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Stickley A, Isaksson J, Koposov R, Schwab-Stone M, Sumiyoshi T, Ruchkin V. Loneliness and posttraumatic stress in U.S. adolescents: A longitudinal study. J Affect Disord 2024; 361:113-119. [PMID: 38852860 DOI: 10.1016/j.jad.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Loneliness and posttraumatic stress (PTS) are common in adolescence. However, there has been little longitudinal research on their association. To address this deficit, this study examined the longitudinal association between these phenomena in a sample of U.S. school students while also exploring if gender was important in this context. METHODS Data were analysed from 2807 adolescents (52.1 % female; age at baseline 11-16 years (M = 12.79)) who were followed over a one-year period. Information was obtained on loneliness in year 1 using a single-item question, while PTS was assessed with the self-report Child Post-Traumatic Stress - Reaction Index (CPTS-RI). A full path analysis was performed to assess the across time associations. RESULTS Almost one-third of the students reported some degree of loneliness while most students had 'mild' PTS. In the path analysis, when controlling for baseline PTS and other covariates, loneliness in year 1 was significantly associated with PTS in year 2 (β = 0.06, 95%CI: 0.02, 0.09). Similarly, PTS in year 1 was significantly associated with loneliness in year 2 (β = 0.19, 95%CI: 0.15, 0.23). An interaction analysis further showed that loneliness was higher in girls with PTS than in their male counterparts. LIMITATIONS The use of a single-item measure to assess loneliness that used the word 'lonely' may have resulted in underreporting. CONCLUSION Loneliness and PTS are bidirectionally associated in adolescence. Efforts to reduce loneliness in adolescence may help in combatting PTS, while clinicians should intervene to address loneliness if detected in adolescents with PTS.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
| | - Johan Isaksson
- Child and Adolescent Psychiatry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Center of Neurodevelopmental Disorders, Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Roman Koposov
- Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Sechenov First Moscow State Medical University, Moscow, Russia
| | - Mary Schwab-Stone
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan; Japan Health Research Promotion Bureau, Toyama, Shinnjiku-ku, Tokyo, Japan
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Regional forensic psychiatric clinic Sala, Sala, Sweden
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Lee S, Randolph SB, Baum CM, Nicholas ML, Connor LT. Social participation mediates the relationship between self-efficacy and loneliness among people with stroke during COVID-19: a cross-sectional study. Top Stroke Rehabil 2024; 31:585-594. [PMID: 38345063 DOI: 10.1080/10749357.2024.2312639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/27/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND People post-stroke experience increased loneliness, compared to their healthy peers and loneliness may have increased during COVID due to social distancing. How social distancing affected loneliness among people after stroke is unknown. Bandura's self-efficacy theory suggests that self-efficacy may be a critical component affecting individuals' emotions, behaviors, attitudes, and interpretation of everyday situations. Additionally, previous studies indicate that self-efficacy is associated with both loneliness and social participation. This study investigates relationships among self-efficacy, social participation, and loneliness in people with stroke. OBJECTIVES Determine how social participation affects the relationship between self-efficacy and loneliness in people with stroke during the COVID-19 pandemic. METHODS 44 participants were community-dwelling individuals, ≥ 6 months post-stroke who participated in a 2-hour phone interview. A regression-based mediation analysis was conducted using these measures: Participation Strategies Self-Efficacy Scale, Activity Card Sort for social participation, and UCLA Loneliness Scale for loneliness. RESULTS The total effect of self-efficacy on loneliness was significant (b = -0.36, p = .01). However, social participation fully mediated the relationship between self-efficacy and loneliness (indirect effect, b = -0.11, 95% CI [-0.24, -0.01]; direct effect, b = -0.25, 95% CI [-0.03, 0]). CONCLUSIONS Self-efficacy is associated with both social participation and loneliness in people with stroke in this cross-sectional study. Mediation analysis findings suggest that interventions focused on increasing social participation may prevent or potentially alleviate loneliness in people with stroke who have low self-efficacy.
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Affiliation(s)
- SangJin Lee
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Samantha B Randolph
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Carolyn M Baum
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - Marjorie L Nicholas
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA, USA
| | - Lisa Tabor Connor
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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3
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Sheftel MG, Margolis R, Verdery AM. Loneliness Trajectories and Chronic Loneliness Around the World. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae098. [PMID: 38814952 PMCID: PMC11227000 DOI: 10.1093/geronb/gbae098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVES We examine cross-national variation in (a) loneliness trajectories and (b) the association between common social risk factors and chronic loneliness in middle and older adulthood. METHODS Using longitudinal data, we assess the country-level prevalence of loneliness trajectories (chronic, transitory, and no loneliness) and the extent of common social risk factors for loneliness (living alone, widowhood, divorce, no grandchildren, having chronic conditions, and never working) among adults 50 and older in 20 countries covering 47% of the global population in this age bracket. Additionally, we compare how the associations between social risk factors and chronic loneliness vary across countries. RESULTS We find considerable variation in the prevalence of chronic loneliness cross-nationally, ranging between 4% (Denmark) and 15% (Greece) of adults 50 and older. Living arrangements have the most consistent association with the likelihood of chronic loneliness across countries, with those ever living alone having an 8% higher likelihood of chronic loneliness on average across countries, with a range of 2%-25%. Additionally, those who never report working and those with chronic conditions have a higher likelihood of chronic loneliness across more than a third of the countries. DISCUSSION These results suggest that policies and interventions targeted to middle age and older adults living alone and with limited work histories or with chronic conditions are critical in reducing the public health challenges of chronic loneliness.
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Affiliation(s)
- Mara Getz Sheftel
- Population Research Institute, Pennsylvania State University, State College, Pennsylvania, USA
| | - Rachel Margolis
- Department of Sociology, University of Western Ontario, London, Ontario, Canada
| | - Ashton M Verdery
- Department of Sociology and Criminology, Pennsylvania State University, State College, Pennsylvania, USA
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4
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Camacho D, Pacheco K, Moxley J, Aranda MP, Reid C, Wethington E. Loneliness and global cognitive functioning in racially and ethnically diverse US midlife and older adults. Front Psychol 2024; 15:1344044. [PMID: 38962235 PMCID: PMC11221402 DOI: 10.3389/fpsyg.2024.1344044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/15/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction Few studies have examined the association of loneliness and cognitive functioning in the US. We used two common measures of loneliness and examined their association in a large sample of US Black, Latino, and White adults (ages ≥ 50). Methods We analyzed Wave 3 of the National Social Life, Health, and Aging Project (N = 2,757). We examined loneliness using one item from the CES-D and the Felt Loneliness Measure (NFLM); cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA) tool, where higher scores indicated better functioning. We used weighted ordinary least squares regressions to examine the effects of loneliness (CES-D loneliness and NFLM in separate models) on MoCA scores. In exploratory analyses, we examined if these relationships varied by race and ethnicity. We adjusted all models for sociodemographic and other salient factors (e.g., chronic disease, depressive symptoms, living alone). Results Mean age was 63.49 years, 52% were female, and 9% were Black and 6% Latino persons. Approximately 54% endorsed feeling lonely on at least one measure; 31% (CES-D) and 46% (NFLM). The relationship between loneliness measures was positive and significant, X 2 (1, N = 2,757) = 435.493 p < 0.001. However, only 40% of lonely individuals were identified as lonely on both assessments. CES-D loneliness was inversely (βˆ = -0.274, p = 0.032) associated with MoCA scores and this association did not vary by race and ethnicity. Greater NFLM loneliness was positively associated (βˆ = 0.445, p < 0.001) with higher MoCA scores for Latino participants only. Discussion Loneliness appears to be an important predictor of cognitive functioning. However, the association of loneliness and cognitive functioning varied when using the CES-D loneliness item or the NFLM. Future work is needed to understand how loneliness and its clinically relevant dimensions (social, emotional, existential, chronicity) relate to global and individual cognitive domains. Research is needed with racially and ethnically diverse midlife and older adults, particularly to understand our counterintuitive finding for Latino participants. Finally, findings also support the need for research on interventions to prevent cognitive decline targeting loneliness.
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Affiliation(s)
- David Camacho
- Department of Disability and Human Development, University of Illinois Chicago, Chicago, IL, United States
| | - Kelly Pacheco
- Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Jerad Moxley
- Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Maria P. Aranda
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, United States
| | - Cary Reid
- Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Elaine Wethington
- Weill Cornell Medicine, Cornell University, New York, NY, United States
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Wang YL, Chen YJ, Liu CC. The relationship between social media usage and loneliness among younger and older adults: the moderating effect of shyness. BMC Psychol 2024; 12:343. [PMID: 38863021 PMCID: PMC11167928 DOI: 10.1186/s40359-024-01727-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/11/2024] [Indexed: 06/13/2024] Open
Abstract
Does social media alleviate or exacerbate loneliness? Past research has shown mixed results regarding the relationship between social media usage and loneliness among younger and older adults. Unlike younger individuals, older adults may decrease their loneliness through social media interactions. Additionally, previous research has indicated that the link between social media use and loneliness can vary depending on one's shy tendency. Therefore, this study aims to explore the relationship between individuals' social media use and loneliness while considering age and shyness tendency as moderating variables. The study employed a questionnaire survey conducted through convenience sampling, resulting in 234 valid responses from participants in Northern Taiwan. Among them, 113 were college students (aged 18 to 25, average age 19.40), and 121 were older adults (aged 50 to 82, average age 60.81). Using hierarchical regression analysis, results indicated that (1) age moderates the relationship between personal social media use and loneliness. Minimal differences were observed among younger individuals, but among older adults, increased social media usage time was associated with a significant reduction in loneliness. (2) Shyness tendency moderate the relationship between personal social media use and loneliness. Individuals with higher shyness tendency experience an increase in loneliness as their social media usage time lengthens.
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Affiliation(s)
- Ya-Ling Wang
- Department of Adult and Continuing Education, National Taiwan Normal University, Taipei, Taiwan.
| | - Yi-Jia Chen
- Department of Adult and Continuing Education, National Taiwan Normal University, Taipei, Taiwan
| | - Chih-Chi Liu
- Department of Adult and Continuing Education, National Taiwan Normal University, Taipei, Taiwan
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Stegen H, Duppen D, Savieri P, Stas L, Pan H, Aartsen M, Callewaert H, Dierckx E, De Donder L. Loneliness prevalence of community-dwelling older adults and the impact of the mode of measurement, data collection, and country: A systematic review and meta-analysis. Int Psychogeriatr 2024:1-15. [PMID: 38525677 DOI: 10.1017/s1041610224000425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis is to assess the prevalence of loneliness in many countries worldwide which have different ways of assessing it. DESIGN Systematic review and meta-analysis. SETTING We searched seven electronic databases for English peer-reviewed studies published between 1992 and 2021. PARTICIPANTS We selected English-language peer-reviewed articles, with data from non-clinical populations of community-dwelling older adults (>60 years), and with "loneliness" or "lonely" in the title. MEASUREMENTS A multilevel random-effects meta-analysis was used to estimate the prevalence of loneliness across studies and to pool prevalence rates for different measurement instruments, data collection methods, and countries. RESULTS Our initial search identified 2,021 studies of which 45 (k = 101 prevalence rates) were included in the final meta-analysis. The estimated pooled prevalence rate was 31.6% (n = 168,473). Measurement instrument was a statistically significant moderator of the overall prevalence of loneliness. Loneliness prevalence was lowest for single-item questions and highest for the 20-item University of California-Los Angeles Loneliness Scale. Also, differences between modes of data collection were significant: the loneliness prevalence was significantly the highest for face-to-face data collection and the lowest for telephone and CATI data collection. Our moderator analysis to look at the country effect indicated that four of the six dimensions of Hofstede also caused a significant increase (Power Distance Index, Uncertainty Avoidance Index, Indulgence) or decrease (Individualism) in loneliness prevalence. CONCLUSIONS This study suggests that there is high variability in loneliness prevalence rates among community-dwelling older adults, influenced by measurement instrument used, mode of data collection, and country.
