Social isolation in Asian Americans: risks associated with socio-demographic, health, and immigration factors

Prevalence of social isolation in the elderly: A systematic review and meta-analysis

Social isolation has become a global issue among the elderly, posing serious challenges to both social and public health. We assessed the prevalence of elderly social isolation and its related factors. Eight electronic databases were searched up to June 28th, 2023. A meta-analysis of the included literature was performed using Stata 16.0. The results showed that the incidence of social isolation in the elderly was 33 % [95 % CI (0.28, 0.38)]. The subgroup analysis revealed that people over 80, with a sample size under 500, assessed using the Lubben Social Network scale and Social Network Index scale, experienced higher social isolation, especially if they were living alone and lacked higher education. It is suggested to pay attention to the psychological well-being of elderly individuals living alone and lacking a high level of education. Early screening could help reduce the incidence of social isolation, and hence its implications, among the elderly.

Multiple long-term conditions, loneliness and social isolation: A scoping review of recent quantitative studies

BACKGROUND

Multiple long-term conditions (MLTC), loneliness and social isolation are common in older adults. Recent studies have explored the association of MLTC with loneliness and social isolation. This scoping review aimed to map this current evidence and identify gaps in the literature.

METHODS

A scoping review was conducted following the PRISMA guidelines for scoping reviews. Ovid Medline, Embase, CINAHL, The Cochrane Library, PsycInfo, and Bielefeld Academic Search Engine were searched for studies published between January 2020-April 2023. Quantitative studies, published in any language, that assessed the association of MLTC with loneliness and/or social isolation were included.

RESULTS

1827 records were identified and screened. Of these, 17 met inclusion criteria. Most studies were cross-sectional and based on older adults. Studies were conducted in Europe, the US, Canada, and low- and middle-income countries. Ten studies focused on the association between MLTC and loneliness, six assessed the association between MLTC and social isolation and one examined associations with both loneliness and social isolation. Most studies reported a significant cross-sectional association of MLTC with loneliness, but there was weaker evidence for a longitudinal association between MLTC and loneliness and an association between MLTC and social isolation. Studies were heterogenous in terms of measures and definitions of loneliness/social isolation and MLTC, confounders adjusted for, and analytical models used, making comparisons difficult.

CONCLUSIONS

Further population-based longitudinal studies using consistent measures and methodological approaches are needed to improve understanding of the association of MLTC with both loneliness and social isolation.

Sociodemographic Factors and Neighborhood/Environmental Conditions Associated with Social Isolation Among Black Older Adults

Objectives: To investigate sociodemographic factors and neighborhood/environmental conditions associated with social isolation (SI) among Black older adults. Methods: We utilized data from the 2014 and 2016 Leave-Behind Questionnaire from the Health and Retirement Study (HRS LBQ) among those who self-identified as Black (N = 2.323). Outcome variables for our study included SI from adult children, other family members, friends, disengagement from social participation and religious services, being unmarried, and living alone. These indicators were also combined into an overall SI index. Critical predictors included gender, age, household income, education, employment status, neighborhood cohesion, neighborhood disorder, urbanicity, and region of residence. Results: Sociodemographic factors of gender, education and household income were significantly associated with SI indicators. Additionally, some neighborhood/environmental conditions were associated with SI indicators. Discussion: SI was found to be patterned by sociodemographic factors. These results can be used to develop effective interventions to mitigate SI among Black older adults.

Understanding the impact of digital technology on the well-being of older immigrants and refugees: A scoping review

Background

The fast-paced development of digital technologies in the areas of social media, pet robots, smart homes, and artificial intelligence, among others, profoundly influence the daily lives of older adults. Digital technology can improve the well-being and quality of life of older adults, older immigrants and refugees who suffer migration-associated stress, loneliness, health and psychosocial challenges.

Aims

The aim of this scoping review is to map out extant empirical literature that has examined the implication of digital technology among older refugees and immigrants.

Methods

Using a1 five-stage framework, we conducted a scoping review of peer-reviewed empirical studies published in English with no time restrictions. We searched nine databases for the reviews, and abstracts were reviewed using Rayyan QCRi(c) before the full-text review. The comprehensive database search yielded 4134 articles, of which 15 met the inclusion criteria.

Results

The results of the review suggest that digital technology is essential to the well-being, quality of life of older immigrants and refugees, especially for maintaining and building new social support networks, navigating opportunities, coping with migration-induced stress through e-leisure, and staying connected to their culture. The literature also revealed poor utilisation of digital technologies amongst older immigrants and refugees, suggesting barriers to access.

