Association between willingness to participate in physical and social activities and loneliness in older adults: A stratified analysis by social isolation status

Sex differences in the relationship between exercise habits and loneliness among older adults: a cross-sectional study

BACKGROUND

Although loneliness has been associated with reduced physical activity, the association between exercise habits and loneliness remains unclear.

METHODS

This study examined whether exercise habits are associated with loneliness among older adults by sex. This study included 10 152 individuals. The University of California Los Angeles Loneliness Scale was used to measure loneliness, with a score of 44 or more defined as loneliness. Information on exercise habits during the year was obtained using a questionnaire on whether participants performed 14 types of exercise. Binomial logistic regression analysis was conducted, with loneliness as the dependent variable and exercise habits as the independent variable.

RESULTS

Overall, 3591 people (35.4%) were lonely, with more males (43.9%) experiencing loneliness than females (28.3%) (P < 0.05). Binomial logistic regression analysis stratified by sex showed that the following exercise types were associated with loneliness among males (odds ratio (95% confidence interval): golf, 0.77 (0.67-0.89); gymnastics, 0.86 (0.75-0.99); exercise circle, 0.77 (0.65-0.91); and team games, 0.76 (0.63-0.90), P < 0.05). In contrast, no association was found between exercise habits and loneliness among females (P > 0.05).

CONCLUSIONS

Loneliness was reduced among males through certain exercise practices. Group exercise interventions may effectively prevent loneliness among males, who are more likely to feel lonely than females.

Association between willingness to exercise and incident disability in older adults: a prospective longitudinal cohort study

PURPOSE

To investigate whether the willingness to exercise (WTE) and exercise habits affect the incidence of disability among older adults.

METHODS

This study included 8,354 individuals (72.5 ± 6.2 years, 55.9% female). The participants were divided into three categories based on their WTE: unwillingness to exercise, willingness to exercise (but without exercise habits), and exercise habits. The incidence of disability was prospectively determined within 24 months of the follow-up. Cox regression analysis was used to examine the relationship between WTE and the incidence of disability.

RESULTS

Overall, 600 (7.2%), 4,703 (56.3%), and 3,051 (36.5%) participants were classified as unwillingness to exercise, willingness to exercise, and exercise habits, respectively. Compared with the unwillingness to exercise group, the willingness to exercise group (hazard ratio [HR] 0.71, 95%Confidence Interval [CI] 0.52-0.96) and the exercise habits group (HR 0.65, 95%CI 0.46-0.92) had a lower risk of disability incidence.

CONCLUSIONS

These results suggest that WTE reduces the risk of disability in older adults. Therefore, the importance of increasing WTE to prevent the occurrence of disabilities is clear. Our results suggest that even though physical activity declines with age, it is important to have the desire to exercise and develop exercise habits.

Dancing with care: promoting social integration and participation in community activities for older adults

Background

It is common for older adults to move to urban communities after retirement, living with their adult children and caring for grandchildren in China. This impacts their social networks and, consequently, their psychological and physical health. However, research on proactive ways to mitigate the negative effects of social dislocation is lacking. This study examined how dancing with care (DWC), a new form of preventative care, promotes social integration among older adults in Chinese communities, focusing specifically on participants' experiences related to community engagement, mutual support, volunteer activity, social connections, and advanced learning through their involvement with DWC.

Methods

Semi-structured interviews were conducted with 60 older adults who regularly participated in DWC in communities in southern China.

Results

DWC's dimensions play a vital role in addressing the social integration of older adults. Through DWC, older adults participate in community activities, engage in mutual support, volunteer in various activities, develop social connections, and learn different things, including the use of advanced technologies.

Conclusion

DWC addresses older people's social integration by providing opportunities to be involved in the community. It provides a promising path for older adults to actively engage in the revival of social capital within their social networks in the community. This study offers valuable insights for enhancing social involvement for older adults.

Study protocol of a sequential, multiple assignment, randomised trial using an adaptive intervention to reduce loneliness among Chinese older adults in Hong Kong

BACKGROUND

Loneliness is a prevalent and alarming issue among older adults that requires effective interventions. While randomised controlled trials have been commonly undertaken to explore reduction in loneliness, there is a growing recognition that a comprehensive treatment strategy involving multiple interventions may yield better outcomes. Therefore, this study aims to develop and identify a two-stage adaptive intervention that combines telephone-delivered behavioural activation (Tele-BA) and mindfulness techniques (Tele-MF) to reduce loneliness in older adults in Hong Kong.

METHODS

A Sequential, Multiple Assignment, Randomised Trial (SMART) design will be adopted. 244 lonely older adults will be recruited from the community and randomly assigned to either one of the 4-week two-stage, embedded adaptive interventions involving different sequences and dosages of Tele-BA and Tele-MF (eg, 4 weeks of Tele-BA followed by booster sessions for responders or 4 weeks of Tele-BA followed by 4 weeks of Tele-BA with motivational component or 4 weeks of Tele-MF for non-responders) based on a set of decision rules. The primary outcome will be loneliness measured by the Revised University of California Los Angeles (UCLA) Loneliness Scale. Secondary outcomes, such as De Jong Gierveld Loneliness Scale, perceived stress, sleep quality and depressive and anxiety symptoms, will be assessed. Adhering to the intention-to-treat principles, the data will be analysed using linear mixed models. The findings may have implications for the development of psychosocial adaptive interventions involving BA and MF to reduce loneliness and improve well-being among older adults in Hong Kong using the SMART design.

