Loneliness, ageism, and mental health: The buffering role of resilience in seniors

Empowering post-stroke older adults through wheelchair development: a conceptual synthesis for stigma reduction and well-being enhancement

Purpose: After a stroke, older adults may encounter social stigma due to their disability and age. This can cause emotions of shame, low self-esteem, and social isolation. The use of assistive devices can make the stigmatizing conditions even more difficult. This study attempts to establish a conceptual framework for designing wheelchairs that can help reduce stigma and improve the well-being of older people with lived experience of stroke.Method: The study utilized the research question construct classification to identify three primary research questions. To address these questions, a bibliographic search was performed using Scopus, Web of Science databases, and PubMed. Articles were selected based on their relevance to the development of wheelchairs and their focus on reducing stigma or enhancing well-being for post-stroke older adults.Results: Seventy articles were chosen to be meticulously reviewed and categorized into sub-themes. This categorization led to the creation of a comprehensive synthesis summary to address each question. The results are further synthesized to formulate a potential theoretical proposition for future investigation. The results suggest enhancing wheelchair design focusing on visibility, symbolism, usefulness, aesthetics, and adaptability through user empowerment and cultural interventions that can effectively reduce stigma, thereby improving the well-being, self-competence, and life quality of post-stroke older adults.Conclusion: The findings offer a design framework for wheelchair innovation specifically aimed at reducing the stigmatizing conditions to improve the well-being of post-stroke older adults through an interdisciplinary perspective. This study suggests further research to explore specific design strategies for wheelchair innovation across various contexts and cultures.

Protective and stress factors for psychological distress: a comparative analysis of LGB and non-LGB older adults

OBJECTIVES

Population ageing raises major public health and psychosocial challenges. Particularly, lesbian, gay, and bisexual (LGB) older people may face increased vulnerabilities and marginalization when compared to their non-LGB (heterosexual) counterparts, which may entail more risks for their mental health. The aim of this study was to comparatively evaluate the levels of protective - social support, spirituality, and resilience and stress factors - loneliness and ageism - among LGB and non-LGB older adults, and their impact on psychological distress (PD).

METHOD

A sample of 647 people aged 60 years or older (M = 66.01; SD = 4.93) was collected, 368 non-LGB and 279 LGB. Participation was carried out through an online survey in Portugal.

RESULTS

LGB older adults had lower scores on all protective factors, except on social support from friends, and higher levels on all stress factors, except on hostile ageism, compared to non-LGB older adults. Further, resilience and loneliness were the main predictors of PD regardless of the sexual orientation. Stress factors explained the levels of PD over and above the effects of protective factors, both among LGB and non-LGB older adults.

CONCLUSION

Psychological distress in aging presents different protective and stressful factors according to the sexual orientation of older adults. More comparative studies are suggested in the intersection between ageing and sexual orientation.

Unequal ageing: the quality of life of senior citizens in the EU before and after COVID-19. A multidimensional approach

Introduction

The ageing population presents a significant demographic and socio-economic challenge for the European Union (EU). Declining fertility rates, coupled with increasing life expectancy, have led to a growing proportion of older individuals within the population, raising concerns about their quality of life. This study aims to assess the quality of life for seniors across EU countries in the years 2015, 2019, and 2022, with a particular focus on the impact of the COVID-19 pandemic. The research seeks to answer the following question: How has the quality of life among seniors in the EU evolved over time, and how has the COVID-19 pandemic affected this trajectory? We hypothesize that the pandemic has exacerbated existing socio-economic inequalities, particularly affecting the most vulnerable older populations.

Methods

This study utilises the Synthetic Measure of Senior Quality of Life (SMSQoL) to evaluate the living conditions of seniors across four critical domains: health, finances, social relations, and environment. Data for the analysis were drawn from Eurostat and national statistical reports, complemented by pilot studies conducted in selected EU countries. The pilot studies focused on gathering qualitative data to supplement the quantitative measures, especially in areas where standardised data were incomplete or unavailable. The assessment spans three years: 2015 (pre-pandemic baseline), 2019 (immediate pre-pandemic), and 2022 (post-pandemic). The analysis includes 27 EU member states and uses both descriptive and inferential statistical methods to evaluate trends and disparities. Cross-sectional analysis was applied to examine the impact of differing social policies, levels of social security, access to healthcare, and economic strength across these countries.

