Impact of internet use on loneliness and contact with others among older adults: cross-sectional analysis

Predicting the Risk of Loneliness in Children and Adolescents: A Machine Learning Study

BACKGROUND

Loneliness is increasingly emerging as a significant public health problem in children and adolescents. Predicting loneliness and finding its risk factors in children and adolescents is lacking and necessary, and would greatly help determine intervention actions.

OBJECTIVE

This study aimed to find appropriate machine learning techniques to predict loneliness and its associated risk factors among schoolchildren.

METHODS

The data were collected from an ongoing prospective puberty cohort that was established in Chongqing, Southwest China. This study used 822 subjects (46.84% boys, age range: 11-16) followed in 2019. Five models, (a) random forest, (b) extreme gradient boosting (XGBoost), (c) logistic regression, (d) neural network, and (e) support vector machine were applied to predict loneliness. A total of 39 indicators were collected and 28 predictors were finally included for prediction after data pre-processing, including demographic, parental relationship, mental health, pubertal development, behaviors, and environmental factors. Model performance was determined by accuracy and AUC. Additionally, random forest and XGBoost were applied to identify the important factors. The XGBoost algorithm with SHAP was also used to interpret the results of our ML model.

RESULTS

All machine learning performed with favorable accuracy. Compared to random forest (AUC: 0.87 (95%CI: 0.80, 0.93)), logistic regression (AUC: 0.80 (95%CI: 0.70, 0.89)), neural network (AUC: 0.80 (95%CI: 0.71, 0.89)), and support vector machine (AUC: 0.79 (95%CI: 0.79, 0.89)), XGBoost algorithm had the highest AUC values 0.87 (95%CI: 0.80, 0.93) in the test set, although the difference was not significant between models. Peer communication, index of general affect, peer alienation, and internet addiction were the top four significant factors of loneliness in children and adolescents.

CONCLUSIONS

The results of this study suggest that machine learning has considerable potential to predict loneliness in children. This may be valuable for the early identification and intervention of loneliness.

A Technology-Supported Psychoeducational Intervention for Older Adults and Their Families to Improve Social Isolation, Loneliness, and Intergenerational Connectedness-A Randomized Controlled Study

Information and communication technologies (ICT) provide digital tools to support and facilitate social engagement. However, the extent to which new ICTs, such as instant messaging, and training on its use, enhance intergenerational family interactions and reduce social isolation and loneliness needs further exploration. In the present study, we developed a brief psychoeducational intervention to promote older adults and their family members (N = 64) to use new technologies to increase communication with each other. With a randomized controlled trial design, we evaluated the effectiveness of the intervention in changing primarily participants' intergenerational interactions, perceived social isolation, and loneliness. Through repeated-measures analysis of variance, an overall condition by time effect was found in younger family members such that contact frequency improved in the intervention condition compared with the waitlist control condition. Using a dyadic framework, we further investigated the role of the intervention in fostering interactions among family members. Dyadic analyses showed a partner effect with contact frequency in younger adults at pre-assessment predicting contact frequency of older adults at post-assessment. This suggests that support and encouragement from younger family members could increase intergenerational interactions and technology adoption among older adults. Moreover, online phone calls served as a promising tool to enhance intergenerational communication; higher user satisfaction was associated with increased ICT use, perceived usefulness, and fewer barriers to technology. This study provides preliminary findings on the effectiveness of ICT-based interventions for engaging older adults and their family members in the use of newer technologies to promote intergenerational interactions and reduce social isolation.

The Purpose of Internet Use and Face-To-Face Communication With Friends and Acquaintances Among Older Adults: A JAGES Longitudinal Study

Internet use influences social interactions in society. However, there is no consensus on whether and what kind of Internet use increases face-to-face communication (FFC). This study investigated the mode of Internet use that increases FFC among older adults after three years. Participants were 8734 adults aged 65 or older who responded to the Japan Gerontological Evaluation Study (JAGES) surveys in 2016 and 2019. The exposures were the purposes of Internet use in 2016. The outcome was the frequency of FFC with friends or acquaintances in 2019. The confounders included 13 demographic, socioeconomic, and psychological variables. We performed modified Poisson regression analyses and found that Internet use for communication in 2016 increased FFC in 2019, especially for low-frequency FFC in 2016. Internet-based non-FFC may help promote FFC and prevent social isolation among older adults who are less likely to interact with others.

The Effectiveness of Interventions for Reducing Loneliness Among Chinese Older Adults: A Systematic Review and Meta-Analysis

This review assesses interventions to reduce loneliness in Chinese older adults, analyzing 36 studies involving 3965 participants. Focusing on individuals aged 50 and over, the meta-analysis reveals a significant overall effect size (Hedges' g = 0.937, 95% CI [0.71,1.16], p<0.001), highlighting the effectiveness of psychological and mixed-method approaches. Despite promising results, methodological concerns suggest cautious interpretation. Future research should aim to refine intervention quality and examine the impact of technology-supported methods on loneliness.

A Tablet-Based Application to Enhance Social Connectedness for Individuals With a Cognitive Impairment: Results From the PRISM-CI Pilot Study

Social engagement is fundamental to successful aging and linked to better emotional, physical, and cognitive health. Maintaining social engagement is challenging for many older adults but especially for those with a cognitive impairment (CI). Information and communication technologies (ICT) can provide enhanced opportunities for social and cognitive engagement for older adults with a CI via increased information, education, and social connectivity access. This study used a pre-test post-test design to evaluate the feasibility, acceptability, and preliminary efficacy of the PRISM-CI software system, a tablet-based application designed to enhance access to resources, information, and social engagement, in 52 individuals with a CI between the ages of 65-88 years who had access to PRISM-CI for five months. Findings show that social isolation, loneliness, and depressive symptoms significantly decreased, and mobile device proficiency significantly increased, from baseline to follow-up. Results highlight ICTs potential to foster social engagement among older adults with a CI.

The Relationship between E-Health Literacy and Educational Participation Motivation among Elderly Individuals: The Chained Mediating Effects of Self-Identity and Social Capital

Aims/Background In light of the increased utilization of digital technology among the elderly population, understanding the relationship between e-health literacy, self-identity, social capital, and educational participation motivation has become crucial. This study aims to investigate these relationships and explore the mediating effects of self-identity and social capital on the elderly population. By shedding light on these aspects, the study seeks to contribute to the existing knowledge base and inform intervention strategies to enhance the elderly individuals' overall well-being and engagement with digital health resources. Methods A questionnaire survey was conducted in a sample consisting of 578 elderly participants. Data of the surveyed variables were analyzed. Mediating effect analysis methods were employed to explore the mediating roles of self-identity and social capital in the relationship between e-health literacy and educational participation motivation among the elderly individuals. Results The results revealed a significant positive correlation between e-health literacy, self-identity, social capital, and educational participation motivation among elderly individuals. Furthermore, self-identity and social capital were found to play significant mediating roles between e-health literacy and educational participation motivation. Specifically, self-identity and social capital acted as complete mediators, with a mediating effect value of 0.61, between e-health literacy and educational participation motivation. Additionally, the chained mediating effect of self-identity and social capital was also significant. Conclusion This study demonstrated that e-health literacy and educational participation motivation are closely intertwined, with self-identity and social capital acting as the mediators in this association, in the elderly population, providing valuable guidance for enhancing the health and quality of life and offering insightful references for the development and implementation of relevant policies.

Association between internet use and annual health checkups among older Japanese adults: propensity score-matched analysis, Japan gerontological evaluation study cross-sectional study 2016

BACKGROUND

The integration of the Internet into daily life has potential implications for public health, especially in promoting preventive healthcare measures like annual health checkups. This study explores the association between Internet use and the likelihood of participating in these checkups among older Japanese citizens.

METHODS

Participants aged 65 and older were randomly selected from 37 municipalities in Japan, ensuring they required no long-term care. Out of 24,313 responses to a postal questionnaire, 11,495 participants were deemed eligible for analysis, achieving a valid participation rate of 70.1%. We applied propensity score matching to balance Internet users and non-users, resulting in 6,504 matched cases. Poisson regression analysis was then used to adjust for demographic, socioeconomic, and behavioral variables that could act as potential confounders.

RESULTS

Our findings show that 55.1% of participants used the Internet several times a month, and among these, 63.5% had attended an annual health checkup in the preceding year. After adjusting for potential confounders, Internet users were found to be 9% more likely to participate in annual health checkups compared to non-users (95% Confidence Interval: 1.02-1.15).

CONCLUSIONS

This study concludes that there is a positive association between Internet use and participation in annual health checkups among older individuals in Japan. The results suggest that Internet use may serve as a tool to promote preventive healthcare practices in older populations. However, the study underscores the need for further investigation to understand the underlying mechanisms of this association and to establish a causal relationship.

