Loneliness, Wellbeing, and Social Activity in Scottish Older Adults Resulting from Social Distancing during the COVID-19 Pandemic

"We're still seeing people on the screen, we still keeping our bodies moving": exploring the transition from face to face to online dance classes for community-dwelling older adults during the COVID-19 pandemic

BACKGROUND

The COVID-19 outbreak meant that people were unable to attend art-based community classes such as dance. In response, activities transitioned to digital modes of delivery. In this study, we aimed to explore the feasibility, inclusivity, and impact of transitioning to an online dance class.

METHODS

Thirty community-dwelling older adults (59-84 years old) were recruited from community groups in Yorkshire (UK). Participants completed an online survey at baseline and after attending 8 weeks of online dance classes. The survey captured perceived benefits on physical activity and mental wellbeing. Two separate focus groups (N = 12) were conducted to explore if the online dance transition could be an opportunity to keep this group active and socially connected.

RESULTS

Survey data revealed no significant difference in the amount of time engaged in physical activity, but mental wellbeing significantly improved. Themes from the focus groups included holistic wellbeing related to the experience of dance, inclusive participation of online dance, and online dance facilitating social connection and sense of belonging.

CONCLUSIONS

The research provided insight into the online transition of a dance class for older adults, especially regarding inclusivity, sense of belonging and social connection.

The effectiveness of preventive home visits on resilience and health-related outcomes among community dwelling older adults: A systematic review

BACKGROUND

This research aimed to assess the effectiveness of preventive home visits (PHVs) in enhancing resilience and health-related outcomes among older adults living in the community.

METHODS

A comprehensive literature search was conducted in nine databases (PubMed, MEDLINE, CINAHL, Embase, Emcare, Web of Science (WOS), Scopus, PsycINFO and Cochrane Library. The search was undertaken between March 15 and 31, 2022 with subsequent updates performed on October 15, 2023 and April 10, 2024. This review also included grey literature sourced via Google, Google Scholar and backward citation searches.

RESULTS

Out of 5,621 records, 20 articles were found to meet the inclusion criteria with a total of 8,035 participants involved and the mean age ranged from 74.0 to 84.4 years. Using McMaster Critical Review Form for Quantitative Studies, we ascertained that the studies included in our analysis had moderate to high levels of quality. In addition to health-related outcomes, PHV interventions were also conducted to evaluate psychological effects (16 studies) and social outcomes (seven studies). Five studies conducted financial assessment to evaluate the costs of health and social care utilisation during PHV interventions. Regarding the results of the review, seven studies showed favourable outcomes, five indicated no effect and eight had equivocal findings. Only one study assessed resilience and determined that PHV had no effect on the resilience of the subjects.

CONCLUSION

This review found that the effectiveness of PHV interventions was uncertain and inconclusive. PHV interventions often prioritise health-related objectives. The incorporation of a holistic approach involving psychosocial health into PHV interventions is relatively uncommon. Due to the paucity of research on resilience as PHV outcome, we are unable to draw a conclusion on the effectiveness of PHV on resilience. Resilience should be prioritised as a psychological assessment in the future development of comprehensive PHV interventions, as it enables older adults to adapt, manage, and respond positively to adversities that may arise with age. Performing financial analysis such as costs and benefits analysis to incorporate the return on investment of PHV interventions is an added value for future research on this topic.

CLINICAL TRIAL REGISTRATION

PROSPERO registration number: CRD42022296919.

Exploring the experience of appetite loss in older age: insights from a qualitative study

BACKGROUND

Poor appetite is common in older age, with estimated prevalence figures ranging between 15-30% in community-dwelling populations. Despite known links between poor appetite and adverse health outcomes, appetite is not routinely assessed and the causes and impact of appetite loss in older age are not well understood. This study aimed to improve understanding of the influences on, and experiences of, appetite loss among older people who have poor appetite and to consider the implications for prevention and treatment strategies.

METHODS

Thirteen older adults aged 60-93 years (9 women) identified as having poor appetite (Simplified Nutritional Appetite Questionnaire (SNAQ) scores < 14; ranging from 8-11) took part in semi-structured interviews. Open-ended questions focused on influences on and experiences of appetite and appetite loss in older age. Interviews were transcribed; reflective thematic analysis was conducted using an inductive approach.

RESULTS

The analysis generated three themes: 1) a complex web of influences on appetite loss, that include biological, psychological, and social factors; 2) living with poor appetite-variation in perceptions of poor appetite and attitudes to appetite loss; 3) living with poor appetite-the role and importance of the eating environment and social interactions. The themes highlight marked differences in individual 'journeys' to poor appetite, with variation in the balance and role of specific causal influences, that impact on the experience of appetite loss and on coping strategies.