Results

The analysis reveals significant disparities in the quality of life among seniors across EU countries, with pronounced differences between regions. In particular:Northern and Western Europe: seniors in these regions generally experienced improved overall life quality over the observed period. Countries such as Sweden and Germany reported gains in health, financial stability, and social relations, largely due to strong social policies and robust healthcare systems.Eastern Europe: Seniors in Eastern European countries, including Romania and Bulgaria, continued to face substantial challenges, with minimal improvements in quality of life. Economic instability, limited access to healthcare, and weaker social security systems were identified as key contributors to this stagnation.Impact of COVID-19: the pandemic exacerbated existing inequalities, particularly in the domains of social relations and finances. Seniors in economically vulnerable regions were disproportionately affected by social isolation and reduced income, intensifying the pre-existing challenges in their living conditions.Quantitative analysis confirmed that while some regions showed resilience, the most vulnerable populations experienced a sharp decline in their overall quality of life, particularly between 2019 and 2022.

Discussion

The findings from this study highlight the persistence of economic and social inequalities in the life conditions among seniors across the EU. While countries in Northern and Western Europe have made strides in improving senior living conditions, Eastern Europe continues to face significant challenges. The COVID-19 pandemic acted as a catalyst, exacerbating these inequalities, particularly in terms of social isolation and financial insecurity. These results align with previous studies that have highlighted the uneven impact of social policies and economic strength on senior well-being across Europe. The disparities underscore the need for more balanced and equitable policy interventions that can address the vulnerabilities of older populations, particularly in regions struggling with economic instability. Future research should focus on longitudinal studies that track the recovery trajectories of seniors post-pandemic and assess the effectiveness of policy measures aimed at mitigating these disparities.

A cross-sectional network analysis of successful aging in a resilience-based framework

Aging inevitably gives rise to many challenges and transitions that can greatly impact our (mental) well-being and quality of life if these are not controlled adequately. Hence, the key to successful aging may not be the absence of these stressors, but the ability to demonstrate resilience against them. The current study set out to explore how resilience and successful aging may intersect by investigating how various resilience capacity-promoting (protective) and resilience capacity-reducing (risk) factors relate to mental well-being and quality of life. Through a large-scale (N = 2000, age 55+, 30 factors) network analysis, we established the interplay between risk/protective factors from various domains, including demographics, (mental) health, (environmental) stress, lifestyle, coping/personality, and ageism. We revealed some unique pathways through which each of these factors contribute to individuals' mental well-being and/or quality of life, and interpreted these findings in terms of a resilience-based framework of successful aging. Our findings emphasize the complexity of factors that can impact quality of life and mental well-being in later life and can steer researchers and practitioners in devising efficacious, multi-pronged interventions that target risk and protective factors simultaneously, thereby maximizing their potential in boosting beneficial outcomes among older individuals.

S, R. B, P. JR, B. M. Evaluating the impact of tai chi therapy on stress reduction among older adults

This study investigates the effectiveness of Tai Chi therapy in reducing stress among older adults in selected community areas of Mehsana District. A quasi-experimental pre-test and post-test design was used with 60 participants aged 60-80, divided into experimental and control groups. The experimental group practiced Tai Chi therapy under supervision for 14 days, while the control group received no intervention. Stress levels were measured using the Perceived Stress Scale (PSS) before and after the intervention. Results showed a significant reduction in stress in the experimental group, with the mean pre-test score of 27.2 dropping to 10.1 post-intervention. In contrast, the control group showed no significant change. The t-test results confirmed Tai Chi's effectiveness in reducing stress (t = 10.43, p < 0.05) for the experimental group, with no significant association between stress reduction and demographic variables. These findings support Tai Chi as a beneficial intervention for managing stress among older adults.

The Long-Lasting Effect of Multidisciplinary Interventions for Emotional and Social Loneliness in Older Community-Dwelling Individuals: A Systematic Review

BACKGROUND

Loneliness can occur at any age, but it is more prevalent among older adults due to the associated risk factors. Various interventions exist to improve this situation, but little is known about their long-term effects. Our aims were to determine if these interventions have long-lasting effects and for how long they can be sustained. Additionally, we aimed to analyze if the interventions carried out by volunteers affected the outcomes regarding loneliness and psychological impact.

