Social relationships, loneliness, and mental health among older men and women in Ireland: A prospective community-based study

Psychosocial Correlates of Loneliness and Suicidality in the Taiwanese General Population

OBJECTIVES

To estimate the prevalence of loneliness and to investigate the associations between loneliness and suicidality among the general population in Taiwan.

DESIGN

Cross-sectional analysis of random samples in surveys.

SAMPLE

During 2016 and 2017, 2148 and 2098 participants (N = 4246) from a representative sampling of the Taiwanese population were interviewed via the computer-assisted telephone system in Taiwan.

MEASUREMENTS

The study measured demographics, psychological distress, suicide risk factors, and loneliness status (single-item measurement). The association between loneliness and psychosocial factors was analyzed using Spearman's correlation. Logistic regression was applied in the association between loneliness and current suicide ideation.

RESULTS

Around 13.1% in the sample perceived feelings of loneliness. Loneliness status was significantly associated with increased psychological distress and suicide risks. The regression model indicated that the three most significant factors linked to loneliness were "no one trustworthy to talk to" (OR = 3.69), substance abuse (OR = 3.43), and depression (OR = 3.07), whereas self-rated mental health (poor to good) (OR = 4.11), loneliness (OR = 2.59), and depression (OR = 2.09) were associated with current suicide ideation.

CONCLUSION

Loneliness was a significant suicide risk factor with multiple underlying psychosocial influences. Establishing support groups or service referrals through early psychosocial assessment could identify or alleviate loneliness and/or reduce suicide risk.

Combined effects of social isolation and loneliness on disability incidence in older adults

OBJECTIVES

Relationships among social isolation, loneliness, and disability onset remain unclear. We investigated the distinct patterns of disability development among Japanese older adults who experience social isolation and loneliness.

DESIGN

This study applied a prospective observational approach.

PARTICIPANTS

Data from 4,716 community-dwelling independent older adults were analyzed.

MEASUREMENTS

The Japanese version of the University of California, Los Angeles Loneliness Scale Version 3 and the Social Isolation Scale were used to measure loneliness and social isolation, respectively. The long-term care insurer conducted monthly follow-ups with participants over two years to determine their care needs. Disability onset was defined as the point at which participants were certified by a care manager as requiring long-term care.

RESULTS

During the follow-up period, 265 participants (5.6 %) required long-term care insurance certification due to disability onset. The incidence of disability in the lonely and not lonely groups was 8.0 % and 4.5 %, respectively. In the socially isolated and not socially isolated groups, it was 7.1 % and 4.4 %, respectively. The Cox proportional hazards regression model revealed a significantly higher risk of disability incidence in the lonely and socially isolated groups. The high-risk group experiencing both loneliness and social isolation exhibited significantly higher hazard ratios than the low-risk group without these symptoms.

CONCLUSIONS

The results indicated that older adults experiencing both social isolation and loneliness were at high-risk for future disability incidence. This finding provides insight into the complex interplay between social factors and disability, which can contribute to the development of effective interventions to promote healthy aging and prevent disability.

Social networks and their association with depression in community-dwelling older adults: a meta-analysis

Depression is a common mental health condition among older adults, while social networks offer protection. This meta-analysis quantifies the relationship between the structural aspects of social networks and depression in this population. Seven electronic databases were searched from inception until July 2023. Eligible studies focused on community-dwelling older adults (mean age ≥60), defined depression, referenced social networks in the abstract, and were published in English. Random-effects meta-analyses combined standardized beta coefficients for continuous depression outcomes and log odds for binary outcomes. Study quality, heterogeneity and potential publication bias were evaluated. Sixty-one studies met the inclusion criteria. Larger network size, frequent contact, and higher network scale scores were linked to lower depression levels, though effect sizes were modest. Network scales, incorporating structural and functional aspects, showed the strongest association with reduced depression, though this finding was rather suggestive. The distinction between family and friend networks was less significant, with combined measures and family ties showing stronger associations. Gender did not significantly influence the association, and continuous depression measures provided more nuanced insights than binary ones. Social networks offer modest protection against depression in older adults. Future research should standardize depression measures, further investigate gender and network differences, and explore long-term effects.

Traumatic life events as predictors for depression in middle-aged men and women: A Finnish twin study

BACKGROUND

We examined exposure to adulthood traumatic life events (TLEs) and their associations with depression in women and men. Then we examined whether those associations are independent of exposure loading and vulnerability including familial confounding.

METHODS

The fourth survey in 2011 of the population-based Finnish Twin Cohort had 8410 participants (45 % men, mean age 60 years). Using the Center for Epidemiologic Studies Depression (CES-D) scale, depression was defined using a cut-off value ≥20. Participants reported exposure to TLEs during adulthood. Logistic regression adjusted for multiple covariates was used as the individual-based analyses. Familial confounding was tested using conditional logistic regression in 399 twin pairs discordant for depression.

RESULTS

More women (15 %) than men (11 %) were depressed. Men reported more traffic accidents (men: 11.8 %, women: 7.4 %), other serious accidents (11.8 %, 5.8 %), and violent crime (3.1 %, 2.0 %) whereas women reported more sexual assault (0.7 %, 10.6 %). Violent crime (Odds Ratio 3.86; 95 % Confidence Intervals 2.59, 5.73), sexual assault (3.49; 2.67, 4.55), physical assault (3.10; 2.45, 3.93), and other serious accidents (1.36; 1.01, 1.85) were associated with depression. These associations, except other serious accidents, remained significant after adjusting for multiple covariates including shared familial factors. The associations did not differ by sex.

LIMITATIONS

A relatively small set of relevant TLEs was reported retrospectively and the order of TLEs was not assessed.

CONCLUSIONS

Women and men differ in exposure to TLEs but, if exposed, they are equally vulnerable for depression. Because traumatic life events are robustly associated with depression, they should be considered in treatment.

Trends, transitions and patterning in social activity over time among aging women and men: A secondary analysis of the Canadian Longitudinal Study on Aging (CLSA)

Social isolation matters for health and longevity, but little research examines transitions into or out of social isolation or whether transitions are gendered or socially patterned. We described gender-specific trends in breadth and lack of social participation over 6 years overall and by age, country of origin, geographic location, education, wealth, and household income. We used three waves of CLSA data to evaluate changes in social isolation (0-1 activities) and broad social participation (5+ activities) in adults aged 45-75 (n = 24,788), by gender and socio-demographics, in linear and multinomial logistic regressions with post-estimated predicted probabilities. The number of social activities decreased over time, with greater declines for women. About half the sample (more men than women) stayed not highly socially active (<5 activities) and almost 1 in 5 became not highly socially active. Most adults (77 %) remained not socially isolated and 14 % became or remained socially isolated. Women were more likely than men to remain not highly socially active and less likely to have multiple social isolation transitions. Broad social participation changed over time for several subgroups of women and men, with gender differences notable for income levels. Social disparities in social isolation transitions differed by gender only for education. Older age and socioeconomically disadvantaged adults had higher probabilities of becoming socially isolated or becoming less socially active. Findings indicated the diversity of social activities declined as Canadians age into later life and transitions in both social isolation and social participation differed between genders, especially for specific vulnerable subpopulations.

The association of material deprivation with major depressive disorder and the role of loneliness and social support: A cross-sectional study

BACKGROUND

Existing research has highlighted the positive association of material deprivation, loneliness, and poor social support with major depressive disorder (MDD). However, there is limited information on the complex interplay between these risk factors. In this study, we investigated (1) whether loneliness and social support moderate the relationship between material deprivation and MDD and (2) whether social support moderates the association between material deprivation and loneliness.

METHODS

We conducted a cross-sectional study analyzing responses from a representative sample of the Spanish adult population, comprising 2790 individuals who were interviewed between 2019 and 2021. The 12-month prevalence of MDD was assessed using the Composite International Diagnostic Interview (CIDI). Loneliness was measured using the three-item UCLA Loneliness Scale, and social support was evaluated with the Oslo social support scale. Material deprivation was measured using an instrument developed by the Spanish National Institute of Statistics (INE). Regression models were constructed to investigate moderating effects.

RESULTS

About 25 % of participants experienced material deprivation and 2.8 % had MDD. Among those with lower levels of loneliness, the probability of MDD was almost 0.10 and no significant differences were found in relation to material deprivation. Conversely, differences depending on material deprivation ranged from 0.10 (95 % CI 0.03, 0.18) to 0.44 (95 % CI 0.24, 0.65) among those with higher levels of loneliness. Social support effectively moderated the association between material deprivation and loneliness.

LIMITATION

The cross-sectional nature limits causal inferences.

CONCLUSION

Social support has the potential to improve loneliness and mental health in individuals with economic difficulties.

