COVID-19 and the Elderly's Mental Illness: The Role of Risk Perception, Social Isolation, Loneliness and Ageism

The Changing Care of Older Adults With Bipolar Disorder: A Narrative Analysis

Older adults with bipolar disorder experience distinct challenges compared to younger age groups with bipolar disorder. They potentially require adaptations to the care they receive. This study aimed to explore experiences of care and changing care needs in older adults with bipolar disorder. People with bipolar disorder (aged ≥60) were recruited through three NHS Trusts in the North West of England, charity organisations, a confidential university participant database, and social media. Participants completed single time-point biographical narrative interviews, which were analysed using narrative analysis. Sixteen participants' accounts led to the creation of four themes: (1) 'Navigating the disruption caused by diagnosis'; (2) 'The removal of services that provided hope'; (3) 'Later life: We are on our own now'; and (4) 'Changing care needs in later life: We still need support'. The care needs of older adults with bipolar disorder appear to change over time, and services often fail to offer adequate, tailored care for this group at present. Current support requires adaptation to be effective and appropriate and to enable this group to age well in later life.

Social Workers' Perspectives on Socially Isolated Older Adults Living with a Robot Companion

Addressing depression and social isolation among solo-living older adults in South Korea requires a multi-faceted approach. This study aims to explore the advantages and obstacles of a robotic elder care program by analyzing social workers' viewpoints regarding interactions between older adults and a companion robot named Hyodol. Through the purposive sampling method, we conducted comprehensive interviews with 10 social workers who are pioneering the integration of robots in elder care. The study participants observed and compared the demographic characteristics of users and non-users, elucidated usage patterns, described the roles of robot companions, and shared remarkable instances. Overall, the experiences of these social workers underscored the positive influence of Hyodol in offering companionship, care, and emotional support, especially in circumstances where clients experienced isolation or lacked regular family interactions. In addition, social workers' perspectives hold significant value in comprehending the genuine effects of anthropomorphism - the inclination to attribute human-like qualities and emotions to robots. Our investigation revealed the existence of two distinct modes of personification among older adults, which we have labeled as "imagination" and "projection."

How did COVID-19 pandemic affect the older adults' needs for robot technologies in Japan?: comparison of participatory design workshops during versus after the COVID-19 pandemic

Social technology can improve the quality of social lives of older adults (OAs) and mitigate negative mental and physical health outcomes. When people engage with technology, they can do so to stimulate social interaction (stimulation hypothesis) or disengage from their real world (disengagement hypothesis), according to Nowland et al.'s model of the relationship between social Internet use and loneliness. External events, such as large periods of social isolation like during the COVID-19 pandemic, can also affect whether people use technology in line with the stimulation or disengagement hypothesis. We examined how the COVID-19 pandemic affected the social challenges OAs faced and their expectations for robot technology to solve their challenges. We conducted two participatory design (PD) workshops with OAs during and after the COVID-19 pandemic. During the pandemic, OAs' primary concern was distanced communication with family members, with a prevalent desire to assist them through technology. They also wanted to share experiences socially, as such OA's attitude toward technology could be explained mostly by the stimulation hypothesis. However, after COVID-19 the pandemic, their focus shifted towards their own wellbeing. Social isolation and loneliness were already significant issues for OAs, and these were exacerbated by the COVID-19 pandemic. Therefore, such OAs' attitudes toward technology after the pandemic could be explained mostly by the disengagement hypothesis. This clearly reflect the OA's current situation that they have been getting further digitally excluded due to rapid technological development during the pandemic. Both during and after the pandemic, OAs found it important to have technologies that were easy to use, which would reduce their digital exclusion. After the pandemic, we found this especially in relation to newly developed technologies meant to help people keep at a distance. To effectively integrate these technologies and avoid excluding large parts of the population, society must address the social challenges faced by OAs.