METHODS

A systematic review was performed by searching the literature in the MEDLINE PubMed, SCOPUS, Web of Science, PsycINFO, and Web of Science databases for interventions focused on the lonely population. The inclusion criteria for this review were the assessment of loneliness using a validated tool, and loneliness being the primary or secondary outcome. The CASPe checklist was used to assess the risk of bias in the selected studies, and the PRISMA-ScR recommendations were followed to present and synthesize the results.

RESULTS

Thirty articles were included. The interventions identified were classified into five categories: psychosocial, technological, health promotion, physical exercise, and multicomponent interventions. Loneliness improved in 24 studies during the post-intervention analysis. Social connectivity and depressive symptoms also improved in most interventions. Long-term follow-ups were conducted with positive results in a total of 16 interventions. Depressive symptoms and social connectivity were also improved. Eight of the interventions were carried out by volunteers and showed good results regarding loneliness.

CONCLUSIONS

The results obtained in this work suggested that multidisciplinary interventions can reduce loneliness, but more controlled clinical studies are needed.

Mediating effect of social support and resilience between loneliness and depression in older adults: A systematic review and meta-analytic structural equation modeling

BACKGROUND

Loneliness is a powerful stressor for depression in older adults, and resilience and social support may mediate this relationship, while the evidence is limited. Hence, our study aims to explore the mediating role of social support and resilience between loneliness and depression and to test possible moderators.

METHODS

We searched 12 databases without language and publish time restrictions and obtained the correlation coefficients. This review constructed two-stage meta-analytical structural equality modeling (MASEA) to test the mediating effect of social support and resilience. Additionally, use one-stage MASEA to test the moderator effect of women proportion, published year, and country of study.

RESULTS

This study included 53 studies and 40, 929 older adults. Loneliness directly affected depression (β = 0.28, 95 % CI: 0.20, 0.36). Social support (β = 0.06, 95 % CI: 0.02, 0.09) and resilience (β = 0.15, 95 % CI: 0.12, 0.18) mediated the relationship. The proportion of women in the sample was moderator (χ2(5) = 11.10, p = 0.05). When the proportion exceeded 60 %, the path coefficient of loneliness and social support (β = -0.45, SE = 0.055) was larger than that of the subgroup below 60 % (β = -0.32, SE = 0.041).

LIMITATIONS

It was indefinite whether the evidence would be supported in longitudinal designs. Influenced by the original research data, it is impossible to calculate the model parameters of gender discrepancy.

CONCLUSIONS

Health aging policy-makers adopting social support and resilience intervention will help strengthen the coping skills of older adults confronting loneliness and reduce the risk of depression.

Exploring Social Support Strategies and Socio-Cultural Factors Influencing Social Isolation and Loneliness: The Role of Digital Literacy

BACKGROUND/OBJECTIVES

Social isolation (SI) and loneliness (L) are the long-standing critical concerns impacting the mental well-being of older adults. The COVID-19 pandemic has exacerbated existing vulnerabilities, leading to a notable rise in perceived social isolation (PSI) and its associated risks among an aging population. Reportedly, nearly 35% of older Americans felt lonely before the pandemic, with the pandemic further intensifying these feelings. This commentary examines the multifaceted factors contributing to PSI, including demographic and socio-economic characteristics.

METHODS

We outline the health risks associated with PSI, including cardiovascular diseases and mental health conditions.

RESULTS

This commentary addresses the potential of information and communication technology (ICT) to alleviate loneliness, despite significant barriers such as the digital divide and technological anxiety among older adults.

CONCLUSIONS

This commentary advocates targeted digital literacy interventions and theoretical frameworks to enhance technology adoption and mitigate PSI, ultimately aiming to improve health outcomes and quality of life for the aging population.

Family Resilience in Primary Caregivers of Children Who Are Deaf and Hard of Hearing

PURPOSE

This study aimed to investigate family resilience-defined as the capacity of a family to harness its collective strengths and resources to recover from and adapt to significant adversities or crises effectively-in primary caregivers of children who are deaf and hard of hearing (cDHH) and its association with quality of life, life satisfaction, perceived social support, and loneliness.