The impact of urban agglomeration planning on depression in older adults

Introduction

The residential environment significantly impacts the mental health of older adults. Urban agglomeration planning, while fostering regional economic development, also influences the psychological well-being of this demographic.

Methods

This study investigates the effects of urban agglomeration planning on depression levels in older adults, utilizing cohort data from the China Health and Retirement Longitudinal Study (CHARLS) and the multi-temporal double-difference-in-differences (DID) model.

Results

Our findings reveal that urban agglomeration planning alleviates depression by enhancing green spaces, improving air quality, and advancing digital infrastructure development. Moreover, these benefits are particularly pronounced among older females, residents of Central and Western regions, and those with lower educational attainment.

Conclusion

Based on our research findings, we recommend expediting the dissemination of urban agglomeration construction experiences to alleviate depression among older adults. In the implementation of policies, it is essential to consider objective conditions such as geographical location and educational level. The formulation of differentiated urban agglomeration planning to promote mental health among older adults.

Temporal associations of emotional and social loneliness and psychosocial functioning in emerging adulthood

Emerging adulthood is an important developmental phase often accompanied by peaks in loneliness, social anxiety, and depression. However, knowledge is lacking on how the relationships between emotional loneliness, social loneliness, social isolation, social anxiety and depression evolve over time. Gaining insight in these temporal relations is crucial for our understanding of how these problems arise and maintain each other across time. Young adults from a university sample (N = 1,357; M = 23.60 years, SD = 6.30) filled out questionnaires on emotional and social loneliness, social isolation, depressive and social anxiety symptoms at three time points within a 3-year period. Random intercept cross-lagged panel models were used to disentangle reciprocal and prospective associations of loneliness subtypes, social isolation, depressive and social anxiety symptoms across time. Results showed that on the within-person level, increases in emotional and social loneliness as well as social isolation predicted higher depression levels on later timepoints. Increases in depressive symptoms also predicted increases in subsequent social loneliness, but not in emotional loneliness. Finally, increases in depressive symptoms predicted increases in social isolation. There were no significant temporal relations between loneliness and social isolation on the one hand and social anxiety symptoms on the other hand. Social distancing imposed by COVID-19 related government restrictions may have impacted the current results. The findings suggest that emotional and social loneliness precede development of depressive symptoms, which in turn precedes development of social loneliness and social isolation, indicating a potential vicious cycle of social loneliness, social isolation and depressive symptoms in emerging adulthood. Social anxiety did not precede nor follow loneliness, depressive symptoms, or social isolation. The current study sheds more light on the temporal order of loneliness and psychopathological symptoms and hereby assists in identifying times where prevention and intervention efforts may be especially helpful to counter development of depression and loneliness.

Alexithymia and attachment on mental health of people with multiple sclerosis: The mediating role of perceived social support and loneliness

BACKGROUND

Multiple sclerosis and its progressive relapsing-remitting nature for MS patients is challenging and significantly affects the mental health of people with MS. We examined the direct effects of alexithymia and attachment on mental health and the indirect effect of attachment, alexithymia, loneliness, and perceived social support on the mental health of people with MS.

MATERIALS AND METHODS

Three hundred and forty-five diagnosed with multiple sclerosis (MS) were deemed eligible for inclusion in the study and selected through the Iranian MS Association. Measures included the Toronto Alexithymia Scale (TAS20), Attachment Style Questionnaire (ASQ), General Health Questionnaire (GHQ28), Social and Emotional Loneliness Scale for Adults (SELSA-S), and Perceived Social Support from Family and Friends Questionnaire (PSS-FA and PSS-F). The mental health of MS patients was analyzed using structural equation models (SEM), examining how alexithymia, attachment, social support, and loneliness, directly and indirectly, affect their mental health. The fit of the model to the data was analyzed using the discrepancy function divided by degrees of freedom (CMIN/DF), Normed Fit Index (NFI), Tucker-Lewis Index (TLI), Comparative Fit Index (CFI), and Root Mean Square Error of Approximation (RMSEA).

RESULTS

The results showed that the model fit was good. Furthermore, findings indicate that 28% (R2 = 0.28) of the mental health changes are explained via study predictors. Alexithymia and attachment directly affect mental health. Attachment style indirectly affects social support and loneliness, while loneliness and family support indirectly affect the mental health of MS patients.

CONCLUSION

The study findings provide valuable insights into the fundamental structures that influence the mental health of individuals with MS. Loneliness and social support are critical mediating factors that significantly impact the mental well-being of these patients. In the times ahead, healthcare professionals must prioritize attachment, alexithymia, social support, and loneliness in their medical and psychological interventions for individuals diagnosed with multiple sclerosis.

A cross-sectional study of the relationship between daily social contact features and the prevalence of common mental disorders in Taiwan, 2000-2015

The aim of this study was to examine the influence of daily contact features on the prevalence of common mental disorders (CMDs) in Taiwan from 2000 to 2015. Data from the Taiwan Social Change Survey for 2000, 2005, 2010, and 2015 were used to examine the relationship between the number and level of familiarity with daily social contacts with the probable CMDs (determined by score of ≥ 3 on a 12-item Chinese Health Questionnaire). Descriptive statistics and multivariable logistic regression analyses were used to assess the association. Among the 7,841 respondents, the prevalence of probable CMDs increased from 18.28% in 2000 to 21.29% in 2015. Multivariable analysis showed that respondents with more daily social contacts were less likely to have probable CMDs in the four observed years adjusting for sociodemographic characteristics and physical health limitations on daily activities in the past two weeks. A negative relationship between probable CMDs and level of familiarity with daily contacts was found in 2000 (OR = 0.67, 95% CI-0.48-0.94) and 2005 (OR = 0.70, 95% CI-0.53-0.93). Findings from our study suggest the development of culturally tailored programs/interventions through features of daily social contacts may reduce the prevalence of CMDs in Taiwan.

Impact of informal social support on the mental health of older adults

Objective

The role of informal social support in fostering active aging within the context of the "silver wave" is significant. This study investigated how such support influenced the mental health of older adults, with the goal of affirming its indispensable contribution to enhancing their psychological well-being.

Methods

Employing Principal Component Analysis (PCA) to construct the informal social support variable, this study rigorously analyzed the effects and underlying mechanisms of informal social support on mental health in older adults, utilizing data from the 2018 China Longitudinal Aging Social Survey (CLASS).

Results

Informal social support exerted a substantial positive influence on the mental health of older adults, particularly among younger, non-agricultural older adult populations who preferred cohabitation with their children. This form of support significantly enhanced mental well-being by elevating life satisfaction, improving access to medical services, and fostering active social engagement.

Conclusion

This study elucidates the role of informal social support in bolstering the mental health of older adults. Future efforts should focus on fostering a supportive environment that enhances older adult care experiences, reforming the healthcare system to better meet the needs of the aging population, and promoting avenues for social engagement, thereby achieving a balanced integration of their emotional and physical care.

Interpersonal interactions, sense of loneliness and perceived depressive emotions among older adults: A cultural-psychological perspective from heterogeneous roles of different relationships

In the context of the "Chinese Differential Mode of Association" in traditional Chinese culture, this paper examines the heterogeneous effects of interpersonal interactions in different relationships on older adults' depressive emotions from a cultural-psychological perspective. Results using data from Chinese General Social Survey demonstrate that: interactions with children are the most helpful in reducing perceived depression for the elderly, followed by communications with siblings and relatives. However, interactions with friends and other fellows do not significantly reduce older people's perceived depression. This reflects the "Chinese Differential Mode of Association" in interpersonal relationships. When using different perceived depression measures, and Double Debiased Machine Learning (DDML) approaches for robustness and endogeneity tests, above findings are very robust. The impact mechanism is that interactions with children and siblings reduce depressive emotions by decreasing older adults' sense of loneliness, while communications with others do not have such a significant effect. This paper further discusses the roles of different types of interactions with adult children. It is found that receiving and providing emotional support can prominently decrease depressive emotions for older people, whereas the effects of monetary support and non-material assistance are less pronounced. In addition, interpersonal interactions' impacts are more significant for those who are female, older than 75 and with poorer health, as well as older people who exercise less frequently, have higher social status, and hold more traditional beliefs. In the current context of active promotion of healthy aging, findings of this paper have important implications for a deeper understanding and scientific management of depressive emotions among the elderly.

Association between the incidence of functional disability and frequency of eating together among older adults living alone: a 6-year follow-up study from the Japan Gerontological Evaluation Study

OBJECTIVE

This study aimed to determine whether the frequency of eating together is associated with the incidence of functional disability in older adults who live alone.

