Association of Social Isolation and Loneliness With Chronic Low Back Pain Among Older Adults: A Cross-sectional Study From Japan Gerontological Evaluation Study (JAGES)

Association of loneliness with the risk of pain in older Chinese adults

This study investigates the long-term effects of loneliness on pain experiences in older Chinese adults, focusing on the mediating role of depression. Data from the China Health and Retirement Longitudinal Study (2013-2020) included 1,592 participants aged 60 and above. Using robust mixed-effects logistic regression models, the study found that lonely participants were more likely to experience 12 site pain: headache (OR 1.23; 95% CI 1.09-1.39), shoulder (OR 1.16; 95% CI 1.04-1.30), wrist (OR 1.14; 95%CI 1.01-1.28), finger (OR 1.14, 95% CI 1.02-1.28), chest (OR 1.26; 95% CI 1.10-1.44), stomach (OR 1.28, 95% CI 1.12-1.46), back (OR 1.23; 95% CI 1.00-1.51), waist (OR 1.46; 95% CI 1.17-1.83), buttock (OR 1.15, 95% CI 1.02-1.30), leg (OR 1.20, 95% CI 1.08-1.33), knee (OR 1.16; 95% CI 1.04-1.30), and toe (OR 1.18; 95% CI 1.04-1.34) than participants who were not lonely. No such finding was found for neck, arm, or ankle pain. The risk of pain due to loneliness did not decrease with an increase in the frequency of social activities. These findings emphasize the need to address mental health as a crucial factor in pain prevention and management.

Health Literacy and Internet Use Among Japanese Older Adults: A Gender-Stratified Cross-Sectional Analysis of the Moderating Effects of Neighborhood Relationships

Background/Objectives: Internet use positively impacts mental health in older adults, with health literacy (HL) playing a key role. While social networks may complement individual HL, the role of neighborhood relationships in this association, particularly by gender, remains unclear. This study examined how the association between HL and Internet use among older adults was modified by neighborhood relationships. Methods: Using baseline data from the Chofu-Digital-Choju project, a cross-sectional analysis was conducted on 1955 community-dwelling adults aged 65-84 (889 men and 1066 women). HL was assessed using the Communicative and Critical Health Literacy scale and dichotomized at four points. Neighborhood relationships were categorized as high (visiting/chatting with neighbors) or low (exchanging greetings/no relationship). Gender-stratified logistic regression analyses were performed with Internet use as the dependent variable, with HL, neighborhood relationships, and their interaction as independent variables. Results: Internet user proportion was 55.6% for men and 41.8% for women. HL was positively associated with Internet use in both genders, though patterns differed. Among men, the HL-Internet use association was consistent (OR = 3.09; 95% CI: 2.25-4.24) regardless of neighborhood relationship levels. For women, this association was significantly modified (interaction OR = 0.46, 95% CI: 0.24-0.87). Women with low HL but strong neighborhood relationships showed increased odds of Internet use (OR = 2.08, 95% CI: 1.32-3.26). Conclusions: Gender-specific patterns in HL and neighborhood relationships influence Internet use among older adults. Neighborhood relationships may compensate for low HL in women, underscoring the need for gender-sensitive strategies to promote digital HL.

The jeong and haan of Vincent van Gogh: neuropeptides of bondedness and loss

We introduce two Korean-named yet transcultural feelings, jeong and haan, to fill gaps in neuroscientific understanding of mammalian bondedness, loss, and aggression. Jeong is a visceral sense of connectedness to a person, place, or thing that may arise after proximity, yet does not require intimacy. The brain opioid theory of social attachment (BOTSA) supports the idea that jeong involves increased activity of enkephalins and beta-endorphins. We propose that withdrawal of jeong-related neuropeptides leads to original haan, a sense of "missingness" that is too subtle to be grossly dysphoric. Through narrative, cognitive appraisals, or moral assignments, however, original haan may transform into the feeling of constructed haan-resentment, bitterness, grievance, sorrow, or suppressed anger. In males, the transformation may be driven by arginine vasopressin, an ancient fight-or-flight neurohormone. Constructed haan may also be driven by vasopressin in females, though data is more sparse, and in both sexes it may depend on situational or societal context. Endogenous opioids inhibit vasopressin, so that when jeong diminishes, vasopressin release may become disinhibited. This relationship implies a companion to the BOTSA, which we articulate as the brain opioid and vasopressin theory of original and constructed haan (BOVTOCH). To illustrate, we reflect on borderline personality disorder, and Vincent van Gogh's self-severing of his ear while living and working with Paul Gauguin, and fearing abandonment by him; yet to understand Van Gogh more completely we also present the brain opioid theory of stable euphoric creativity (BOTSEC), to model the subjective "highs" associated with creative flow states. Together these brain opioid theories may help to explain how feelings related to social bondedness can influence a range of phenomena. For example, opioid drug dependence may be, at least partly, a maladaptive response to feelings of isolation or disconnectedness; the health protective effects of social bonds could be related to tonic exposure to endogenous opioids and their anti-inflammatory properties; endogenous opioid-based social relational enhancement may contribute to placebo responding. Finally we conclude by pointing out the possibility of virtuous cycles of social connectedness and creativity, when feelings of bondedness and euphoric flow reinforce one another through endogenous opioid elevation.