METHOD

The study involved 108 primary caregivers of cDHH and 139 primary caregivers of children with normal hearing. Participants underwent psychometric evaluations including the Family Resilience Scale, World Health Organization Quality of Life Assessment-Brief Form, Satisfaction with Life Scale, UCLA Loneliness Scale, and Multidimensional Scale of Perceived Social Support.

RESULTS

Significant differences were found in almost every scale and its subdimension between the two groups (p < .05). Correlation analysis revealed significant correlations between all scale total scores for both groups (p < .05, .153 < | r | < .737). Quality of life was found to be a significant predictor of family resilience, F(1, 139) = 41.824, R2 = .279, B = 0.495, t = 6.467, p < .001.

CONCLUSIONS

Our study highlights the significant impact of having cDHH on caregivers' family resilience, quality of life, life satisfaction, feelings of loneliness, and perceived social support. The results underscore the importance of enhancing caregivers' quality of life as a potential strategy to improve their family resilience. Further research is needed to understand the complex interplay of factors influencing these outcomes.

Translation, Cross-Cultural Adaptation, and Validation of the Fear of Dependency Scale Into European Portuguese

BACKGROUND

Dependency is defined as a person's inability to meet basic human needs. In the context of aging, biopsychosocial changes compromise functionality, predisposing older adults to rely on others to perform daily activities. Fear of dependency describes the fear people have of appearing and/or being weak and/or reliant on others. The Fear of Dependency Scale (FDS), developed by Adams-Price and Ralston in 2016, aims to assess the fear of dependency by measuring an individual's attitudes toward being helped.

OBJECTIVE

This study presents a European Portuguese version of the FDS and examines its psychometric properties (internal consistency reliability and content validity).

METHODS

The translation and both cultural and linguistic adaptation of the FDS were performed by a panel of experts. A cross-sectional study was then performed to evaluate the psychometric properties (in terms of its reliability and validity) of the translated version of the FDS among a sample of 100 community-dwelling older adults.

RESULTS

The European Portuguese version of the FDS exhibited good psychometric properties. The scale's internal consistency was 0.84.

CONCLUSIONS

The European Portuguese version of the FDS is a reliable, valid, and practical instrument for assessing the fear of dependency in older adults in the Portuguese population. It can be used in the context of health care provision and research.

Exploring the mediating influence of acceptance of change: A study on gerontechnology acceptance, mental well-being, and urban-rural disparities among older adults

BACKGROUND

The global aging population necessitates leveraging technology for older adults' independence and mental well-being. Gerontechnology, tailored for older users, thrives when accessible and accepted, with the pivotal role of acceptance of change shaping its adoption.

AIMS

This study investigates the mediating role of acceptance of change in the relationship between gerontechnology acceptance and mental well-being among older adults and explores disparities in urban and rural settings DESIGN & METHODS: A cross-sectional, correlational design adhering to STROBE guidelines collected data through an interview survey from 802 older adults. Instruments included the Older Adult Structured Survey, Short Version of Senior Technology Acceptance, Acceptance of Change Scale, and the World Health Organization Well-Being Index.

RESULTS

The results underscore a significant correlation between technology adoption, adaptability, and mental well-being among 60-year-olds and older. Notably, an individual's openness to change significantly influences the technology-mental well-being relationship, emphasizing its impact on overall health. Urban areas exhibit a stronger positive correlation between technology acceptance and mental well-being, whereas rural regions demonstrate a more pronounced negative correlation.

CONCLUSION

This research contributes valuable knowledge for addressing the unique challenges older adults face in diverse geographic settings, paving the way for targeted and effective initiatives.

IMPLICATIONS

Nurses should prioritize understanding the nexus between gerontechnology acceptance, change adaptability, and mental wellness, integrating technology education and culturally sensitive interventions to enhance care strategies for older adults in diverse geographic settings. This study lays the groundwork for developing person-centered geriatric nursing care plans, underscoring the importance of harnessing technology for improved mental well-being.