METHODS

This 6-year observational prospective cohort study utilised self-reported questionnaires. Data were drawn from the participants of the Japan Gerontological Evaluation Study project between 2016 and 2022. The participants were independent older adults aged ≥65 years living alone in Japan. The primary outcome was the incidence of functional disability during the follow-up period, with the self-reported frequency of eating together serving as the explanatory variable. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using Cox proportional hazards models after adjusting for confounders associated with incident functional disability.

RESULTS

Among the 7167 participants, the mean age at baseline was 75.3 ± 6.5 years and 69.2% were female. About, 12.8% of participants (n = 917) developed functional disabilities during the observation period. The incidence rates were 11.7% for 'every day', 11.3% for 'several times a week', 11.5% for 'several times a month', 12.7% for 'several times a year' and 19.0% for 'seldom'. The frequency of eating together 'seldom' was significantly associated with an increased incidence of functional disability (HR: 1.55, 95% CI: 1.10-2.18).

CONCLUSION

Among older adults living alone, infrequent eating together ('seldom') was identified as a risk factor for developing functional disability.

The association of social networks and depression in community-dwelling older adults: a systematic review

BACKGROUND AND OBJECTIVE

Depression is a globally prevalent mental condition, particularly among older adults. Previous research has identified that social networks have a buffering effect on depression. Existing systematic reviews have either limited their research to specific geographic areas or provided evidence from over a decade ago. The vast body of recent literature particularly from the last decade emphasizes the need for a comprehensive review. This systematic review aims to analyze the association of structural aspects of social networks and depression in older adults.

METHODS

The electronic databases APA PsycINFO, ProQuest, PSYINDEX, PubMed, Scopus, SocINDEX, and Web of Science were searched from date of data base inception until 11 July 2023. Studies were eligible for inclusion if they reported on community-dwelling older adults (defined as a mean age of at least 60 years old), had an acceptable definition for depression, referred to the term social network in the abstract, and were published in English. Quality was appraised using the Newcastle Ottawa Scale for cross-sectional and longitudinal studies. Outcome data were extracted independently from each study and analyzed by direction of the relationship, social network domain and cross-sectional or longitudinal study design.

RESULTS

In total, 127 studies were included. The study categorizes structural network aspects into seven domains and finds that larger and more diverse networks, along with closer social ties, help mitigate depression. The literature on the relationships between depression and network density, homogeneity, and geographical proximity is scarce and inconclusive. DISCUSSION AND IMPLICATIONS: Despite inconsistent findings, this review highlights the importance of quantifying complex social relations of older adults. Limitations of this review include publication and language bias as well as the exclusion of qualitative research. Further research should use longitudinal approaches to further investigate the reciprocal relationship between social networks and depression. Following this review, interventions should promote the integration of older adults in larger and more diverse social settings. Other: This work was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Grant [454899704]. This systematic review was pre-registered. The review-protocol can be accessed at https://doi.org/10.17605/OSF.IO/6QDPK .

Lonely and scrolling during the COVID-19 pandemic: understanding the problematic social media use and mental health link among university students

Introduction

Undergraduate university students experienced many academic and non-academic stressors during the first year of the coronavirus (COVID-19) pandemic, putting them at a greater risk of negative mental health outcomes. Reports worldwide have shown high incidences of depressive, anxiety, and stress scores among university students at the beginning of the pandemic. Emerging evidence also suggests that to cope with the stress and loneliness of the pandemic, many youth and young adults increased the amount of time they spent on social media platforms.

Methods

Undergraduate students participated in an online study aimed to understand the link between time spent on social media, coping through the use of social media and problematic social media use (PSMU) with mental health symptoms, such as stress, depression, anxiety, and loneliness, during the COVID-19 pandemic.

Results

While time spent on social media was only weakly associated with stress, depression, anxiety and loneliness scores, PSMU more strongly mapped onto these outcomes. Additionally, students who were coping highly using social media displayed elevated stress, depression, anxiety and loneliness levels in comparison to those reporting low levels of coping with social media. Finally, students who reported high levels of coping using social media displayed higher PSMU scores, with this relationship appearing more pronounced in students who had higher levels of loneliness.

Conclusion

These data support evidence that it is not necessarily time spent on social media but rather PSMU that is relevant for mental health symptoms, and that PSMU is exacerbated by loneliness. Moreover, the current results highlight the effects of maladaptive coping on mental health symptoms and PSMU among university students during the COVID-19 pandemic.

Elevated Risk of Dementia Diagnosis in Older Adults with Low Frequencies and Durations of Social Conversation

Background

Social networks and social participation have protective effects on cognitive function maintenance and Alzheimer's disease and general dementia development.

Objective

We aimed to investigate the association between conversations and dementia incidence in older adults.

Methods

This longitudinal prospective cohort study used population data from the National Center for Geriatric and Gerontology-Study of Geriatric Syndromes (NCGG-SGS) from September 2015 to February 2017. The database included 4,167 individuals in Japan aged ≥60 years who were generally healthy and without major cognitive impairment. Participants were classified into two groups according to six daily conversation measures at baseline. The conversation index was calculated as a composite score for these measures. Participants were tracked monthly over 60 months for new-onset dementia.

Results

Data from 2,531 participants were analyzed (72.7±6.7 years; range: 60-96 years). Dementia incidence per 1,000 person-years was 15.7 (95% confidence interval, 13.6-18.1). The Youden index determined the cut-off point for dementia incidence, with a conversation index of 16/17 points. The low conversation group included more participants with new-onset dementia. Cox proportional hazards regression crude models showed remarkable relationships between dementia onset and specific conversation measurements, including conversation index. According to the Cox regression adjusted model, the cut-off point of the conversation index showed only a remarkable relationship with dementia onset.

Conclusions

Dementia risk was extensively associated with low daily conversation statuses. The assessment of conversational factors may be useful as a risk indicator for the development of Alzheimer's disease and general dementia.

The Association between Adverse Childhood and Adulthood Experiences, Social Isolation, Loneliness, and Depression among Young Adults in South Korea

This study examined the association between social isolation, loneliness, and depressive symptoms among young adults in South Korea after controlling for sociodemographic variables, adverse child and adult experiences, and perceived health status. The researcher analyzed the data of 2014 young adults aged 18-34 years from the Youth Social Economic Survey using hierarchical multiple regression analysis conducted with IBM SPSS Statistics 28.0. Among the sociodemographic variables, sex, education, and household income were significantly related to depressive symptoms. Females reported higher levels of depressive symptoms than males, and those attending college or having a college (or higher) degree reported lower levels of depressive symptoms than those with a high-school diploma or lower. Higher household income was associated with lower levels of depressive symptoms. Perceived health status was negatively associated with depressive symptoms, while adverse childhood and adulthood experiences, social isolation, and loneliness were positively associated with it. Among the major independent variables, loneliness was most strongly related to depressive symptoms, whereas social isolation had the weakest relevance to it. The prediction model proposed explained 32.7% of the variance in depressive symptoms and was considered good. Therefore, focusing on loneliness may be more important than focusing on social isolation to prevent and deal with depressive symptoms among young adults.

Punicalagin's Protective Effects on Parkinson's Progression in Socially Isolated and Socialized Rats: Insights into Multifaceted Pathway

Parkinson's disease (PD) is a gradual deterioration of dopaminergic neurons, leading to motor impairments. Social isolation (SI), a recognized stressor, has recently gained attention as a potential influencing factor in the progress of neurodegenerative illnesses. We aimed to investigate the intricate relationship between SI and PD progression, both independently and in the presence of manganese chloride (MnCl2), while evaluating the punicalagin (PUN) therapeutic effects, a natural compound established for its cytoprotective, anti-inflammatory, and anti-apoptotic activities. In this five-week experiment, seven groups of male albino rats were organized: G1 (normal control), G2 (SI), G3 (MnCl2), G4 (SI + MnCl2), G5 (SI + PUN), G6 (MnCl2 + PUN), and G7 (SI + PUN + MnCl2). The results revealed significant changes in behavior, biochemistry, and histopathology in rats exposed to SI and/or MnCl2, with the most pronounced effects detected in the SI rats concurrently exposed to MnCl2. These effects were associated with augmented oxidative stress biomarkers and reduced antioxidant activity of the Nrf2/HO-1 pathway. Additionally, inflammatory pathways (HMGB1/RAGE/TLR4/NF-ᴋB/NLRP3/Caspase-1 and JAK-2/STAT-3) were upregulated, while dysregulation of signaling pathways (PI3K/AKT/GSK-3β/CREB), sustained endoplasmic reticulum stress by activation PERK/CHOP/Bcl-2, and impaired autophagy (AMPK/SIRT-1/Beclin-1 axis) were observed. Apoptosis induction and a decrease in monoamine levels were also noted. Remarkably, treatment with PUN effectively alleviated behaviour, histopathological changes, and biochemical alterations induced by SI and/or MnCl2. These findings emphasize the role of SI in PD progress and propose PUN as a potential therapeutic intervention to mitigate PD. PUN's mechanisms of action involve modulation of pathways such as HMGB1/RAGE/TLR4/NF-ᴋB/NLRP3/Caspase-1, JAK-2/STAT-3, PI3K/AKT/GSK-3β/CREB, AMPK/SIRT-1, Nrf2/HO-1, and PERK/CHOP/Bcl-2.