Feasibility and acceptability of virtual programs for people with dementia and their caregivers

OBJECTIVE

To assess the feasibility and acceptability of the Oshawa Senior Community Centres (OSCC55 +) virtual programs (VP) in addressing the needs for social connection and interaction for people with dementia (PWD) and their informal caregivers (ICG).

BACKGROUND

During the pandemic, PWD faced increased loneliness and reduced social interaction due to a loss of community programs. The OSCC55 + developed VPs to combat social isolation and provide respite for ICG. These efforts highlight the importance of accessible, and technology-based VPs for maintaining social connectedness for PWD.

METHODS

A qualitative interpretive research design with PWD (n = 14) interviews and ICG focus group and one-on-one interviews (n = 11). This research explored the lived experiences of PWD and their ICG, examining the feasibility and acceptability of the VPs.

RESULTS

The PWD and ICG interviews provided insight into the positive impacts of VP, challenges of VP, program barriers, program facilitating factors, and suggestions for future improvement for the OSCC55 + VPs. Participants highlighted that the VP created an option for them to remain socially connected to their community; while also outlining the positive impact on reducing loneliness, challenges with technology use, the importance of involving younger generations and volunteers, and the need for more culturally inclusive programs.

CONCLUSIONS

The VP developed by OSCC55 + were perceived as effective and useful for PWD and their ICG, helping to reduce feelings of loneliness and relieving caregiving tasks. These findings suggest that VP can complement in-person programs in the future, offering a hybrid model that leverages the strengths of both approaches to better meet the needs of PWD and ICG.

Internet Use and Higher-Level Functional Capacity Decline Suppression in Japanese Older Adults With Low Education: JAGES 2016-2019 Longitudinal Study

BACKGROUND

Higher-level functional capacity (HLFC) is crucial for the independent living of older adults. While internet use positively impacts the health of older adults, its effect on HLFC and how this effect varies with educational attainment remains uncertain.

OBJECTIVE

This longitudinal study aimed to investigate whether internet use could mitigate the risk of HLFC decline and if this benefit extends to older adults with lower levels of education.

METHODS

The data were sourced from the Japan Gerontological Evaluation Study (JAGES), encompassing 8050 community-dwelling adults aged 65 years and older from 2016 to 2019. The study focused on those who remained self-sufficient from 2016 to 2019, identifying participants with independent HLFC in 2016. The Tokyo Metropolitan Institute of Gerontology Index of Competence defined HLFC operationally, consisting of 3 subscales, namely instrumental activities of daily living, intellectual activity, and social role. The primary variable was the frequency of internet use in 2016; participants who reported using the internet were classified as internet users, while those who answered "No" were identified as nonusers. The study compared the effects of internet use on HLFC decline across educational levels of ≤9 years, 10-12 years, and ≥13 years using Poisson regression analysis adjusted for robust SE to calculate the risk ratio (RR) and 95% CI for HLFC decline in 2019.

RESULTS

After adjusting for demographic and health condition risk factors, internet use was significantly linked to a decreased risk of HLFC decline in older adults over 3 years, including those with lower educational levels. Internet users with ≤9 years of educational attainment experienced a suppressed decline in the total score (RR 0.57, 95% CI 0.43-0.76; P<.001); instrumental activities of daily living (RR 0.58, 95% CI 0.38-0.91; P=.02), intellectual activity (RR 0.60, 95% CI 0.41-0.89; P=.01), and social role (RR 0.74, 95% CI 0.56-0.97; P=.03) compared with nonusers. Participants with 10-12 years of education showed suppression rates of 0.78 (95% CI 0.63-0.98; P=.03), 0.59 (95% CI 0.39-0.90; P=.01), 0.91 (95% CI 0.63-1.31; P=.61), and 0.82 (95% CI 0.68-1.00; P=.05), respectively, and those with ≥13 years displayed suppression rates of 0.65 (95% CI 0.51-0.85; P=.001), 0.55 (95% CI 0.36-0.83; P=.01), 0.64 (95% CI 0.37-1.10; P=.11), and 0.83 (95% CI 0.64-1.08; P=.17), respectively.

CONCLUSIONS

These findings indicate that internet use supports the maintenance of HLFC independence in older adults with higher education and those with lower educational levels. Encouraging internet use among older adults with lower levels of education through future policies could help narrow functional health disparities associated with educational attainment.

The impact of internet device diversity on depressive symptoms among middle-aged and older adults in China: A cross-lagged model of social participation as the mediating role

BACKGROUND

Depressive symptoms is more prevalent in middle-aged and older populations, and the development of Internet technology has brought new challenges and opportunities for the mental health of this group. This study aims to explore the bidirectional relationship between Internet device diversity and levels of depressive symptoms through longitudinal data analysis, as well as investigate the mediating role of social participation.

METHODS

Data for the analysis was retrieved from the China Health and Retirement Longitudinal Study (CHARLS) in 2015, 2018, and 2020, which included 9259 middle-aged and older adults. The sum of the number of devices mentioned by each participant was calculated to assess the diversity of internet device use, a weighted total score of how frequently and to what extent individuals had participated in various social activities in the past month was calculated to measure the social engagement, and the Center for Epidemiological Studies Depression Scale was used to calculate depressive symptoms. A cross-lagged mediation model and bivariate correlation analysis were employed to examine the longitudinal relationships among depressive symptoms, internet device diversity, and social participation. Age, gender, highest education level, marital status, drinking status, smoking history, self-rated health, sleep duration, and chronic health conditions were adjusted as covariates.

RESULTS

The results from the three waves of longitudinal data revealed mutual predictive relationships among internet device diversity, social participation, and depressive symptoms. The mediating effect was significant (β = -0.612, 95 % CI -0.796 to -0.429), with significant gender differences observed. Furthermore, our findings indicated that social participation functioned as a protective factor against depressive symptoms, and the association between social participation and depressive symptoms was not a straightforward linear relationship. This suggests that participation in social activities (either high or low) is associated with a lower risk of depressive symptoms compared to no social participation, with no gender differences.

CONCLUSIONS

This study suggests that there is a relationship between internet device diversity and lower levels of depressive symptoms among middle-aged and older adults in China. Social participation mediates the relationship between internet device diversity and depressive symptoms, and different levels of social engagement have different effects on depressive symptoms. It is recommended to increase support for social participation among middle-aged and older adults, strengthen structural social capital, and better leverage the use of the internet to reduce depressive symptoms levels and promote the physical and mental well-being of this population.

The impact of internet usage on the mental health of older adults in China: empirical analysis from a multi-dimensional perspective

Background

The process of population aging in China is currently undergoing rapid acceleration. Simultaneously, the swift advancement of digitalization is fundamentally transforming individuals' lifestyles. The usage of the internet and mobile internet tools by the older adults population is relatively inadequate. The issue of digital exclusion and its impact on the life quality of the older adult population has received significant attention.

Objective

This study utilized microdata from the China Health and Retirement Longitudinal Study (CHARLS 2020) to empirically investigate the impact of internet usage on the mental health of older adult individuals. The depression index was utilized to assess the mental health, while four variables were employed to evaluate internet usage among the older adults in this study.

Methods

The Center for Epidemiological Studies Depression Scale (CES-D) in CHARLS data was used to measure the depression index of older adults. Four variables including usage of internet, usage of WeChat, usage of WeChat moments and usage of mobile payment were used to represent the internet use of older adults, and there was progressive relationship between these four variables. In the empirical study, multiple regression analysis was adopted to empirically analysis the impact of internet usage on the mental health of older adults. In order to reduce the influence of endogenous problems on regression results, the propensity score matching method was used to verify the validity and robustness of regression results.

Results

(1) Internet usage can significantly reduce the psychological depression of older adults and promote the formation of positive psychology; (2) With the increase of the depth of internet usage, especially the use of mobile internet and mobile payment, the internet use will have greater improvement effect on the depression; (3) The heterogeneity test found that there were certain differences in the impact of internet usage on different older adult groups; (4) Through a step-by-step analysis of 10 sub-indicators of depression index, the study found that Internet use mainly affected four indicators: "life hope," "happiness," "loneliness" and "life confidence," while demonstrating no significant effect on other sub-indicators.

Conclusion

According to the research, internet usage can significantly reduce the psychological depression index of the older adults and promote the formation of positive psychology. In China, digital exclusion is more prevalent in rural areas and among the less educated older adults. Public policies can be formulated to enhance internet adoption among these older adults population.