Best practices for implementing a technology-based intervention protocol: Participant and researcher considerations

Technology-based interventions present a promising approach to support health and wellness for older adults with a range of cognitive abilities. Technology can enhance access to interventions and support scaling of programs to reach more people. However, the use of technology for intervention delivery requires particular attention to users' needs and preferences and ensuring the materials are adaptable and supportive of a diverse range of technology proficiency levels. We share best practices based on lessons learned from the deployment of a randomized controlled trial (RCT) wherein we delivered an 8-week social engagement intervention through a video technology platform called OneClick for older adults with varying cognitive abilities. We developed a set of best practices and guidelines informed by the lessons learned through this RCT implementation. Technology-based interventions require attention to the application (e.g., video calls), system requirements (e.g., system memory, broadband internet), training (e.g., adaptability based on user competency), and support (e.g., handouts, live contact). These best practices relate to user needs; training design; personnel responsibility; structuring delivery and content; and evaluating success. These research-based best practices can guide the design, development, and implementation of technology-based interventions to support older adults with varying cognitive abilities.

Adverse childhood experiences (ACEs), resilience, and outcomes in older adulthood: A scoping review

BACKGROUND

Previous research has demonstrated a dose-response relationship between exposure to adverse childhood experiences (ACEs) and adverse outcomes in adulthood. Despite widely known associations, previous reviews have primarily focused on outcomes in younger and middle-aged adults exposed to ACEs to the exclusion of older adults and do not consider the potential role of resilience for understanding outcomes in older adulthood.

OBJECTIVE

The present scoping review aimed to examine the extent and nature of existing literature on the influence of ACEs and resilience on the cognitive, physical, mental, and social health outcomes among older adults.

METHODS

We conducted a search of five electronic databases (CINAHL, MEDLINE, PsycINFO, AgeLine, Scopus) using the following keywords: adversity, resilience, aging, and older adults. We limited our inclusion criteria to works published in English or French after 1998 as Felitti et al. published the first study describing ACEs in this year.

RESULTS

Of the 4926 studies screened, 27 studies met the inclusion criteria. Overall, results from the included studies indicated that exposure to adversity during childhood was associated with worse outcomes in older adulthood. Additionally, we found that resilience and resiliency-related factors (e.g., problem-focused coping strategies) mitigated or reduced harms associated with ACEs to improve outcomes in older adulthood.

CONCLUSIONS

Exposure to ACEs is associated with reduced functioning in later adulthood. Findings from this review indicate a need for further exploration into the role of ACEs, and the potential effects of resilience, on health outcomes in older adults to develop better individual- and population-level interventions for this group.

The Role of Age in Adult ADHD Quality Care: A Longitudinal Analysis of Electronic Health Record Data

OBJECTIVE

Several studies have shown that Adult ADHD presents differently in younger and older adults. We sought to assess the difference in care between these two groups using previously identified quality measures (QMs).

METHODS

Using electronic health record data, we matched a younger group of ADHD patients to an older group. We then assessed the achievement of the QMs using probit models with and without interaction terms.

RESULTS

The majority of QMs shown an increase in achievement for both groups over time. However, significant differences in quality of care between younger and older adult ADHD patients persisted. By the end of the study period, with the exception of three QMs, younger patients achieved the QMs more.

CONCLUSION

While, in general, the quality of care for adult ADHD increased from 2010 to 2020, there were still differences in care between younger and older adult ADHD patients.

The dhikr and the mental health of the elderly in Aceh, Indonesia

Background

The ageing population in Indonesia is increasing. However, biological and social changes and declines may trigger mental health problems among the elderly. Existing data show that the prevalence of mental health problems (depression) among the elderly in Indonesia is above 15%.

Aim

This study aims to investigate the relationship between the Majelis Zikir (dhikr assembly) and the mental health of the elderly.

Setting

The research was conducted in Aceh Barat District, Aceh Province, Indonesia.

Methods

This study uses a retrospective cohort design. The study sample consists of individuals aged 60 years or older. The total sample size was 114 (57 exposed and 57 unexposed groups). The research instrument was in the form of a questionnaire.

