Mobile Application Use and Loneliness among Older Adults in the Digital Age: Insights from a Survey in Hong Kong during the COVID-19 Pandemic

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.

The relationship between social media use and psychosocial outcomes in older adults: A systematic review

OBJECTIVES

Social isolation and loneliness are prevalent in older adults and are detrimental to physical and mental health. Social media use has been shown to be effective in maintaining social connections and improving older adults' psychosocial outcomes. This study aimed to systematically review and synthesize current research on this topic.

DESIGN

Searches were conducted in November 2021 (and updated in October 2023) in PsycINFO, PubMed, and CINAHL. Inclusion criteria: (1) participants ≥ 65 years (mean, median, or minimum age) and (2) reported impact of social media use on psychosocial outcomes (including loneliness, depression, anxiety, social connectedness, wellbeing, life satisfaction, and quality of life). Quality appraisal tools were utilized, and results were synthesized using narrative synthesis.

RESULTS

Sixty-four papers met inclusion criteria, including cross-sectional (n = 38), observational longitudinal (n = 6), interventional (n = 9), mixed-methods (n = 4), and qualitative (n = 7) studies. Participant numbers ranged from 6 to 16,925. While associations between social media use and positive psychosocial outcomes were generally reported in cross-sectional studies, the impact of social media use over time from longitudinal studies was mixed and inconclusive.

CONCLUSIONS

While social media use is associated with positive psychosocial outcomes, casual conclusions cannot be drawn. Few longitudinal and randomized controlled trial studies existed, and these reported mixed findings. Large variations in study methodology including participants, measurement of social media use, and outcome measures contributed to the inconsistencies of findings. Addressing this heterogeneity through standardized approaches and more rigorous research may enhance understanding.

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

BACKGROUND AND OBJECTIVES

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

RESEARCH DESIGN AND METHODS

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

RESULTS

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

DISCUSSION AND IMPLICATIONS

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

Non-rigorous versus rigorous home confinement differently impacts mental health, quality of life and behaviors. Which one was better? A cross-sectional study with older Brazilian adults during covid-19 first wave

BACKGROUND

The implementation of social distancing measures during covid-19 influenced health outcomes and population´s behaviors, and its rigidity was very different across countries. We aimed to verify the association between the rigidity of social distancing measures of covid-19 first wave with depression symptoms, quality of life and sleep quality in older adults.

METHODS

This is a cross-sectional study including 1023 older adults (90% women; 67.68 ± 5.92 years old) of a community-based program in Fortaleza (Brazil). Dependent variables (depression symptoms, sleep quality, and quality of life) were measured through phone calls along June 2020, during the first covid-19 wave. Confinement rigidity (non-rigorous and rigorous) was considered as independent variable. Sociodemographic characteristics (sex, marital status, scholarity, and ethnicity), number of health conditions, nutritional status, movement behavior (physical activity and sitting time), technological skills, and pet ownership were considered as confounding variables. A binomial logistic regression (odds ratio [OR]) was performed to verify the association of confinement rigidity and depression symptoms, sleep quality, and quality of life, adjusted by confounding variables.

RESULTS

Older adults who adopted a less rigid lockdown had a higher frequency of depression symptoms, worse perception of quality of life, and bad sleep quality (p < 0.001). Confinement rigidity was able to explain the probability of depression symptoms occurrence (OR: 2.067 [95% CI: 1.531-2.791]; p < 0.001), worse quality of life (OR: 1.488 [95% CI: 1.139-1.944]; p < 0.05), and bad sleep quality (OR: 1.839 [95% CI: 1.412-2.395]; p < 0.001). Even adjusted by confounding variables, confinement rigidity was able to explain the poor outcomes analyzed in older adults.

CONCLUSION

Our findings showed that less rigid lockdown was associated with a superior frequency of depression symptoms, worse sleep quality, and lower perception of quality of life in older adults. Therefore, our study could improve comprehension regarding the impact of social distancing measures rigidity in health-related conditions and in the context of covid-19 and other similar pandemic situations.

Shared Destiny in the Digital Era: Sensation Seeking, Loneliness, and Excessive Internet Use among Middle-Aged and Older Adults in Mainland China

With digital infrastructures becoming the foundation of modern life and a shared lifestyle, the internet has become a popular leisure tool for middle-aged and elderly individuals. However, inappropriate use of the internet can jeopardize their health and quality of life, and excessive internet use by middle-aged and older adults is a cause for concern. This study found that middle-aged and older adults are vulnerable to excessive internet use. One predictor of excessive use is loneliness, but its effect is relatively limited. It is a mediating variable rather than the essential cause of excessive internet use by middle-aged and older adults. The effect of sensation seeking is a strong predictor of middle-aged and older adults' excessive internet use, which means they have a strong desire to use the internet to satisfy their emotional needs, thus, resulting in excessive internet use. The social nature of digital infrastructure in a relational framework and the impact of the internet on different populations are likely more complex than we imagine and have the potential to cause many unintended effects.