The mediating and moderating effects of psychological distress on the relationship between social media use with perceived social isolation and sleep quality of late middle-aged and older adults

OBJECTIVES

Older adults are more likely to have poor sleep quality and be socially isolated. The present study examined the potential benefits and disadvantages of social media use (SMU) with respect to sleep quality and perceived social isolation among Iranian late-middle-aged and older adults with focus a on both the mediating and moderating role of psychological distress.

METHODS

A population-based cross-sectional study was conducted among 900 older community-dwellers living in Shiraz using a structured questionnaire. Social media use was assessed by estimating the frequency of social networking site visits per week. Data concerning self-rated physical health, chronic medical and mental health conditions, perceived social isolation, sleep quality, and psychological distress were also collected. Multiple linear regression was used to identify independent variables associated with outcomes. Then, mediation and moderation models were used to examine the potential mediating and moderating effects of psychological distress and SMU on their relationships with the study variables.

RESULTS

Higher social media use was associated with better sleep quality and less perceived social isolation. Nevertheless, the relationships between SMU and participants' sleep quality and perceived social isolation were largely mediated by their level of psychological distress. Furthermore, SMU had a significant moderating effect in the relationship between the psychological distress and the levels of perceived social isolation, so that participants with higher frequency of SMU per week felt less loneliness.

CONCLUSIONS

The study findings suggest that SMU has a positive buffering effect regarding late middle-aged and older adults' mental health mainly through moderation of their perceived social isolation. The mediating role of psychological distress in research examining the relationship between SMU and older adults' mental health outcomes should be considered in future research.

A mixed methods feasibility study of a virtual group-based social support program for older adults in residential care

OBJECTIVES

In response to calls for inventive ways to mitigate risks of physical distancing due to the COVID-19 pandemic for older adults living in residential care, the JAVA Music Club-Digital (JMC-D) was developed. The current feasibility study investigated benefits, usability, and implementation of weekly JMC-D sessions over 6 months.

METHOD

Employing a pre-post mixed methods study, depressive symptoms, loneliness, social isolation, and quality of life were measured at baseline, 3 and 6 months. Qualitative interviews were conducted at 3 months.

RESULTS

Twenty-one residents were recruited. Across the three time points there was a large effect for depressive symptoms, social isolation, and quality of life, though not statistically significant. There was a significant immediate increase in happiness following engagement in the JMC-D sessions. Thematic analysis of semi-structured interviews generated two overarching themes: Experiencing the JMC-D (subthemes: Benefits, Navigating the virtual platform, Feedback) and Considerations for Implementation (subthemes: Perceived purpose, Characteristics that impact the experience, and Infrastructure and resources).

CONCLUSION

Findings are encouraging and suggest that the JMC-D may support emotional and other psychosocial indices of wellness in residential care during times of physical distancing. Appropriate staffing, resources, and internet accessibility are important for implementation and uptake.

Internet Use as a Moderator of the Relationship Between Personal Resources and Stress in Older Adults: Cross-Sectional Study

BACKGROUND

Internet use has dramatically increased worldwide, with over two-thirds of the world's population using it, including the older adult population. Technical resources such as internet use have been shown to influence psychological processes such as stress positively. Following the Conservation of Resources theory by Hobfoll, stress experience largely depends on individuals' personal resources and the changes in these resources. While personal resource loss has been shown to lead to stress, we know little regarding the role that technical resources may play on the relationship between personal resources and stress.

OBJECTIVE

This study aims to investigate the moderating effect of technical resources (internet use) on the relationship between personal resources and stress in younger and older adults.

METHODS

A total of 275 younger adults (aged 18 to 30 years) and 224 older adults (aged ≥65 years) indicated their levels of stress; change in personal resources (ie, cognitive, social, and self-efficacy resource loss and gain); and internet use. Variance analyses, multiple regression, and moderation analyses were performed to investigate the correlates of stress.

RESULTS

Results showed that older adults, despite experiencing higher levels of resource loss (questionnaire scores: 1.82 vs 1.54; P<.001) and less resource gain (questionnaire scores: 1.82 vs 2.31; P<.001), were less stressed than younger adults (questionnaire scores: 1.99 vs 2.47; P<.001). We observed that the relationship among resource loss, resource gain, and stress in older adults was moderated by their level of internet use (β=.09; P=.05). Specifically, older adults who used the internet more frequently were less stressed when they experienced high levels of both loss and gain compared to their counterparts who used internet the less in the same conditions. Furthermore, older adults with low resource gain and high resource loss expressed less stress when they used the internet more often compared to those with low internet use.

CONCLUSIONS

These findings highlight the importance of internet use in mitigating stress among older adults experiencing resource loss and gain, emphasizing the potential of digital interventions to promote mental health in this population.

Interventions for loneliness in older adults: a systematic review of reviews

Loneliness in older persons is a major risk factor for adverse health outcomes. Before the COVID-19 pandemic led to unprecedented isolation and hampered programs aimed at preventing or reducing loneliness, many interventions were developed and evaluated. However, previous reviews provide limited or conflicting summaries of intervention effectiveness. This systematic review aimed to assess previous review quality and bias, as well as to summarize key findings into an overarching narrative on intervention efficacy. The authors searched nine electronic databases and indices to identify systematic reviews of interventions to reduce loneliness in older people prior to the COVID-19 pandemic; 6,925 records were found initially. Of these, 19 reviews met inclusion criteria; these encompassed 101 unique primary intervention studies that varied in research design, sample size, intervention setting, and measures of loneliness across 21 nations. While 42% of reviews had minimal risk of bias, only 8% of primary studies appraised similarly. Among the 101 unique articles reviewed, 63% of tested interventions were deemed by article author(s) as effective or partially effective. Generally, interventions that included animals, psychological therapies, and skill-building activities were more successful than interventions focused on social facilitation or health promotion. However, interventions that targeted multiple objectives aimed at reducing loneliness (e.g., improving social skills, enhancing social support, increasing social opportunities, and changing maladaptive social cognition) were more effective than single-objective interventions. Future programs should incorporate multiple approaches, and these interventions should be rigorously tested.

Older Adults' Perceptions of the Technology Influence on Interpersonal Communication: A Cross-Sectional Study

This study aimed to understand the association between the online experience of older adults, their socio-demographic background, and their perceptions regarding the influence of the new technologies on their interpersonal communication. Technology familiarity and grey digital divide approaches served as the study's theoretical framework. The data were obtained from the 2020 Israel Social Survey and analyzed using multinomial logistic regression models. The sample included adults aged 60 years and older (N = 1,607). The findings show that online group participation and general Internet use, though to a varying extent, corresponded to more positive perceptions of influence of the new technologies on both family and peer communication. Female gender, tertiary education, and belonging to ethnic majority group were associated with more positive perceptions in the studied context. The results imply that online experience of older adults is more dominant than their background with respect to perceptions regarding the influence of new technologies on interpersonal communication. The findings imply that older adults should engage in various activities on the Internet, especially in the online group participation, in order to have better perceptions regarding the new technology influence on interpersonal communication.

Addressing loneliness and social isolation through the involvement of primary and secondary informal caregivers in nursing homes: a scoping review

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.

Adherence to 24-Hour Movement Guidelines Among Chinese Older Adults: Prevalence, Correlates, and Associations With Physical and Mental Health Outcomes

BACKGROUND

It is known that 24-hour movement behaviors, including physical activity (PA), sedentary behavior (SB), and sleep, are crucial components affecting older adults' health. Canadian 24-hour movement guidelines for older adults were launched in 2020, emphasizing the combined role of these 3 movement behaviors in promoting older adults' health. However, research on the prevalence and correlates of guideline adherence and its associations with health-related outcomes is limited, especially among Chinese older adults.

OBJECTIVE

This study aimed to investigate the prevalence and correlates of meeting 24-hour movement guidelines among Chinese older adults. Furthermore, this study aimed to examine the associations of guideline adherence with older adults' physical and mental health outcomes.

METHODS

Using a stratified cluster random sampling approach, a total of 4562 older adults (mean age 67.68 years, SD 5.03 years; female proportion: 2544/4562, 55.8%) were recruited from the latest provincial health surveillance of Hubei China from July 25 to November 19, 2020. Measures included demographics, movement behaviors (PA, SB, and sleep), BMI, waist circumference, waist-hip ratio (WHR), percentage body fat (PBF), systolic and diastolic blood pressure, physical fitness, depressive symptoms, and loneliness. Generalized linear mixed models were employed to examine the associations between variables using SPSS 28.0 (IBM Corp).