Results

The respondents had an average age of 67.61 years, with more females (63.2%), more educated (67.5%), more unemployed (71.1%) and 61.4% felt that their income was sufficient. The analysis showed that the relative risk value of members of the dhikr assembly was 1.857 (95% CI: 1.266-2.724) and showed a significant relationship between the dhikr assembly and mental health.

Conclusion

Dhikr, as one of the forms of religious activities in Islam, has a positive role in older people's mental health. Elderly members of the dhikr assembly are likelier to achieve better mental health.

Contribution

The findings in this study can assist healthcare professionals and policymakers in their efforts to maintain and improve the mental health of the elderly through dhikr.

Mitigating the Harmful Impact of Ageism among Older Individuals: The Buffering Role of Resilience Factors

Frequent exposure to ageism has significant repercussions on the quality of life and mental well-being/health of older adults. Resilience may play a crucial role in mitigating these effects. The current study aimed to investigate the potential buffering roles of two types of coping variables-behavioral coping and a positive appraisal style-in older adults (N = 2000, aged 55-93). Confirming previous findings, higher levels of perceived negative ageism (PNA) were associated with diminished quality of life and mental well-being, increased depression and loneliness. However, individuals that tend to employ behavioral coping strategies when confronted with challenging/stressful situations showed a weaker relationship between PNA and quality of life, mental well-being, and depression. Embracing a positive appraisal style attenuated the negative impact of PNA on feelings of depression and loneliness. Interestingly, younger older adults appeared to benefit the most from these resilience factors. Despite considerable inter-individual variability, encouraging the utilization of behavioral coping strategies and nurturing a positive appraisal style could serve as effective approaches to mitigate the detrimental effects of PNA.

Exposure to Violence in Social Unrest, Resilience, and Mental Health of Older People in Hong Kong

OBJECTIVE

Older adults are prone to the negative effects of exposure to violence on their mental health. This study aimed to examine the impact of exposure to violence during social unrest and the role of resilience in the mental health of older people.

DESIGN

A total of 1,203 people aged 65 years or older were randomly selected for a telephone survey using the random digit dialing numbering method in Hong Kong.

MEASUREMENTS

A 13-item scale was developed to measure exposure to violence. The Chinese versions of the Connor-Davidson Resilience Scale and the Startle, Physiological Arousal, Anger, and Numbness scales for measuring mental health status were adopted in the survey.

RESULTS

The results showed that the more frequently older people were exposed to information, the more negative mental health status they had. However, exposure to witnessing and experiencing violence was not significantly associated with mental health status. Older adults' level of resilience had a moderating effect between exposure to information and mental health, whereas the effect of exposure to information on mental health was stronger for respondents with lower resilience.

CONCLUSION

This study showed that emotional problems caused by exposure to related information among older people should be properly addressed during massive social unrest and conflict. Their resilience capacity is an important moderating factor. Future interventions and support services should focus on enhancing the resilience of older people to better equip them with overcoming problems related to macro-social issues.

Changes in perceived ageism during the COVID-19 pandemic: impact on quality of life and mental well-being among Dutch adults aged 55 and older

Objectives: The COVID-19 pandemic brought ageism to the forefront of public discourse. Negative ageism incurs more negative self-perceptions of aging, which affects physical and mental functioning. Whether negative ageism as perceived and experienced by older adults has worsened as the pandemic lingered, and how such changes impact quality of life (QoL) and mental well-being (MWB), remain urgent questions.Method: In a sample of adults aged 55 or older (n = 500), we aimed to address this by administering the Perceived Ageism Questionnaire twice during the pandemic (T1: between October 2020 and May 2021; T2: on average 45 wk after T1).Results: Higher levels of perceived negative ageism were associated with lower QoL and MWB, at least partially through its unfavorable effects on self-perceptions of aging, even after controlling for ageism experiences in the preceding year (at T2, corrected for T1). Furthermore, we found that perceived negative ageism increased from T1 to T2, which had negative implications for QoL/MWB. Opposite effects were found for perceived positive ageism, although less consistently.Conclusion: These patterns reveal that ageism as perceived and experienced by adults of 55 or older became stronger and more negative throughout the COVID-19 pandemic, which had detrimental implications for individuals' QoL and MWB. These disconcerting findings emphasize the importance of combatting negative ageism in our society.

