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

Mapping of technological strategies for reducing social isolation in homebound older adults: A scoping review

BACKGROUND

Homebound older adults (HOAs) are particularly vulnerable to social isolation and loneliness, which engender a poorer physical and mental health, and greater cognitive decline. The purpose of this review is to map the literature to identify potential technological strategies that reduce social isolation in HOAs, and to understand facilitators and barriers for adoption and implementation.

METHODS

Six databases including PubMed (MEDLINE), Google Scholar, Cochrane Database, EBSCOHost, National Library ProQuest, Web of Science, and the Journal of Medical Internet Research were searched for relevant articles. Peer-reviewed literature published in English from Jan 2014 to Feb 2024 that employed technological strategies applicable to HOAs and assessed social isolation or connectedness as an outcome measure were included.

RESULTS

107 studies were reviewed and classified into different technological categories based on their functions and features. A social technology framework encompassing delivery, hardware, software, content, training, and support was conceptualized with core characteristics identified from the reviewed technological strategies. Cost and complexity of technology, and resource commitment were identified as barriers while user-friendliness, content curation and a supportive ecosystem may facilitate the adoption of a technological strategy to address social isolation in HOAs.

CONCLUSION

There is a need for early and concerted effort to identify HOAs, provide technology training, and empower them to tap on the digital world to complement and/or supplement social interactions. Development of cost-effective and rapid-to-implement technology is vital for HOAs who are at highest risk to social isolation.

When concentrated disadvantage happens: Exploring the nexus of energy and internet insecurities among vulnerable households

Digital divide and energy insecurity are pervasive issues among underserved communities, issues that become prounoued during the COVID-19 lockdowns. These disparities underscore the critical need to address them promptly to narrow socio-economic gaps. Our study, based on an online survey of 2,588 respondents in the United Kingdom, explores how concentrated socio-economic disadvantage exacerbates insecurities relating to energy and internet access. Our findings reveal that marginalized groups including low-income households, women, renters, ethnic minorities, and individuals with lower educational attainment are disproportionately affected. Our research extends beyond financial implications to explore the broader social and psychological effects such as trust in utility and internet providers. The study also demonstrates how heightened burdens from energy and internet costs adversely affect the quality of indoor environments, underscoring the interconnected nature of these challenges. Based on these insights, we advocate for policy interventions that adopt comprehensive social justice frameworks to tackle these intersecting inequalities effectively.

Implementation of a Comprehensive and Personalised Approach for Older People with Psychosocial Frailty in Valencia (Spain): Study Protocol for a Pre-Post Controlled Trial

With ageing, the risk of frailty increases, becoming a common condition that exposes older people to an increased risk of multiple adverse health outcomes. In Valencia (Spain), the ValueCare project develops and applies a value-based care approach that addresses the multidimensional nature of frailty by implementing integrated and personalized care to tackle psychosocial frailty. A pre-post controlled design with a baseline measurement at inclusion, at the end of implementation and a follow-up measurement after 6 months of intervention. In Valencia (Spain), 120 participants over 65 years of age are recruited from primary care centres to receive the ValueCare comprehensive and personalised care plan according to the results and are compared with 120 participants receiving "usual care". An assessment questionnaire is designed using validated instruments, and a personalised care plan is developed specifically for each participant based on the results obtained. The study protocol has been registered under the ISRCTN registration number ISRCTN25089186. Addressing frailty as a multidimensional and multifactorial risk condition requires the development and implementation of comprehensive assessments and care. In this context, this study will provide new insights into the feasibility and effectiveness of a value-based methodology for integrated care supported by ICT for older people experiencing frailty.

Nursing students' attitudes towards the use of digital technology in the healthcare of older adults- a cross-sectional study in Norway and Sweden

BACKGROUND

Implementation of digital technology has been suggested as a potential solution to future healthcare challenges. Healthcare personnel's attitudes are important in the acceptance and implementation of digital technologies.

AIM

The aims of this study were to (1) translate and validate two different questionnaires to Norwegian and Swedish respectively, and then (2) use these to examine nursing students' attitudes towards digital technology in healthcare, as well as their attitudes towards older adults' abilities to use digital technology.

DESIGN

Cross-sectional.

METHODS

A web-based questionnaire was distributed in first year nursing students in a Norwegian and a Swedish university college, respectively. The questionnaire consisted of the short form of the 'Information Technology Attitude Scales for Health (ITASH)' and the 'Attitudes Towards Older Adults Using Digital technology (ATOAUT-11)' questionnaire. The questionnaires were translated and validated in both countries. Frequencies, Student's t-test, and one-way ANOVA were used to analyze the data.

RESULTS

In total 236 students responded to the questionnaire in the period September 2022 to April 2023. Students mainly reported positive attitudes towards digital technology use in general. They most agreed with the items 'Using digital technology devices makes my communication with other health professionals faster', 'The sort of information I can get from the digital technology devices helps me give better care to patient', and 'Digital technology skills are becoming more and more necessary for healthcare professionals'. However, they reported more negative attitudes towards older adults using digital technology. They most agreed with the items 'One needs a lot of patience to explain to an older adult how to use digital technologies', 'It's hard to explain to older adults how to use digital technology', 'Using digital technology is harder for most older adults', and 'Most older adults fear using digital technology because they fear of being scammed or cheated'.