Conclusion

The study concluded by highlighting the need for more research and interventions that focus on multiple strategies, including education for increased access to and utilisation of digital technology to ensure that more older migrants can benefit from the advantages of digital technology in a safe way.

Social isolation during the COVID-19 pandemic in Spain: a population study

Since March of 2020, billions of people worldwide have been asked to limit their social contacts in an effort to contain the spread of the SARS-CoV-2 virus. However, little research has been carried out to date on the impact of such social distancing measures on the social isolation levels of the population. In this paper, we study the impact of the pandemic on the social isolation of the Spanish population, by means of 32,359 answers to a citizen survey collected over a period of 7 months. We uncover (1) a significant increase in the prevalence of social isolation in the population, reaching almost 26%; (2) gender and age differences, with the largest prevalence of isolation among middle-aged individuals; (3) a strong relationship between economic impact and social isolation; and (4) differences in social isolation, depending on the number of COVID-19 protection measures and on the perception of coronavirus infection risk by our participants. Our research sheds quantitative light on the sociological impact of the pandemic, and enables us to identify key factors in the interplay between the deployment of non-pharmaceutical interventions to contain the spread of an infectious disease and a population’s levels of social isolation.

Social Connectedness and Associations with Gambling Risk in New Zealand

Multiple factors are associated with disordered gambling, with some populations having a greater risk for developing disordered gambling than others. The present study, utilising data previously collected for a New Zealand (NZ) national gambling survey, explored the associations of social connectedness and leisure activities with risky gambling behaviour and quality of life. Poorer social connectedness and leisure activities were found to be associated with increased gambling risk and poorer quality of life, respectively. Social connectedness and leisure activities strongly predicted type of gambling activities and quality of life. Furthermore, Māori (NZ's indigenous population) had lower social connectedness and fewer leisure activities, and a greater gambling risk, as well as higher psychological distress, than the NZ European/Other population. These findings indicate that the risk of progressing from recreational gambling to risky gambling is relatively higher for Māori, and that social connectedness and leisure activities could be contributing factors for this increased risk. It is, therefore, important that social connectedness and leisure activities are seriously considered in public health and treatment efforts to reduce gambling harm for vulnerable populations.

Relationship of social isolation with mental distress among older Korean Americans: The moderating role of social cohesion

Social isolation has been associated with poor mental health outcomes, particularly for older immigrants who do not have a protective social environment. The purpose of this study was to investigate the relationship of social isolation (living alone, marginal family ties and marginal friend ties) with mental distress and to examine the moderating role of social cohesion (family cohesion and community cohesion). We hypothesised that social isolation and social cohesion would be directly associated with mental distress and that social cohesion would buffer the influence of social isolation on mental distress. Data were drawn from the Study of Older Korean Americans (SOKA), which included 2150 older Korean Americans aged 60 or over in multiple areas, collected during 2017-2018. A series of hierarchical regression models of mental distress examined the direct and interactive role of social isolation and social cohesion. Approximately one-third of the sample lived alone, 20% had marginal family ties and 27% had marginal friend ties. All three indicators of social isolation had a significant direct effect on mental health; however, living alone lost its statistical significance with the inclusion of social cohesion variables. Both indicators of family and community cohesion were significantly associated with lower levels of mental distress. In addition, family cohesion buffered the negative effects of marginal ties to family and friends on mental distress. The significant role of a positive social environment must be considered when addressing the needs of older immigrants who are socially isolated.

Association of everyday discrimination with health outcomes among Asian and non-Asian US older adults before and during the COVID-19 pandemic