RESULTS

Only 1.8% (83/4562) of participants met all 3 movement guidelines, while 32.1% (1466/4562), 3.4% (155/4562), and 66.4% (3031/4562) met the individual behavioral guidelines for PA, SB, and sleep, respectively. Participants who were older, were female, and lived in municipalities with lower economic levels were less likely to meet all 3 movement guidelines. Adhering to individual or combined movement guidelines was associated with greater physical fitness and lower values of BMI, waist circumference, WHR, PBF, depressive symptoms, and loneliness, with the exception of the relationship of SB+sleep guidelines with loneliness. Furthermore, only meeting SB guidelines or meeting both PA and SB guidelines was associated with lower systolic blood pressure.

CONCLUSIONS

This is the first study to investigate adherence to 24-hour movement guidelines among Chinese older adults with regard to prevalence, correlates, and associations with physical and mental health outcomes. The findings emphasize the urgent need for promoting healthy movement behaviors among Chinese older adults. Future interventions to improve older adults' physical and mental health should involve enhancing their overall movement behaviors and should consider demographic differences.

The relationship between social media usage and loneliness among younger and older adults: the moderating effect of shyness

Does social media alleviate or exacerbate loneliness? Past research has shown mixed results regarding the relationship between social media usage and loneliness among younger and older adults. Unlike younger individuals, older adults may decrease their loneliness through social media interactions. Additionally, previous research has indicated that the link between social media use and loneliness can vary depending on one's shy tendency. Therefore, this study aims to explore the relationship between individuals' social media use and loneliness while considering age and shyness tendency as moderating variables. The study employed a questionnaire survey conducted through convenience sampling, resulting in 234 valid responses from participants in Northern Taiwan. Among them, 113 were college students (aged 18 to 25, average age 19.40), and 121 were older adults (aged 50 to 82, average age 60.81). Using hierarchical regression analysis, results indicated that (1) age moderates the relationship between personal social media use and loneliness. Minimal differences were observed among younger individuals, but among older adults, increased social media usage time was associated with a significant reduction in loneliness. (2) Shyness tendency moderate the relationship between personal social media use and loneliness. Individuals with higher shyness tendency experience an increase in loneliness as their social media usage time lengthens.

The Problematic Online Dating Apps Use Scale (PODAUS): Development and evaluation of its psychometric properties

The internet has facilitated significant transformations in interpersonal interactions, and offers new possibilities for finding romantic partners through the use of online dating apps. However, as with other technology-based tools, some individuals can develop problematic patterns of dating apps use, exhibiting symptoms resembling addiction. Consequently, the aim of the present study was the development of a new psychometric instrument to assess problematic dating apps use, the Problematic Online Dating Apps Use Scale (PODAUS), and the examination of its psychometric properties. The sample comprised 384 participants (254 females and 130 males; Mage=25.90 years; SD=5.21) who used dating apps daily. They completed an online survey including the PODAUS, Bergen Social Media Addiction Scale, Cyber Pornography Addiction Test, Love Addiction Inventory-Short-Form, and Ten-Item Personality Inventory. The PODAUS showed a one-factor structure with good indications of validity, reliability, and gender measurement invariance. Problematic online dating apps use was significantly associated with problematic social media use, problematic cyberpornography use, love addiction, and three personality traits (i.e., agreeableness, conscientiousness, and openness). The PODAUS is a new and succinct self-report measure that assesses problematic dating apps use, and can be easily used in both research and clinical practice.

Smart Speaker and ICT Use in Relationship With Social Connectedness During the Pandemic: Loneliness and Social Isolation Found in Older Adults in Low-Income Housing

BACKGROUND AND OBJECTIVES

Social well-being of older adults living in low-income housing was disproportionately affected by the coronavirus disease 2019 pandemic. We explored low-income residents' experiences of social isolation and loneliness and strategies to remain socially connected during the pandemic.

RESEARCH DESIGN AND METHODS

As part of a larger, 3-phase user-centered design study, we conducted a qualitative study using focus groups to gain insights into social isolation experiences and the role of information and communication technologies (ICTs), including smart speakers, in social connectedness (N = 25, 76% African American). We also collected survey data to describe social isolation, loneliness, and current ICT use in the sample. Participants included both smart speaker users and nonusers.

RESULTS

Experiences of social isolation and loneliness varied by participants' sociodemographic characteristics and previous experiences with smart speakers. Qualitative analysis showed participants demonstrated coping strategies developed during the pandemic to adapt to new norms of connecting with others, including technology-enabled social interactions. Participants expressed a strong desire to build community together in their facilities and highlighted the potential role of smart speakers in making meaningful social connections, encompassing safety checks to have a means for emergencies, and providing a virtual companion. Access, digital literacy, training, security, and privacy issues were discussed as factors affecting their adoption of new ICT for enhanced social connectedness.

DISCUSSION AND IMPLICATIONS

This study highlights the importance of understanding the unique social isolation experience, demographics, and social determinants of health of low-income residents to develop ICT-based interventions for social connectedness.

The Benefits of Technology for Engaging Aging Adults: Findings From the PRISM 2.0 Trial

Background and Objectives

Technology has potential for providing support for aging adults. This study evaluated the Personal Reminder Information and Social Management 2.0 (PRISM 2.0) software, in terms of enhancing social engagement and quality of life, and decreasing loneliness among older adults.

Research Design and Methods

The randomized field trial conducted in diverse living contexts (rural locations, senior housing, and assisted living communities [ALC]). Two hundred and forty-five adults, aged 64 to 99 years, were randomly assigned to the PRISM 2.0 (integrated software system designed for aging through an iterative design process) or a Standard Tablet (without PRISM) Control condition, where participants received the same amount of contact and training as those in the PRISM 2.0 condition. Primary outcomes included measures of loneliness, social support, social connectedness, and quality of life. Secondary outcomes included measures of social isolation, mobile device proficiency, and technology readiness. Data were collected at baseline and 6 and 9 months postrandomization. This article focuses on the 6-month outcomes due to coronavirus disease 2019-related data challenges at 9 months.

Results

Contrary to our hypothesis, participants in rural locations and senior housing in both conditions reported less loneliness and social isolation, and greater social support and quality of life at 6 months, and an increase in mobile device proficiency. Participants in the ALCs in both conditions also evidenced an increase in mobile device proficiency. Improvements in quality of life and health-related quality of life were associated with decreases in loneliness.

Discussion and Implications

This study provides compelling evidence about the benefits of technology for older adults in terms of enhancing social outcomes and quality of life. However, the findings also underscore that for technology applications to be successful, they need to be adapted to the abilities and needs of the user group and instructional support needs to be provided.

Clinical Trials Registration #

NCT03116399.

Impact of community-based technology training with low-income older adults

OBJECTIVES

Compared with younger and middle-aged adults, older adults are less likely to adopt new computer technology, potentially limiting access to healthcare and many other important resources available online. This limitation could impact cognitive abilities, well-being, and mental health outcomes of older adults. The aims of the present study were to increase access to online county and healthcare resources, while also assessing the impact of technology access on cognitive functioning and multiple well-being domains.

METHODS

A pilot community collaboration provided a two-month tablet training intervention, focused on increasing digital independence via tablet navigation, resources access, and fraud and scam prevention, to 20 low-income older adult participants (75% female, Mage = 70.85). Pre- and post-test phone interviews were conducted to measure any changes in digital independence, cognitive abilities, well-being, mental health, and mindset.

RESULTS

Linear mixed effects models revealed no significant changes in outcome measures from pre- to post-test. However, we found effects of digital independence on several well-being measures, providing important information for the impact of technology access and training for low-income older adults.

CONCLUSION

This pilot intervention offers limited but promising results, inspiring further investigations that may inform public health and policy services to address barriers to access and potentially improve psychological health.

Navigating the digital landscape: Relationship between type of internet use and well-being among students-A mediation and moderation analysis

Background

The amount and frequency of internet use are often used to forecast its pros and cons, with mixed findings. After COVID-19, technological advances and sociological upheavals have shown the internet's ability to support numerous activities, necessitating a change in internet use. Beyond internet use frequency, it has been advised to examine why people use it and how it affects their well-being. Hence, we aimed to investigate the various mediators and moderators in the relationship between the quality of internet use (type of activity) and well-being. Further, we investigated whether user attributes such as initial age and frequency of internet use moderate the influence of internet use quality on problematic internet use, loneliness, and well-being.

Methods

131 students in Manipur who were 18 years old were included in this cross-sectional study. Self-rated measures of the Adult Internet Usage questionnaire, Internet Addiction Test, and Mental Health Continuum-Short Form assessed internet use, dependence, and well-being.

Results

Loneliness mediates the association between well-being and internet behaviors related to personal use-self-actualization (BootSE = .53, BootLLCI = .10, BootULCI = 2.18), cultural use-belonging (BootSE =.57, BootLLCI = -2.23, BootULCI = -.02). Average online hours moderate economic use-education, loneliness, and well-being (BootSE =.13, BootLLCI = -.55, BootULCI = -.04).