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Affiliation(s)
- Hannelore Stegen
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Daan Duppen
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Perseverence Savieri
- Core facility - Support for Quantitative and Qualitative Research (SQUARE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Lara Stas
- Core facility - Support for Quantitative and Qualitative Research (SQUARE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Honghui Pan
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Brussels Interdisciplinary Research centre on Migration and Minorities (BIRMM), Brussels, Belgium
| | - Marja Aartsen
- Norwegian Social Research, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Hannelore Callewaert
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Eva Dierckx
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Alexianen Zorggroep Tienen, Psychiatric Clinic, Tienen, Belgium
| | - Liesbeth De Donder
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Smith S, Lally P, Steptoe A, Chavez-Ugalde Y, Beeken RJ, Fisher A. Prevalence of loneliness and associations with health behaviours and body mass index in 5835 people living with and beyond cancer: a cross-sectional study. BMC Public Health 2024; 24:635. [PMID: 38419011 PMCID: PMC10903019 DOI: 10.1186/s12889-024-17797-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/17/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND A cancer diagnosis and its treatment may be an especially isolating experience. Despite evidence that positive health behaviours can improve outcomes for people living with and beyond cancer (LWBC), no studies have examined associations between loneliness and different health behaviours in this population. This study aimed to describe the prevalence of loneliness in a large sample of UK adults LWBC and to explore whether loneliness was associated with multiple health behaviours. METHODS Participants were adults (aged ≥ 18 years) diagnosed with breast, prostate or colorectal cancer who completed the Health and Lifestyle After Cancer Survey. Loneliness was reported using the UCLA loneliness score, dichotomised into higher (≥ 6) versus lower (< 6) loneliness. Engagement in moderate-to-vigorous physical activity, dietary intake, smoking status, alcohol use, and self-reported height and weight were recorded. Behaviours were coded to reflect meeting or not meeting the World Cancer Research Fund recommendations for people LWBC. Logistic regression analyses explored associations between loneliness and health behaviours. Covariates were age, sex, ethnicity, education, marital status, living situation, cancer type, spread and treatment, time since treatment, time since diagnosis and number of comorbid conditions. Multiple imputation was used to account for missing data. RESULTS 5835 participants, mean age 67.4 (standard deviation = 11.8) years, completed the survey. 56% were female (n = 3266) and 44% (n = 2553) male, and 48% (n = 2786) were living with or beyond breast cancer, 32% (n = 1839) prostate, and 21% (n = 1210) colorectal. Of 5485 who completed the loneliness scale, 81% (n = 4423) of participants reported lower and 19% (n = 1035) higher loneliness. After adjustment for confounders, those reporting higher levels of loneliness had lower odds of meeting the WCRF recommendations for moderate-to-vigorous physical activity (Odds Ratio [OR] 0.78, 95% Confidence Internal [CI], 0.67, 0.97, p =.028), fruit and vegetable intake (OR 0.81, CI 0.67, 1.00, p =.046), and smoking (OR 0.62, 0.46, 0.84, p =.003). No association was observed between loneliness and the other dietary behaviours, alcohol, or body mass index. CONCLUSIONS Loneliness is relatively common in people LWBC and may represent an unmet need. People LWBC who experience higher levels of loneliness may need additional support to improve their health behaviours.
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Affiliation(s)
- Susan Smith
- Department of Behavioural Science and Health, University College London, Gower Street, WC1E 6BT, London, UK
| | - Phillippa Lally
- Department of Psychological Sciences, University of Surrey, GU2 7XH, Guildford, Surrey, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, Gower Street, WC1E 6BT, London, UK
| | - Yanaina Chavez-Ugalde
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, CB2 0QQ, Cambridge, Box 285, UK
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, LS2 9JT, Leeds, UK
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, Gower Street, WC1E 6BT, London, UK.
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Wei Y, Tang J, Zhao J, Liang J, Li Z, Bai S. Association of loneliness and social isolation with mental disorders among medical residents during the COVID-19 pandemic: A multi-center cross-sectional study. Psychiatry Res 2023; 327:115233. [PMID: 37567113 PMCID: PMC10172154 DOI: 10.1016/j.psychres.2023.115233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/26/2023] [Accepted: 04/29/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Loneliness and social isolation usually increase the risk of mental disorders. However, this association among Chinese medical residents during the COVID-19 pandemic remains unclear. METHODS This study was conducted in September 2022; 1,338 medical residents from three hospitals in Northeastern China were included in the final analysis. The data were collected via online self-administered questionnaires. Adjusted odds ratios and 95% confidence intervals were determined for adjusting for potential confounders by binary logistic regression. RESULTS Among the 1,338 participants, 12.93% (173), 9.94% (133), and 9.72% (130) had experienced major depression, major anxiety, and suicidal ideation, respectively. Further, 24.40% (327) and 44.50% (596) of the total participants had experienced loneliness and social isolation. Loneliness increased the risk of major depression, major anxiety, and suicidal ideation (all p<0.001); Compared with the lowest quartile, the odds ratios of the highest quartile were 4.81, 4.63, and 5.34. The same result was obtained in relation to social isolation (all p<0.001). CONCLUSIONS The findings of this study revealed a considerable prevalence of loneliness, social isolation, and mental disorders among Chinese medical residents during the COVID-19 pandemic. Both loneliness and social isolation increased the risk of major depression, major anxiety, and suicidal ideation.
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Affiliation(s)
- Yingliang Wei
- Department of Orthopedics, Shengjing Hospital of China Medical University.
| | - Jun Tang
- Department of thoracic surgery, Shengjing hospital of China Medical University; Department of postgraduate Administration, Shengjing Hospital of China Medical University.
| | - Jianzhu Zhao
- Department of oncology, Shengjing hospital of China Medical University.
| | - Jiajian Liang
- Department of Orthopedics, Shengjing Hospital of China Medical University.
| | - Zhiyuan Li
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Song Bai
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China.
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Lullau APM, Haga EMW, Ronold EH, Dwyer GE. Antidepressant mechanisms of ketamine: a review of actions with relevance to treatment-resistance and neuroprogression. Front Neurosci 2023; 17:1223145. [PMID: 37614344 PMCID: PMC10442706 DOI: 10.3389/fnins.2023.1223145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/12/2023] [Indexed: 08/25/2023] Open
Abstract
Concurrent with recent insights into the neuroprogressive nature of depression, ketamine shows promise in interfering with several neuroprogressive factors, and has been suggested to reverse neuropathological patterns seen in depression. These insights come at a time of great need for novel approaches, as prevalence is rising and current treatment options remain inadequate for a large number of people. The rapidly growing literature on ketamine's antidepressant potential has yielded multiple proposed mechanisms of action, many of which have implications for recently elucidated aspects of depressive pathology. This review aims to provide the reader with an understanding of neuroprogressive aspects of depressive pathology and how ketamine is suggested to act on it. Literature was identified through PubMed and Google Scholar, and the reference lists of retrieved articles. When reviewing the evidence of depressive pathology, a picture emerges of four elements interacting with each other to facilitate progressive worsening, namely stress, inflammation, neurotoxicity and neurodegeneration. Ketamine acts on all of these levels of pathology, with rapid and potent reductions of depressive symptoms. Converging evidence suggests that ketamine works to increase stress resilience and reverse stress-induced dysfunction, modulate systemic inflammation and neuroinflammation, attenuate neurotoxic processes and glial dysfunction, and facilitate synaptogenesis rather than neurodegeneration. Still, much remains to be revealed about ketamine's antidepressant mechanisms of action, and research is lacking on the durability of effect. The findings discussed herein calls for more longitudinal approaches when determining efficacy and its relation to neuroprogressive factors, and could provide relevant considerations for clinical implementation.
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Affiliation(s)
- August P. M. Lullau
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Emily M. W. Haga
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Eivind H. Ronold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Gerard E. Dwyer
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- NORMENT Centre of Excellence, Haukeland University Hospital, Bergen, Norway
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10
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Lim MH, Manera KE, Owen KB, Phongsavan P, Smith BJ. The prevalence of chronic and episodic loneliness and social isolation from a longitudinal survey. Sci Rep 2023; 13:12453. [PMID: 37528108 PMCID: PMC10393986 DOI: 10.1038/s41598-023-39289-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/22/2023] [Indexed: 08/03/2023] Open
Abstract
Loneliness and social isolation, experienced more long-term, has been shown to increase mortality and lead to poorer health outcomes in specific cohorts. However, it is unclear what the prevalence of chronic loneliness and social isolation is, and which demographic groups are most at risk of reporting more chronic forms. A psychometrically validated classification system was used to identify people who met criteria for episodic and chronic loneliness and social isolation using the Household Income and Labour Dynamics in Australia (HILDA) survey waves 14-18. The prevalence of loneliness (overall 34%; 21% episodic, 13% chronic) far exceeded that of social isolation (overall 17%; 13% episodic, 4% chronic). There was consistency in the demographic characteristics (from age, sex, household type, income) of those who experienced loneliness and social isolation. However, people with a long-term health condition had an elevated risk of episodic loneliness (AOR 1.24, 95% CI 1.11-1.39) and a markedly higher risk of chronic loneliness (AOR 2.01, 95% CI 1.76-2.29), compared with those without a long-term health condition. Loneliness, both episodic and chronic subtypes, is more prevalent than social isolation. However, both chronic loneliness and social isolation remains neglected and poorly targeted within current practice and policy.
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Affiliation(s)
- Michelle H Lim
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Victoria, Australia.
| | - Karine E Manera
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Katherine B Owen
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Philayrath Phongsavan
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Ben J Smith
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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11
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Simegn W, Sisay G, Seid AM, Dagne H. Loneliness and its associated factors among university students during late stage of COVID-19 pandemic: An online cross-sectional study. PLoS One 2023; 18:e0287365. [PMID: 37410760 PMCID: PMC10325105 DOI: 10.1371/journal.pone.0287365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/21/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic resulted in a number of psychosocial and emotional catastrophes, including loneliness. The associated lockdowns, reduced social support, and insufficiently perceived interactions are expected to heighten the level of loneliness during the pandemic. However, there is a dearth of evidence regarding the level of loneliness and what correlates with loneliness among university students in Africa, particularly in Ethiopia. OBJECTIVES The general objective of this study was to assess the prevalence and associated factors of loneliness among university students during the COVID-19 pandemic in Ethiopia. METHODS A cross-sectional study was undertaken. An online data collection tool was distributed to voluntary undergraduate university students. The sampling technique used was snowball sampling. Students were requested to pass the online data collection tool to at least one of their friends to ease data collection. SPSS version 26.0 was used for data analysis. Both descriptive and inferential statistics were used to report the results. Binary logistic regression was used to identify factors associated with loneliness. A P-value less than 0.2 was used to screen variables for the multivariable analysis, and a P-value less than 0.05 was used to declare significance in the final multivariable logistic regression. RESULT A total of 426 study participants responded. Out of the total, 62.9% were males, and 37.1% attended fields related to health. Over three-fourths (76.5%) of the study participants encountered loneliness. Females (adjusted odds ratio (AOR): 1.75; 95% confidence interval (CI): 1.01, 3.04), non-health-related departments (AOR: 1.94; 95% CI: 1.17, 3.35), ever encountering sexual harassment (AOR: 3.32; 95% CI: 1.46, 7.53), sleeping problems (AOR: 2.13; 95% CI: 1.06, 4.30), perceived stress (AOR: 6.40; 95% CI: 1.85, 22.19) and poor social support (AOR: 3.13; 95% CI: 1.10, 8.87) were significantly associated with loneliness. CONCLUSION AND RECOMMENDATION A significant proportion of students were victims of loneliness during the COVID-19 pandemic. Being female, working in non-health-related fields, having sleeping problems, encountering sexual harassment, perceived stress, and poor social support were significantly associated with loneliness. Interventions to reduce loneliness should focus on related psychosocial support to reduce stress, sleeping disturbances, and poor social support. A special focus should also be given to female students.