Comorbid Depressive and Anxiety Symptomatology in Older Adults: The Role of Aging Self-Stereotypes, Loneliness, and Feelings of Guilt Associated with Self-Perception as a Burden

The main objective of this study was to analyze the differences between older adults' symptom profiles (subclinical, anxiety, depressive, and comorbid) in negative aging self-stereotypes, loneliness, and feelings of guilt associated with self-perception as a burden. Participants were 310 community-dwelling people aged 60 years and over. The sample was grouped into four symptom profiles of older adults: anxiety, depressive, comorbid anxiety-depression, and subclinical symptoms. We carried out multinomial logistic regression analyses to analyze the role of assessed variables in the explanation of the four symptom profiles. Older adults who reported a comorbid symptomatology presented higher negative aging self-stereotypes and feelings of loneliness than the other three profiles. Compared with the subclinical profile, older adults who reported clinical symptomatology (anxiety, depressive, and comorbid profile) presented higher feelings of guilt associated with self-perception as a burden. The findings of this study suggest potential associations that may contribute to understanding and treating comorbid anxiety and depressive symptoms in older adults.

Community-based end-of-life care in Singapore and nursing care implications for older adults in the post-COVID-19 world

PURPOSE OF REVIEW

To render holistic overview on community-based end-of-life care in the context of Singapore, with analysis of nursing care implications for older adults requiring end-of-life care services.

RECENT FINDINGS

Healthcare professionals caring for older adults with life-limiting conditions had to play an active role in the constantly evolving healthcare landscape during the coronavirus disease 2019 (COVID-19) pandemic. Usual meetings and community-based end-of-life care interventions were converted to online mode, utilizing digital technology. In order to provide value-based and culturally relevant care, further studies are warranted to evaluate healthcare professionals, patients and family caregivers' preferences whilst utilizing digital technology. As a result of COVID-19 pandemic restrictions to minimize infection transmissions, animal-assisted volunteering activities were conducted virtually. Regular healthcare professionals' engagement in wellness interventions is necessary to boost morale and prevent potential psychological distress.

SUMMARY

To strengthen the delivery of end-of-life community care services, the following recommendations are proposed: active youth engagement via inter-collaborations and connectedness of community organizations; improving support for vulnerable older adults in need of end-of-life care services; and enhancing healthcare professionals well-being through the implementation of timely support interventions.

What factors explain the changes in major depressive disorder symptoms by age group during the COVID-19 pandemic? A longitudinal study

BACKGROUND

Data collected during the COVID-19 pandemic suggest an increase in major depressive disorder (MDD) among younger adults. The current study aims to assess the association of age groups and MDD risk before and during the COVID-19 pandemic and quantify the effect of potential mediating variables such as loneliness, social support, resilience, and socioeconomic factors.

METHODS

A representative sample of Spanish adults was interviewed before (2019, N = 1880) and during (2020, N = 1103) the COVID-19 pandemic. MDD was assessed using the CIDI, loneliness through the UCLA scale, social support through the OSSS-3, resilience with the 6-BRS, and worsened economic circumstances and unemployment through a single question. Mixed-models were used to study changes in MDD by age group. Regression models were constructed to quantify the association between age and potential mediators, as well as their mediating effect on the association between age group and MDD.

RESULTS

Among the younger age cohorts (18-29 and 30-44 years) the probability of having MDD during the pandemic increased from 0.04 (95 % CI: 0.002-0.09) to 0.25 (0.12-0.39) and from 0.02 (-0.001-0.03) to 0.11 (0.04-0.17), respectively. Some 36.6 % of the association between age and risk of MDD during the pandemic was explained by loneliness (12.0 %), low resilience (10.7 %), and worsened economic situation (13.9 %).

LIMITATIONS

Reliance on self-report data and generalizability of the findings limited to the Spanish population.

CONCLUSIONS

Strategies to decrease the impact of a pandemic on depressive symptoms among young adults should address loneliness, provide tools to improve resilience, and enjoy improved financial support.

Perceptions of neighborhood environment and loneliness among older Chinese adults: the mediator role of cognitive and structural social capital

OBJECTIVE

This study aimed to examine the mediating role of social capital in the association between perceived physical neighborhood environment and loneliness among older adults in urban China.

METHOD

Data were derived from face-to-face interviews with people (n = 472) aged 60 or older in urban communities of Shanghai, China, in 2020. Loneliness was measured by the 6-item De Jong Gierveld Scale. A multiple mediator model was adopted to examine the research hypotheses.

RESULTS

Cognitive social capital played a full mediation role in the association between perceived community health care (β = -.061, p < .05), safety (β = -.168, p < .001), recreational services (β = -.058, p < .05), and loneliness. Structural social capital was associated with loneliness (β = -.102, p < .05), whereas its mediator effect was not significant. Perceived transportation convenience had neither a direct nor an indirect effect on loneliness among older adults.

CONCLUSION

Findings indicate that older adults' perceptions of healthcare services, safety, and recreational resources could help alleviate their loneliness via fostering cognitive social capital. Interventions improving older adults' perceptions of community health care, safety, and recreation, and their social capital level could help reduce the prevalence of loneliness.

Relationship between frailty and loneliness among community-dwelling Turkish older people

BACKGROUND

The scarcity of concrete data between loneliness and frailty was found and to fill this gap, the present study aimed to examine the relationship between frailty and loneliness in elderly individuals. The study was conducted to determine the relationship between loneliness and frailty in individuals aged 65 and over.

METHOD

The study had a cross-sectional descriptive correlational design. The study group consisted of 527 volunteers aged 65 and over who applied to six family health centres between 15.03.2019 and 15.05.2019 and met the inclusion criteria. The Information Form, Tilburg Frailty Indicator (TFI), and Loneliness Scale for the Elderly (LSE) were used to collect the study data.

RESULTS

It was found that the mean age of individuals with frailty (69.67 ± 4.38) was found to be higher at a statistically significant level than those without frailty (67.83 ± 3.07) (t = -5.390; P = 0.001). It was found that a total of 89.1% of those who stated they had a serious disease (χ²  = 69.688, P < 0.001) and 68.9% (χ²  = 24.315, P < 0.001) of those who had a serious disease in a loved one were statistically frail. The mean total score obtained in the LSE was 12.702 ± 5.76 and it was statistically significant at a high level (t = -12.225, P < 0.001) There was a statistically significant relationship between the TFI and its subscales, and the LSE and subscale scores of the individuals who participated in the study.

CONCLUSION

A positive and significant relationship was detected between all subscales of loneliness and frailty; therefore, it can be argued that the negativity in one negatively affects the other. According to these results, it can be recommended to conduct screening and intervention programs to prevent frailty and loneliness in individuals aged 65 and over and prioritise the risk factors that were found in the present study.

The impact of social-relationship patterns on worsening mental health among the elderly during the COVID-19 pandemic: Evidence from Hungary

Evidence indicates the coronavirus pandemic has severely affected the oldest age group: in Hungary 92.7 per cent of those who died due to COVID-19 infection were 60 years of age or older. The age structure of the deceased was very similar in other countries. As, due to their underlying health status, elderly people are more vulnerable to the serious diseases caused by the coronavirus, strict government restrictions were introduced worldwide to protect them when the epidemic broke out. However, this social isolation can cause severe psychological and emotional strain. The study aim was to examine how patterns of social relationships were related to changes in mental health of the elderly during the COVID-19 pandemic in Hungary. We used the database of SHARE COVID-19 for our analysis. Descriptive and multivariate analyses were conducted. Findings of this study suggest that the network lacking contacts increases the severity of depression, anxiety, sleeping disorders, and loneliness the most among the elderly. Interestingly, the group with an intense close-knit network had a higher risk of worsening mental symptoms compared to multiple contact actives. Moreover, electronic communication - telephone, Skype - did not help either: there was a particularly high probability of worsening depression in this group. Another interesting result is that both in the group dominated by family contacts and among those with multiple relationships, the chances of worsening mental symptoms were lower, thus, personal contact - whether they include family members or other acquaintances - is truly protective. Results demonstrate that both the network characterised by lack of contact network and electronic contact activity contribute to greater risk of worsening mental health within elderly. A network pattern characterised by various types and forms of contacts is the most beneficial to mental health, and intensive contacts of limited scope alone are not sufficient to protect mental health.