Aerobic Fitness as an Important Moderator Risk Factor for Loneliness in Physically Trained Older People: An Explanatory Case Study Using Machine Learning

BACKGROUND

Loneliness in older people seems to have emerged as an increasingly prevalent social problem.

OBJECTIVE

To apply a machine learning (ML) algorithm to the task of understanding the influence of sociodemographic variables, physical fitness, physical activity levels (PAL), and sedentary behavior (SB) on the loneliness feelings of physically trained older people.

MATERIALS AND METHODS

The UCLA loneliness scale was used to evaluate loneliness, the Functional Fitness Test Battery was used to evaluate the correlation of sociodemographic variables, physical fitness, PAL, and SB in the loneliness feelings scores of 23 trained older people (19 women and 4 men). For this purpose, a naive Bayes ML algorithm was applied.

RESULTS

After analysis, we inferred that aerobic fitness (AF), hand grip strength (HG), and upper limb strength (ULS) comprised the most relevant variables panel to cause high participant loneliness with 100% accuracy and F-1 score.

CONCLUSIONS

The naive Bayes algorithm with leave-one-out cross-validation (LOOCV) predicted loneliness in trained older with a high precision. In addition, AF was the most potent variable in reducing loneliness risk.

Double Stigma in Portuguese Lesbian, Gay, and Bisexual Older Adults: A Study of Health Status

The double stigma-sexual stigma and ageism-can affect the health status of lesbian, gay, and bisexual (LGB) older adults, but little is known about this topic in Portugal and internationally. The aim of this study was to assess the health status and the prevalence of chronic diseases of Portuguese LGB older adults, as well as to assess the relationship between double stigma and health status. A sample of 280 Portuguese LGB older adults completed a chronic disease questionnaire, the Homosexuality-Related Stigma Scale, the Ambivalent Ageism Scale, and the SF-12 Short Form Health Survey. A structural equation model was performed using the double stigma variables as independent variables and health status as outcome. The mental health status of Portuguese LGB older adults was lower when compared to people from studies from more than 10 countries. Higher sexual self-stigma, sexual enacted stigma related to health care, and benevolent ageism significantly explained the worse general health status. The double stigma significantly affects the health status of these older adults in a profile of internalization of sexual stigma and benevolent age discrimination, and not necessarily by a hostile/aggressive profile. More research is needed on the double stigma.

Discrimination, stigma and mental health: what's next?

Stigma and discrimination are a major ongoing problem in the field of mental health as these impact on patient outcomes, access to and acceptability of therapeutic interventions, their quality of life, general wellbeing, social inclusion and opportunities. Social stereotypes, culture and prejudices all contribute to continuing discrimination in mental health. Different settings where people function may also be sources of discrimination such as work and educational environments. The lack of knowledge and understanding of mental health/illness by individuals, their families, carers and policymakers as well as the social media reporting also impact on social attitudes to discrimination. It has been also described a relevant impact of stigma among specific social minorities reporting poor mental health such as elderly people, youths, sexual variants, persons with disability. Educational programs, raising awareness trainings and proper public policies may be developed in order to reduce stigma at social level with favourable outcomes for people with mental illness.

Impact of COVID-19 Confinement on Mental Health in Youth and Vulnerable Populations: An Extensive Narrative Review

The objective of this narrative review is to analyze the impact of COVID-19 on the mental health of particularly vulnerable groups. This information will allow a better understanding of the determining factors that influence the appearance and/or maintenance of mood disorders. To achieve the main objective of this study, a critical review was carried out in which primary sources such as scientific articles, secondary sources such as databases, and other appropriate reference indexes were considered. The results indicated that there was an increase in the diagnosis of mood disorders and the use of medication associated with these disorders, mainly during the period of reclusion that was declared worldwide in March 2020. In addition, risk factors such as loneliness, a lack of resilience, and a lack of adequate coping strategies negatively impacted these groups. The future consequences of this may be reflected over many years thereafter, and it is important that all data obtained from this point forward be considered by mental health professionals and the general population. This review can be a starting point for looking directly at the most vulnerable populations and considering both the resources available to them and the possible aftermath of a traumatic period in everyone’s lives.