CONCLUSIONS

A broad range of influences (including biological, psychological and social factors) and experiences of appetite loss in older age were described. Future research should consider person-centred approaches, that take account of individual narratives of appetite loss, in the design of effective strategies to support older adults.

Psychological distress is affected by fear of COVID-19 via lifestyle disruption and leisure restriction among older adults in Japan: a cross-sectional study

Introduction

Engaging in social activities is an essential component of a healthy lifestyle for community-dwelling older adults. Critically, as with past disasters, there is concern about the effects of long-term activity restrictions due to the coronavirus disease 2019 (COVID-19) pandemic on health of older adults. However, the precise associations between fear of COVID-19, lifestyle satisfaction, leisure activities, and psychological distress are unclear.

Objective

The purpose of this study was to comprehensively determine the associations between fear of COVID-19, lifestyle satisfaction, leisure engagement, and psychological distress among community-dwelling older adults in the context of the ongoing COVID-19 pandemic.

Materials and methods

A questionnaire survey administered by mail was conducted from October 1 to October 15, 2021. The questionnaire included the Fear of COVID-19 Scale, the Lifestyle Satisfaction Scale, the Leisure Activity Scale for Contemporary Older Adults, and the Kessler Psychological Distress Scale-6. Based on previous studies, we developed a hypothetical model for the association between fear of COVID-19, lifestyle satisfaction, leisure engagement, and psychological distress and performed structural equation modeling to assess the relationships between these variables.

Results

Participants included 301 Japanese citizens (23.6% male, 76.4% female), with a mean age of 76.7 ± 4.58 years. Goodness-of-fit from structural equation modeling was generally good. Analysis of standardized coefficients revealed a significant positive relationship between fear of COVID-19 and psychological distress (β = 0.33, p < 0.001) and lifestyle satisfaction and leisure activities (β = 0.35, p < 0.001). We further observed a significant negative relationship between fear of COVID-19 and lifestyle satisfaction (β = -0.23, p < 0.001) and between leisure activities and psychological distress (β = -0.33, p < 0.001).

Conclusion

Fear of COVID-19 is significantly associated with psychological distress, both directly and via its effects on lifestyle satisfaction and leisure activities. That is, not only did fear of COVID-19 directly impact psychological distress of participants, it also affected psychological distress through lifestyle disruption and leisure restriction. This results may be used to better understand how a national emergency that substantially restricts daily life, such as COVID-19 or an earthquake disaster, can affect the psychological health and wellbeing of older, community-dwelling adults.

Daytime Napping and Cognitive Health in Older Adults: A Systematic Review

BACKGROUND

Daytime napping may improve cognitive function in older adults. However, the association can be complicated by specific features of napping and the older adult's health. This systematic review aims to synthesize the current literature on napping and cognition in older adults and provide recommendations for future research and daytime sleep practice in older adults.

METHODS

Systematic searches for relative research published between January 1995 and October 2022 were conducted at PubMed, MEDLINE, PsycINFO, and Google Scholar using keywords individually and in multiple combinations. Manual searches were performed to identify additional studies. All included studies were critically appraised by 2 authors.

RESULTS

Thirty-five studies, including 23 observational and 12 intervention studies, were reviewed. Findings from observational studies suggest a possible inverted U-shaped association between napping duration and cognitive function: short and moderate duration of naps benefited cognitive health in older adults compared with both non-napping and long or extended napping. Findings from intervention studies suggest one session of afternoon napping might improve psychomotor function and working memory, although with some inconsistency. The effect of multiple nap sessions on cognition was inconclusive due to a limited number of studies.

CONCLUSION

More rigorous research studies are needed to investigate what causes different patterns of daytime napping, the associations between these distinct patterns and cognitive function, and to determine whether interventions targeting napping patterns can improve cognition in older adults. In addition, future research needs to comprehensively assess daytime napping using a combination of measures such as sleep diary and actigraphy.

Experiences of Older Adults During COVID-19: Loss, Boredom, Uncertainty, Worry, and Resilience

The coronavirus disease 2019 (COVID-19) pandemic and resulting instructions to stay home and social distance enhanced concerns of the impact of social isolation on the physical and mental well-being of older adults. Eighteen community-dwelling older adults participated in interviews describing their experiences early in the COVID-19 pandemic. Participants experienced loss of activities, routines, and social connection, and feelings of worry and uncertainty. Nevertheless, participants were hopeful about the future and demonstrated resilience in overcoming boredom as they became intentional in finding new activities and using technology to maintain connection with others. Older adults may need support in such situations to manage boredom and uncertainty and avoid social isolation. [Journal of Gerontological Nursing, 49(6), 27-32.].