CONCLUSION

The ITASH and the ATOAUT-11 is appropriate for use in a Norwegian and Swedish setting. Even if nursing students are positive to digital technology in healthcare in general, they are sceptical to older adults using digital technology. This may impact on their attitudes to using digital technology in the healthcare of older adults. These aspects need emphasis when revising nursing education curricula focusing on developing technological competencies in nursing, and gaining knowledge regarding older adults' use of digital technology.

Social isolation, depression, nutritional status and quality of life during COVID-19 among Chinese community-dwelling older adults: a cross-sectional study

OBJECTIVE

This survey investigated the relationship between social isolation, depression, nutritional status and quality of life among community-dwelling older adults during COVID-19.

DESIGN

This was a cross-sectional survey study.

SETTING

Communities in Pudong New Area, Shanghai, China that have contracted with Renji Hospital, affiliated with Shanghai Jiao Tong University School of Medicine.

PARTICIPANTS

From May to July 2022, 406 community-dwelling older adults were selected by convenience sampling in Shanghai, China.

PRIMARY AND SECONDARY OUTCOME MEASURES

The Lubben Social Network Scale, Geriatric Depression Scale, 36-item Short Form Health Survey Scale and risk assessment of malnutrition were used in older adults. Mediation models were constructed to determine the mediating role of depression and nutritional status on social isolation and quality of life among older adults.

RESULTS

The prevalence of social isolation among older adults in the community was 44.3%. The total social isolation score in community-dwelling older adults was positively associated with the total malnutrition risk and quality of life scores, and negatively associated with depression (p<0.01). Logistic regression demonstrated that living alone, loss of families or friends during COVID-19 and depression were risk factors for social isolation among community-dwelling older adults (p<0.05). Social isolation could directly affect the quality of life (β=0.306). In addition, depression (β=0.334) and nutritional status (β=0.058) had a significant mediating effect on the relationship between social isolation and quality of life.

CONCLUSIONS

Our findings showed that the prevalence of social isolation among older adults increased during COVID-19. Depression and nutritional status played parallel mediating roles on the effect of social isolation on quality of life. Community workers and healthcare providers should develop intervention plans to improve the status of social isolation in older adults, eliminating existing and ongoing adverse effects.

Digital affinitiy and cognitive reserve: Salience for resilient aging in pandemic

Objective: The study aimed to analyze the impact of technology in the older adults after acute pandemic regarding to the development of digital confidence. Method: A sample of n. 56 healthy older adults (N = 22 female, N = 34 male) aged 64 to 86 years (M = 73.7, SD = 6.40) participated in observational study. The sample was distributed in two groups: (a) pre-COVID and (b) post-COVID. Psychological battery was applied: Mini-Mental State Examination, Cognitive Reserve Index Questionnaire, Beck Depression Inventory-II, Affinity for Technology Interaction Scale, and then Digital Mastery Questionnaire. Descriptive and (M)ANOVA statistical analyses have been applied. Results: Our results confirmed the increase in technology usage among elders, the higher use of smart devices and then more confident digital daily living; then, the improving of digital affinity for technology and higher adherence in seniors than older. In sex effect, men seemed developing higher digital confidence for digital experience, for access and use of financial online services than women. In the process of improvement by massive digital experience in daily living the cognitive reserve had relevant influence: elders with high level of cognitive reserve appeared to enhance own competence in digital mastery and affinity for technology. Conclusions: Our study highlighted the higher cognitive reserve being protective in older adults favoring the efficacy to the changing in daily living as well the develop of adaptive behaviors in order to achieve high Quality of Life.

Digital Practices by Citizens During the COVID-19 Pandemic: Findings From an International Multisite Study

BACKGROUND

The COVID-19 pandemic brought digital practices and engagement to the forefront of society, which were based on behavioral changes associated with adhering to different government mandates. Further behavioral changes included transitioning from working in the office to working from home, with the use of various social media and communication platforms to maintain a level of social connectedness, especially given that many people who were living in different types of communities, such as rural, urban, and city spaces, were socially isolated from friends, family members, and community groups. Although there is a growing body of research exploring how technology is being used by people, there is limited information and insight about the digital practices employed across different age cohorts living in different physical spaces and residing in different countries.

OBJECTIVE

This paper presents the findings from an international multisite study exploring the impact of social media and the internet on the health and well-being of individuals in different countries during the COVID-19 pandemic.

METHODS

Data were collected via a series of online surveys deployed between April 4, 2020, and September 30, 2021. The age of respondents varied from 18 years to over 60 years across the 3 regions of Europe, Asia, and North America. On exploring the associations of technology use, social connectedness, and sociodemographic factors with loneliness and well-being through bivariate and multivariate analyses, significant differences were observed.