Conclusion

To conclude, the effectiveness of internet use affects well-being differently depending on the type of activity. After a certain point, even seemingly good internet activities may have diminishing returns.

Exploring discontinuous intentions of social media users: a cognition-affect-conation perspective

Introduction

Drawing on the cognition-affect-conation (C-A-C) framework, this study investigates how perceived information and social and system feature overload induce depression and anxiety, which leads to affect discontinuous intentions of the social media users.

Methods

The data collected from 570 social networking site users in China are analyzed through structural equation modeling (SEM).

Results and Discussion

The findings show that perceived information overload, perceived social overload, and perceived system feature overload directly affect depression and anxiety among social networking site users, which directly leads to discontinuous intentions. This study fulfills the identified need for an in-depth investigation of discontinuous behavior in social networking sites. The findings provide social networking site providers with guidelines on how to actively manage social networking site user's behavior to reduce the effects of negative emotions on social networking sites.

Information and Communication Technology-Based Application for Cognitive Behavioral Therapy among Community-Dwelling Older Adults with Insomnia: Development and Validation Study

This study developed an information and communication technology-based mobile application to administer cognitive behavioral therapy to community-dwelling older adults with insomnia. First, the content of the application was determined through a systematic review and preference survey. Preference data on the perception, needs, and preference for non-face-to-face service content were collected from 15 July 2021 to 31 August 2021 from 100 community-dwelling older adults aged 65 years and older. In the design stage, the structure and function of the application were determined, and an interface was designed. The application was developed in conjunction with design experts and programmers using Android Studio software (Android 9). Usability tests were conducted during the implementation stage, followed by an evaluation stage. The evaluation revealed that the application's structure and functions should comprise sleep information, sleep-habit improvement, sleep assistance, video, real-time counseling, and exercise services. These elements were finalized after receiving the results of a preference analysis and advice from an advisory panel of experts in different fields. The developed application was rated with a score of four or higher in all areas. This study successfully developed, implemented, and evaluated a new mobile application called Smart Sleep for community-dwelling older adults with insomnia.

The age-based digital divide in an increasingly digital world: A focus group investigation during the COVID-19 pandemic

BACKGROUND AND OBJECTIVES

Previous research has identified numerous benefits of information and communication technology (ICT) on the well-being of older adults. However, it has been increasingly recognized that older adults do not necessarily catch up with the rapidly digitalized society, known as the 'age-based digital divide'. The progress of digitalization has been accelerated during the COVID-19 pandemic, which may have widened the digital divide. This study aimed to gain a better understanding of their living experience and concerns about digital exclusion during the pandemic. The perceptions of older adults in Hong Kong, a highly digitalized, metropolitan city, towards the digital age and its impact on their daily living during the COVID-19 pandemic were explored.

RESEARCH DESIGN AND METHODS

We conducted 12 focus group interviews with 77 community-dwelling older adults during the COVID-19 pandemic. Data were analyzed using thematic analysis, applying both organization, reduction, and refinement.

RESULTS

Four themes were identified: 1) Diversified means to access community information; 2) Facilitated daily living through the usage of ICTs; 3) Concerns about age-related decline in function; and 4) Fear of digital exclusion and accelerated digitalization during the pandemic. The results indicate that ICT provided numerous benefits to the daily life of older adults, but our participants also expressed concerns about age-related losses and the fear of digital exclusion due to the ongoing digitalization of society.

DISCUSSION AND IMPLICATIONS

Our findings indicated that older adults do not necessarily benefit from technological innovations, which are becoming more pervasive during the pandemic. To create age-friendly environments that cater to the needs of all members of society in the digital age, policymakers and service providers should provide diverse choices for older adults, rather than relying solely on one-size-fits-all technological solutions.

Testing a frailty prevention program for older men during COVID-19: A 2-year mixed-methods pilot study

BACKGROUND

Frailty is a syndrome related to declining functioning attributed to aging. As a reversible, often improved condition, preventive measures for frailty can be effective.

OBJECTIVE

This study aimed to evaluate a frailty prevention program for older men comprising face-to-face meetings and an original social mobile application. We also examined the effect of COVID-19-associated social isolation on the implementation of this program.

METHODS

We conducted a mixed-methods pilot study featuring a single group before and after comparison of 11 man participants, ≥65 years, living in Japanese cities with a spouse or relatives. Program outcome measures included frailty, loneliness, grip strength, step count and mental health status. Process evaluation considered the experience of participants through a semi-structured interview.

RESULTS

The intervention period included an interval of self-isolation owing to the spread of COVID-19. Among the outcomes, grip strength decreased after intervention. No significant negative changes were observed in other items. Themes emerging from participant experiences with the program included 'Cooperation with researchers and contributing to research', 'Greater awareness of health', 'Interest in and experience of "newness"', 'Hesitation over active engagement', 'Casual ties with members' and 'Relationships that do not breach personal boundaries'.

CONCLUSIONS

Although the COVID-19 pandemic overlapped with the intervention, participants maintained their mental health. The program was a novel, stimulating experience for older men and demonstrated the usefulness of information and communication technology in supporting their social activities.

IMPLICATIONS FOR PRACTICE

As a community health nursing initiative for older people, we propose activities that combine group and online support. Frailty prevention programs for older men must contain content that stimulates their interests, such as 'health' and 'newness'.

Internet accessibility and incident depressive symptoms in middle aged and older adults in China: A national longitudinal cohort study

BACKGROUND

With the rapid development of the Internet over the past ten years, its widespread applications and accessibility may cause dynamic changes in the association between internet use and depressive symptoms.

OBJECTIVE

We aim to explore the association between internet accessibility (including broadband connection, internet use, frequency, and devices for internet use), as well as its changes, and the risk of incident depressive symptoms for middle aged and older adults based on a cohort study.

METHODS

8772 participants with three repeat waves of follow-up (average 6.04 years) were included. Cox proportional hazards regressions were used to explore risk effects. Hazard ratios (HRs) and 95 % Confidence Intervals [CI] were presented.

RESULTS

Incidence density for depressive symptoms was 53.89 for every 1000 person-years. The rate of internet usage by middle aged and older adults in China increased evidently from 2012 to 2018 (16.39 % vs 77.41 %). Broadband internet connection (BIC) (HR = 0.80, 95%CI: 0.71, 0.90) and moderate frequency of internet use (IU) (HR = 0.30, 95%CI: 0.10, 0.92) were associated with decreased risk of depressive symptoms. Participants who changed from no internet accessibility to internet accessibility were associated with a lower risk of depressive symptoms (BIC: HR = 0.46, 95%CI: 0.41, 0.51; IU: HR = 0.42, 95%CI: 0.34, 0.51). Using large screen devices (HR = 0.64, 95%CI: 0.45, 0.91) for internet access, instead of phones, was associated with lower risk of depressive symptoms.

CONCLUSIONS

Older adults should be encouraged to use the Internet; online time, frequency, and devices for internet use should be considered simultaneously.

The Protective Role of Group Activity Prior to COVID-19 Pandemic Quarantine on the Relation between Loneliness and Quality of Life during COVID-19 Pandemic

BACKGROUND

Studies of aging have suggested that QoL is positively associated with active social contacts and supportive face to face social networks. However, social networks and contacts in later life decrease due to a variety of reasons; the narrowing of social networks contributes to increased social isolation and loneliness and leads to the deterioration of well-being and QoL among adult persons. The goal of this study was to explore the relationship between loneliness feelings and QoL during the COVID-19 quarantine as potentially moderated by group physical activity prior to the COVID-19 pandemic quarantine.

METHODS

A convenience sample of 99 older adults aged 60 and over was interviewed. Using bootstrapping, we tested the strength and significance of the conditional moderation effect of group physical activity prior to the COVID-19 pandemic quarantine on the relationship between loneliness feelings and QoL during the COVID-19 quarantine.

RESULTS

the results demonstrated a direct negative effect between loneliness feelings and QoL during the COVID-19 pandemic and that the relationship was moderated by group physical activity prior to the COVID-19 pandemic quarantine (p = 0.000).

CONCLUSION

the findings indicate that policy makers and professionals working with older adults should seek ways to attract older adults to participate in group physical activity and enjoy its long-term social benefits.

The Relationship Between Internet Use for Social Purposes, Loneliness, and Depressive Symptoms Among the Oldest Old

The internet enables communication with social partners and has been found to be related to higher psychological well-being among older adults. Using data from the representative German North Rhine-Westphalia 80+ (NRW80+) study (n = 1,698, Mage = 84.86), we conducted linear regression and mediation analyses to compare levels of loneliness and depressive symptoms of onliners using the internet for social or other purposes with offliners. Oldest old onliners used the internet mostly for social purposes, and this type of internet use was related to a significantly lower level of loneliness and fewer depressive symptoms compared to offliners. The mediation analysis revealed that internet use for social purposes was related to lower levels of loneliness, which in turn was associated with a lower number of depressive symptoms. The findings suggest that internet use for social purposes may help the oldest old to reduce feelings of loneliness and depressive symptoms.