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Affiliation(s)
- Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Gashaw Sisay
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | | | - Henok Dagne
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Skolarus L, Thrash-Sall E, Hellem AK, Giacalone M, Burke J, Lin CC, Bailey S, Corches C, Dinh M, Casetti A, Mansour M, Bowie K, Roth R, Whitfield C, Sales A. Community-Led, Cross-Sector Partnership of Housing and Health Care to Promote Aging in Place (Unite Health Project): Protocol for a Prospective Observational Study. JMIR Res Protoc 2023; 12:e47855. [PMID: 37384383 PMCID: PMC10365602 DOI: 10.2196/47855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND For many older Americans, aging in place is their preferred living arrangement. Minoritized and socioeconomically disadvantaged older adults are up to 3 times more likely to experience disability than other groups, which increases their likelihood of being unable to age in place. Bold ideas to facilitate aging in place, particularly among vulnerable populations, are needed. One such idea is the Unite care model, a community-initiated, academic-supported, cross-sector initiative that combines 2 sectors: housing and health care. The Unite care model colocates a federally qualified health center clinic on an older adult affordable housing campus in Flint, Michigan. OBJECTIVE There are two aims to this study. Aim 1 is to evaluate the implementation of the Unite care model in terms of acceptability, adoption, and penetration. Aim 2 is to determine which older adults use the care model and whether the care model promotes aging in place through risk factor reduction and improvement in the physical and social environment. METHODS We will assess the care model using a concurrent, exploratory mixed methods design. For aim 1, acceptability will be assessed through semistructured interviews with key stakeholder groups; adoption and penetration will be assessed using housing and health care records. For aim 2, residents residing in the Unite clinic building will participate in structured outcome assessments at 6 and 12 months. Risk factor reduction will be measured by change in systolic blood pressure from baseline to 12 months and change in the physical and social environment (item counts) will also be assessed from baseline to 12 months. RESULTS Data collection for aim 1 began in July 2021 and is anticipated to end in April 2023. Data collection for aim 2 began in June 2021 and concluded in November 2022. Data analysis for aim 1 is anticipated to begin in the summer of 2023 and analysis for aim 2 will begin in the spring of 2023. CONCLUSIONS If successful, the Unite care model could serve as a new care model to promote aging in place among older adults living in poverty and older Black Americans. The results of this proposal will inform whether larger scale testing of this new model of care is warranted. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47855.
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Affiliation(s)
- Lesli Skolarus
- Davee Department of Neurology, Northwestern University, Chicago, IL, United States
| | | | - Abby Katherine Hellem
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | | | - James Burke
- Department of Neurology, The Ohio State University, Columbus, OH, United States
| | - Chun Chieh Lin
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Sarah Bailey
- Bridges Into the Future, Flint, MI, United States
| | - Casey Corches
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Mackenzie Dinh
- Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Amanda Casetti
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Maria Mansour
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Kaitlyn Bowie
- Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Rylyn Roth
- Department of Neurology, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Candace Whitfield
- Emergency Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Anne Sales
- Sinclair School of Nursing, University of Missouri, Columbia, MO, United States
- Department of Family and Community Medicine, University of Missouri, Columbia, MO, United States
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13
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Paquet C, Whitehead J, Shah R, Adams AM, Dooley D, Spreng RN, Aunio AL, Dubé L. Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources. J Med Internet Res 2023; 25:e40213. [PMID: 37195738 PMCID: PMC10233446 DOI: 10.2196/40213] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community. OBJECTIVE This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults. METHODS A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources. RESULTS The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services. CONCLUSIONS A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.
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Affiliation(s)
- Catherine Paquet
- Département de Marketing, Faculté des Sciences de l'Administration, Université Laval, Québec, QC, Canada
- Centre de Recherche, Centre Hospitalier Universitaire de Québec - Université Laval, Quebec, QC, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Quebec, QC, Canada
| | - Jocelyne Whitehead
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Rishabh Shah
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Alayne Mary Adams
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Damion Dooley
- Centre for Infectious Disease Genomics and One Health, Simon Fraser University, Vancouver, BC, Canada
| | - R Nathan Spreng
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | | | - Laurette Dubé
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
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14
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Gazadinda R, Putri GW, Maulana H. Reducing Loneliness in Undergraduate Students through E-Journaling Intervention: A Pre-Experimental Study. BULLETIN OF COUNSELING AND PSYCHOTHERAPY 2023. [DOI: 10.51214/bocp.v5i1.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
The Covid-19 pandemic in Indonesia has had a devastating psychological impact on society, with the rise of online interaction failing to replace face-to-face interaction, particularly among undergraduate students. Loneliness is a prevalent mental health problem among students during the pandemic. This study aimed to assess the effectiveness of e-journaling intervention in reducing loneliness among undergraduate students. A pre-experimental design was used, with 38 undergraduate students participating in writing activities in the form of journaling every weekday for two weeks. Pre and post-tests were given using the De Jong Giervield Loneliness Scale to evaluate loneliness. The results of a Wilcoxon signed-rank test showed no significant difference in loneliness before and after the intervention, with only 40% of participants showing a decrease in loneliness. This suggests that e-journaling intervention is not an effective way to reduce student loneliness during the pandemic. A randomized controlled study is recommended for further exploration of the efficacy of e-journaling intervention.
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15
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Ezeokonkwo FC, Sekula KL, Stokes JE, Theeke LA, Zoucha R, Troutman-Jordan M, Sharma D. Relationships between Interpersonal Goals and Loneliness in Older Adults: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1914. [PMID: 36767280 PMCID: PMC9914752 DOI: 10.3390/ijerph20031914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Loneliness is linked to many physiological and psychological issues and disproportionately affects older adults. Interpersonal goals (compassion and self-image) are essential to interpersonal relationships; however, how they relate to loneliness in older adults is unknown. We investigated the impact of interpersonal goals on loneliness using the Ecosystem-Egosystem Theory of Social Motivation. This study, adopting a descriptive cross-sectional correlational design, used data from the 2016 Health and Retirement Study. Participants (n = 3212) included people aged >65 years (mean age: 75; female: 60.1%). We performed exploratory factor analysis with principal axis factoring and varimax rotation to examine the suitability of compassionate and self-image goals as separate factors. The complex samples general linear model was used to assess the relationship between loneliness and interpersonal goals. Interpersonal goals were significantly negatively associated with loneliness. Respondents with higher compassion and self-image goals reported lower loneliness levels. Our results contribute to understanding how interpersonal goals relate to loneliness in older adults. These initial findings warrant further investigation.
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Affiliation(s)
| | | | - Jeffrey E. Stokes
- Department of Gerontology, McCormack Graduate School of Policy and Global Studies, University of Massachusetts, Boston, MA 02125, USA
| | - Laurie A. Theeke
- School of Nursing, George Washington University, Washington, DC 20006, USA
| | - Rick Zoucha
- School of Nursing, Duquesne University, Pittsburgh, PA 15282, USA
| | | | - Dinesh Sharma
- Department of Mathematics and Statistics, James Madison University, Harrisonburg, VA 22807, USA
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16
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Smith KJ, Victor C. The Association of Loneliness With Health and Social Care Utilization in Older Adults in the General Population: A Systematic Review. THE GERONTOLOGIST 2022; 62:e578-e596. [PMID: 34875042 DOI: 10.1093/geront/gnab177] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Loneliness is proposed to be linked with increased service use. This review examined the association of loneliness and health and social care utilization (HSCU) in older adults from the general population. RESEARCH DESIGN AND METHODS Four databases were screened for studies that examined the association of loneliness (predictor) with HSCU (outcome) in older adults (defined as the majority of sample 60 or older). Study quality was assessed with the National Institutes for Health scale for observational cohorts and cross-sectional studies. RESULTS We identified 32 studies, of which 9 prospective studies were evaluated as being good or good-fair quality. Two good-fair quality studies found that loneliness at baseline was associated with subsequent admission to a residential care home. There was emerging evidence that loneliness was associated with emergency department use (n = 1) and cardiovascular disease-specific hospitalization (n = 1). Once adjusted for confounders, the highest quality studies found no association of baseline loneliness with physician utilization, outpatient service utilization, skilled nursing facility use, and planned or unplanned hospital admissions. The remaining studies were cross-sectional, or of fair to poor quality, and inadequate to reliably determine whether loneliness was associated with a subsequent change in HSCU. DISCUSSION AND IMPLICATIONS There was heterogeneity in study design, measurement, and study quality. This generated an inconsistent evidence base where we cannot determine clear inferences about the relationship between loneliness and HSCU. Only one consistent finding was observed between 2 good-fair quality studies regarding care home admission. To determine clinical implications and make reliable inferences, additional good quality longitudinal research is needed.
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Affiliation(s)
- Kimberley J Smith
- School of Psychology, Faculty of Health and Medicine, University of Surrey, Guildford, UK
| | - Christina Victor
- Department of Health Sciences, Brunel University London, Uxbridge, UK
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17
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Van Orden KA, Conwell Y, Chapman BP, Buttaccio A, VanBergen A, Beckwith E, Santee A, Rowe J, Palumbos D, Williams G, Messing S, Sörensen S, Tu X. The helping older people engage (HOPE) study: Protocol & COVID modifications for a randomized trial. Contemp Clin Trials Commun 2022; 30:101040. [PMID: 36479062 PMCID: PMC9720528 DOI: 10.1016/j.conctc.2022.101040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/31/2022] [Accepted: 11/27/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives Evidence-based strategies to reduce loneliness in later life are needed because loneliness impacts all domains of health, functioning, and quality of life. Volunteering is a promising strategy, as a large literature of observational studies documents associations between volunteering and better health and well-being. However, relatively few studies have used randomized controlled trials (RCTs) to examine benefits of volunteering, and none have examined loneliness. The primary objective of the Helping Older People Engage (HOPE) study is to examine the social-emotional benefits of a social volunteering program for lonely older adults. This manuscript describes the rationale and design of the trial. Methods We are randomly assigning adults aged 60 or older (up to 300) who report loneliness to 12 months of either AmeriCorps Seniors volunteering program or an active control (self-guided life review). Co-primary outcomes are assessed via self-report-loneliness (UCLA Loneliness Scale) and quality of life (WHOQOL-Bref). Enrollment was completed in May 2022 and follow-up assessments will continue through May 2023, with completion of primary outcomes soon thereafter. Conclusions Since older adults who report loneliness are less likely to actively seek out volunteering opportunities, if results support efficacy of volunteering for reducing loneliness, dissemination and scaling up efforts may involve connecting primary care patients who are lonely with AmeriCorps Seniors through aging services agencies.This RCT is registered at clinicaltrials.gov (NCT03343483).