RESULTS

The levels of loneliness were higher among respondents who used social media messengers or many social media apps than among those who did not use social media messengers or used ≤1 social media app. Additionally, the levels of loneliness were higher among respondents who were not members of an online community support group than among those who were members of an online community support group. Psychological well-being was significantly lower and loneliness was significantly higher among people living in small towns and rural areas than among those living in suburban and urban communities. Younger respondents (18-29 years old), single adults, unemployed individuals, and those with lower levels of education were more likely to experience loneliness.

CONCLUSIONS

From an international and interdisciplinary perspective, policymakers and stakeholders should extend and explore interventions targeting loneliness experienced by single young adults and further examine how this may vary across geographies. The study findings have implications across the fields of gerontechnology, health sciences, social sciences, media communication, computers, and information technology.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.3389/fsoc.2020.574811.

QFD-Based Research on Sustainable User Experience Optimization Design of Smart Home Products for the Elderly: A Case Study of Smart Refrigerators

In the current situation of global aging, the current market shortage of age-appropriate smart home products and the recent epidemic have led to greater isolation of the elderly, seriously affecting their physical and mental health. In order to optimize the sustainable user experience of the elderly when using smart home products, this paper proposes a research method based on Quality Function Deployment (QFD) for the optimal design of user experience of smart home products for the elderly, taking the design of age-appropriate home smart refrigerators as an example. Firstly, based on the results of market research and user interviews, the requirements of smart refrigerators for the elderly are screened and integrated, and the Kano model is used to prioritize these needs, resulting in the identification of important features needed in smart refrigerators for the elderly. Secondly, based on QFD, user requirements are transformed into design requirements, and a quality house model is established to ascertain the degree of importance of each design requirement through user ratings so as to obtain the key requirements as the theoretical basis for the solution design. Finally, optional solutions are generated for concept evaluation based on PUGH concept selection, comparing the advantages and disadvantages of the solutions and recombining them into an evaluation to determine the best solution. The quantitative evaluation of the four solutions reveals that Solution A has the highest score of 117.358, followed by Solution D with 113.259, Solution B with 96.415, and Solution C with 85.511, which is the lowest. The scoring allows the best design solution to be selected and applied to product development. The results show that the introduction of the Kano model and PUGH concept selection into QFD can be effectively used as a research method for optimizing the user experience of smart refrigerators for the elderly, and a corresponding design strategy for sustainable user experience optimization is proposed. The method and strategy provide guidance for the innovative design of new smart home products.

The Impact of Interface Design Element Features on Task Performance in Older Adults: Evidence from Eye-Tracking and EEG Signals

It is crucial that the interface design of mobile apps be age-appropriate at this stage of global aging, as the new epidemic has resulted in a higher sense of isolation among older persons. In this study, four typical senior social service mobile applications were chosen to give older persons the ability to complete user login duties. The participants were 16 older adults (7 men and 9 women) aged 55 to 76. Both objective and subjective data, including task completion time, gaze length, pupil diameter changes, EEG wave amplitude changes, and subjective sensations of older persons, were gathered using a combination of eye-movement and EEG signal approaches. The program was created to investigate the effects of interface design aspects on older people’s task performance, including interface layout, interface color, information density, icon size and position, etc. The study’s findings revealed that when the user task completion time and average fixation duration were shorter, the line of sight was more equally distributed, the visual focus was closer to the login button, and the average EEG amplitude of the user changed more, the older adults performed better. The palace layout had a more positive effect on job completion among older individuals when it came to interface layout. In terms of interface color, colored (contrasting) colors should serve to highlight the interface’s essential information points while they can be removed. In terms of interface information density, a low-density level interface design can simplify and lower the cognitive load of task execution for older people. The first level of icons in the interface and their position in the visual center of the interface is the best interface design for older persons in terms of icon size and position. The results of this study have theoretical ramifications for a thorough understanding of the factors influencing older people’s task performance, practical ramifications for the design of older people-centered interfaces, and they contribute to our understanding of the characteristics of older people’s interface interaction behavior.

Ageing with Interstitial lung disease: preserving health and well being

PURPOSE OF REVIEW

Ageing, the accrual of molecular and cellular damage over a lifetime confers progressive physiologic dysfunction of bodily systems, leaving the body in a heightened state of vulnerability to biophysical and psychosocial stressors. The inflection point is frailty which easily leads to disability and death. Interstitial lung disease (ILD) creates biophysical and psychosocial stresses difficult for even optimally fit patients to cope with. With evolving ILD treatment pathways, people with ILD are living longer.

RECENT FINDINGS

ILD and ageing are bi-directionally influential: ILD, its treatments, complications, and collateral systemic extra-pulmonary damage (hypoxic and oxidative stress) wear on the ageing person and ageing impacts a person's tolerance of ILD. ILD extent may proportionally accelerate age-related vulnerabilities. ILD related to inflammatory systemic diseases, e.g. connective tissue diseases or sarcoidosis, exert an even more complex biophysical impact on the body.

SUMMARY

The present review stresses goals of preventing frailty in ILD and preserving general health and well being of people living with ILD of any age, from time of diagnosis and as they age. The development of a prediction score is proposed to classify those at risk of frailty and guide interventions that preserve successful ageing for all levels of ILD severity.

VIDEO ABSTRACT

http://links.lww.com/COPM/A32.