Fear of COVID-19 and Adverse Psychological Health Outcomes Among Chinese Elderly: a Serial Mediation Model of Social Participation and Loneliness

This cross-sectional study examined fear of COVID-19, social participation, loneliness, and adverse psychological health outcomes among Chinese older adults after the pandemic control measures were relaxed. We also tested the correlations among these variables and examined the serial-mediating effects of social participation and loneliness on the relationship between fear of COVID-19 and adverse psychological health outcomes. Participants were 508 Chinese elderly individuals (Mage = 70.53 ± 7.90 years; 56.5% women). We used Pearson correlation analyses and Hayes' PROCESS macro analysis (Model 6). Respondents had a relatively higher level of fear of COVID-19 compared to the general population. Their levels of loneliness, anxiety, and depression were higher than those of Chinese older adults who were surveyed before the restriction policy changed in previous research. The correlations among fear of COVID-19, social participation, loneliness, and adverse psychological health outcomes were significant, supporting the serial-mediating effects of social participation and loneliness on the relationship between fear of COVID-19 and adverse psychological health outcomes. Attention should be paid to the mental health issues of Chinese older adults, and the impacts of fear of COVID-19 and social participation on their mental health should be emphasized. Future researchers should use random systematic sampling methods, conduct longitudinal tracking and perform intervention studies.

Structural equation model of coping and life satisfaction of community-dwelling older people during the COVID-19 pandemic

BACKGROUND

COVID-19 put older individuals at high risk for morbidity and mortality, isolation, reduced coping, and lower satisfaction with life. Many older adults experienced social isolation, fear, and anxiety. We hypothesized that successful coping with these stressors would maintain or improve satisfaction with life, a crucial psychological outcome during the pandemic. Our study investigated relationships between older people's coping and life satisfaction during the pandemic and their optimism, sense of mastery, closeness with spouse, family, and friends, and vulnerabilities from frailty, comorbid diseases, memory problems, and dependencies in instrumental activities of daily living (IADL).

METHODS

The study was based on a special COVID-19 sample of 1351 community-dwelling older adults who participated in the 2020 Health and Retirement Survey. A comprehensive structural equation modeling was used to test direct and indirect effects, with life satisfaction as the main outcome and coping as a mediator between the other variables and coping.

RESULTS

Most survey respondents were female and between the ages of 65-74 years. They averaged 1.7 chronic conditions, one in seven was frail, about one-third rated their memory as fair or poor, and about one in seven reported one or more difficulties in IADL. As hypothesized-older people with increased sense of mastery and optimism were better able to cope and had greater life satisfaction. In addition, close relationships with friends and with other family members besides the spouse/partner or children contributed to more successful coping, while the interpersonal closeness of all types contributed directly to greater life satisfaction. Finally, older people with more IADL limitations reported greater difficulty coping and lower life satisfaction, and those older people who were frail or had multiple comorbid diseases reported lower life satisfaction.

CONCLUSIONS

Optimism, sense of mastery and closeness with family/friends promotes coping and life satisfaction, whereas frailty and comorbidities make coping more challenging and lead to lower life satisfaction particularly during a pandemic. Our study improves on prior research because of its nationally representative sample and formal specification and testing of a comprehensive theoretical framework.

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

Introduction

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

Objective

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

Methods

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

Results

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

Conclusion

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

Delivering a psychosocial program for older people living in retirement homes during the Covid-19 pandemic: A process evaluation and recommendations for community interventions

The Covid-19 pandemic lockdown regulations caused retirement homes to temporarily ban in-person visitation potentially increasing the mental health risks of older people. An opportunity arose for a multistakeholder community collaboration to design a mental health program for older people. To evaluate the process of delivering a 12-week psychosocial program aimed at preventing loneliness, countering boredom, and providing older people in restricted settings with education about Covid-19 during the lockdown, in Durban, South Africa. A qualitative retrospective design was used. Data from two focus groups and six semistructured individual interviews conducted with stakeholders (volunteers, social workers, and residents) postproject were analyzed using reflexive thematic analysis. Stakeholders had varied experiences of the project, in terms of content, processes of engagement, and implementation, resulting in five themes. The study concluded with recommendations. A strong need exists for multistakeholder community collaborations when implementing a program where the context restricts physical access.

Associations Between Changes in Loneliness and Social Connections, and Mental Health During the COVID-19 Pandemic: The Women's Health Initiative

BACKGROUND

Older women have faced significant disruptions in social connections during the coronavirus disease 2019 pandemic. Whether loneliness increased or whether a change in loneliness from pre- to intrapandemic period was associated with mental health during the pandemic is unknown.