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18
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AL-Mhanna SB, Wan Ghazali WS, Mohamed M, Mohamed RN, Mirza MB, Basheer SN, Arora S, Afolabi HA, Mutalub YB, Goni MD, Sheikh AM. The Impact of COVID-19 on Physical Activity Patterns of Dental Students: A Multinational Survey. Healthcare (Basel) 2022; 10:2140. [PMID: 36360481 PMCID: PMC9691137 DOI: 10.3390/healthcare10112140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND The authorities of the world had to take extraordinary containment measures due to the coronavirus (COVID-19) pandemic spreading across the globe. The only way to stay active during the pandemic was at-home physical activity (PA). The current study evaluates how these preventative measures impacted the PA and well-being of students. METHODS This study is multicentral and was conducted in Malaysia, India, Cambodia, and Saudi Arabia; participants were recruited from four different regions to answer the online questionnaire provided via a link shared using their personal WhatsApp, Facebook Messenger, and Twitter social media. RESULTS The means of vigorous, moderate, and light PA (min/day) between the active and inactive groups were significantly different (p = 0.001, 0.007, and 0.001), respectively. In comparison with pre-COVID-19, the participants reported that it became more challenging to engage in regular exercise since the onset of social distance, associated with a lack of motivation followed by "less confidence", "less enjoyment", "less support, and fewer opportunities to engage in exercise"; moreover, it was "difficult to maintain close relationships" and "hard to voice their options on contentious matters" (p = 0.001). Public health measures affected the PA and well-being of active and inactive students; this demonstrates that health promotion strategies aimed at enhancing levels of PA in inactive students may be necessary to improve students' well-being.
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Affiliation(s)
- Sameer Badri AL-Mhanna
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Wan Syaheedah Wan Ghazali
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Roshan Noor Mohamed
- Department of Pediatric Dentistry, Faculty of Dentistry, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Mubashir Baig Mirza
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, P.O. Box 173, Al-Kharj 11942, Saudi Arabia
| | - Syed Nahid Basheer
- Division of Operative Dentistry, Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Suraj Arora
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, P.O. Box 960, Abha 61421, Saudi Arabia
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Yahkub Babatunde Mutalub
- Department of Clinical Pharmacology, College of Medical Sciences, Abubakar Tafawa Balewa University, Bauchi 74027, Nigeria
| | - Mohammed Dauda Goni
- Faculty of Veterinary Medicine, Universiti Malaysia Kelantan, City Campus, Kota Bharu 16100, Kelantan, Malaysia
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Wu J, Zhang J, Fokkema T. The micro-macro interplay of economic factors in late-life loneliness: Evidence from Europe and China. Front Public Health 2022; 10:968411. [PMID: 36176511 PMCID: PMC9513610 DOI: 10.3389/fpubh.2022.968411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/09/2022] [Indexed: 01/25/2023] Open
Abstract
Individual socioeconomic status has a significant impact on whether older adults can initiate and maintain social relationships and participate in society, hence it affects loneliness. At the macro level, income inequality is expected to increase the risk of loneliness by eroding social cohesion and trust, while welfare generosity might protect people from loneliness. The aim of the study is to explore whether income inequality and welfare generosity at the country level moderate the effect of socioeconomic status at the individual level on late-life loneliness. Data were obtained from the HRS family of surveys - the Survey of Health, Aging and Retirement in Europe (SHARE) (wave 5, 2011/12) and China Health and Retirement Longitudinal Study (CHARLS) (wave 2, 2012/13). Respondents aged 50 years and older from twelve European countries and China were included in the study. Logistic country fixed effect models were used in the analysis. The findings show a stronger effect of individual socioeconomic status on late-life loneliness in more income-unequal societies and a weaker effect in more welfare-generous societies. There is a need to consider the impact of income distribution and welfare spending on the risk of loneliness among those older adults with low socioeconomic status when tailoring preventive programs and interventions to reduce loneliness among this vulnerable group.
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Affiliation(s)
- Jing Wu
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden,*Correspondence: Jing Wu
| | - Jing Zhang
- Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Tineke Fokkema
- Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, Netherlands,Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW/University of Groningen, The Hague, Netherlands
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Loneliness Status and Related Factors among the Hakka Elderly in Fujian, China: Based on the Health Ecological Model. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:2633297. [PMID: 36046082 PMCID: PMC9420631 DOI: 10.1155/2022/2633297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/07/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022]
Abstract
There are few studies estimating the loneliness of the Hakka elderly in China. This study aims to examine the loneliness status and related factors among the Hakka elderly in Fujian, China. The short-form UCLA Loneliness Scale (ULS-8) was used to assess the loneliness of the Hakka elderly. Factors associated with loneliness were classified as individual indicators, behavioral indicators, interpersonal indicators, and social indicators according to the health ecological model (HEM). Hierarchical linear regression models were established to identify the main factors that were most predictive of loneliness. A sample of 1,262 Hakka elderly people was included in this study. Females (β = 0.631, P=0.012), those with ≥2 chronic diseases (β = 1.340, P < 0.001), those who were currently living in rural areas (β = 4.863, P < 0.001) or suburban areas (β = 2.027, P < 0.001), those with parents both died (β = 0.886, P=0.001), and those with the Urban Employees Basic Medical Insurance (UEBMI; β = 0.852, P=0.030) obtained a higher score of ULS-8. Those exercised regularly (β = −2.494, P < 0.001), those had leisure activities (β = −1.937, P < 0.001), those ate healthy (β = −1.270, P < 0.001), and those with better self-rated financial status and higher education level received a lower score of ULS-8. There are differences in loneliness among different Hakka elderly population subgroups, and healthy behaviors and lifestyles may reduce the loneliness of the Hakka elderly. Relevant interventions should be implemented in a targeted manner, focusing on susceptible populations. This is most evident among those who were female, living in rural areas, with parents both died, with lower education, and with multiple chronic diseases.
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Li Y, Spini D. Intersectional social identities and loneliness: Evidence from a municipality in Switzerland. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3560-3573. [PMID: 35355276 PMCID: PMC9544721 DOI: 10.1002/jcop.22855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/06/2022] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
We examined the extent to which intersectional social identities combine to shape risks of loneliness and identified the specific social clusters that are most at risk of loneliness for more precise and targeted interventions to reduce loneliness in a Swiss municipality. Based on data collected using participatory action research, we used the novel multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to estimate the predictive power of intersectional social attributes on risk of loneliness. We found that 56% of the between-strata variance was captured by intersectional interaction but was not explained by the additive effect of social identities. We also found that nationality and education had the strongest predictive power for loneliness. Interventions to reduce loneliness may benefit from understanding the resident population's intersectional identities given that individuals with the same combinations of social identities face a common set of social exposures relating to loneliness.
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Affiliation(s)
- Yang Li
- National Centre of Competence in Life Course Research LIVES, Institute of Social SciencesUniversity of LausanneLausanneSwitzerland
| | - Dario Spini
- National Centre of Competence in Life Course Research LIVES, Institute of Social SciencesUniversity of LausanneLausanneSwitzerland
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22
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Kreouzi M, Theodorakis N, Constantinou C. Lessons Learned From Blue Zones, Lifestyle Medicine Pillars and Beyond: An Update on the Contributions of Behavior and Genetics to Wellbeing and Longevity. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221118494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Blue Zones are regions of the world that have a higher number of individuals who live longer than the expected average. The current paper revisits principles previously identified to be common in Blue Zones and to be contributing to longevity ( move naturally, eat wisely, improve resilience to stress, get adequate sleep, keep strong family ties, stimulate strong community support, respect for the planet and having a purpose in life’), compares these to the 6 pillars of Lifestyle Medicine ( healthy eating, exercising, avoidance of smoking and other risky substances, stress management, restorative sleep, and forming and maintaining relationships) and reviews new studies investigating the association between behavioral factors and longevity. In addition to the role of behavior, the review also discusses the important role of genetics and emphasizes the importance of conducting further research to understand how behavioral and genetic factors may affect molecular pathways with consequent effects on wellbeing and longevity.
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Affiliation(s)
- Magdalini Kreouzi
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus (MK, CC); Department of Internal Medicine, Limassol General Hospital, Limassol, Cyprus (NT)
| | - Nikolaos Theodorakis
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus (MK, CC); Department of Internal Medicine, Limassol General Hospital, Limassol, Cyprus (NT)
| | - Constantina Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus (MK, CC); Department of Internal Medicine, Limassol General Hospital, Limassol, Cyprus (NT)
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Music Listening Was an Emotional Resource and Social Surrogate for Older Adults During the COVID-19 Pandemic: A Qualitative Study. BEHAVIOUR CHANGE 2022. [DOI: 10.1017/bec.2022.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Abstract
Loneliness and isolation worsen health and wellbeing have been exacerbated by COVID-19, and represent a significant concern for supporting older adults. Music listening has effects that could be particularly supportive during periods of isolation. The aim of this study is to examine older adults’ music listening behaviour during the COVID-19 pandemic and explore music's social and emotional impact in this context. Semi-structured interviews enhanced with music-elicitation were carried out remotely between May and June 2021. Participants were self-selected, community-dwelling older adults residing in Northern Ireland (N = 14; 6 males; 60–83 years). Most were living with their spouse or family, all were of White ethnicity and had varying levels of education. Data were analysed using reflexive thematic analysis. Two main themes were identified: (1) Music as an emotional resource and (2) Music as a social surrogate. Older adults had a preference for using music to induce positive feelings, and used music for negative affect regulation and consolation. Music acted as a social surrogate providing company, and reminders of social relationships and experiences. Music listening was a valued behaviour during COVID-19. Findings have implications for how music listening might be used as an accessible, low-resource tool for supporting isolated older adults.
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Lin CY, Tsai CS, Fan CW, Griffiths MD, Chang CC, Yen CF, Pakpour AH. Psychometric Evaluation of Three Versions of the UCLA Loneliness Scale (Full, Eight-Item, and Three-Item Versions) among Sexual Minority Men in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138095. [PMID: 35805754 PMCID: PMC9265606 DOI: 10.3390/ijerph19138095] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023]
Abstract
The UCLA Loneliness Scale, with different short versions, is widely used to assess levels of loneliness. However, whether the scale is valid in assessing loneliness among sexual-minority men is unknown. Additionally, it is unclear whether the 8-item and 3-item short versions are comparable to the full 20-item version. The present study compared the validity of the three versions of the UCLA Loneliness Scale (i.e., 20-item, 8-item, and 3-item versions) among gay and bisexual men in Taiwan. The participants comprised 400 gay and bisexual men in Taiwan who completed a cross-sectional online survey, which included the UCLA Loneliness Scale, Center for Epidemiological Studies Depression Scale (CES-D) and State–Trait Anxiety Inventory (STAI). Confirmatory factor analysis was used to evaluate factorial validity. Convergent validity was examined between the three versions of the UCLA Loneliness Scale and the CES-D and STAI. Known-group validity was investigated with participants’ sexual orientation and educational levels. The unidimensional construct was supported in all three versions of the UCLA Loneliness Scale tested in the present study. Convergent validity was supported as the level of loneliness was correlated with the level of depression and anxiety for all three versions. There were no significant differences between gay and bisexual men, although significant differences were found across different educational levels. The study confirmed that all three versions of the UCLA Loneliness Scale were comparable with satisfactory reliability and validity in Taiwanese sexual-minority men.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, FL 32803, USA;
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK;
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan
- Department of Health Psychology, Chang Jung Christian University, Tainan 71101, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2228116 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2228116 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
| | - Amir H. Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, SE-551 11 Jönköping, Sweden;
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Liu G, Li S, Kong F. Association between social support, smartphone usage and loneliness among the migrant elderly following children in Jinan, China: a cross-sectional study. BMJ Open 2022; 12:e060510. [PMID: 35613788 PMCID: PMC9174823 DOI: 10.1136/bmjopen-2021-060510] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES As the fast population ageing in the past few decades, China has also witnessed an increase in the number of migrant elderly following children (MEFC). This study aims to examine the relationship between MEFC's social support, smartphone usage and loneliness in Jinan, China. DESIGN Cross-sectional survey. SETTING Shandong Province, China. PARTICIPANTS The participants were 656 MEFC aged 60 years or above. PRIMARY AND SECONDARY OUTCOME MEASURES Loneliness was measured by an eight-item version of the University of California Los Angeles Loneliness Scale (ULS-8). A t-test and one-way Analysis of Variance (ANOVA) were conducted to compare the level of loneliness across different sociodemographic variables, social support indicators and smartphone usage indicators. Structural equation modelling was used to validate the association between the above variables. RESULTS The MEFC's mean score on the ULS-8 was 12.82±4.05, indicating a relatively lower level of loneliness. It was found that social support and smartphone usage exerted negative effects on loneliness of the MEFC, and the standardised direct effects were -0.165 (95% CI -0.257 to -0.070) and -0.094 (95% CI -0.180 to -0.003), respectively. Social support was found to be positively associated with smartphone usage of the MEFC, and the standardised direct effect was 0.147 (95% CI 0.052 to 0.246). CONCLUSIONS The loneliness of the MEFC was relatively low and was clarified to be negatively associated with social support and smartphone usage. Effective intervention measures on social support and smartphone usage to alleviate loneliness among the MEFC in China were recommended based on this study.