Loneliness, social isolation, depression and anxiety among the elderly in Shanghai: Findings from a longitudinal study

OBJECTIVES

To investigate the longitudinal associations between loneliness, social isolation, depression and anxiety in the elderly.

METHODS

A longitudinal cohort study was conducted among 634 older adults from three districts of Shanghai. Data were collected at baseline and 6-month follow-up. Loneliness and social isolation were measured using the De Jong Gierveld Loneliness Scale and the Lubben Social Network Scale respectively. Depressive and anxiety symptoms were assessed using the subscales of Depression Anxiety Stress Scales. Logistic regression and negative binomial regression models were used to examine the associations.

RESULTS

We found that moderate to severe loneliness at baseline predicted higher depression scores 6 months later (incidence rate ratio (IRR)=1.99, 95% confidence interval (CI) [1.12, 3.53], p=0.019), while higher depression scores at baseline predicted social isolation at follow-up (odds ratio (OR)=1.14, 95% CI [1.03, 1.27], p=0.012). We also observed that higher anxiety scores predicted lower risk of social isolation (OR=0.87, 95% CI [0.77, 0.98], p=0.021). Additionally, persistent loneliness at both timepoints was significantly associated with higher depression scores at follow-up, and persistent social isolation was associated with a greater likelihood of having moderate to severe loneliness and higher depression scores at follow-up.

CONCLUSIONS

Loneliness was found to be a robust predictor of changes in depressive symptoms. Both persistent loneliness and social isolation were closely associated with depression. We should develop effective and feasible interventions for older adults who have depressive symptoms or who are at risk of long-term social relationship problems to avoid the vicious circle among depression, social isolation and loneliness.

The Association of Social Support and Loneliness with Symptoms of Depression, Anxiety, and Posttraumatic Stress during the COVID-19 Pandemic: A Meta-Analysis

BACKGROUND

Research suggests that changes in social support and loneliness have affected mental disorder symptoms during the COVID-19 pandemic. However, there are a lack of studies comparing the robustness of these associations.

AIMS

The aims were to estimate the strength of the associations of loneliness and social support with symptoms of depression, anxiety, and posttraumatic stress during the COVID-19 pandemic (2020-2022) in the general population.

METHOD

The method entailed a systematic review and random-effects meta-analysis of quantitative studies.

RESULTS

Seventy-three studies were included in the meta-analysis. The pooled correlations of the effect size of the association of loneliness with symptoms of depression, anxiety, and posttraumatic stress were 0.49, 0.40, and 0.38, respectively. The corresponding figures for social support were 0.29, 0.19, and 0.18, respectively. Subgroup analyses revealed that the strength of some associations could be influenced by the sociodemographic characteristics of the study samples, such as age, gender, region, and COVID-19 stringency index, and by methodological moderators, such as sample size, collection date, methodological quality, and the measurement scales.

CONCLUSIONS

Social support had a weak association with mental disorder symptoms during the COVID-19 pandemic while the association with loneliness was moderate. Strategies to address loneliness could be highly effective in reducing the impact of the pandemic on social relationships and mental health.

Loneliness and Death Anxiety: Differences Between Active and Bedridden Older Men

Physical activity might be impact on death anxiety and loneliness in adult people. Accordingly, the present study examined loneliness and death anxiety in two groups of active and bedridden older men living in nursing homes in Yazd. This descriptive-analytical and cross-sectional study was conducted on older men living in nursing homes in Yazd, Iran. The participants were 148 older men who were randomly selected. The instruments used to collect the data were the Social and Emotional Loneliness Scale for Adults (SELSA-S) and the Death Anxiety Scale One-way ANOVA was also used. The findings indicated the active older men scored lower in loneliness and death compared to the bedridden older men. Loneliness and death anxiety are important psychological components that are more common in inactive older than their active counterparts. Therefore, physical activity in old age can improve older adults' quality of life.

Social relationship satisfaction and accumulation of chronic conditions and multimorbidity: a national cohort of Australian women

Background

Social relationships are associated with mortality and chronic conditions. However, little is known about the effects of social relationship satisfaction on multiple chronic conditions (multimorbidity).

Aims

To examine whether social relationship satisfaction is associated with the accumulation of multimorbidity.

Methods

Data from 7 694 Australian women who were free from 11 chronic conditions at 45-50 years of age in 1996 were analysed. Five types of social relationship satisfaction (partner, family members, friends, work and social activities) were measured approximately every 3 years and scored from 0 (very dissatisfied) to 3 (very satisfied). Scores from each relationship type were summed to provide an overall satisfaction score (range: ≤5-15). The outcome of interest was the accumulation of multimorbidity in 11 chronic conditions.

Results

Over a 20-year period, 4 484 (58.3%) women reported multimorbidities. Overall, the level of social relationship satisfaction had a dose-response relationship with the accumulation of multimorbidities. Compared with women reporting the highest satisfaction (score 15), women with the lowest satisfaction (score ≤5) had the highest odds of accumulating multimorbidity (odds ratio (OR)= 2.35, 95% confidence interval (CI): 1.94 to 2.83) in the adjusted model. Similar results were observed for each social relationship type. Other risk factors, such as socioeconomic, behavioural and menopausal status, together explained 22.72% of the association.

Conclusions

Social relationship satisfaction is associated with the accumulation of multimorbidity, and the relationship is only partly explained by socioeconomic, behavioural and reproductive factors. Social connections (eg, satisfaction with social relationships) should be considered a public health priority in chronic disease prevention and intervention.

Understanding changes in mental health symptoms from young-old to old-old adults by sex using multiple-group latent transition analysis

Older adults are classified into three homogeneous groups: young-old (age 65-74), old-old (age 75-84), and oldest-old (age 85 and over). Mental health symptoms are likely to change over time, especially when older adults transition from one age group to another. Yet, little is known on changes in mental health symptoms as they transition to another age group, and if these changes differ by sex. This is a secondary data analysis using the longitudinal data from the National Social Life, Health, and Aging Project. A total of 1183 young-old adults at wave 1 was included. Mental health symptoms were depression, anxiety, loneliness, perceived stress, and happiness. Multiple-group latent transition analysis was conducted to model the transition probabilities of latent classes and to compare these differences between sex. Descriptive and inferential statistics were conducted to obtain demographic characteristics and to test for differences. Three latent classes were identified based on severity: class 1-mild, class 2-moderate, and class 3-severe. Regardless of sex, young-old adults remained in the same class from waves 1 to 2. However, they moved to a less severe group when transitioning into the old-old from waves 2 to 3. Statistically significant differences were found in their demographic characteristics among the latent classes. Older adults, when transitioning from young-old to old-old, are likely to transition to latent classes with less severe mental health symptoms in both sex. Clinicians need to provide a comprehensive assessment to all older adults, regardless of the severity of their mental health symptoms, to promote well-being.

Associations between social media use and loneliness in a cross-national population: do motives for social media use matter?

BACKGROUND

We aimed to examine the association between social media use and loneliness two years after the COVID-19 pandemic outbreak.

METHODS

Participants were 1649 adults who completed a cross-sectional online survey disseminated openly in Norway, United Kingdom, USA, and Australia between November 2021 and January 2022. Linear regressions examined time spent on social media and participants' characteristics on loneliness, and interactions by motives for social media use.

RESULTS

Participants who worried more about their health and were younger, not employed, and without a spouse or partner reported higher levels of loneliness compared to their counterparts. More time spent on social media was associated with more loneliness (β = 0.12, p < 0.001). Three profile groups emerged for social media use motives: 1) social media use motive ratings on avoiding difficult feelings higher or the same as for maintaining contact; 2) slightly higher ratings for maintaining contact; and 3) substantially higher ratings for maintaining contact. Time spent on social media was significant only in motive profile groups 2 and 3 (β = 0.12 and β = 0.14, both p < 0.01).

CONCLUSIONS

Our findings suggest that people who use social media for the motive of maintaining their relationships feel lonelier than those who spend the same amount of time on social media for other reasons. While social media may facilitate social contact to a degree, they may not facilitate the type of contact sought by those who use social media primarily for this reason.

Staying connected in old age: associations between bonding social capital, loneliness and well-being and the value of digital media

OBJECTIVES

We examined associations between age, bonding social capital (BSC), loneliness and psychological, social and emotional well-being in old age. As in theory digital media can support both preservation of and access to someone's social capital, we also explored associations between the use of WhatsApp, social network sites (SNS) and Internet applications and respectively BSC and loneliness.