Increases in anti-Asian COVID-19 related discriminatory behaviors have been observed, many of which targeted older adults. Studies demonstrate that racial discrimination is associated with worse health outcomes, including anxiety, depression, and sleep difficulties. No previous studies have examined the impact of day-to-day experiences of discrimination before and during COVID-19 on both Asian and non-Asian older adults within the same sample. We examined whether everyday discrimination was associated with increased anxiety and depression symptoms, decreased levels of functioning, and increased sleep difficulties among Asian and non-Asian US older adults before and during the pandemic. Data came from the Positive Minds-Strong Bodies randomized clinical trial, an evidence-based mental health and disability prevention intervention for racially and ethnically diverse older adults with elevated depression or anxiety symptoms and minor to moderate disability. We conducted secondary data analyses in a cohort of 165 older adults (56 Asian and 109 non-Asian) assessed before COVID-19 (May 2015-May 2018) and during COVID-19 (March 2021-July 2022). Regression models examined whether everyday discrimination impacted health outcomes differently before and during COVID-19, and whether this effect was stronger among Asian compared to non-Asian older adults. Non-Asian older adults reported the same levels of everyday discrimination before and during COVID-19. Consistent with literature suggesting that social distancing has inadvertently kept US Asian populations from experiencing discrimination, Asian older adults reported marginally lower levels of everyday discrimination during the pandemic compared with pre-pandemic. We found that everyday discrimination was not associated with health outcomes before COVID-19. In contrast, during the pandemic, everyday discrimination was associated with worse anxiety and depression symptoms and worse levels of functioning, although only the impact on depression was significantly stronger compared with before the pandemic. This negative impact of everyday discrimination on health outcomes during the pandemic appeared to affect both Asian and non-Asian older adults similarly. Social support and social cohesion buffered against the negative effect of everyday discrimination on depression and level of functioning during the pandemic. Results suggest that public health interventions aimed at reducing everyday discrimination and emphasizing social support and cohesion can potentially improve health outcomes for all US older adult populations.

Clinical trial registration

www.ClinicalTrials.gov; identifier: NCT02317432.

Association between loneliness and acceptance of using robots and pets as companions among older Chinese immigrants during the COVID-19 pandemic

Objectives

To examine loneliness experienced by middle‐aged and older Chinese immigrants and its association with accepting technology as a companion (apps, Internet and robots) versus owning pets, when social distancing measures were implemented in New Zealand during the first COVID‐19 outbreak.

Methods

This study conducted a community‐based cross‐sectional survey. Chinese immigrants who were 45–87 years old (n = 173) were invited to answer an online survey in the Chinese language, collecting demographic data, responses to the 6‐item De Jong Gierveld Loneliness Scale and experiences in using technology and pet ownership. Descriptive analyses and inferential statistics tests were utilised in the data analysis.

Results

A moderate level of overall loneliness with a mean score of 3.68 (SD 1.84), ranging from 0 to 6, was reported by participants. Emotional and social loneliness ranged from 0 to 3 with mean scores of 1.69 (SD 0.98) and 1.99 (SD 1.24), respectively. Self‐reported health, financial status, English language abilities, transportation and experiences of using the Internet and apps were significantly related to experiencing loneliness. Loneliness had a weak association with acceptance of robots and pets, but 67.8% and 58.3% of participants who felt lonely, accepted companionship of robots and pets, respectively.

Conclusions

The level of loneliness among older and middle‐aged immigrants increased during the COVID‐19 pandemic. Further evidence of the specific dimensions of loneliness and the utility of technology to alleviate loneliness among immigrant groups is needed. Interventions tailored for older people with specific cultural requirements to address loneliness are needed.

Cognitive health risks posed by social isolation and loneliness in older Korean Americans

BACKGROUND

This study examines associations among social isolation, loneliness, and cognitive health risks in older Korean Americans, focusing on the mediating role of loneliness in the relationship between social isolation and objective and subjective measures of cognitive impairment.

METHODS

Data are from 2061 participants in the Study of Older Korean Americans, a multi-state survey of Korean immigrants age 60 and older (Mage = 73.2, SD = 7.93). Social isolation was indexed with the Lubben Social Network Scale- 6; loneliness, with the short-form UCLA Loneliness Scale. Objective and subjective measures of cognitive impairment included the Mini-Mental State Examination and a single-item self-rating of cognitive health.

RESULTS

In the logistic regression model for objective cognitive impairment, social isolation was significantly associated, but loneliness was not. In the model for subjective cognitive impairment, both social isolation and loneliness were significant factors. However, the effect of social isolation became non-significant when loneliness was considered, suggesting a potential mediating role of loneliness. The subsequent mediation analysis confirmed that the indirect effect of social isolation on subjective cognitive impairment through loneliness was significant (B = .20, SE = .03, 95% CI = .12, .28).

CONCLUSION

Our analyses provide evidence for the proposed mediating effect of loneliness in the relationship between social isolation and subjective cognitive impairment. Intervention efforts should focus on reducing feelings of loneliness experienced by older immigrants, possibly by engaging them in socially meaningful and cognitively stimulating activities.