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Affiliation(s)
- Guangwen Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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Association between Sense of Belonging and Loneliness among the Migrant Elderly Following Children in Jinan, Shandong Province, China: The Moderating Effect of Migration Pattern. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074396. [PMID: 35410076 PMCID: PMC8998737 DOI: 10.3390/ijerph19074396] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/26/2022] [Accepted: 04/04/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Driven by accelerating population aging and migration, the number of older migrants has increased rapidly in China. Those who moved to cities to look after grandchildren were referred to as the migrant elderly following children (MEFC). This study aims to examine the relationship between sense of belonging and loneliness and explore the moderating effect of migration pattern among the MEFC in China. METHODS The study included 656 MEFC aged 60 years and above. Loneliness was evaluated by the eight-item University of California Los Angeles Loneliness Scale (ULS-8). Sense of belonging and migration pattern were measured using a self-designed questionnaire. Hierarchical multiple regression was conducted to test the proposed association and moderating effect. A margins plot was introduced to illustrate this effect. RESULTS The average ULS-8 score was 12.82 ± 4.05, revealing a low level of loneliness. A weak sense of belonging was related with a higher level of loneliness (β = 0.096, p = 0.014). Migration pattern was found to exacerbate this association (β = 0.138, p = 0.026), especially for the elderly who migrated across provinces. CONCLUSIONS Sense of belonging was correlated with loneliness, and the moderating role of migration pattern was established. Both policymakers and the adult children of inter-provincial migrant elderly should focus on this special subgroup.
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Abshire DA, Graves JM, Amiri S, Williams-Gilbert W. Differences in Loneliness Across the Rural-Urban Continuum Among Adults Living in Washington State. J Rural Health 2022; 38:187-193. [PMID: 33180354 PMCID: PMC8674765 DOI: 10.1111/jrh.12535] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE Rural residents may be at higher risk for loneliness than urban residents due to factors such as social isolation, poorer health, and socioeconomic disadvantage. To date, there have been few studies examining rural-urban differences in loneliness among adults in the United States. We examined differences in loneliness across the rural-urban continuum among adult residents living in Washington State. METHODS Stratified random sampling was used to select 2,575 adults from small rural, large rural, suburban, and urban areas who were invited to complete a survey on factors affecting health. Data were obtained from 616 adults (278 from small rural, 100 from large rural, 98 from suburban, and 140 from urban areas) from June 2018 through October 2019. Loneliness was measured using the UCLA Loneliness Scale (3rd version). Multivariable linear and logistic regressions were used to examine geographic differences in loneliness (measured continuously and dichotomously). FINDINGS Mean unadjusted loneliness scores were lower in suburban compared to urban areas (35.06 vs 38.57, P = .03). The prevalence of loneliness was 50.7%, 59.0%, 40.8%, and 54.3% in small rural, large rural, suburban, and urban areas, respectively. Suburban living was associated with lower odds for being lonely compared to urban living (unadjusted OR = 0.58; 95% CI = 0.34-0.98), but this association was not statistically significant in the adjusted model (OR = 0.63; 95% CI = 0.33-1.19). CONCLUSION Loneliness is a prevalent health issue across the rural-urban continuum among Washington State adults.
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Affiliation(s)
| | - Janessa M. Graves
- College of Nursing, Washington State University, Spokane, Washington
| | - Solmaz Amiri
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
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Alshehri K, Algethami NE, Algethami RA, ALAyyubi RH, Alotaibi GH, Alotaibi JS, Altawairqi SA. Relationship Between Loneliness and Hypothyroidism. Cureus 2021; 13:e19955. [PMID: 34868792 PMCID: PMC8627679 DOI: 10.7759/cureus.19955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 11/23/2022] Open
Abstract
Aim This study aimed to assess the relationship between loneliness and hypothyroidism in patients with hypothyroidism and to determine predictors of loneliness. Materials and methods A cross-sectional study was conducted on hypothyroid patients attending the endocrine clinics at Alhada Military Hospital and Prince Mansour Military Hospital, Taif, Saudi Arabia between the period of December 2020 and May 2021. Patients with more than 18 years of hypothyroidism were included and those with other thyroid diseases were excluded as well as those with other comorbidities and psychiatric disorders and those who were living alone. Data were collected using an online pre-structured questionnaire. Results The study included 231 hypothyroid patients with a mean age of 43.34 ± 12.9 years, and 90.9% were females. The majority (96.5%) were taking levothyroxine, and 27.3% were practicing physical activity. Only 2.2% of the participants had a high degree of loneliness, whereas 47.2%, 34.6%, and 16% had low, moderate, and moderately high degrees of loneliness, respectively. Discussion In this study, 2.2% of sampled hypothyroid patients had high (2.2%) or moderately high degrees of loneliness feelings (16%). Duration of hypothyroidism was a significant predictor for high loneliness score.
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Affiliation(s)
- Khalid Alshehri
- Family Medicine, Prince Mansour Military Hospital, Taif, SAU
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29
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Schuster AM, Cotten SR. COVID-19's Influence on Information and Communication Technologies in Long-Term Care: Results From an Online Survey with Long-Term Care Administrators. JMIR Aging 2021; 5:e32442. [PMID: 34878989 PMCID: PMC8757586 DOI: 10.2196/32442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/01/2021] [Accepted: 12/02/2021] [Indexed: 01/20/2023] Open
Abstract
Background The prevalence of COVID-19 in the United States led to mandated lockdowns for long-term care (LTC) facilities, resulting in loss of in-person contact with social ties for LTC residents. Though information and communication technologies (ICTs) can be used by LTC residents to support their socioemotional needs, residents must have access to ICTs to use them. Objective This study explored ICT access and use in LTC facilities and how LTC facilities adapted to try to enhance social connections for their residents during the COVID-19 pandemic. Methods LTC administrators in South Carolina (United States) were invited to complete a web-based survey exploring ICT access and use in LTC facilities and whether access and use changed as a result of the COVID-19 pandemic. Results LTC administrators (N=70, 12 nursing homes [NHs], and 58 assisted living facilities [ALFs]) completed the web-based survey. Since March 2020, a total of 53% (37/70) of the LTC facilities have purchased ICTs for residents’ use. ICTs have mainly been used for videoconferencing with family members (31/36, 86%), friends (25/36, 69%), and health care providers (26/36, 72%). NHs were 10.23 times more likely to purchase ICTs for residents’ use during the COVID-19 pandemic than ALFs (odds ratio 11.23, 95% CI 1.12-113.02; P=.04). Benefits of ICT use included residents feeling connected to their family members, friends, and other residents. Barriers to ICT use included staff not having time to assist residents with using the technology, nonfunctional technology, and residents who do not want to share technology. Conclusions Our results suggest that over half of the LTC facilities in this study were able to acquire ICTs for their residents to use during the COVID-19 pandemic. Additional research is needed to explore how residents adapted to using the ICTs and whether LTC facilities developed and adopted technology integration plans, which could help them be prepared for future situations that may affect LTC residents’ engagement and communication opportunities, such as another pandemic.
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Tanskanen J, Arpin S, Mohr C. Do Loneliness and Social Isolation Predict Mortality Because of Hazardous Drinking? JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2021. [DOI: 10.1521/jscp.2021.40.6.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction: Subjective feelings of loneliness and objective social isolation have been consistently connected with ill-health and mortality, though little work has empirically examined the mechanisms explaining the adverse effects. This study examines whether alcohol consumption explains the connection of loneliness and social isolation on mortality in different age and gender groups. Methods: The sample comprised a representative 1994 Finnish sample (n = 8,650) matched with 22-year follow-up mortality data. A multigroup path analysis with discrete survival time analyses was conducted. Results: There were unique differences in the associations between loneliness, social isolation, alcohol consumption, and mortality based on age and gender groups. Loneliness and particularly social isolation predicted mortality partly through subjective intoxication for women under 40 and men 40–65. Discussion: Loneliness and social isolation are associated with mortality, partly through subjective intoxication. Interventions targeted at reducing loneliness and social isolation may help address underlying causes of excess alcohol consumption and mortality.
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The Critical Role of Coping Strategies in Moderating Loneliness and Quality of Life: Parallel and Unique Processes among Transgender and Heterosexual Cisgender People in Pakistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179109. [PMID: 34501701 PMCID: PMC8431102 DOI: 10.3390/ijerph18179109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/05/2021] [Accepted: 08/26/2021] [Indexed: 11/19/2022]
Abstract
Groups marginalized and/or isolated by minority status—including transgender individuals—are at significant risk for loneliness and diminished quality of life (QoL), effects that can be mitigated to some extent by coping styles. In this study, we examined the relationships among coping styles, loneliness, and QoL outcomes in a marginalized but understudied gender minority group, namely, 200 transgender individuals living in communities in an emerging/developing non-Western geo-cultural region of South-Central Asia (Pakistan), comparing them against a reference group of 100 heterosexual cisgender individuals. Results indicated strong relationships among coping styles, loneliness, and QoL in both transgender and cisgender groups. Moderating variable analysis revealed that coping skills—whether adaptive or maladaptive—help explain differences in loneliness and QoL not only between trans- and cis-gender individuals, but also within just the transgender group. The implications of these findings for intervention strategies to improve QoL among transgender populations are discussed, with reference to both the specific context within Pakistan and the larger context of transgender marginalization within many developing/emerging countries.
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32
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Gildea F. We need to spread the network effects of strong communities. Perspect Public Health 2021; 141:191-192. [PMID: 34286648 DOI: 10.1177/17579139211018546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sebastião E, Mirda D. Group-based physical activity as a means to reduce social isolation and loneliness among older adults. Aging Clin Exp Res 2021; 33:2003-2006. [PMID: 33387363 DOI: 10.1007/s40520-020-01722-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/19/2020] [Indexed: 11/27/2022]
Abstract
Social isolation and loneliness are critical health epidemics among older adults. The present manuscript aimed to underscore group-based physical activity (GBPA) as an approach to prevent and/or reduce social isolation and loneliness among older adults and, therefore, avoid its negative health consequences. We compiled evidence from the literature to answer the following question: would GBPA be a better approach to prevent/reduce social isolation and loneliness among older adults compared to individual physical activity? There is evidence demonstrating that older adults participating in GBPA not only acquire the well-known physical benefits of physical activity but also experience improvements in social connectedness, due to the fact that individuals exercising with others. To this end, beyond providing physical health benefits, GBPA for older adults may have the potential to help prevent social isolation and loneliness by improving levels of social connectedness in this age group. Further research is much needed, as the literature seems to be scarce. This would help devise tailored exercise programs for those reporting to be isolated or feeling lonely.