METHODS

Older women (n = 27 479; mean age 83.2 [SD: 5.4] years) completed surveys in mid-2020, including questions about loneliness, living arrangements, changes in social connections, and mental health. Loneliness was also previously assessed in 2014-2016. We examined whether loneliness changed from the pre- to intrapandemic period and explored factors associated with this change. In multivariable models, we investigated the association of changes in loneliness and social connections with mental health.

RESULTS

Loneliness increased from pre- to intrapandemic levels. Factors associated with worsening loneliness included older age, experiencing stressful life events, bereavement, histories of vascular disease and depression, and social connection disruptions. Factors associated with a decrease in loneliness included identifying as Black, engaging in more frequent physical activity, being optimistic, and having a higher purpose in life. A 3-point increase in loneliness scores was associated with higher perceived stress, higher depressive, and higher anxiety symptoms. Social connection disruptions showed modest or no associations with mental health.

CONCLUSIONS

Loneliness increased during the pandemic in older women and was associated with higher stress, depressive, and anxiety symptoms. Our findings point to opportunities for interventions targeting lifestyle behaviors, well-being, disrupted social connections, and paying closer attention to those with specific medical and mental health histories that may reduce loneliness and improve mental health.

Changes in Volunteering of Older Adults in the Time of the COVID-19 Pandemic: The Role of Motivations

This paper elucidates the relationship between possible changes in volunteering experienced by older people during the COVID-19 pandemic, and their motivation to volunteer, as well as the direct or indirect experience of COVID-19 symptoms. Given the well-known positive benefits of volunteering in older age both for individuals (in terms of improved health and wellbeing) and society at large, there is a paucity of studies on older volunteers in the time of COVID-19. In this context, older people's volunteering was highly challenged due to age-based physical and social restrictions put in place by national governments, which have been considered as ageist by a large part of the gerontological scientific community. This study was carried out on a sample of 240 Italian older volunteers. The results suggest that during the COVID-19 pandemic, especially older volunteers driven by social goals (e.g., opportunities to have relationships with others) were able to continue volunteer activities without needing to change them. The study also clarified that having directly or indirectly experienced COVID-19 symptoms did not influence changes in voluntary activities of older people. These results have important policy implications, given the indication that through volunteering, older individuals may try to counter the undesired calls by the governments for self-isolation and physical distancing. It is important that in emergency situations involving older people, policy makers should not treat them as only recipients of health and social care, but also as useful providers of help in the community.

People's Perception of Well-Being during the COVID-19 Pandemic: A Case Study in Japan

This study aims to examine people's perception of well-being during the COVID-19 pandemic in Japan and quantitatively clarify key factors towards realizing evidence-based policymaking. In March 2022, 400 participants responded to a survey conducted through Rakuten Insight. The authors applied an ordinal logistic regression (OLR), followed by principal component analysis (PCA), to create a new compound indicator (CI) to represent people's perception of well-being during the pandemic in addition to ordinary least squares (OLS) regression with a forward-backward stepwise selection method, where the dependent variable is the principal component score of the first principal component (PC1), while the independent variables are the same as the abovementioned OLR. Consequently, while analyzing OLR, some independent variables showed statistical significance, while the CI provided an option to grasp people's perception of well-being. Furthermore, family structure was statistically significant in all cases of OLR and OLS. Moreover, in terms of the standardized coefficients (beta) of OLS, the family structure had the greatest impact on the CI. Based on the study results, the authors advocate that the Japanese government should pay more attention to single-person households affected by the COVID-19 pandemic.

Loneliness, loneliness literacy, and change in loneliness during the COVID-19 pandemic among older adults: a cross-sectional study

BACKGROUND

Loneliness has become a significant public health concern for older people. However, little is known about the association of loneliness, loneliness literacy, and changes in loneliness during the COVID-19 pandemic with mental well-being. The purpose of this study was to explore whether loneliness literacy is related to a lower risk of loneliness, increased loneliness during the COVID-19 pandemic, and improved mental well-being for community-based older adults.

METHODS

A telephone survey was conducted to collect data from older adults aged 65 years or older in Taiwan (n = 804). Loneliness, change in loneliness during COVID-19, and loneliness literacy were the main variables. Mental well-being was assessed by depressive symptoms and life satisfaction. Related factors included personal level (demographics, health conditions, health behaviors, and problem-focused/ emotion-focused coping strategies), interpersonal level (marital status, living arrangements, social support, social participation, leisure activities, and social interactions during COVID-19), and societal level (areas and regions) factors.