Mediating and Moderating Effects of Internet Use on Urban-Rural Disparities in Health Among Older Adults: Nationally Representative Cross-Sectional Survey in China

BACKGROUND

The urban-rural disparities in health outcomes in China are remarkable. The internet has shown the potential to reduce the likelihood of contracting a disease by increasing disease knowledge. However, little is known about the effects of internet use in alleviating health inequities between urban and rural areas.

OBJECTIVE

This study aimed to examine the mediation and moderation of health disparities between urban and rural older adults through internet use.

METHODS

A total of 8223 respondents were selected from the China Health and Retirement Longitudinal Study 2018 data set. Basic activities of daily living, a brief Community Screening Instrument for Dementia, and the Centre for Epidemiologic Studies Depression Scale were used to measure functional disability, cognitive function, and depressive symptoms, respectively. Logistic regressions testing "internet use×urban-rural status" interactions for moderation and Karlson-Holm-Breen decomposition for mediation were performed.

RESULTS

Internet use moderated the urban-rural disparities in cognitive function (odds ratio 7.327, 95% CI 3.011-17.832) and depressive symptoms (odds ratio 1.070, 95% CI 1.037-1.787), but the moderating effects were significant only for those using the internet daily. Karlson-Holm-Breen results showed the suppression effects of using the internet daily (β=.012, 95% CI .002-.021) on the association between urban-rural status and cognitive function. The urban-rural inequality in depressive symptoms was partially attributed to the disparity in internet use (β=-.027, 95% CI -.043 to -.009).

CONCLUSIONS

The urban-rural inequalities in mental health are partially attributable to disparities in the prevalence of internet use between the 2 groups. However, using the internet is more beneficial for the psychological health of rural users, thereby alleviating the urban-rural disparities in health. Providing convenient channels for rural older adults to use the internet, improving the ability of rural users to effectively use the internet, and promoting internet popularity in rural areas are effective approaches to reducing urban-rural health inequalities.

The Impact of Age and Psychosocial Factors on Cognitive and Auditory Outcomes During the COVID-19 Pandemic

PURPOSE

In March 2020, the U.K. government announced that people should isolate to reduce the spread of the virus that causes COVID-19. Outside a pandemic, psychosocial factors, such as socialization and mental health, may impact the relationship between hearing loss and increased dementia risk. We aim to report the impact of psychosocial factors, including social isolation, depression, and engagement in activities, on hearing and cognitive function in younger and older adults during the COVID-19 pandemic.

METHOD

An online survey and experiment assessed self-reported psychosocial factors, self-reported hearing ability and speech-in-noise perception, and cognition. Data were collected between June 2020 and February 2021. Older (n = 112, Mage = 70.08) and younger (n = 121, Mage = 20.52) monolingual speakers of English, without any language or neurological disorders participated. Multiple linear regression models were employed to investigate hypothesized associations between psychosocial factors, and hearing and cognition, in older and younger adults.

RESULTS

Multiple regression analyses indicated that older adults displayed poorer speech-in-noise perception and poorer performance on one of four cognitive tasks, compared with younger adults; increased depression was associated with poorer subjective hearing. Other psychosocial factors did not significantly predict hearing or cognitive function.

CONCLUSIONS

Data suggest that self-reported hearing and depression are related. This conclusion is important for understanding the associations between hearing loss and cognitive decline in the long term, as both hearing loss and depression are risk factors for dementia.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23810838.

Multidimensional Internet Use, Social Participation, and Depression Among Middle-Aged and Elderly Chinese Individuals: Nationwide Cross-Sectional Study

BACKGROUND

There is growing evidence that the internet has beneficial effects on the mental health of middle-aged and older people (≥45 years), but the evidence is inconclusive, and the underlying mechanisms are less known.

OBJECTIVE

This study aims to explore the relationship between multidimensional (devices, frequency, and purpose) internet use and depression in middle-aged and elderly Chinese, as well as the mediating effect of social participation. Moreover, this study will explore the moderating effect of the regional informatization development level (RIDL) on the relationships between individual internet use, social participation, and depression.

METHODS

Data on 17,676 participants aged 45 years or older were obtained from the China Health and Retirement Longitudinal Study (CHARLS) 2018 data set. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to identify the presence of depression. Logistic regression was used to explore the relationship between each dimension of internet use and depression. Multiple linear regression was used to explore the mediating effect of social participation and the moderating effect of the RIDL.

RESULTS

The results showed that 28.33% (5008/17,676) of the total population had depression. In terms of regional subgroups, respondents living in the western region exhibited the highest proportion of depression (2041/5884, 34.69%). Internet use was negatively associated with depression (odds ratio 0.613, 95% CI 0.542-0.692; P<.001). Various dimensions of internet use positively contributed to individual social participation and reduced individual depression (devices: β=-.170, 95% CI -0.209 to -0.127; frequency: β=-.065, 95% CI -0.081 to -0.047; and purpose: β=-.043, 95% CI -0.053 to -0.031). In addition, the RIDL weakened the relationship between individual-level internet use and social participation (internet use: F74.12,9.82=7.55, P<.001; devices: F51.65/9.88=5.23, P=.005; frequency: F66.74/10.08=6.62, P=.001; and purpose: F66.52/9.78=6.80, P=.001), and negatively moderated the relationship between the frequency of internet use and depression (frequency: F662.67/188.79=3.51, P=.03).

CONCLUSIONS

This study found that different dimensions of internet use are associated with lower levels of depression. Social participation partially mediates the association between multidimensional internet use and depression in the eastern, central, and western regions, respectively. Additionally, the RIDL helps individuals further their internet use and social participation, reducing the impact of depression. However, this effect weakens sequentially from the western region to the central region and then to the eastern region.

Intergenerational solidarity with digital communication and psychological well-being among older parents during the COVID-19 pandemic

We aimed to identify intergenerational solidarity (emotional closeness, in-person contact, phone contact, geographic proximity, consensus, and conflict) with digital communication (texting, video call, and social media interaction) with adult children among older parents during the COVID-19 pandemic. In addition, we aimed to investigate whether intergenerational solidarity with digital communication latent classes were associated with older parents' psychological well-being. We used the 2022 survey of the Longitudinal Study of Generations (LSOG). The sample consisted of 519 older parents who reported about 1245 adult children. Two-level latent class analysis identified six classes at the child level (Level 1: distant but digitally connected, tight-knit and digitally connected, tight-knit traditional, detached, intimate but distant, and sociable). In addition, the analysis identified three classes at the parent level (Level 2: digitally connected, mixed, and intimate but distant). Results of multivariate regression showed that older parents in the digitally connected latent class had better psychological well-being than those in the mixed latent class. Consequently, our finding indicates that digital solidarity with adult children can be beneficial for older parents' psychological well-being during the COVID-19 pandemic.

Clarity of Emotions and Goals: Exploring Associations with Subjective Well-Being Across Adulthood

Despite declines in cognition associated with age, emotional health tends to increase. However, extant studies find few differences in the type or number of emotion regulation strategies used by older compared to younger adults. This study tested the hypothesis that older adults have greater clarity of their emotions and goals compared to younger adults. Participants (total N = 709, ages 18-81) recruited in age-stratified samples completed measures of emotional clarity, goal clarity, depression, and life satisfaction. Results suggested that emotional clarity and goal clarity are positively correlated factors, with emotional clarity showing the lowest levels in emerging adults and highest levels in older adults. Goal clarity was lowest among emerging adults, but only small differences were found between middle and older adults. Across adulthood both emotional clarity and goal clarity were linked to lower depressive symptoms and greater life satisfaction. Limitations include data being cross-sectional and self-report based and the youngest sample being recruited differently from the older samples, but the results raise the possibility of developmental changes in emotional clarity across adulthood.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-022-00179-6.

Helps you, helps me? Provision of instrumental and personal care and loneliness among adults aged 50 years and older during the COVID-19 pandemic

PURPOSE

To examine the association between provision of instrumental and personal care, and loneliness in adults aged 50 years and older during the COVID-19 pandemic. Instrumental care referred to the provision of assistance with obtaining necessary or essential products and/or services, whereas personal care referred to the assistance with daily life activities or the provision of emotional support. Social capital and caregiver stress theories served as the study's theoretical framework.