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Affiliation(s)
- Emerson Sebastião
- Health and Exercise Research Group, Department of Kinesiology and Physical Education, Northern Illinois University, 1425 Lincoln Highway, De Kalb, IL, 60115, USA.
| | - Daniel Mirda
- Health and Exercise Research Group, Department of Kinesiology and Physical Education, Northern Illinois University, 1425 Lincoln Highway, De Kalb, IL, 60115, USA
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Jelińska M, Paradowski MB. The Impact of Demographics, Life and Work Circumstances on College and University Instructors' Well-Being During Quaranteaching. Front Psychol 2021; 12:643229. [PMID: 34177698 PMCID: PMC8226323 DOI: 10.3389/fpsyg.2021.643229] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/05/2021] [Indexed: 12/23/2022] Open
Abstract
In response to the outbreak of the COVID-19 pandemic, educational institutions around the world were forced into lockdown in order to contain the spread of the virus. To ensure continuous provision of education, most transitioned to emergency remote instruction. This has been particularly the case in higher education (HE) institutions. The circumstances of the pandemic have brought unprecedented psychological pressure on the population, in the case of educators and students exacerbated by the transition to a mode of instruction that was completely novel to the majority. The present study examines how college and university instructors dealt with teaching online in these unparalleled circumstances, with a focus on how factors connected with their daily lives and livelihoods influenced their well-being. Between April and September 2020, a comprehensive online survey was filled out by 804 HE instructors from 92 countries. We explore how sociodemographic variables such as gender, age, relationship status, living conditions, and length of professional experience non-trivially affect situational anxiety, work-life synergy, coping, and productivity. The results contribute to a better understanding of the impact of the pandemic and emergency remote instruction on college and university instructors’ well-being by explaining the mechanisms mediating the relationship between individual, contextual, and affective variables. It may provide helpful guidelines for college and university administrators as well as teachers themselves as to how help alleviate the adverse effects of the continuing pandemic and possible similar disruptions leading to school closures on coping and well-being.
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Affiliation(s)
| | - Michał B Paradowski
- Institute of Linguistics, University of Silesia, Sosnowiec, Poland.,Institute of Applied Linguistics, University of Warsaw, Warsaw, Poland
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35
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Garjani A, Hunter R, Law GR, Middleton RM, Tuite-Dalton KA, Dobson R, Ford DV, Hughes S, Pearson OR, Rog D, Tallantyre EC, Nicholas R, Morriss R, Evangelou N, das Nair R. Mental health of people with multiple sclerosis during the COVID-19 outbreak: A prospective cohort and cross-sectional case-control study of the UK MS Register. Mult Scler 2021; 28:1060-1071. [PMID: 34080892 DOI: 10.1177/13524585211020435] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND People with MS (pwMS) have had higher rates of anxiety and depression than the general population before the COVID-19 pandemic, placing them at higher risk of experiencing poor psychological wellbeing during the pandemic. OBJECTIVE To assess mental health and its social/lifestyle determinants in pwMS during the first wave of the outbreak in the United Kingdom. METHODS This is a community-based, prospective longitudinal cohort and cross-sectional case-control online questionnaire study. It includes 2010 pwMS from the UK MS Register and 380 people without MS. RESULTS The Hospital Anxiety and Depression Scale scores of pwMS for anxiety and depression during the outbreak did not change from the previous year. PwMS were more likely to have anxiety (using General Anxiety Disorder-7) and/or depression (using Patient Health Questionnaire-9) than controls during the outbreak (OR: 2.14, 95% CI: 1.58-2.91). PwMS felt lonelier (OR: 1.37, 95% CI: 1.04-1.80) reported worse social support (OR: 1.90, 95% CI: 1.18-3.07) and reported worsened exercise habits (OR: 1.65, 95% CI: 1.18-2.32) during the outbreak than controls. CONCLUSION Early in the pandemic, pwMS remained at higher risk of experiencing anxiety and depression than the general population. It is important that multidisciplinary teams improve their support for the wellbeing of pwMS, who are vulnerable to the negative effects of the pandemic on their lifestyle and social support.
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Affiliation(s)
- Afagh Garjani
- Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK/Department of Academic Clinical Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Rachael Hunter
- College of Health and Human Science, Swansea University, Swansea, UK
| | - Graham R Law
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | | | | | - Ruth Dobson
- Preventive Neurology Unit, Queen Mary University London, London, UK
| | - David V Ford
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Stella Hughes
- Department of Neurology, Belfast Health and Social Care Trust, Belfast, UK
| | - Owen R Pearson
- Neurology Department, Swansea Bay University Health Board, Swansea, UK
| | - David Rog
- Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - Emma C Tallantyre
- Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, UK
| | - Richard Nicholas
- Population Data Science, Swansea University Medical School, Swansea, UK/Department of Cellular and Molecular Neuroscience, Imperial College London, London, UK/Department of Visual Neuroscience, UCL Institute of Ophthalmology, London, UK
| | - Richard Morriss
- Mental Health and Clinical Neurosciences Academic Unit, University of Nottingham, Nottingham, UK/Institute of Mental Health, University of Nottingham, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Nikos Evangelou
- Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK/Department of Academic Clinical Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Roshan das Nair
- Mental Health and Clinical Neurosciences Academic Unit, University of Nottingham, Nottingham, UK/Institute of Mental Health, University of Nottingham, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
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Burns A, Leavey G, O'Sullivan R. Loneliness and Healthcare Use in Older Adults: Evidence From a Nationally Representative Cohort in Northern Ireland-A Cross-Sectional Replication Study. Front Public Health 2021; 9:620264. [PMID: 34026705 PMCID: PMC8131653 DOI: 10.3389/fpubh.2021.620264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Few have explored associations between loneliness and healthcare use independent of health and health behaviors. Recent indication of gender effects also requires validation across health service and cultural settings. We investigated the associations among loneliness, health and healthcare use (HCU) in older adults including stratification to investigate whether associations differed by gender. Methods: Secondary analysis of a nationally representative sample of 8,309 community-dwelling adults aged 50 and over from the Northern Ireland Cohort for the Longitudinal Study of Aging. Primary outcomes were: self-reported General Practice (GP) and emergency department (ED) visits in past year. Negative binomial and logistic regression analysis were used to investigate associations between loneliness and HCU, later adjusting for potential confounders (health and health behaviors). Results: Loneliness was consistently positively associated with both GP and ED visits (with IRRs ranging from 1.10 to 1.49 for GP visits, 1.16 to 1.98 for ED visits and ORs ranging from 1.13 to 1.51 for reporting at least one ED visit). With addition of health and health behaviors, all associations between loneliness and HCU became non-significant, excepting a small independent association between UCLA score and GP visits [IRR 1.03 (95% CI 1.01-1.05)]. Stratification of models revealed no gender effects. Conclusion: All but one association between loneliness and HCU became non-significant when health and health behaviors were included. The remaining association was small but implications remain for health service resources at population level. No gender effects were present in contrast to recent findings in the Republic of Ireland. Further studies on gender, loneliness and healthcare use needed.
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Affiliation(s)
- Annette Burns
- Ageing Research and Development Division, The Institute of Public Health in Ireland, Dublin, Ireland
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Ireland
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Ireland
| | - Roger O'Sullivan
- Ageing Research and Development Division, The Institute of Public Health in Ireland, Dublin, Ireland
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, Ireland
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Abstract
OBJECTIVE Providing care to a loved one with cancer places demands on caregivers that result in changes to their daily routines and disruptions to their social relationships that then contribute to loneliness. Though caregivers' psychosocial challenges have been well studied, loneliness - a determinant of health - has not been well studied in this population. This narrative review sought to describe the current evidence on loneliness among caregivers of cancer patients. We aimed to (1) define loneliness, (2) describe its prevalence, (3) describe the association between loneliness and health outcomes, (4) describe risks and consequences of loneliness among cancer caregivers, (5) identify ways to assess loneliness, and (6) recommend strategies to mitigate loneliness in this unique population. METHOD We used evidence from articles listed in PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, book chapters, and reports. Articles were reviewed for the following inclusion criteria: (1) published in English, (2) caregivers of cancer patients, (3) loneliness as a study variable, and (4) peer-reviewed with no restriction on the timeframe of publication. Caregivers were defined as relatives, friends, or partners who provide most of the care and support for someone with cancer. RESULTS Eighteen studies met inclusion criteria and were included in the analysis. Caregivers' experiences of loneliness can contribute to negative effects on one's social, emotional, and physical well-being. Social support interventions may not be sufficient to address this problem. Existing recommendations to mitigate loneliness include cognitive and psychological reframing, one-on-one and group therapy, befriending, resilience training, and technology-based interventions. SIGNIFICANCE OF RESULTS Limited attention to loneliness in cancer caregivers poses a twofold problem that impacts patient and caregiver outcomes. Interventions are critically needed to address loneliness as a determinant of health in caregivers, given their pivotal role in providing care and impacting health outcomes for people with cancer.
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Abstract
Abstract
The amount of financial debt held by older adults has grown substantially over the past two decades in Europe. This study examines the association of objective and subjective debt burden with social and emotional loneliness among 1,606 older adults in the Netherlands. Objective debt burden is based on financial terms, such as debt-to-income ratio; whereas subjective debt burden measures the psychological distress caused by financial debt. Data are from the 2015/2016 wave of the Longitudinal Aging Study Amsterdam. First, we use means-comparison tests to examine whether older adults who experience social and emotional loneliness differ from older adults who do not experience loneliness regarding their subjective and objective debt burdens. Subsequently, using linear regression models we address two questions: whether social loneliness and emotional loneliness are associated with objective and subjective debt burden; and whether social participation, social network size, anxiety and depression mediate these relationships. We find that subjective debt burden (i.e. the worry related to debt) is a significant predictor of social loneliness, above and beyond the role of social and psychological measures. Objective debt burden, in contrast, is unrelated to social and emotional loneliness. Social participation, social network size, anxiety and depression do not mediate the debt-burden-to-loneliness relationships. The results point to the importance of subjective debt burden in understanding social loneliness and designing interventions.
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Teater B, Chonody JM, Davis N. Risk and Protective Factors of Loneliness among Older Adults: The Significance of Social Isolation and Quality and Type of Contact. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:128-141. [PMID: 33371828 DOI: 10.1080/19371918.2020.1866140] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Loneliness has a significant impact on the health and well-being of older people, including an increased risk of mortality. This cross-sectional study explored possible risk and protective factors that can help explain loneliness and emotional and social loneliness in a sample of community-dwelling older adults (N = 477). The survey incorporated a standardized scale of loneliness and items to assess type and quality of contact with others, community support, social isolation, physical health, cognitive health, and functional ability. Bivariate and multivariate analyses explored the factors that contributed to loneliness, emotional loneliness, and social loneliness. Results indicated overall quality of contact with others, use of phone contact, and social isolation was significant in all three regressions; other significant variables were different for each analysis. The findings support social work and public health recommendations for addressing loneliness, particularly within the current climate of "social distancing" under the COVID-19 pandemic.