RESULTS

Four dimensions of loneliness literacy were identified by factor analysis: self-efficacy, social support, socialization, and in-home support. Self-efficacy and in-home support were related to lower loneliness. Lower self-efficacy, higher social support, and higher socialization were related to changes (increases) in loneliness during COVID-19. In-home support may prevent depressive symptoms, while self-efficacy was beneficial for better life satisfaction. In addition, emotion-focused coping may increase loneliness during COVID-19, while satisfaction with family support would be a protective factor against loneliness.

CONCLUSION

Loneliness literacy is related to loneliness and increased loneliness during the COVID-19 pandemic. Building up an age-friendly community with embedded services/information and learning positive coping and mental resilience strategies are suggested.

Spatiotemporal variations of public opinion on social distancing in the Netherlands: Comparison of Twitter and longitudinal survey data

Background

Social distancing has been implemented by many countries to curb the COVID-19 pandemic. Understanding public support for this policy calls for effective and efficient methods of monitoring public opinion on social distancing. Twitter analysis has been suggested as a cheaper and faster-responding alternative to traditional survey methods. The current empirical evidence is mixed in terms of the correspondence between the two methods.

Objective

We aim to compare the two methods in the context of monitoring the Dutch public's opinion on social distancing. For this comparison, we quantified the temporal and spatial variations in public opinion and their sensitivities to critical events using data from both Dutch Twitter users and respondents from a longitudinal survey.

Methods

A longitudinal survey on a representative Dutch sample (n = 1,200) was conducted between July and November 2020 to measure opinions on social distancing weekly. From the same period, near 100,000 Dutch tweets were categorized as supporting or rejecting social distancing based on a model trained with annotated data. Average stances for the 12 Dutch provinces and over the 20 weeks were computed from the two data sources and were compared through visualizations and statistical analyses.

Results

Both data sources suggested strong support for social distancing, but public opinion was much more varied among tweets than survey responses. Both data sources showed an increase in public support for social distancing over time, and a strong temporal correspondence between them was found for most of the provinces. In addition, the survey but not Twitter data revealed structured differences among the 12 provinces, while the two data sources did not correspond much spatially. Finally, stances estimated from tweets were more sensitive to critical events happened during the study period.

Conclusions

Our findings indicate consistencies between Twitter data analysis and survey methods in describing the overall stance on social distancing and temporal trends. The lack of spatial correspondence may imply limitations in the data collections and calls for surveys with larger regional samples. For public health management, Twitter analysis can be used to complement survey methods, especially for capturing public's reactivities to critical events amid the current pandemic.

"… Exercise opportunities became very important": Scottish older adults' changes in physical activity during Covid19'

BACKGROUND

The purpose of this study was to explore perceived changes in physical activity (PA) due to Covid19 stay-at-home and social distancing guidance among older adults.

METHODS

Participants (n = 1429, 77% female, 84% ≥60 years) living in Scotland completed an online survey in Summer 2020 measuring PA and wellbeing (indexed through loneliness, and health-related quality of life). The survey included open- and closed-ended questions about how these variables changed in response to Covid19 social distancing and 'shielding' guidelines.

RESULTS

From the International Physical Activity Questionnaire (IPAQ), the majority reported high volumes of PA, indicative of being 'moderately' or 'highly' active. When asked specifically about strength training, 12% reported engagement on ≥2d/wk. Most participants reported that PA had changed during this time, citing reduced use of exercise facilities, increased active travel, and online PA classes; although only 16% reported engaging in PA online.

CONCLUSIONS

Higher levels of PA were found to be associated with better health-related quality of life. Additional efforts should be made to support PA engagement in older adults, including strength training and other tailored approaches to support individual needs.

Loneliness and personal well-being in young people: Moderating effects of individual, interpersonal, and community factors

INTRODUCTION

Loneliness is prevalent among young people. But, there is little work exploring the association between loneliness with well-being among this age group. Framed by social-ecological theory, we examined demographic, interpersonal, and community factors associated with personal wellbeing and, critically, identified malleable moderators of the relationship between loneliness and well-being that could be targeted in intervention efforts.

METHODS

We used cross-sectional, secondary data from 965 young people (aged 16-24) from the Community Life Survey in England. Loneliness was measured using a single-item direct measure; personal wellbeing was measured through a composite measure containing items assessing happiness, life satisfaction, and a sense that life is worthwhile (α = 0.88). Regression techniques were used to assess associations between individual, interpersonal, and community factors and well-being, and to identify moderators of the relationship between loneliness and well-being.