MATERIALS AND METHODS

The data were obtained from the two COVID-19 waves of the Survey of Health, Ageing, and Retirement in Europe (SHARE) conducted in 2020 and 2021. The data were analyzed using logistic regression models. The analytical sample consisted of 48,722 adults in the abovementioned age bracket residing in Europe and Israel.

RESULTS

Providing instrumental care negatively related to loneliness. Providing instrumental care to a single category of people negatively related to loneliness, whereas providing personal care to multiple categories of people positively related to loneliness. Providing personal care to children positively related to loneliness.

CONCLUSIONS

The results suggest that different types of care provision correspond differently to the experience of loneliness while partially supporting both theoretical frameworks. Moreover, care indicators correspond differently to loneliness. The results imply that for a better understanding of the link between care provision and loneliness in later life, various parameters as well as various types of care provision should be examined.

Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources

BACKGROUND

Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community.

OBJECTIVE

This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults.

METHODS

A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources.

RESULTS

The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services.

CONCLUSIONS

A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.

An exploratory psychometric network analysis of loneliness scales in a sample of older adults

To examine the relationships within and between commonly used measures of loneliness to determine the suitability of the measures in older adults. Further, to determine whether certain items in these measures are more psychometrically robust in terms of capturing different types of loneliness across this population. Data were obtained from 350 older adults via completion of an online survey. Four measures of loneliness were completed. These were the University of California Los Angeles Loneliness Scale 4 (Version 3), the de Jong Gierveld Loneliness Scale, the Social and Emotional Loneliness Scale for Adults (Short Version) and a direct measure of loneliness. Analysis via a regularized partial correlation network and via clique percolation revealed that only the SELSA-S encompassed loneliness relating to deficits in social, family and romantic relationships. The remaining measures tapped mostly into social loneliness alone. The direct measure of loneliness had the strongest connection to the UCLA item-4 and the de Jong Gierveld item-1 exhibited the strongest bridge centrality, being a member of the most clusters. The results indicate that should researchers be interested in assessing loneliness resulting from specific relationships, then the SELSA-S would be the most suitable measure. Whereas the other measures are suitable for assessing loneliness more generally. The results further suggest that the de Jong Gierveld item-1 may be a more suitable direct measure of loneliness than that currently employed as it taps into a greater number of relationships.

Using Immersive Virtual Reality to Enhance Social Interaction Among Older Adults: A Cross-Site Investigation

Background and Objectives

Virtual reality (VR) applications are increasingly being targeted toward older adults as a means to maintain physical and cognitive skills and to connect with others, especially during the coronavirus disease 2019 era. Our knowledge about how older adults interact with VR is limited, however, since this is an emerging area and the related research literature is still rather slim. The current study focused specifically on older adults' reactions to a social-VR environment, examining participant's views about the possibility of meaningful interactions in this format, the impacts of social-VR immersion on mood and attitude, and features of the VR environment that affected these outcomes.

Research Design and Methods

The researchers designed a novel social-VR environment with features intended to prompt conversation and collaborative problem-solving among older adults. Participants were recruited from 3 diverse geographic locations (Tallahassee, FL; Ithaca, NY; and New York City, NY), and were randomly assigned to a partner from one of the other sites for social-VR interaction. The sample consisted of 36 individuals aged 60 and older.

Results

Reactions to the social VR were quite positive. Older adults reported high levels of engagement in the environment and perceived the social VR to be enjoyable and usable. Perceived spatial presence was found to be a central driver of positive outcomes. A majority of the participants indicated a willingness to reconnect with their VR partner in the future. The data also identified important areas for improvement that were of concern to older adults, such as the use of more realistic avatars, larger controllers more suited to aging hands, and more time for training/familiarization.

Discussion and Implications

Overall, these findings suggest that VR can be an effective format for social engagement among older adults.

Impact of technology on social isolation: Longitudinal analysis from the National Health Aging Trends Study

BACKGROUND

Social isolation is a key public health concern and has been associated with numerous negative health consequences. Technology is increasingly thought of as a solution to address social isolation. This study examines the longitudinal association between the access and use of technology and social isolation in older adults 65 and older, living in the United States.

METHODS

This observational cohort study included community-dwelling older adults (N = 6704) who participated in the National Health and Aging Trends Study. Regression analyses were conducted using data from 2015 to 2019. Information about technology access and use was ascertained using self-reported questionnaires. The primary outcome was the risk of social isolation.

RESULTS

At baseline, the majority of older adults that were not socially isolated had a working cell phone (88%) or computer (71%) and used email or text messaging (56%). Older adults that had access to (cell phone- incidence rate ratio [IRR] 0.62 [95% CI 0.48-0.81]; computer- IRR 0.63 [95% CI 0.51-0.78]), and used technology (email or text messaging- IRR 0.64 [95% CI 0.51-0.80]) in the year prior had a lower risk of social isolation than older adults who reported they did not access or use technology. Additionally, over four years, older adults who reported that they had access to a computer had a lower risk (0.69 [0.57, 0.84]) for social isolation than their counterparts.

CONCLUSION

In this cohort study, technology access was associated with a lower risk for social isolation among community-dwelling older adults. These findings suggest that technology has an important role in approaches that seek to prevent social isolation among older adults.

The 100 Top-Cited Studies on Loneliness: A Bibliometric Analysis

The present study explores characteristics of the top 100 most-cited articles on loneliness. A systematic search was carried out using the Thomson Reuters Web of Science Core Collection to collect studies on loneliness from inception to June 1, 2022. The initial search resulted in 6,250 search results, which included articles, book chapters, conference proceedings, editorials, and letters. Two authors independently screened the literature and extracted the data. The study supervisor removed any discrepancies. Top 100 papers (articles and reviews) on loneliness published in English were extracted. Data analysis and visualization were performed on Excel, Web of Science (WoS) Data Analyzer, and VOSviewer 1.6.16. The total number of citations of the 100 top-cited articles was 42,044, ranging from 203 to 2,201 per article. All of the studies were published from 1989 to 2021, and the years with the highest number of top-cited articles published were 2003 and 2008. Most publications were from the following journals: Computers in Human Behavior, Developmental Psychology, Psychological Science, Psychology, and Aging (n=4 each). The most cited article was titled "UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure" by Russell, DW, in the Journal of Personality Assessment. The most productive institute was the University of Chicago. The two most productive authors were Cacioppo, JT, and Hawkley, LC. Of the 100 top-cited publications, 87 were original articles and 13 were reviews. The top three WoS categories were psychology multidisciplinary, gerontology, and psychiatry. In total, 37 author keywords were elicited and further clubbed into eight distinct clusters. The study provides new insight into loneliness research, which may help doctors, researchers, and stakeholders achieve a more comprehensive understanding of trends and influential contributions to the field and highlight under-researched areas, which could be the basis for future investigation.

TFOS lifestyle: Impact of societal challenges on the ocular surface

Societal factors associated with ocular surface diseases were mapped using a framework to characterize the relationship between the individual, their health and environment. The impact of the COVID-19 pandemic and mitigating factors on ocular surface diseases were considered in a systematic review. Age and sex effects were generally well-characterized for inflammatory, infectious, autoimmune and trauma-related conditions. Sex and gender, through biological, socio-economic, and cultural factors impact the prevalence and severity of disease, access to, and use of, care. Genetic factors, race, smoking and co-morbidities are generally well characterized, with interdependencies with geographical, employment and socioeconomic factors. Living and working conditions include employment, education, water and sanitation, poverty and socioeconomic class. Employment type and hobbies are associated with eye trauma and burns. Regional, global socio-economic, cultural and environmental conditions, include remoteness, geography, seasonality, availability of and access to services. Violence associated with war, acid attacks and domestic violence are associated with traumatic injuries. The impacts of conflict, pandemic and climate are exacerbated by decreased food security, access to health services and workers. Digital technology can impact diseases through physical and mental health effects and access to health information and services. The COVID-19 pandemic and related mitigating strategies are mostly associated with an increased risk of developing new or worsening existing ocular surface diseases. Societal factors impact the type and severity of ocular surface diseases, although there is considerable interdependence between factors. The overlay of the digital environment, natural disasters, conflict and the pandemic have modified access to services in some regions.

Effects of a 'social activity program that encourages interaction' on rural older people's psychosocial health: Mixed-methods research

BACKGROUND

We developed a program that encourages interaction among older people living at home by combining face-to-face and online activities and examined its effects on older adults' psychosocial health.

METHODS

In this mixed-methods study, we recruited 11 women and 6 men (Mage = 79.5 ± 6.4 years), who lived in a rural community and participated in a senior citizen club. The intervention was conducted for 13 months, comprising monthly face-to-face group and social media activities. For the program process evaluation, we collected focus-group interview data on participants' perceptions of their personal lives, club membership, and community post-intervention. For the outcome evaluation, we collected six outcome measures pre- and post-intervention: loneliness, subjective health, subjective well-being, self-esteem, social support and social activity satisfaction. Finally, through the integration of the process-outcome evaluation, we inferred what effects the program had on participants' psychosocial health.