COVID-19 Narratives from Those with Chronic Illness

Older, chronically ill adults already at risk for social isolation experienced exacerbated isolation due these COVID-19 interventions. This study aimed to describe the narratives of older adults with chronic illness during COVID-19, connect them to the broader literature and use them as exemplars for a holistic analysis of policies for respiratory pandemics. Using narratives related to COVID-19 experiences from a larger research study on spiritual coping with chronic heart failure, the study rendered the themes of isolation, uncertainty, and making the best of it which were connected to additional literature validating the experiences of the participants. The narratives and their themes were then used as a launching point for a holistic analysis of the pandemic response and its effects on well-being for older adults. Clinicians and policymakers should carefully consider not just the physical health burden of a respiratory pandemic on older, chronically, ill adults, but also the holistic health burdens of policies. With these broader health domain considerations in mind ethical and practical recommendations future responses to viral respiratory pandemics are offered.

Older adults' perceptions of ageism before and during the COVID-19 pandemic

OBJECTIVES

Studies assessing the effects of ageism on older adults during the COVID-19 pandemic suggest that perceiving ageism is associated with lower self-reported mental and physical health. Yet, it remains unknown whether these pandemic associations are distinct from pre-pandemic associations. The present study addressed this issue by controlling for pre-pandemic levels of ageism and mental and physical health in order to assess which pandemic-era experiences of ageism predict well-being in older people.

METHOD

Both prior to and during the pandemic, 117 older adults completed measures of perceived ageism, self-perceptions of aging, subjective age, subjective health, and life satisfaction.

RESULTS

During the pandemic, perceived ageism predicted lower subjective health and life satisfaction. However, when controlling for pre-pandemic measures, perceived ageism during the pandemic predicted only subjective health but not life satisfaction. Perceptions of continued growth positively predicted both measures across most analyses.

CONCLUSION

The present findings suggest caution when interpreting the effects of ageism on well-being during the pandemic, as those associations may already have existed pre-pandemic. The finding that perceptions of continued growth positively predicted subjective health and life satisfaction suggests that promoting more positive self-perceptions of aging, along with combatting ageism in society, may represent important policy objectives.

Changes in selected exerkines concentration post folk-dance training are accompanied by glucose homeostasis and physical performance improvement in older adults

The study aimed to evaluate the impact of selected exerkines concentration induced by folk-dance and balance training on physical performance, insulin resistance, and blood pressure in older adults. Participants (n = 41, age 71.3 ± 5.5 years) were randomly assigned to folk-dance (DG), balance training (BG), or control group (CG). The training was performed 3 times a week for 12 weeks. Physical performance tests-time up and go (TUG) and 6-min walk test (6MWT), blood pressure, insulin resistance, and selected proteins induced by exercise (exerkines) were assessed at baseline and post-exercise intervention. Significant improvement in TUG (p = 0.006 for BG and 0.039 for DG) and 6MWT tests (in BG and DG p = 0.001), reduction of systolic blood pressure (p = 0.001 for BG and 0.003 for DG), and diastolic blood pressure (for BG; p = 0.001) were registered post-intervention. These positive changes were accompanied by the drop in brain-derived neurotrophic factor (p = 0.002 for BG and 0.002 for DG), the increase of irisin concentration (p = 0.029 for BG and 0.022 for DG) in both groups, and DG the amelioration of insulin resistance indicators (HOMA-IR p = 0.023 and QUICKI p = 0.035). Folk-dance training significantly reduced the c-terminal agrin fragment (CAF; p = 0.024). Obtained data indicated that both training programs effectively improved physical performance and blood pressure, accompanied by changes in selected exerkines. Still, folk-dance had enhanced insulin sensitivity.