RESULTS

Loneliness was negatively associated with well-being. Chatting with neighbors and having people to provide help moderated the relationship between loneliness and well-being. Full-time students and those with good physical health had higher well-being while being a carer was predictive of lower well-being. All community variables were strongly associated with increased well-being. Of all interpersonal variables investigated, only having people to count on was associated with increased well-being.

CONCLUSIONS

Our results demonstrate that supportive relationships and close community ties are important for reducing the negative impact of loneliness on youth well-being. Interventions to improve well-being could benefit from targeting these aspects of young people's social and community lives, while acknowledging individual vulnerabilities, such as poor physical health.

Use of Digital Tools, Social Isolation, and Lockdown in People 80 Years and Older Living at Home

The COVID-19 crisis and associated lockdowns have exposed the extent of social isolation among older adults (OAs). Currently, the French government and medical, social, and charitable organizations are working to find means of limiting the multiple psychological and physical consequences of social isolation on the health of OAs. One proposal is to help the elderly become more comfortable using digital tools (DTs). However, the ability of DTs to reduce social isolation is disputed in the literature. This study aimed to collect the views of OAs on social isolation; to identify the determinants of the use or not of DTs, in particular in the context of a lockdown; and the role of DTs in the strategy to reduce social isolation. This qualitative study was based on 27 semi-structured individual interviews with OAs ≥ 80 years, in Côte-d’Or and Haute-Marne (French departments), from March to May 2021. A total of 96.3% of participants had already owned one or more DTs (mobile phone, tablet, or computer) for several years. The lockdown had not prompted the population to equip themselves more. The most common reason for using DTs was to maintain contact with relatives, and 63% of the participants said that DTs have a positive impact in reducing social isolation. However, there is a significant need for assistance and training in their use, especially since many services are now offered online. The participants suggested that the key to minimizing social isolation remained the maintenance of social contacts. In conclusion, DTs appear to be useful for helping the elderly maintain social links with relatives and, therefore, have a strategic place in the reduction of social isolation. However, these tools should not replace in-person interactions.

Loneliness and mental well-being in the Polish population during the COVID-19 pandemic: a cross-sectional study

OBJECTIVE

There is a growing concern that the restrictions imposed due to the COVID-19 pandemic could lead to increased loneliness and mental disorders, which are considered a major public health problem. The aim of the study was to assess loneliness, anxiety, depression and irritability in the Polish population during the COVID-19 pandemic.

DESIGN

A cross-sectional study. The study participants completed an online questionnaire using the computer-assisted web interview technique. Data were collected using Revised UCLA Loneliness Scale and Hospital Anxiety and Depression Scale.

SETTING

Poland.

PARTICIPANTS

This study was conducted between 6 October and 12 October 2020, in a representative sample of 890 Polish residents.

PRIMARY OUTCOME MEASURES

Self-reported loneliness; sociodemographic and COVID-19 pandemic factors associated with loneliness, anxiety, depression and irritability.

RESULTS

The analyses showed a moderately high degree of loneliness in 22%, symptoms of anxiety in 27%, depression in 14% and irritability in 33% of the respondents. The increasing severity of anxiety, depression and irritation in the study group was accompanied by higher loneliness. Generally, younger people, both tested positive for SARS-CoV-2 and those who experienced home quarantine, scored higher in both scales.

CONCLUSIONS

It is necessary to identify those most vulnerable to loneliness, anxiety and depression during a crisis to assess health needs and proactively allocate resources during and after the pandemic. Loneliness, anxiety, depression and irritability are important factors to consider in a population of younger, disadvantaged people, who tested positive for SARS-CoV-2, people who were quarantined at home, and people who believe that their physical and mental health is worse than in the pre-pandemic period. It is important to cater for the mental health of individuals during the COVID-19 pandemic and to promote psychological interventions to improve mental well-being in potentially vulnerable social groups.

Managing Perceived Loneliness and Social-Isolation Levels for Older Adults: A Survey with Focus on Wearables-Based Solutions