Exploring the association of social isolation and loneliness on the experience of COVID-19 infection and hospitalization in the Japanese population: the JACSIS study

PURPOSE

Social isolation and loneliness have been long-standing public health concerns, and the coronavirus disease 2019 (COVID-19) pandemic has exacerbated these issues. Therefore, this study aimed to investigate the associations of social isolation and loneliness during the pandemic with experience of COVID-19 infection and hospitalization in the Japanese population.

METHODS

Data were sourced from the Japan COVID-19 and Society Internet Survey (JACSIS), a large-scale, web-based national survey of individuals aged 15-79. This study used JACSIS data from 2020 to 2022, representing the first and third years of the pandemic. Social isolation was measured by the frequency of direct and indirect contact with people other than co-residing family members. Loneliness was evaluated using the UCLA Loneliness Scale, while COVID-19 infection and hospitalization were self-reported.

RESULTS

A total of 13,612 individuals were included, of whom 1.5% had experienced hospital admission due to COVID-19, and 9.3% were infected but not hospitalized. Social isolation was inversely associated with COVID-19 infection risk (odds ratio = 0.77; 95% confidence interval: 0.66-0.90), while a higher level of loneliness was related to hospitalization (odds ratio = 2.21; 95% confidence interval: 1.59-3.09). Sex-stratified analyses revealed stronger associations in men than women.

CONCLUSION

This study highlights the complex relationship between psychosocial factors and infectious disease outcomes, underscoring the need for comprehensive approaches to address the multifaceted challenges posed by global health crises.

Causal associations between frailty and low back pain: a bidirectional two-sample mendelian randomization study

BACKGROUND

Previous observational studies have revealed a potentially robust bidirectional relationship between frailty and low back pain (LBP). However, the precise causal relationship remains unclear.

METHODS

To examine the potential causal association between frailty and LBP, we conducted bidirectional two-sample Mendelian randomization analysis (MR) study. Genetic data on frailty index (FI) and LBP were acquired from publicly available genome-wide association studies (GWAS). Various MR methodologies were utilized, such as inverse variance weighting (IVW), weighted median, and MR-Egger, to evaluate causality. Additionally, sensitivity analyses were conducted to evaluate the robustness of the findings.

RESULTS

Genetically predicted higher FI (IVW, odds ratio [OR] = 1.66, 95% CI 1.17-2.36, p = 4.92E-03) was associated with a higher risk of LBP. As for the reverse direction, genetic liability to LBP showed consistent associations with a higher FI (IVW, OR = 1.13, 95% CI 1.07-1.19, p = 2.67E-05). The outcomes from various MR techniques and sensitivity analyses indicate the robustness of our findings.

CONCLUSION

Our research findings provide additional evidence bolstering the bidirectional causal relationship between frailty and LBP.

Association of depressive symptoms with risk of incidence low back pain in middle-aged and older Chinese adults

BACKGROUND

Elevated Depressive symptoms (DS) and low back pain (LBP) pose significant and growing public health challenges, and China is no exception. This study innovatively examined the relationship between specific DS and distinct patterns of DS and incident LBP.

METHODS

This study extracted data from 4713 participants aged 45+ years from the China and Health Retirement Longitudinal Study (CHARLS), followed-up for incidence LBP (June 2011-September 2020). DS was assessed by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). The incident LBP was determined by self-reported. Latent class analysis (LCA) was employed to categorize patterns of DS. Cox proportional hazards regression models were used to examine the association between DS and incident LBP.

RESULTS

Over the 9.25-year follow-up period, 2234 incident LBP cases were identified. There was a significant independent association between positive DS and incident LBP with an HR of 1.73 (95 % CI = 1.55-1.94). Of the 10-item DS, difficulty concentrating (adjusted HR = 1.16, 95 % CI = 1.03-1.31), effortfulness (adjusted HR = 1.32, 95 % CI = 1.18-1.49), hopelessness (adjusted HR = 1.13, 95 % CI = 1.02-1.25), restless sleep (adjusted HR = 1.17, 95 % CI = 1.06-1.30), and loneliness (adjusted HR = 1.18, 95 % CI = 1.02-1.36), each independently associated with incident LBP. Regarding patterns of DS, compared to the "healthy" pattern of DS, four patterns showed significant association with incident LBP, especially the cumulative pattern of DS.

LIMITATIONS

DS and LBP were assessed based on self-reported.

CONCLUSIONS

In middle-aged and older Chinese adults, 5 specific DS (difficulty concentrating, effortfulness, hopelessness, restless sleep, and loneliness) and distinct patterns of DS indicate varied risks of developing LBP.