Short- and Medium-Term Effects of Ageism on Loneliness Experienced During the COVID-19 Pandemic

Loneliness, common in old age, may be partially attributed to ageism. The present study explored the short- and medium-term effect of ageism on loneliness experienced during the COVID-19 pandemic using prospective data derived from the Israeli sample of the Survey of Health, Aging and Retirement in Europe (SHARE) (N = 553). Ageism was measured before the COVID-19 outbreak and loneliness in the summer of 2020 and 2021 using a direct single question. We also tested for age differences in this association. In both the 2020 and 2021 models, ageism was related to increased loneliness. This association remained significant after adjusting for a host of demographic, health, and social variables. In the 2020 model, we also found that the positive association between ageism and loneliness was significant only in people aged 70+. We discussed the results with reference to the COVID-19 pandemic, which drew attention to two global social phenomena: loneliness and ageism.

"I'm Too Old for That": The Role of Ageism and Sexual Dysfunctional Beliefs in Sexual Health in a Sample of Heterosexual and LGB Older Adults: A Pilot Study

The role of ageism (i.e., discrimination against individuals or groups on the basis of their age), in particular toward the sexuality of the elderly, remains, to date, an overlooked issue. A few studies have suggested that ageistic stereotypes can negatively affect older adults' sexual health. No data are available, in particular, about differences among heterosexual and LGB (lesbian, gay, and bisexual) populations. The present study aimed to investigate differences in perceived ageism and related dysfunctional beliefs in a sample of heterosexual (n = 104) and LGB (n = 103) older adults (aged 55 or older; mean age 66.5) and their impact on sexual health and satisfaction. LGB individuals reported higher rates of masturbation and sexual intercourse and an increased quality of sexual activity as compared to heterosexuals. In addition, no differences between the groups emerged as regards perceived ageism and dysfunctional beliefs toward ageing. In conclusion, LGB individuals perceived more ageism toward sexuality than their counterparts; however, heterosexuals were more likely to have dysfunctional beliefs toward sexuality in ageing. The study findings highlight the significance of examining sexual orientation to understand experiences of sexuality in ageing of the growing older population. Renewed socio-educational efforts based on these data are clearly needed.

Determinants of depressive symptoms increase in older persons during the COVID-19 pandemic: evidence from Czech cohort study using repeated assessments

BACKGROUND

Numerous studies reported higher levels of mental health issues during the COVID-19 pandemic but only a minority used repeated measurements. We investigated change in depressive symptoms in the Czech ageing cohort and the impact of pre-existing and COVID-19-related stressors.

METHODS

We used data on 2853 participants (mean age 73.4 years) from the Czech part of the prospective Health, Alcohol and Psychosocial factors In Eastern Europe cohort that participated in postal questionnaire surveys before (September 2017-June 2018) and during the pandemic (October 2020-April 2021). Participants reported their depressive symptoms using the Centre for Epidemiological Studies-Depression Scale including 10 (CESD-10) tool. A principal component analysis (PCA) was used to create representative components of the pandemic-related stressors. The impact of the stressors on change in depressive symptoms was tested using multivariable linear regression, after adjustment for age and potential confounders.

RESULTS

Three patterns of the pandemic-related stressors ('financial stressors', 'social and perception stressors' and 'death and hospitalisation stressors') were extracted from the PCA. The mean CESD-10 score increased from 4.90 to 5.37 (p<0.001). In fully adjusted models, significantly larger increases in depression score were reported by older people (β=0.052; p=0.006), those with poor self-rated health (β=0.170; p<0.001), those who experienced death or hospitalisation of a close person (β=0.064; p<0.001), social deprivation (β=0.057; p<0.001), delays in healthcare (β=0.048; p=0.005) and those who suffered from COVID-19 (β=0.045; p=0.008).

CONCLUSION

This study confirms an increase in depressive symptoms in older persons during the pandemic and identified several pandemic-related risk factors suggesting that public health policies should address this vulnerable group by adopting the preventing strategies.