As an inevitable process, the number of older adults is increasing in many countries worldwide. Two of the main problems that society is being confronted with more and more, in this respect, are the inter-related aspects of feelings of loneliness and social isolation among older adults. In particular, the ongoing COVID-19 crisis and its associated restrictions have exacerbated the loneliness and social-isolation problems. This paper is first and foremost a comprehensive survey of loneliness monitoring and management solutions, from the multidisciplinary perspective of technology, gerontology, socio-psychology, and urban built environment. In addition, our paper also investigates machine learning-based technological solutions with wearable-sensor data, suitable to measure, monitor, manage, and/or diminish the levels of loneliness and social isolation, when one also considers the constraints and characteristics coming from social science, gerontology, and architecture/urban built environments points of view. Compared to the existing state of the art, our work is unique from the cross-disciplinary point of view, because our authors' team combines the expertise from four distinct domains, i.e., gerontology, social psychology, architecture, and wireless technology in addressing the two inter-related problems of loneliness and social isolation in older adults. This work combines a cross-disciplinary survey of the literature in the four aforementioned domains with a proposed wearable-based technological solution, introduced first as a generic framework and, then, exemplified through a simple proof of concept with dummy data. As the main findings, we provide a comprehensive view on challenges and solutions in utilizing various technologies, particularly those carried by users, also known as wearables, to measure, manage, and/or diminish the social isolation and the perceived loneliness among older adults. In addition, we also summarize the identified solutions which can be used for measuring and monitoring various loneliness- and social isolation-related metrics, and we present and validate, through a simple proof-of-concept mechanism, an approach based on machine learning for predicting and estimating loneliness levels. Open research issues in this field are also discussed.

Impact of the COVID-19 pandemic on community-dwelling older adults: A longitudinal qualitative study of participants from the Hertfordshire Cohort Study

BACKGROUND

Older adults have been especially vulnerable to adverse effects from the COVID-19 pandemic including higher mortality and more severe disease complications. At the same time, social isolation, malnutrition and physical inactivity are serious concerns among older adults. The pandemic and associated restrictions may serve to exacerbate these issues, presenting increased risks to physical and mental health. The aims of this qualitative study were: i) to explore how community-living older people in the UK experienced the first wave of the COVID-19 pandemic, specifically how it impacted their well-being and associated health behaviours; ii) to explore how older people's experiences and behaviours changed over time throughout the first wave.

METHODS

Qualitative data were collected by conducting serial telephone interviews, with an interval of approximately three months. Participants were from the Hertfordshire Cohort Study, all aged over 80 years. Discussions were audio-recorded, information related to the COVID-19 pandemic was transcribed verbatim and transcripts analysed thematically. Interviews were conducted from March to October 2020.

RESULTS

Data for twelve participants (7 men and 5 women) from a total of 35 interviews were used, comprising two or three timepoints per participant. Analysis identified five overarching themes: 1) shopping strategies and food accessibility, 2) limitations on activities and going out, 3) disruption to healthcare, 4) social and psychological repercussions, and 5) coping strategies. Findings highlight challenges associated with accessing shops, healthcare, and usual activities due to pandemic-related restrictions. Longitudinal findings showed that for some, the ongoing pandemic and related restrictions appeared to aggravate mental health issues (low mood, anxiety) over time, as well as greater feelings of isolation or loneliness, reduced activity and functional limitations; this was despite some relaxation of restrictions later on. Coping strategies used by participants included finding ways to keep busy and to do physical activity safely, maintaining social contact remotely, and having an optimistic or positive outlook, a 'do what you can' attitude.

CONCLUSIONS

Interventions are likely to be needed in the wake of the COVID-19 pandemic to support health behaviours, such as increasing physical activity, social engagement and improving mental health among community-living older adults.

Lifestyle Modification Program on a Metabolically Healthy Elderly Population with Overweight/Obesity, Young-Old vs. Old-Old. CONSEQUENCES of COVID-19 Lockdown in This Program

The SARS-CoV-2 pandemic led to lockdowns, which affected the elderly, a high-risk group. Lockdown may lead to weight gain due to increased food intake and reduced physical activity (PA). Our study aimed to analyze the impact of a 12-month lifestyle intervention on a metabolically healthy overweight/obese elderly (MHOe) population and how the lockdown by COVID-19 affected this program. Methods: MHOe participants (65-87 years) were recruited to participate in a lifestyle modification intervention based on the Mediterranean diet (MedDiet) and regular PA. Participants were classified into two groups: young-old (<75 years) or old-old (≥75 years). Anthropometric and clinical characteristics, energy intake, and energy expenditure were analyzed at baseline and after 12 months of intervention. Results: The final sample included 158 MHOe participants of both sexes (age: 72.21 ± 5.04 years, BMI: 31.56 ± 3.82 kg/m2): 109 young-old (age: 69.26 ± 2.83 years, BMI: 32.0 ± 3.85 kg/m2) and 49 old-old (age: 78.06 ± 2.88 years, BMI: 30.67 ± 3.64 kg/m2). After 12 months of intervention and despite lockdown, the young-old group increased MedDiet adherence (+1 point), but both groups drastically decreased daily PA, especially old-old participants. Fat mass significantly declined in the total population and the young-old. Depression significantly increased (26.9% vs. 21.0%, p < 0.0001), especially in the old-old (36.7% vs. 22.0%, p < 0.0001). No significant changes were found in the glycemic or lipid profile. Conclusions: This study indicates that ongoing MedDiet intake and regular PA can be considered preventative treatment for metabolic diseases in MHOe subjects. However, mental health worsened during the study and should be addressed in elderly individuals.