METHOD

In this cross-sectional study a sample of 349 older adults (range = 70y-93y; Mean(SD)=74.8y(4.9y); 59.6% male) filled out a questionnaire including the bonding social capital subscale of the personal social capital scale for elderly (PSCSE), validated scales measuring social, emotional, and psychological well-being and loneliness, the SNS intensity scale and items measuring frequencies of Whatsapp use and use of various Internet functions. Also relevant demographic and other covariates were included.

RESULTS

Regression analyses including relevant covariates confirmed our hypotheses, finding negative associations between BSC and both age and loneliness, and positive associations between BSC and psychological, social and emotional well-being. WhatsApp and Internet use were both found positively associated with BSC, whilst a negative association between WhatsApp use and loneliness was found. SNS use was not associated with BSC nor with loneliness.

CONCLUSION

Our findings indicate BSC as an important factor in positive aging and illustrate a widening gap between the need for socio-emotional resources versus their availability. With regard to digital media, we conclude that its value in old age should be sought in providing access to one's bonding social capital rather than adding to it by expanding the number of social relations.

Flying high: pilot peer coaching to champion well-being and mitigate hazardous attitudes

Purpose

The “Germanwings” air crash in 2015 in which 150 people were killed highlighted the challenges pilots working in the aviation industry face. Pilots regularly work for extensive periods in inhospitable and high-pressure operational conditions, exposing them to considerable work-related stress. This has raised calls for a more systemic cultural change across the aviation industry, championing a more holistic perspective of pilot health and well-being. The study aims to explore how peer coaching (PC) can promote an inclusive psychosocial safety climate enhancing pilot well-being and can mitigate hazardous attitudes and dysfunctional behaviours.

Design/methodology/approach

Adopting an interpretative phenomenological analysis (IPA), semi-structured interviews and questionnaires were conducted with military and civilian peer coach/coachee pilots and key industry stakeholders, totalling 39 participants. The research provided significant insights into the perceived value of PC in promoting both pilot health and mental well-being (MW) and flight safety across the aviation industry.

Findings

The study highlights four key PC superordinate themes, namely, coaching skills, significance of well-being, building of peer relationships and importance of confidentiality and autonomy. Such combined themes build reciprocal trust within peer conversations that can inspire engagement and effectively promote personal well-being. The contagious effect of such local interventions can help stimulate systemic cultural change and promote a positive psychosocial safety climate throughout an organisation and, in this case, across the aviation industry. This study provides a PC conceptual framework “Mutuality Equality Goals Autonomy Non-evaluative feedback, Skill Confidentiality Voluntary Supervisory (MEGANS CVS),” highlighting the salient features of PC in promoting MW.

Research limitations/implications

The study highlights the salient features of PC and its role in promoting peer conversations that enable personal transition, openness and acceptance. This study also highlights how PC and well-being can be used to encourage inclusivity and engagement, thereby strengthening institutional resilience.

Practical implications

This study highlights how PC that can assist HRM/HRD professionals to embed a more inclusive and salutogenic approach to MW that can reshape organisational cultures. This study highlights the significance and link of workplace stress to hazardous attitudes and dysfunctional behaviours. It further notes that whilst the MEGANS CVS peer coaching framework has been applied to pilots, it can also be applied across all sectors and levels.

Social implications

This study highlights the value of PC as an inexpensive means to engage at the grassroots level, which not only improves personal performance, safety and well-being but by building peer relationships can also act as a catalyst for positive and deep organisational cultural change.

Originality/value

This study offers the MEGANS CVS framework that exposes insights into PC practice that can assist HRM/HRD professionals embed a more inclusive and salutogenic approach to health and well-being that can reshape organisational cultures. This study highlights the significance and link of workplace stress to hazardous attitudes and dysfunctional behaviours, and whilst this framework has been applied to pilots, it can also have relevance across all sectors and levels. This study calls for a “salutogenic turn,” employing MW and PC to transform organisational capabilities to be more forward-thinking and solution-focused, promoting an inclusive “just culture” where leaders positively lead their people.

Predictive models for social functioning in healthy young adults: A machine learning study integrating neuroanatomical, cognitive, and behavioral data

Poor social functioning is an emerging public health problem associated with physical and mental health consequences. Developing prognostic tools is critical to identify individuals at risk for poor social functioning and guide interventions. We aimed to inform prediction models of social functioning by evaluating models relying on bio-behavioral data using machine learning. With data from the Human Connectome Project Healthy Young Adult sample (age 22-35, N = 1,101), we built Support Vector Regression models to estimate social functioning from variable sets of brain morphology to behavior with increasing complexity: 1) brain-only model, 2) brain-cognition model, 3) cognition-behavioral model, and 4) combined brain-cognition-behavioral model. Predictive accuracy of each model was assessed and the importance of individual variables for model performance was determined. The combined and cognition-behavioral models significantly predicted social functioning, whereas the brain-only and brain-cognition models did not. Negative affect, psychological wellbeing, extraversion, withdrawal, and cortical thickness of the rostral middle-frontal and superior-temporal regions were the most important predictors in the combined model. Results demonstrate that social functioning can be accurately predicted using machine learning methods. Behavioral markers may be more significant predictors of social functioning than brain measures for healthy young adults and may represent important leverage points for preventative intervention.

Continuous Neurophysiologic Data Accurately Predict Mood and Energy in the Elderly

The elderly have an elevated risk of clinical depression because of isolation from family and friends and a reticence to report their emotional states. The present study explored whether data from a commercial neuroscience platform could predict low mood and low energy in members of a retirement community. Neurophysiologic data were collected continuously for three weeks at 1Hz and averaged into hourly and daily measures, while mood and energy were captured with self-reports. Two neurophysiologic measures averaged over a day predicted low mood and low energy with 68% and 75% accuracy. Principal components analysis showed that neurologic variables were statistically associated with mood and energy two days in advance. Applying machine learning to hourly data classified low mood and low energy with 99% and 98% accuracy. Two-day lagged hourly neurophysiologic data predicted low mood and low energy with 98% and 96% accuracy. This study demonstrates that continuous measurement of neurophysiologic variables may be an effective way to reduce the incidence of mood disorders in vulnerable people by identifying when interventions are needed.

Exclusion from social relations in later life: on the gendered associations of social networks with mental wellbeing

Objectives: This study addresses the gendered risks of loneliness and depression in later life from a social exclusion perspective. Exclusion from social relations (ESR) in older age is an unwanted situation associated with increased loneliness and depressive symptoms, with gender differences in the perception of solitude, and the evaluation of existing social networks, potentially accounting for the increased susceptibility of older women.Method: Secondary analyses was conducted in a sample of 60,918 participants in the Survey on Health, Aging and Retirement in Europe (SHARE). Older persons' subjective perception of solitude (i.e. solitude satisfaction), and their satisfaction with established relations (i.e. network satisfaction), were examined in gender-stratified regression models, predicting loneliness and depressive symptomatology, controlling for network size, demographics, and health.Results: There was no convincing evidence for significant associations between solitude satisfaction (SoS) and loneliness among older men, nor between network satisfaction (NeS) and loneliness for both genders. Low SoS and low NeS were independently associated with more depressive symptoms and an increased probability of depression, especially among older women. This vulnerability could not be attributed to increased loneliness, as only among older women, low SoS was associated with lower levels of loneliness, and lower levels of loneliness was anaemically associated with more depressive symptoms.Conclusions: The perception of solitude, and the evaluation of social relations, are associated with gendered risks of depression among older persons who are challenged by objective and subjective ESR states.

An Evaluation of the Effects of Active Game Play on Cognition, Quality of Life and Depression for Older People with Dementia

OBJECTIVES

This pilot study was intended to evaluate the effects of active game play on cognition, quality of life, and depression for older people with dementia.

METHODS

Thirty-eight older people with dementia were recruited. Eighteen people received eight-week active game play using Xbox 360 Kinect. Twenty people received their usual care. The Mini Mental State Examination, Quality of Life-Alzheimer's Disease and Cornell Scale for Depression in Dementia were used to measure the outcomes.

RESULTS

The results showed that there was no significant improvement on the mean scores of Mini Mental State Examination (P = .252), however, the active game play increased the mean score of Quality of Life-Alzheimer's Disease (P = .005), and reduced the mean score of Cornell Scale for Depression in Dementia (P = .001) in comparison with the usual care group.

CONCLUSIONS

The study demonstrated that the active game play was effective in improving quality of life and alleviating depression in older people with dementia.

CLINICAL IMPLICATIONS

Findings highlight the potential for gaming as a non-pharmacological interventions for older people with dementia.

Social Disconnectedness and Mental Health Problems During the COVID-19 Pandemic in China: A Moderated Mediation Model

Objectives: This study aimed to examine the mediating effect of perceived isolation and the moderating effect of COVID-19 related concerns in the relationship between social disconnectedness and mental health problems during the COVID-19 pandemic in China.