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Affiliation(s)
- Barbra Teater
- Department of Social Work, College of Staten Island, New York, New York, USA
- The Graduate Center, City University of New York, New York, New York, USA
| | - Jill M Chonody
- School of Social Work, Boise State University, Boise, Idaho, USA
| | - Nadia Davis
- Department of Social Work, College of Staten Island, New York, New York, USA
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40
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Kelechi TJ, Muise-Helmericks RC, Theeke LA, Cole SW, Madisetti M, Mueller M, Prentice MA. An observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcers. BMC Geriatr 2021; 21:118. [PMID: 33568107 PMCID: PMC7877027 DOI: 10.1186/s12877-021-02060-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/01/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Chronic venous leg ulcers (CVLUs) are the most common type of lower extremity wound. Even when treated with evidenced-based care, 30-50% of CVLUs fail to heal. A specific gap exists about the association between psychosocial stressors, particularly loneliness, and biomarkers of inflammation and immunity. Loneliness is highly prevalent in persons with CVLUs, has damaging effects on health, and contributes to the development of multiple chronic conditions, promotes aberrant inflammation, and diminishes healing. However, the confluence of loneliness, inflammation and the wound healing trajectory has not been elucidated; specifically whether loneliness substantially mediates systemic inflammation and alters healing over time. This study seeks to address whether there is a specific biomarker profile associated with loneliness, CVLUs, and wound healing that is different from non-lonely persons with CVLUs. METHODS An observational prospective study will identify, characterize and explore associations among psychosocial stressors, symptoms and biomarkers between 2 CVLU groups, with loneliness+ (n = 28) and without loneliness- (n = 28) during 4 weeks of wound treatment, measured at 3 time points. We will examine psychosocial stressors and symptoms using psychometrically-sound measures include PROMIS® and other questionnaires for loneliness, social isolation, depression, anxiety, stigma, sleep, fatigue, pain, quality of life, cognition, and function. Demographics data including health history, sex, age, wound type and size, wound age, and treatment will be recorded from the electronic health record. We will characterize a biomarker panel of inflammatory genes including chemotaxic and growth factors, vascular damage, and immune regulators that express in response to loneliness to loneliness and CVLUs using well-established RNA sequence and PCR methods for whole blood samples. In an exploratory aim we will explore whether age and sex/psychological stressors and symptoms indicate potential moderation/mediation of the effect of loneliness on the biomarker profile over the study period. DISCUSSION This study will provide insight into the influence of psychosocial stressors, symptoms, and biological mechanisms on wound healing, towards advancing a future healing prediction model and interventions to address these stressors and symptoms experienced by persons with CVLUs.
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Affiliation(s)
- Teresa J Kelechi
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Robin C Muise-Helmericks
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Laurie A Theeke
- School of Nursing, West Virginia University, Morgantown, West Virgina, USA
| | - Steven W Cole
- Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Mohan Madisetti
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA.
| | - Martina Mueller
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Margaret A Prentice
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA
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McElfresh JJ, Skiba MB, Segrin CG, Badger TA, Crane TE, Crist JD, Thomson CA. Interventions for Loneliness Among Adult Cancer Survivors: A Systematic Review and Meta-Analysis. J Psychosoc Oncol 2021; 39:509-533. [PMID: 33413036 DOI: 10.1080/07347332.2020.1867690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Problem identification: Loneliness is common after cancer, contributing to poor outcomes. Interventions to modify loneliness are needed. This systematic review describes the current literature regarding loneliness interventions in cancer survivors.Literature search: Databases including: Ovid/MEDLINE; The Cochrane Central Register of Controlled Trials (CENTRAL); Elsevier/Embase; Clarivate/Web of Science (Core Collection), EBSCO/PsycINFO, EBSCO/CINAHL were used to perform a systematic review of literature using PRISMA guidelines. Second, risk of bias, meta-analysis and a narrative synthesis approach was completed to synthesize findings from multiple studies.Data evaluation/synthesis: Six thousand five hundred three studies were initially evaluated; eight studies met inclusion criteria. Findings indicate a paucity of interventions, generally of lower quality. Interventions were feasible and acceptable; those interventions with cultural modifications were more likely to demonstrate effectiveness.Conclusions: There are limited interventions addressing loneliness in cancer survivors. Development and testing of culturally-relevant programs are warranted.Implications for psychosocial oncology: Current studies suggest the psychosocial symptom of loneliness is modifiable among adult cancer survivors. Few interventions have been tested and shown to be effectiveness in cancer survivors in the U.S. and none have been tailored for older adult survivors, by patient gender/sex and few for specific race/ethnic groups. Results from this systematic review: a narrative synthesis and meta-analysis can inform future interventions targeting loneliness in this growing, yet vulnerable, adult cancer survivor population.
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Affiliation(s)
| | - Meghan B Skiba
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, USA
| | - Chris G Segrin
- College of Social and Behavioral Sciences, University of Arizona, Tucson, AZ, USA
| | - Terry A Badger
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Tracy E Crane
- Department of Biobehavioral Sciences, College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Janice D Crist
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Cynthia A Thomson
- Department of Health Promotion Sciences and the University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
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Palamar JJ, Le A, Acosta P. Shifts in Drug Use Behavior Among Electronic Dance Music Partygoers in New York During COVID-19 Social Distancing. Subst Use Misuse 2021; 56:238-244. [PMID: 33317365 PMCID: PMC7935433 DOI: 10.1080/10826084.2020.1857408] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Little is known about how COVID-19-related social distancing has affected illegal drug use. We surveyed electronic dance music (EDM) partygoers-a population known for high levels of drug use-to determine whether their drug use patterns had changed during state-mandated social distancing in New York. Methods: Individuals were recruited online and screened for eligibility throughout April and May 2020. We surveyed 128 eligible adults and queried, retrospectively, whether their drug use behavior had changed during COVID-19-related social distancing. Results: Most participants reporting past-three-month use reported decreased frequency of use during COVID-19-related social distancing. Specifically, 78.6% reduced frequency of use of cocaine, 71.1% reduced frequency of use of ecstasy/MDMA/Molly, and 68.0% reduced frequency of use of LSD. Although some participants reported increased frequency of use of cocaine (7.1%), ecstasy (7.9%), or LSD (12.0%), 35.0% reported increased frequency of cannabis use. Most (66.7%) of those reporting cocaine use reduced the amount used. The majority of those reporting use of cannabis, ecstasy, cocaine, and/or LSD reported that drug cost (80.0-84.0%) and drug quality (84.2-92.0%) did not change during social distancing. Having a college degree was associated with higher odds for decreasing frequency of cannabis use. Older participants (ages ≥23) were at lower odds for decreasing frequency of cocaine use, as were those earning >$500 per week, and participants who attended EDM events biweekly or more often were at higher odds for decreasing frequency of LSD use. Conclusions: Participants in this sample tended to reduce party drug use during COVID-19-related social distancing.
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Austin Le
- Department of Population Health, New York University Grossman School of Medicine, New York, NY.,New York University College of Dentistry, New York, NY
| | - Patricia Acosta
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
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Roland H, Ilin Shpilkerman Y, Schaub J, Comeau AC. Connection Through Calls: The Impact of a Seniors Center Without Walls on Older Adults' Social Isolation and Loneliness. Gerontol Geriatr Med 2021; 7:23337214211063102. [PMID: 35005099 PMCID: PMC8728775 DOI: 10.1177/23337214211063102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/29/2021] [Accepted: 11/10/2021] [Indexed: 11/15/2022] Open
Abstract
The Edmonton Seniors Centre Without Walls program provides free health, psychosocial, and educational telephone programming for older adults who experience multiple barriers to traditional in-person programming. The aim of this program evaluation was to assess outcomes of participation using validated scales of loneliness and psychosocial and health quality of life. Telephone interviews were conducted pre (n = 160) and post (n = 99) with participants. Given the variation in average attendance, results were assessed by level of participation: Low, Moderate, and High Users. There was statistically significant improvement in all participants' attitudes towards their self-realization and towards energy levels, and EQ-5D-5L anxiety/depression scale after participation, along with a significant reduction in feelings of social isolation. The highest rates of improvement were seen within High Users. These findings suggest that telephone-based programs could be a useful intervention to improve the wellbeing and socially connectedness of older adults.
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Affiliation(s)
- Heather Roland
- Edmonton Southside Primary Care
Network, Edmonton, AB, Canada
| | | | - Jessica Schaub
- Edmonton Southside Primary Care
Network, Edmonton, AB, Canada
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Lee SL, Pearce E, Ajnakina O, Johnson S, Lewis G, Mann F, Pitman A, Solmi F, Sommerlad A, Steptoe A, Tymoszuk U, Lewis G. The association between loneliness and depressive symptoms among adults aged 50 years and older: a 12-year population-based cohort study. Lancet Psychiatry 2021; 8:48-57. [PMID: 33181096 PMCID: PMC8009277 DOI: 10.1016/s2215-0366(20)30383-7] [Citation(s) in RCA: 165] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Loneliness is experienced by a third of older adults in the UK and is a modifiable potential risk factor for depressive symptoms. It is unclear how the association between loneliness and depressive symptoms persists over time, and whether it is independent of related social constructs and genetic confounders. We aimed to investigate the association between loneliness and depressive symptoms, assessed on multiple occasions during 12 years of follow-up, in a large, nationally representative cohort of adults aged 50 years and older in England. METHODS We did a longitudinal study using seven waves of data that were collected once every 2 years between 2004 and 2017, from adults aged 50 years and older in the English Longitudinal Study of Ageing (ELSA). The exposure was loneliness at baseline (wave two), measured with the short 1980 revision of the University of California, Los Angeles Loneliness Scale (R-UCLA). The primary outcome was a score indicating severity of depression measured at six subsequent timepoints (waves three to eight), using the eight-item version of the Centre for Epidemiologic Studies Depression Scale (CES-D). Analyses were linear multilevel regressions, before and after adjusting for social isolation, social support, polygenic risk scores, and other sociodemographic and health-related confounders. The secondary outcome was depression diagnosis, measured using a binary version of the CES-D. FINDINGS 4211 (46%) of 9171 eligible participants had complete data on exposure, outcome, and confounders, and were included in our complete case sample. After all adjustments, a 1-point increase in loneliness score was associated with a 0·16 (95% CI 0·13-0·19) increase in depressive symptom severity score (averaged across all follow-ups). We estimated a population attributable fraction for depression associated with loneliness of 18% (95% CI 12-24) at 1 year of follow-up and 11% (3-19) at the final follow-up (wave eight), suggesting that 11-18% of cases of depression could potentially be prevented if loneliness were eliminated. Associations between loneliness and depressive symptoms remained after 12 years of follow-up, although effect sizes were smaller with longer follow-up. INTERPRETATION Irrespective of other social experiences, higher loneliness scores at baseline were associated with higher depression symptom severity scores during 12 years of follow-up among adults aged 50 years and older. Interventions that reduce loneliness could prevent or reduce depression in older adults, which presents a growing public health problem worldwide. FUNDING National Institute on Aging and a consortium of UK Government departments coordinated by the National Institute for Health Research.
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Affiliation(s)
- Siu Long Lee
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Eiluned Pearce
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Olesya Ajnakina
- Department of Behavioural Science and Health, University College London, London, UK; Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Farhana Mann
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Francesca Solmi
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Andrew Sommerlad
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Urszula Tymoszuk
- Centre for Performance Science, Royal College of Music, Imperial College London, London, UK
| | - Gemma Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.
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Groarke JM, Berry E, Graham-Wisener L, McKenna-Plumley PE, McGlinchey E, Armour C. Loneliness in the UK during the COVID-19 pandemic: Cross-sectional results from the COVID-19 Psychological Wellbeing Study. PLoS One 2020; 15:e0239698. [PMID: 32970764 PMCID: PMC7513993 DOI: 10.1371/journal.pone.0239698] [Citation(s) in RCA: 389] [Impact Index Per Article: 97.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/11/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Loneliness is a significant public health issue. The COVID-19 pandemic has resulted in lockdown measures limiting social contact. The UK public are worried about the impact of these measures on mental health outcomes. Understanding the prevalence and predictors of loneliness at this time is a priority issue for research. METHOD The study employed a cross-sectional online survey design. Baseline data collected between March 23rd and April 24th 2020 from UK adults in the COVID-19 Psychological Wellbeing Study were analysed (N = 1964, 18-87 years, M = 37.11, SD = 12.86, 70% female). Logistic regression analysis examined the influence of sociodemographic, social, health and COVID-19 specific factors on loneliness. RESULTS The prevalence of loneliness was 27% (530/1964). Risk factors for loneliness were younger age group (OR: 4.67-5.31), being separated or divorced (OR: 2.29), scores meeting clinical criteria for depression (OR: 1.74), greater emotion regulation difficulties (OR: 1.04), and poor quality sleep due to the COVID-19 crisis (OR: 1.30). Higher levels of social support (OR: 0.92), being married/co-habiting (OR: 0.35) and living with a greater number of adults (OR: 0.87) were protective factors. CONCLUSIONS Rates of loneliness during the initial phase of lockdown were high. Risk factors were not specific to the COVID-19 crisis. Findings suggest that supportive interventions to reduce loneliness should prioritise younger people and those with mental health symptoms. Improving emotion regulation and sleep quality, and increasing social support may be optimal initial targets to reduce the impact of COVID-19 regulations on mental health outcomes.