RESULTS

In the process evaluation, we identified four themes: 'Stimulation brought about by relationships with peers,' 'Realization as to where they feel they belong,' 'Rethinking of oneself in the community,' and 'Awareness of attachment to and coexistence with the community.' In the outcome evaluation, the outcome measures were maintained without significant decline post-intervention.

CONCLUSION

Through the integration of the process-outcome evaluation, we deduced three effects of the program on psychosocial health: (1) fulfilment of subjective health, (2) maintenance and assurance of moderate distance connectedness and (3) orientation toward aging in place.

IMPLICATIONS FOR PRACTICE

This study offers a promising opportunity for further development and research into community-based preventive nursing care intervention strategies to maintain the psychosocial health of homebound older people in communities with social activity groups.

Reciprocal associations between social media use and self-perception of aging among older adults: Do men and women differ?

PURPOSE

Despite the positive impact of social media use in late adulthood, social media use is still low among older adults. Research in technology adoption and utilization indicates the importance of age-specific factors, such as self-perception of aging (SPA). As it is unclear whether SPA facilitates social media use or social media use promotes SPA, reverse causality has emerged as a major point of contention within this literature, with several studies reporting conflicting results. Thus, in this study, we aim to contribute unique insight by examining (1) whether positive and negative SPAs demonstrate unique associations with social media use and (2) whether these reciprocal associations differ by gender.

METHODS

Using two waves (2014 and 2018) from the Health and Retirement Study, 4101 older Americans (age ≥65 years) with normal baseline cognition were included in this study. Autoregressive cross-lagged analyses were conducted to assess reciprocal associations between SPA and social media use among the total sample and by gender subgroups.

RESULTS

Controlling for covariates, we found that more frequent social media use marginally predicted higher positive SPA four years later (B = 0.02, p = .07), and higher negative SPA marginally predicted less frequent social media use four years later (B = -0.07, p = .08). However, the by-gender analysis showed that the positive effect of social media use on positive SPA was only significant among older men (B = 0.04, p < .05), whereas the negative impact of negative SPA on social media use only existed among older women (B = -0.13, p < .01).

CONCLUSIONS

The reciprocal associations between SPA and social media use differ by the valence of SPA (positive/negative) and gender. Future interventions for SPA and digital technology use among older adults should be gender-tailored.

Internet access, support, usage divides, and depressive symptoms among older adults in China: A nationally representative cross-sectional study

OBJECTIVE

This study examines the associations between multiple sub-dimensions of the digital divide, including Internet access, support, usage divides, and depressive symptoms among older adults as well as the potential moderating effects of rural/urban status on these associations in China.

METHODS

Data were obtained from the 2018 China Longitudinal Aging Social Survey, which provided a nationally representative sample of 11,418 participants aged 60 years and older. Multivariate linear regression models were used to analyze the associations between digital divide and depressive symptoms. The moderating role of rural/urban status was tested based on the interaction terms.

RESULTS

After controlling for the covariates, access to Internet devices, support for Internet use from family, and using the Internet for communication, entertainment, or as instruments, were found to be significantly associated with a lower level of depressive symptoms (P < 0.05), and compared with no access to the Internet, accessing and using the Internet was significantly related to decreased depressive risks (P < 0.001), whereas access to the Internet with non-use was not statistically significant. Additionally, the associations between multidimensional aspects of the digital divide and depressive symptoms were moderated by rural/urban status, with these associations being significantly stronger among rural older adults (P < 0.05).

CONCLUSIONS

This study highlights the importance of assessing the associations between digital divide and depressive symptoms from the multidimensional perspectives of access, support, and usage. Policy interventions targeting various aspects of the digital divide should be implemented to ensure active Internet engagement among older adults, especially those living in rural areas.

Internet use and life satisfaction among Chinese older adults: the mediating effects of social interaction

Internet use has been suggested to have a crucial effect on older adults' quality of life; however, few studies have investigated the underlying mechanisms in the relationship between internet use and life satisfaction among older adults. Employing multiple linear regression models and mediation analysis with 2019 Chinese Social Survey (CSS) data, this study analyzed the associations between the internet use and life satisfaction of Chinese older adults. Additionally, it explored the mediating role of social interaction, including online and offline social interactions. The results showed that internet use was positively associated with older adults' life satisfaction, and offline social interaction significantly mediated internet use. Our findings indicate that internet use could improve older adults' quality of life by promoting offline social interaction. Therefore, the government, communities, and families should create conditions for older adults to integrate into online society and participate in offline social interaction.

The experience of living alone as an older woman in the UK during the Covid pandemic: an interpretative phenomenological analysis

BACKGROUND AND OBJECTIVES

More people are living alone across the life course: in later life this can have implications for practical and psychosocial support. The Covid pandemic emphasised the importance of this when the UK government restricted movement outside of households to limit the spread of disease. This had important ramifications regarding social contact and practical support. The objectives of this study were to explore the experience of older women living alone during this time, with a focus on health and wellbeing.

RESEARCH DESIGN AND METHODS

This study used an Interpretative Phenomenological approach. Semi-structured interviews were undertaken with seven women (aged 65 +), living alone in the UK. Interviews were carried out between May and October 2020. Interpretative Phenomenological Analysis was used to analyse the transcripts.

RESULTS

Findings show that life course events shaped how living alone was experienced in later life. Convergences and divergences in lived experience were identified. Three superordinate themes emerged from the Interpretative Phenomenological Analysis: Productivity, Ownership, and Interconnectedness.

DISCUSSION AND IMPLICATIONS

Findings highlight the importance of life course events in shaping the experience of later life. They also provide a better understanding of the lived experience of living alone as an older woman, increasing knowledge of this group and how living alone can affect health and wellbeing. Implications for research and practice are discussed, such as the importance of recognising the specific support needs for this group in later life, and the need for further knowledge about groups whose needs are not met by standard practice.

A Scoping Review of Aging Experiences Among Culturally and Linguistically Diverse People in Australia: Toward Better Aging Policy and Cultural Well-Being for Migrant and Refugee Adults

BACKGROUND AND OBJECTIVES

Australia's population is growing, aging, and becoming more ethnically diverse, resulting in barriers and challenges around social inclusion for non-English-speaking migrants and refugees. This scoping review investigates the experiences of aging within Australia among older adults from culturally and linguistically diverse (CALD) migrant and refugee backgrounds to identify barriers to social integration.

RESEARCH DESIGN AND METHODS

A scoping review of English language literature and gray literature on the experiences of aging among CALD migrants and refugees living in Australia was conducted from January 2000 to January 2021, according to Arksey and O'Malley's review process. A total of 34 studies were identified for analysis.

RESULTS

Three primary themes were identified: (a) sociocultural similarities in settlement experiences, (b) engagement with technology for social connection, and (c) engagement with family and community networks.

DISCUSSION AND IMPLICATIONS

Aging, language, sociocultural, and technology contexts shape attitudes to belonging, as well as access to sociomedical services. We argue a cultural well-being framework may assist in developing policy for improved social integration of older CALD adults. As the focus is on social and cultural experiences, all studies with a primary focus on medical and other chronic conditions were excluded. Future studies could include health-related articles to present a more comprehensive approach regarding older CALD adult needs. Follow-up research could focus on the impact of the coronavirus disease 2019 pandemic on the experiences of older adults in Australia, in particular those of CALD backgrounds.

Verification of the Effectiveness of a Communication Application in Improving Social Connectedness and Physical Health among Unacquainted Older Men: A Mixed-Methods Pilot Study

This study aimed to verify the effectiveness of an application (app) in establishing social connectedness among unacquainted older men, as well as improving their physical health. The nine participants were men aged 65 and older in the subarctic zone of Hokkaido, Japan. A mix of quantitative and qualitative methods were adopted as the study design. A questionnaire survey was completed before and after the intervention, and a semi-structured interview was conducted after the intervention. An app-installed smartphone was loaned to the participants, which allowed them to share pictures, voice recordings, and their step count. Quantitative data were analyzed using descriptive statistics and the Wilcoxon signed-rank test, and qualitative data were analyzed using qualitative descriptive analysis to generate categories. The average age of the participants was 77.7 years. The relationship between participants who were interacting for the first time through the app advanced as their understanding of each other's personalities deepened. The average step count during the third and fourth months was significantly higher than in the first two months. By using the app, older men were able to build relationships with one another. In addition, visualizing the number of steps on the app was effective in improving the number of steps.