Ageism and the Pandemic: Risk and Protective Factors of Well-Being in Older People

The COVID-19 pandemic has particularly affected the older population both in terms of the high number of victims and the psychological impact. Moreover, the pandemic has made older people more vulnerable to isolation and loneliness, and victims of ageism. The aim of the present study was to investigate the risk and protective factors for the well-being of older people during the pandemic. The role of positive affect, confidence in the future, current physical health, social isolation, loneliness, and ageism were analysed. A self-report questionnaire was administered to 1301 participants (mean age: 77.3 years, DS: 5.46), almost equally distributed by gender (56.1% female). Descriptive and correlational analyses were performed, together with SEM. The results showed that perceived age discrimination positively predicts loneliness and negatively and indirectly predicts well-being. Furthermore, positive affect, confidence in the future, and current physical health are protective factors, while loneliness, social isolation, and ageism are risk factors. Future emergency policies must take into account the impact of such actions on the well-being of this segment of the population.

Healthcare Professionals' Views and Perspectives towards Aging

Improving care for the older population is a growing clinical need in the United States. Ageism and other attitudes of healthcare professionals can negatively impact care for older adults. This study investigated healthcare professionals' (N = 140) views towards aging and characterized a confluence of factors influencing ageism perspectives in healthcare workers using path analysis models. These models proposed relationships between aging anxiety, expectations regarding aging, age, ageism, and knowledge. Aging anxiety had a less critical role in the final model than hypothesized and influenced ageism in healthcare workers through its negative effect (β = -0.27) on expectations regarding aging. In contrast, aging knowledge (β = -0.23), age (β = -0.27), and expectations regarding aging (β = -0.48) directly and inversely influenced ageism. Increased knowledge about the aging process could lower ageism amongst healthcare professionals and improve care for older adults. The results put forth in this study help to characterize and understand healthcare workers' complex views towards the aging population they often encounter. Moreover, these results highlight the need and utility of leveraging practitioner education for combating ageism in the clinical setting.

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.

Association of everyday discrimination with health outcomes among Asian and non-Asian US older adults before and during the COVID-19 pandemic

Increases in anti-Asian COVID-19 related discriminatory behaviors have been observed, many of which targeted older adults. Studies demonstrate that racial discrimination is associated with worse health outcomes, including anxiety, depression, and sleep difficulties. No previous studies have examined the impact of day-to-day experiences of discrimination before and during COVID-19 on both Asian and non-Asian older adults within the same sample. We examined whether everyday discrimination was associated with increased anxiety and depression symptoms, decreased levels of functioning, and increased sleep difficulties among Asian and non-Asian US older adults before and during the pandemic. Data came from the Positive Minds-Strong Bodies randomized clinical trial, an evidence-based mental health and disability prevention intervention for racially and ethnically diverse older adults with elevated depression or anxiety symptoms and minor to moderate disability. We conducted secondary data analyses in a cohort of 165 older adults (56 Asian and 109 non-Asian) assessed before COVID-19 (May 2015-May 2018) and during COVID-19 (March 2021-July 2022). Regression models examined whether everyday discrimination impacted health outcomes differently before and during COVID-19, and whether this effect was stronger among Asian compared to non-Asian older adults. Non-Asian older adults reported the same levels of everyday discrimination before and during COVID-19. Consistent with literature suggesting that social distancing has inadvertently kept US Asian populations from experiencing discrimination, Asian older adults reported marginally lower levels of everyday discrimination during the pandemic compared with pre-pandemic. We found that everyday discrimination was not associated with health outcomes before COVID-19. In contrast, during the pandemic, everyday discrimination was associated with worse anxiety and depression symptoms and worse levels of functioning, although only the impact on depression was significantly stronger compared with before the pandemic. This negative impact of everyday discrimination on health outcomes during the pandemic appeared to affect both Asian and non-Asian older adults similarly. Social support and social cohesion buffered against the negative effect of everyday discrimination on depression and level of functioning during the pandemic. Results suggest that public health interventions aimed at reducing everyday discrimination and emphasizing social support and cohesion can potentially improve health outcomes for all US older adult populations.

Clinical trial registration

www.ClinicalTrials.gov; identifier: NCT02317432.

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.