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Affiliation(s)
- Jenny M. Groarke
- Centre for Improving Health-Related Quality of Life (CIHRQoL), School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Emma Berry
- Centre for Improving Health-Related Quality of Life (CIHRQoL), School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Lisa Graham-Wisener
- Centre for Improving Health-Related Quality of Life (CIHRQoL), School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Phoebe E. McKenna-Plumley
- Centre for Improving Health-Related Quality of Life (CIHRQoL), School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Emily McGlinchey
- Stress Trauma and Related Conditions (STARC) Research Lab, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Cherie Armour
- Centre for Improving Health-Related Quality of Life (CIHRQoL), School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
- Stress Trauma and Related Conditions (STARC) Research Lab, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
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Zhong S, Lee C, Foster MJ, Bian J. Intergenerational communities: A systematic literature review of intergenerational interactions and older adults' health-related outcomes. Soc Sci Med 2020; 264:113374. [PMID: 33017736 DOI: 10.1016/j.socscimed.2020.113374] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 12/23/2022]
Abstract
RATIONALE Population aging is a major societal challenge that the US and many other countries are facing. The roles of intergenerational interactions are being increasingly recognized as important factors influencing health and well-being of older adults and other generations. OBJECTIVE This systematic review paper provides a critical assessment of the current state of knowledge about the impacts of intergenerational activities on older adults' health-related outcomes. METHODS Literature searches were conducted in October 2019 within MEDLINE, SocIndex, APA PsycInfo, and CINAHL Complete, using a pre-developed list of relevant keywords. Identified papers were reviewed and selected based on the following eligibility criteria: (1) older adults aged 50 or over as the study population, (2) nonfamily member intergenerational interactions as independent variables, (3) older adults' health-related outcomes as dependent variables, and (4) empirical and quantitative studies performed in the US and written in English. A total of 24 out of 22,674 identified articles met these eligibility criteria. RESULTS All of the 24 studies focused on evaluating intergenerational programs and their intervention effects. No studies addressed community or environmental interventions/effects. Program-based intergenerational interactions showed positive associations with older adults' physical health, psychosocial health (e.g. reduced depression), cognitive function, social relationships, and well-being/quality of life. Moreover, engagement in intergenerational activities was linked with increased physical and social activities. CONCLUSIONS This review showed solid evidence supporting the significance of program-based interventions in promoting intergenerational activities and associated health benefits. Significant knowledge gaps are also found resulting from the lack of studies examining the roles of physical environmental interventions/factors, diverse types of intergenerational interactions, and location-driven activities. Such studies can contribute to a better understanding of the specific attributes, both program-based and place-based supports, of the community environment that can promote intergenerational interactions and healthy aging in place.
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Affiliation(s)
- Sinan Zhong
- Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX, 77843-3137, USA.
| | - Chanam Lee
- Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX, 77843-3137, USA.
| | - Margaret J Foster
- Medical Sciences Library, Texas A&M University, 4462 TAMU, College Station, TX, 77843-4462, USA.
| | - Jiahe Bian
- Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX, 77843-3137, USA.
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Gardiner C, Laud P, Heaton T, Gott M. What is the prevalence of loneliness amongst older people living in residential and nursing care homes? A systematic review and meta-analysis. Age Ageing 2020; 49:748-757. [PMID: 32396600 DOI: 10.1093/ageing/afaa049] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 02/05/2020] [Accepted: 03/02/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND the number of older people living in residential and nursing care homes is rising. Loneliness is a major problem for older people, but little is known about the prevalence of loneliness amongst older people living in care homes. AIM to undertake a systematic review of literature on the prevalence of moderate and severe loneliness amongst older people living in residential and nursing care homes. DESIGN we systematically reviewed the databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Embase, Scopus, Cochrane and Allied and Complementary Medicine Database (AMED) from inception to January 2019. We included all studies reporting data on the prevalence of loneliness amongst older people living in care homes. A random-effects meta-analysis was conducted on all eligible data. RESULTS a total of 13 articles were included, representing 5,115 participants (age range of 55-102 years, mean age 83.5 years, 68% female). There was a significant variation between studies in estimates of prevalence. The prevalence of moderate loneliness ranged from 31 to 100%, and the prevalence of severe loneliness ranged from 9 to 81%. The estimated mean prevalence of 'moderate loneliness' was 61% (95% confidence interval (CI): 0.41, 0.80). The estimated mean prevalence of 'severe loneliness' was 35% (95% CI: 0.14, 0.60). CONCLUSION the prevalence of both moderate loneliness and severe loneliness amongst care home residents is high enough to warrant concern. However, the significant variation in prevalence estimates warrants further research. Future studies should identify which interventions can address loneliness and promote meaningful social engagement to enhance quality of life in care homes.
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Hansen KV. Loneliness among Elderly People: Can Food and Meals Change this Situation? JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09298-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractIn a relationship, it is natural that one person lives longer than the other, leading to many challenges, including the possibility of loneliness. This article focuses on how food and meals can help reduce loneliness among the elderly. There are many reasons for loneliness or emptiness, including being a widow or a widower, illness, and poverty. As the number of elderly people is greatly increasing in all welfare states, meals are an important function that should be maintained throughout life. This study used CurroCus® group interviews, or fast focus groups. Nine CurroCus® groups were conducted, lasting for 37–56 min (average = 45 min). Altogether, 76 persons participated, ranging in age from 60 to 87 years; participants were predominantly female (> 80%). The collected empirical data were recorded, transcribed, and entered into NVivo 11.0. Interviews were analysed using a grounded theory approach. The main findings of this article fall into two main categories: togetherness and life action. Based on the interpretation of respondents’ answers, elderly people make both conscious and unconscious choices that help reduce loneliness. They also gather around food and meals to experience more togetherness. In future research, loneliness strategies carried out unknowingly should be investigated more closely. In addition, elderly participants should self-report on meal activities throughout the day.
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Franssen T, Stijnen M, Hamers F, Schneider F. Age differences in demographic, social and health-related factors associated with loneliness across the adult life span (19-65 years): a cross-sectional study in the Netherlands. BMC Public Health 2020; 20:1118. [PMID: 32758200 PMCID: PMC7409622 DOI: 10.1186/s12889-020-09208-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 07/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recognition of loneliness as a health concern among adults stresses the need to understand the factors associated with loneliness. Research into factors of influence in the various phases of the adult life span (19-65 years) is scarce. Therefore, the associations between demographic, social and health-related factors and loneliness among young (19-34 years), early middle-aged (35-49 years) and late middle-aged adults (50-65 years) were explored. METHODS A secondary analysis with a large cross-sectional dataset was performed. Data was collected from September to December 2016 in the Netherlands, by a self-report survey. Loneliness was measured using the De Jong-Gierveld Loneliness Scale. In total, 26,342 adults (19-65 years) participated (response rate: 34%). Multiple logistic regression analyses were performed to examine associations between demographic, social and health-related factors as independent variables, and loneliness as dependent variable among the three age groups. RESULTS Prevalence of loneliness among young, early and late middle-aged adults was 39.7, 43.3 and 48.2%, respectively. Living alone, frequency of neighbour contact, perceived social exclusion, psychological distress, psychological and emotional wellbeing were consistently associated with loneliness across the groups. The association between ethnicity and loneliness was stronger among young and early middle-aged adults, compared to late middle-aged adults. Young adults showed the strongest association between contact frequency with friends and loneliness. The strength of association between financial imbalance and loneliness gradually decreased from young to late middle-aged adults. Educational level was associated with loneliness among young adults only, while an association between employment status and loneliness was found solely among early middle-aged adults. For late middle-aged adults only, perceived health was associated with loneliness. Frequency of family contact was associated with loneliness, only among early and late middle-aged adults. CONCLUSION This study indicates that factors associated with loneliness across the adult life span may be understood from an age-normative life-stage perspective. Accordingly, there is no one-size-fits-all approach to reduce loneliness among adults, suggesting that a variety of interventions or an indirect approach may be necessary. Future research should focus on causal relations between factors and loneliness in different age groups, using a longitudinal research-design with, preferably, an even broader set of factors.
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Affiliation(s)
- Thanée Franssen
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Postbus 616, Maastricht, 6200 MD, The Netherlands.
| | - Mandy Stijnen
- Department of Health Services of Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Postbus 616, Maastricht, 6200 MD, The Netherlands.,Public Health Service South-Limburg, Academic Collaborative Centre for Public Health, Postbus 33, Heerlen, 6400 AA, The Netherlands
| | - Femke Hamers
- Public Health Service, Postbus 1150, Limburg-North, Venlo, 5900 BD, The Netherlands
| | - Francine Schneider
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Postbus 616, Maastricht, 6200 MD, The Netherlands
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Assari S, Cobb S, Saqib M, Bazargan M. Economic Strain Deteriorates While Education Fails to Protect Black Older Adults Against Depressive Symptoms, Pain, Self-rated Health, Chronic Disease, and Sick Days. ACTA ACUST UNITED AC 2020; 4:49-62. [PMID: 32724902 DOI: 10.29245/2578-2959/2020/2.1203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background A large body of empirical evidence on Minorities' Diminished Returns (MDRs) suggests that educational attainment shows smaller health effects for Blacks compared to Whites. At the same time, economic strain may operate as a risk factor for a wide range of undesired mental and physical health outcomes in Black communities. Aim The current study investigated the combined effects of education and economic strain on the following five health outcomes in Black older adults in underserved areas of South Los Angeles: depressive symptoms, number of chronic diseases, pain intensity, self-rated health, and sick days. Methods This cross-sectional study included 619 Black older adults residing in South Los Angeles. Data on demographic factors (age and gender), socioeconomic characteristics, economic strain, health insurance, living arrangement, marital status, health behaviors, depressive symptoms, pain intensity, number of chronic diseases, sick days, and self-rated health were collected. Five linear regressions were used to analyze the data. Results Although high education was associated with less economic strain, it was the economic strain, not educational attainment, which was universally associated with depressive symptoms, pain intensity, self-rated health, chronic diseases, and sick days, independent of covariates. Similar patterns emerged for all health outcomes suggesting that the risk associated with economic strain and lack of health gain due to educational attainment are both robust and independent of type of health outcome. Conclusion In economically constrained urban environments, economic strain is a more salient social determinant of health of Black older adults than educational attainment. While education loses some of its protective effects, economic strain deteriorates health of Black population across domains. There is a need for bold economic and social policies that increase access of Black communities to cash at times of emergency. There is also a need to improve the education quality in the Black communities.
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Affiliation(s)
- Shervin Assari
- Departments of Family Medicine, Charles R Drew University of Medicine and Science
| | - Sharon Cobb
- School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Mohammed Saqib
- University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Mohsen Bazargan
- Departments of Family Medicine, Charles R Drew University of Medicine and Science.,Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
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