ETHICS AND DISSEMINATION

Ethical approval was obtained by the Human Research Ethics Committee at The Education University of Hong Kong (reference: 2022-2023-0117). The findings from this study will be presented in academic conferences and submitted for publication.

TRIAL REGISTRATION NUMBER

ChiCTR2300077472.

The mediating role of loneliness in the effect of physical activity barriers on quality of life

BACKGROUND

This study aims to examine the mediating role of loneliness in the effect of physical activity barriers on quality of life.

METHODS

The sample of the study consisted of 374 people over the age of 65 who applied to a hospital. The data collection tools used in the study are 'Personal Information Form', 'Physical Activity Barriers Questionnaire' 'World Health Organization Quality of Life Instrument-Older Adults Module' and 'Loneliness Scale for the Elderly'. The mediating effect analysis was conducted through the 'Process Macro' developed by Hayes.

RESULTS

According to the obtained results, loneliness mediates the relationship between physical activity barriers and quality of life. Individuals with high levels of loneliness and physical activity barriers have lower levels of quality of life. When the results of the regression analysis indicating the mediating effect were analyzed, it was determined that the effect of physical activity barriers on quality of life were negative and significant. As the level of physical activity barriers increases, the level of quality of life decreases.

CONCLUSION

In conclusion, it was determined that loneliness plays a mediating role in the relationship between physical activity barriers and the level of quality of life. The study results suggest that adopting a physically active lifestyle is important to reduce adverse health outcomes in the elderly.

Association between illness perception and social alienation among maintenance hemodialysis patients: The mediating role of fear of progression

PURPOSE

This study aimed to investigate the mediating role of fear of progression on illness perception and social alienation among maintenance hemodialysis (MHD) patients.

BACKGROUND

MHD is frequently accompanied by increased pain and complications such as itchy skin, chronic fatigue, and muscle spasms. Cardiovascular disease rates are also elevated among MHD patients, which can heighten their anxiety regarding prognosis and treatment discomfort. This chronic fear may severely impact social functioning, leading patients to withdraw from interpersonal interactions and experience heightened helplessness and loneliness. Further investigation is necessary to understand the factors behind the high level of social alienation in MHD patients and their underlying mechanisms.

DESIGN

A cross-sectional study guided by the STROBE.

METHODS

A convenience sample of 230 MHD patients were enrolled from January to May 2023. Data including demographic and clinical characteristics, illness perception, fear of progression, and social alienation were collected. Descriptive analysis and Pearson correlations were conducted using IBM SPSS version 25.0. The mediating effect was analyzed using Model 4 of the PROCESS macro for SPSS, with the Bootstrap method employed to assess its significance.

RESULTS

The score of social alienation in MHD patients was high, with illness perception and fear of progression both significantly correlated with social alienation. In the mediating effects model, illness perception can predict social alienation in MHD patients, and fear of progression use plays a part in mediating the process by which illness perception affects social alienation. The Kappa Squared (κ2) value of 21.9%, suggests a medium effect size.

CONCLUSIONS

Illness perception directly predicts social alienation in MHD patients and exerts an indirect effect through the mediating role of fear of progression. Suggests that healthcare professionals should concentrate on MHD patients with high negative illness perceptions to alleviate their fear of progression, thereby decreasing the level of social alienation and enhancing their integration into society.

Risk of dementia with hearing impairment and social isolation

INTRODUCTION

This study aimed to determine whether the concomitance of hearing impairment and isolation with lack of conversation, which is considered self-evident but has not been investigated extensively, is associated with the occurrence of dementia.

METHODS

A total of 2745 participants were divided into four groups according to the presence/absence of hearing impairment and isolation with lack of conversation. The association of dementia with hearing impairment and isolation with lack of conversation was analyzed using Cox proportional hazards regression.

RESULTS

The combined hearing impairment and isolation with lack of conversation (hazard ratio: 1.69, 95% confidence interval: 1.09-2.61) and non-hearing impairment and isolation with lack of conversation (hazard ratio: 1.60, 95% confidence: 1.07-2.39) were associated with the development of dementia.

DISCUSSION

These findings emphasize the importance of promoting high-quality social relationships throughout life by adopting preventive measures against isolation with lack of conversation from the early stage of awareness of hearing impairment.

Highlights

Dementia affects 12.9% of those with hearing impairment and isolation.Hearing impairment and isolation are associated with increased risk of dementia.Addressing these risk factors may help reduce the risk of developing dementia.Preventing isolation and promoting quality social relationships is important.