Gabriel Caron
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
| | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan S7N5E5, Canada
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N5E5, Canada
| | - Marie-Josee Fleury
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec H3A1A1, Canada
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
| | - Xiangfei Meng
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec H3A1A1, Canada
- Douglas Research Centre, Montreal, Quebec H4H 1R3, Canada
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Sommerlad A, Kivimäki M, Larson EB, Röhr S, Shirai K, Singh-Manoux A, Livingston G. Social participation and risk of developing dementia. NATURE AGING 2023; 3:532-545. [PMID: 37202513 DOI: 10.1038/s43587-023-00387-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/22/2023] [Indexed: 05/20/2023]
Abstract
The increasing number of people with dementia globally illustrates the urgent need to reduce dementia's scale and impact. Lifetime social participation may affect dementia risk by increasing cognitive reserve, and through brain maintenance by reducing stress and improving cerebrovascular health. It may therefore have important implications for individual behavior and public health policy aimed at reducing dementia burden. Observational study evidence indicates that greater social participation in midlife and late life is associated with 30-50% lower subsequent dementia risk, although some of this may not be causal. Social participation interventions have led to improved cognition but, partly due to short follow-up and small numbers of participants, no reduction in risk of dementia. We summarize the evidence linking social participation with dementia, discuss potential mechanisms by which social participation is likely to reduce and mitigate the impact of neuropathology in the brain, and consider the implications for future clinical and policy dementia prevention interventions.
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Affiliation(s)
- Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK.
- Camden and Islington NHS Foundation Trust, London, UK.
| | - Mika Kivimäki
- Division of Psychiatry, University College London, London, UK
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eric B Larson
- University of Washington Schools of Medicine and Public Health, Seattle, WA, USA
| | - Susanne Röhr
- School of Psychology, Massey University, Manawatu, New Zealand
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Kokoro Shirai
- Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Archana Singh-Manoux
- Division of Psychiatry, University College London, London, UK
- Université Paris Cité, Inserm, U1153, Paris, France
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
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Munawar K, Fadzil Z, Choudhry FR, Kausar R. Cognitive Functioning, Dependency, and Quality of Life Among Older Adults. ACTIVITIES, ADAPTATION & AGING 2023. [DOI: 10.1080/01924788.2023.2193786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Straiton N, Hollings M, Gullick J, Gallagher R. Wearable Activity Trackers Objectively Measure Incidental Physical Activity in Older Adults Undergoing Aortic Valve Replacement. SENSORS (BASEL, SWITZERLAND) 2023; 23:3347. [PMID: 36992058 PMCID: PMC10051559 DOI: 10.3390/s23063347] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND For older adults with severe aortic stenosis (AS) undergoing aortic valve replacement (AVR), recovery of physical function is important, yet few studies objectively measure it in real-world environments. This exploratory study explored the acceptability and feasibility of using wearable trackers to measure incidental physical activity (PA) in AS patients before and after AVR. METHODS Fifteen adults with severe AS wore an activity tracker at baseline, and ten at one month follow-up. Functional capacity (six-minute walk test, 6MWT) and HRQoL (SF 12) were also assessed. RESULTS At baseline, AS participants (n = 15, 53.3% female, mean age 82.3 ± 7.0 years) wore the tracker for four consecutive days more than 85% of the total prescribed time, this improved at follow-up. Before AVR, participants demonstrated a wide range of incidental PA (step count median 3437 per day), and functional capacity (6MWT median 272 m). Post-AVR, participants with the lowest incidental PA, functional capacity, and HRQoL at baseline had the greatest improvements within each measure; however, improvements in one measure did not translate to improvements in another. CONCLUSION The majority of older AS participants wore the activity trackers for the required time period before and after AVR, and the data attained were useful for understanding AS patients' physical function.
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