Life in a time of COVID: a mixed method study of the changes in lifestyle, mental and psychosocial health during and after lockdown in Western Australians

BACKGROUND

Since the beginning of the COVID-19 pandemic, the Western Australian government imposed multiple restrictions that impacted daily life activities and the social life. The aim of this study was to examine the effects of COVID-19 lockdown on the community's physical, mental and psychosocial health.

METHODS

Approximately 2 months after a three-month lockdown, a cross-sectional study was opened to Western Australian adults for an 8-week period (25th August - 21 October 2020). Participants competed a 25-min questionnaire adapted from the Western Australia Health and Wellbeing Surveillance system. Participants provided information on their socio-demographic status, lifestyle behaviours, mental health, and psychosocial health during and post-lockdown. Open-ended questions explored key issues in greater detail. Changes between the lockdown and post-lockdown period were assessed using Wilcoxon signed rank test and One-Sample Kolmogorov-Smirnov Normal tests as appropriate. Sex differences were examined using the Mann-Whitney U test. A content analysis approach examined responses to the open-ended questions with frequencies and variations in responses determined using Chi-Square tests.

RESULTS

A total of 547 complete responses were obtained. Compared to post-lockdown period, lockdown was associated with a significantly lower levels of physical activity, poorer mental well-being and sense of control over one's life, and a higher level of loneliness. Similarly, during lockdown, there was a significantly higher consumption of junk food, soft drinks and alcoholic drinks but no change in fruit and vegetable intake. Participants recalled health campaigns on hand washing and social distancing and there was a retrospective view that more timely and informative campaigns on physical activity, nutrition and mental well-being should have been available during lockdown.

CONCLUSIONS

While advice on infection control measures were appropriately provided, there is a need for concurrent health promotional information to help combat the changes in physical, mental and psychosocial well-being observed during quarantine to prevent negative health consequences in the community even if there are minimal effects of the pandemic itself.

Prior Social Contact and Mental Health Trajectories during COVID-19: Neighborhood Friendship Protects Vulnerable Older Adults

Social networking protects mental health during a crisis. Prior contact with social organizations, friends, and non-friend neighbors may be associated with better trajectories of loneliness, depression and subjective memory during COVID-19. Regression analysis was conducted using longitudinal data from a representative sample of n = 3105 US adults aged ≥55 in April-October 2020. Latent profile analysis was also conducted. Prior contact with friends (B = -0.075, p < 0.001), neighbors (B = -0.048, p = 0.007), and social organizations (B = -0.073, p < 0.001) predicted for better mental health during COVID-19. Three profiles were identified: Profile 1 had the best outcomes, with prior contact with social organizations (B = -0.052, p = 0.044) predicting decreasing loneliness. For Profile 2, prior 'meeting' contact with friends predicted decreasing loneliness (B = -0.075, p < 0.001) and better subjective memory (B = -0.130, p = 0.011). Conversely, prior contact with neighbors (B = -0.165, p = 0.010) predicted worsening loneliness among Profile 3. The COVID-19 pandemic has had a differential impact on the mental health trajectories of aging adults with social ties of different strengths. Stronger neighborhood networks are important to mitigate poor mental health outcomes among vulnerable older adults during a crisis. Older adults who are living alone and had relied on non-friend neighbors for social connectedness require additional community supports. Policy interventions are required to mitigate the mental health impact of future pandemics.

Using Technology the Right Way to Support Social Connectedness for Older People in the Era of COVID-19

The restrictions imposed in response to the COVID-19 pandemic pose significant risks to the human rights of older people from limitations in how people are able to engage with their social lives and from increased risk of discrimination linked to conceptualization of COVID-19 as a disease of the old. Further, COVID-19 increases risks of social isolation through public health and societal responses such as lockdowns. These responses have resulted in significant shifts in how citizens and service providers think about technology as a tool to allow people to stay socially connected. However, there are risks to the rights of older people inherent in the use of technology related to their ability to access technology and ageist assumptions that may limit engagement. The ‘Technology and Social Connectedness’ project was a pre-pandemic mixed-methods study involving evidence review, secondary analyses, and qualitative methods. Cross-dataset analyses led to evidence-based guidance to inform a rights-based approach to using technology. This paper provides analysis from the project that foregrounds a rights-based approach demonstrating how we developed the guidance within this framework and, contextualized within the pandemic response in Scotland, how that guidance can help others to protect and uphold the human rights of older people.