Methods: A cross-sectional online survey of 11,682 Chinese residents were conducted during the COVID-19 outbreak. Conditional process analysis was performed to test the mediating effect of perceived isolation and the moderating effect of COVID-19 related concerns.

Results: Social disconnectedness was positively related to mental health problems, and perceived isolation significantly mediated their relationship. COVID-19 related concerns exacerbated the direct link between social disconnectedness and mental health problems as well as the indirect link via perceived isolation.

Conclusion: Social disconnectedness was a key predictor of mental health problems during the COVID-19 outbreak. The direct and indirect effects of social disconnectedness on mental health problems were stronger for respondents who had more COVID-19 related concerns. Understanding the underlying mechanisms by which social disconnectedness is related to mental health problems has important practical implications for the prevention of mental health problems during the COVID-19 pandemic.

Gender Differences in Correlates of Loneliness among Community-Dwelling Older Koreans

Background: Despite a relatively large number of studies exploring late-life loneliness, few studies have compared gender differences in the correlates of loneliness of older adults. Thus, we examined the gender differences in correlates of loneliness among community-dwelling older adults. Methods: This study was a secondary analysis of data from a parent study conducted among community-dwelling Koreans 65 years of age or older. Loneliness was measured by the 20-item Revised University of California Los Angeles Loneliness Scale. As potential correlates, demographic, health-related, and social variables were included. Multivariate hierarchical regression analyses were performed separately by gender. Results: Men were more likely to be lonely than women, after controlling for demographic, health-related, and social variables. A social network of family ties and being married were found to be inversely correlated with loneliness in men but not in women. A social network of friendship ties and participation in a variety of community activities were inversely correlated with loneliness in both men and women. Conclusions: A social network of family ties and being married may help reduce late-life loneliness, particularly among men. This study highlights the importance of considering gender differences in the design of strategies for preventing and alleviating late-life loneliness.

Loneliness as a Mediator in the Association Between Social Isolation and Psychological Distress: A Cross-Sectional Study With Older Korean Immigrants in the United States

The present study explored the role of loneliness in the association between social isolation and psychological distress, using a cross-sectional sample of older Korean immigrants in the U.S. Considering structural (unmarried and living alone) and relational (isolation from family and friends) social isolation, we hypothesized that (1) both types of social isolation would be associated with loneliness and psychological distress and (2) their effect on psychological distress would be mediated through loneliness. Data came from the Study of Older Korean Americans (SOKA), a multisite survey of Korean immigrants aged 60 and older (n = 2,150). The multivariate analyses demonstrated that older individuals with structural and relational isolation reported higher levels of loneliness and psychological distress. Loneliness was found to mediate the effect of both types of social isolation on psychological distress. The intervening role of loneliness suggests strategies to alleviate the mental health consequences of social isolation in older immigrants.

Fluoxetine ameliorates Alzheimer's disease progression and prevents the exacerbation of cardiovascular dysfunction of socially isolated depressed rats through activation of Nrf2/HO-1 and hindering TLR4/NLRP3 inflammasome signaling pathway

Depression is a risk factor for Alzheimer's (AD) and cardiovascular diseases (CVD). Therefore, depression treatment restricts its deteriorating effects on mood, memory and CV system. Fluoxetine is the most widely used antidepressant drug, it has neuroprotective effect through its antioxidant/anti-inflammatory properties. The current study investigated for the first-time the cross link between depression, AD and CVD besides, role of fluoxetine in mitigating such disorders. Depression was induced in rats by social isolation (SI) for 12 weeks, AlCL3 (70 mg/kg/day, i.p.) was used to induce AD which was administered either in SI or normal control (NC) grouped rats starting at 8th week till the end of the experiment, fluoxetine (10 mg/kg/day, p.o) treatment also was started at 8th week. SI and AD showed a statistically significant deteriorated effect on behavioral, neurochemical and histopathological analysis which was exaggerated when two disorder combined than each alone. Fluoxetine treatment showed protective effect against SI, AD and prevents exacerbation of CVD. Fluoxetine improved animals' behavior, increased brain monoamines, BDNF besides increased antioxidant defense mechanism of SOD, TAC contents and increased protein expression of Nrf2/HO-1 with significant decrease of AChE activity, β-amyloid, Tau protein, MDA, TNF-α, IL1β contents as well as decreased protein expression of NF-kB, TLR4, NLRP3 and caspase1. It also showed cardioprotective effects as it improved lipid profile with pronounced decrease of cardiac enzymes of CK-MB, troponin and MEF2. In conclusion, fluoxetine represents as a promising drug against central and peripheral disorders through its anti-inflammatory/antioxidant effects via targeting antioxidant Nrf2/HO-1 and hindering TLR4/NLRP3 inflammasome signaling pathways.

Assessing the psychosocial dimensions of frailty among older adults in Singapore: a community-based cross-sectional study

OBJECTIVE

To examine how multiple dimensions of mental and social health, in addition to physical health, were associated with frailty among older adults.

DESIGN

A door-to-door sampling household community-based survey.

SETTING

Thirty-two public housing blocks within a residential town in Singapore's central region.

PARTICIPANTS

497 residents aged 60 years or older from the public housing town.

OUTCOME MEASURES

Physical frailty was assessed using the FRAIL Scale, which stands for fatigue, resistance, ambulation, illnesses and loss of weight. Physical health was assessed by multimorbidity, physical activity and functional ability; mental illness was assessed by the General Health Questionnaire (GHQ); and social domains were assessed by the Lubben Social Network Scale, Community Integration Measure and UCLA (University of California, Los Angeles) Loneliness Scale.

RESULTS

Compared with robust (59.5%) and prefrail (32.6%) older adults, frail adults (7.9%) reported higher morbidity, lower functional ability and physical activity, higher scores on GHQ, and lower scores on all three social health scales. In multiple regression models, frailty was significantly associated with age 81-90 years (adjusted OR=2.22, 95% CI 1.23 to 3.99), having 2-3 (adjusted OR=1.56, 95% CI 1.02 to 2.38) or >3 (adjusted OR=1.83, 95% CI 1.05 to 3.18) chronic diseases, reduced ability to perform daily tasks without assistance (adjusted OR=0.41, 95% CI 0.23 to 0.73), having fallen in the past 6 months (adjusted OR=2.18, 95% CI 1.18 to 4.06), social dysfunction in GHQ (adjusted OR=1.24, 95% CI 1.08 to 1.43) and loneliness (adjusted OR=1.26, 95% CI 1.06 to 1.50). Physical activity did not remain significantly associated with frailty when mental and social health-related factors were entered in the regression.

CONCLUSION

Community intervention for frailty prevention and management needs to include mental health promotion and social engagement to increase its impact on older adults.

The effect of loneliness and social support on the course of major depressive disorder among adults aged 50 years and older: A longitudinal study

BACKGROUND

Previous research indicates that social support, loneliness, and major depressive disorder (MDD) are interrelated. Little is known about the potential pathways among these factors, in particular in the case of adults aged 50 years and older and suffering from MDD. The objective was to investigate whether loneliness mediates the association between low social support and recurrent episodes of MDD.

METHODS

We used data from a cohort of the Spanish general population interviewed at three time-points over a 7-year period. We included 404 individuals aged 50+ suffering from MDD in the baseline assessment. A 12-month major depressive episode was assessed with the Composite International Diagnostic Interview (CIDI) at each interview. The University of California, Los Angeles Loneliness Scale was used to measure loneliness, whereas social support was assessed through the Oslo Social Support Scale. We tested cross-lagged and autoregressive longitudinal associations using structural equation modeling.

RESULTS

We identified two significant longitudinal mediation patterns: lower social support predicted higher subsequent levels of loneliness (Coef. = -0.16; p < .05), which in turn predicted an increase in MDD recurrence (Coef. = 0.05; p < .05).

CONCLUSIONS

Interventions focused on promoting social support among older adults suffering from MDD may decrease feelings of loneliness and prevent recurrent episodes of MDD.

Depression trajectories among older community dwelling adults: Results from the Irish Longitudinal Study on Ageing (TILDA)

BACKGROUND

This study investigated the role of a large range psychological, attitudinal and health related variables as predictors of depression trajectories amongst older adults over a 4-year time period.

METHODS

Data from three consecutive waves of the TILDA survey of older community dwelling adults aged 50+ in Ireland were combined for analysis. Depression symptom scores were assessed using the Center for Epidemiological Studies- Depression scale (CES-D). Changes in depression scores over three time points were modelled as distinct trajectory classes using group-based trajectory modelling, whilst simultaneously controlling for demographic, attitudinal and health related predictors of these trajectory classes using multinomial regression.

RESULTS

Four distinct depression trajectories were identified as (1) a stable low symptom level group (79%), (2) a moderate but deteriorating symptoms group (7.6%), (3) a moderate but improving group (10.1%) and (4) a vulnerable group with consistently high symptoms (3.1%). Multinomial logistic regression indicated that limiting pain, mobility impairments, perceived stress and loneliness predicted membership of the moderate and higher depressive symptom classes. Retirement status and higher reported levels of worry were associated with a greater likelihood of membership of the moderate symptom classes only.

LIMITATIONS

Use of the CES-D is open to bias due to subjective nature of respondent reporting.

CONCLUSIONS

Results concur with previous studies on the development of depression among older people and highlight the key health related and psychological variables that may inform interventions aimed at mitigating risks of developing depression among older adults.

Patterns of social relationships among community-dwelling older adults in Japan: latent class analysis

BACKGROUND

Social relationships may be the key to successful aging among older adults. However, little is known about the variability of social relationships among community-dwelling older people. This study aimed to describe the patterns of social relationships and examine the differences in sociodemographic characteristics and mental and physical health status among these patterns.

METHODS

We obtained the data from a questionnaire survey in 2017 for older adults aged 65 and above who lived in a suburban area in Japan. The Index of Social Interaction (ISI) was used to evaluate social relationships. The final sample comprised 964 people who were independently mobile and answered at least one item of the ISI. To clarify the patterns of social relationships, latent class analysis was performed with five subscales of ISI treated as indicator variables. Multinomial logistic regression was conducted to examine the factors associated with the patterns of social relationships.

RESULTS

The patterns of social relationships were classified into three classes: "Active" (73.6%), "Socially isolated" (14.7%), and "Less motivated" (11.7%). Persons who had depressive symptoms were more likely to be allocated to the "Socially isolated" (Odds Ratio [OR] 1.80, 95% Confidence Interval [CI] 1.13-2.86) or the "Less motivated" groups (OR 1.69, 95% CI 1.00-2.85) compared to the "Active" group. In addition, men (OR 1.72, 95% CI 1.07-2.76) and those living alone (OR 3.07, 95% CI 1.43-6.61) were more likely to be allocated to the "Socially isolated" group. Moreover, those who were dependent, according to the instrumental activities and daily living functions, were more likely to be assigned to the "Socially isolated" (OR 2.19, 95% CI 1.21-3.97) or "Less motivated" (OR 6.29, 95% CI 3.47-11.39) groups.

CONCLUSION

This study revealed the patterns of social relationships in older adults and suggested that there may be variations of social relationships among community dwellers. The results also indicated the necessity of assessing individual patterns of social relationships and devising strategies for each pattern in public health practice.

Relationships between Sense of Community, Authenticity, and Meaning in Life in Four Social Communities in France

This research explored the effects of sense of community and authenticity on meaning in life in social communities in France. The sample included one hundred participants from four social communities (i.e., political, religious, virtual learning, and mutual aid). The Meaning in Life Questionnaire, the Sense of Community Scale, and the Authenticity Scale were administered to the respondents. The correlational analyses indicated that sense of community and authenticity were more related to the presence of meaning (r = 0.29 and r = 0.54, respectively) than to the search for meaning (r = −0.39 and r = 0.03, respectively). In addition, no interaction effects were found between sense of community and the three dimensions of authenticity, suggesting that the level of authenticity did not influence the relationships between sense of community and presence of or search for meaning. The practical and research implications of the study for social communities in the field of existential psychology were discussed.

Social Relationships and Adaptation in Later Life

Social relations encompass a complex and dynamic set of characteristics that have been shown to distinctly affect health and quality of life across the lifespan and especially in older adulthood. In this chapter we begin with a brief review of several prominent theories of social relations. Next, we consider how social relations can be understood based on the resource they provide (e.g., contact frequency, social support), the relationship they stem from (e.g., friends, family), the strength of the tie (e.g., strong, weak) as well as the means of communication (e.g., offline, online). We briefly summarize how these characteristics have been shown to uniquely influence health and quality of life in older adulthood. Finally, we contemplate potential clinical applications, provide recommendations for the future and offer final concluding comments.

Satisfaction with social connectedness as a predictor for positive and negative symptoms of psychosis: A PHAMOUS study

PURPOSE

This study examines satisfaction with social connectedness (SSC) as predictor of positive and negative symptoms in people with a psychotic disorder.

METHODS

Data from the Pharmacotherapy Monitoring and Outcome Survey (PHAMOUS) was used from patients assessed between 2014 and 2019, diagnosed with a psychotic disorder (N = 2109). Items about social connectedness of the Manchester short assessment of Quality of Life (ManSA) were used to measure SSC. Linear mixed models were used to estimate the association of SSC with the Positive and Negative Syndrome Scale (PANSS) after one and two years against α = 0.01. Analyses were adjusted for symptoms, time since onset, gender and age. Additionally, fluctuation of positive and negative symptom scores over time was estimated.

RESULTS

The mean duration of illness of the sample was 18.8 years (SD 10.7) with >65% showing only small variation in positive and negative symptoms over a two to five-year time period. After adjustment for covariates, SSC showed to be negatively associated with positive symptoms after one year (β = -0.47, p < 0.001, 95% CI = -0.70, -025) and two years (β = -0.59, p < 0.001, 95% CI = -0.88, -0.30), and for negative symptoms after one year (β = -0.52, p < 0.001, 95% CI = -0.77, -0.27). The prediction of negative symptoms was not significant at two years.

CONCLUSION

This research indicates that interventions on SSC might positively impact mental health for people with psychosis. SSC is a small and robust predictor of future levels of positive symptoms. Negative symptoms could be predicted by SSC at one year.

Rumination and Sleep Quality Among Older Adults: Examining the Role of Social Support

OBJECTIVES

Although the adverse link between rumination and sleep quality is well established, much of the literature neglects the role of social factors. This study examined the role of older adults' perceived social support from spouses and from family/friends in modifying the association between trait rumination and sleep quality. Existing hypotheses suggest that social support may play 3 unique roles, each tested within the current study: (H1) support may act as a protective factor that buffers negative effects of rumination on sleep quality, (H2) support may curtail rumination and, in turn, promote sleep quality, and (H3) rumination may erode support and, in turn, undermine sleep quality.

METHOD

Data came from 86 partnered older adults in independent-living or retirement communities (Mage = 75.70 years). We utilized 3 waves of interview data collected annually between 2017 and 2019. The first hypothesis was tested using moderation in multilevel models; the second 2 hypotheses were evaluated with prospective associations using multilevel mediation.

RESULTS

Negative effects of high-trait rumination on time-varying sleep quality were attenuated among those who reported high, stable levels of support from their spouses. Perceived family/friend support did not yield the same protective effect. There was no evidence that support preempted, or was eroded by, rumination.

DISCUSSION

Perceived spousal support may act as a psychosocial resource that mitigates negative effects of trait rumination on older adults' sleep quality. Interventions aimed at mitigating maladaptive outcomes of rumination on sleep quality for older adults should consider spousal support as a key target.

The Faroese Septuagenarians cohort: A comparison of well-being before and during the COVID-19 pandemic among older home-dwelling Faroese

AIMS

Despite success in avoiding morbidity and mortality in the oldest members of the population during the COVID-19 pandemic, the crisis may have affected the well-being of older adults, for example due to social distancing measures. The aim of this study was to examine the well-being of older Faroese by conducting a direct comparison of well-being indicators on the same group of elderly people before and during the COVID-19 pandemic.

METHODS

Data were collected from 227 home-dwelling adults aged 82-86 years from the Faroese Septuagenarians cohort. The pre-COVID-19 period was from December 2017 to January 2019, and the COVID-19 period was from 8 June to 15 July 2020. Three aspects of well-being were assessed: loneliness, self-rated health and quality of life (WHOQOL-BREF).

RESULTS

During the COVID-19 pandemic, there were significant increases in loneliness (21.8% vs. 6.8%; p<0.001) and in worse self-rated health compared to the previous year (37.2% vs. 19.0%; p<0.001). In terms of quality of life, the domains of overall quality of life (74.33±14.96 vs. 71.88±15.21; p=0.04) and physical health (73.81±17.11 vs. 71.66±17.37; p=0.03) deteriorated. On the other hand, the domains of social relationships (78.87±16.52 vs. 85.81±13.35; p<0.001), environment (82.49±10.78 vs. 87.06±7.88; p<0.001) and psychological health (77.07±11.52 vs. 80.53±10.89; p<0.001) improved during the pandemic.

CONCLUSIONS

Our findings suggest that attention should be directed to loneliness and physical well-being amongst home-dwelling old adults, despite the elderly showed resilience and improved psychological health, social relations and environment domains in a quality of life assessment during the COVID-19 pandemic.