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Tiilikainen E, Aartsen M, Kraav SL. Early-life circumstances and late life loneliness trajectories among Finnish older adults. BMC Geriatr 2024; 24:459. [PMID: 38789957 PMCID: PMC11127366 DOI: 10.1186/s12877-024-04967-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/11/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Later life loneliness has become a significant public health concern worldwide. Research has focused on the prevalence, risk factors and consequences of loneliness in different age groups. This study aimed to advance the understanding of the impact of early-life circumstances on later life loneliness by examining the associations between adversities in childhood and youth and loneliness trajectories in Finnish older adults. METHODS The data were derived from the 10-year follow-up survey study Good Aging in the Lahti Region (n = 1552, mean age 64.89 years). The baseline study was conducted in 2002 with a regionally and locally stratified random sample of older persons living in the Lahti Region located in southern Finland. The follow-up surveys were carried out in 2005, 2008 and 2012. Loneliness was measured using a single question at the three follow-ups. Childhood conditions were retrospectively assessed at baseline with questions regarding the death of parents, household affection, relocation, and fear of a family member. Latent class growth analysis with time invariant covariates was used to identify loneliness trajectories and to examine the associations between loneliness trajectories and adverse circumstances in childhood and youth. RESULTS The results identified three distinct loneliness trajectories: low, moderate, and severe, including 36%, 50% and 14%, respectively, of the study population. The non-significant slopes of the three trajectories indicate that trajectories were stable during the seven years of follow-up. Being afraid of a family member, having a cold childhood, and death of a father or mother in childhood or youth significantly increased the odds of having a severe loneliness trajectory as compared to low loneliness trajectory. None of the early-life circumstances differentiated between severe and moderate levels of loneliness. CONCLUSIONS The findings suggest that some adverse early-life circumstances increase the odds of an unfavorable loneliness trajectory in later life. The results highlight the need to recognize the role of diverse life-course adversities in loneliness research and interventions. The study also underscores the importance of identifying individuals who are at risk of long-term and severe loneliness and providing them with appropriate support to decrease and/or prevent the negative health consequences of loneliness in old age.
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Affiliation(s)
- Elisa Tiilikainen
- Department of Social Sciences, University of Finland, Helsinki, Finland.
| | - Marja Aartsen
- NOVA - Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
| | - Siiri-Liisi Kraav
- Department of Social Sciences, University of Finland, Helsinki, Finland
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Robertson MA, Petersen EE, Ross-White A, Camargo-Plazas P, Andrew M, Egan R. Experience of loneliness and depression due to spousal separation by long-term care residents and their spouses: a qualitative systematic review. JBI Evid Synth 2024:02174543-990000000-00297. [PMID: 38632969 DOI: 10.11124/jbies-23-00334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
OBJECTIVE The objective of this review was to describe the experiences of loneliness and/or depression for residents and their spouses who are separated by long-term care placement. INTRODUCTION Loneliness and depression have a pernicious influence on the overall health and well-being of older adults. Older adults' mental health is significantly affected by social relationships, including those between spouses. However, research pertaining to the experience or effect of spousal separation on long-term care residents and community-dwelling spouses' feelings of loneliness and/or depression is limited. INCLUSION CRITERIA This systematic review included studies that recruited community-dwelling spouses and long-term care residents over 50 years of age with living spouses from whom they are separated due to long-term care placement. Studies on the experiences of loneliness and/or depression due to spousal separation with one or both spouses living in long-term care were included in this review. METHODS Ovid MEDLINE(R) was used for the initial search. A full search strategy was developed for Ovid MEDLINE(R), CINAHL (EBSCOhost), Embase (Ovid), and PsycINFO (Ovid). The review was conducted using the JBI approach, with 2 independent reviewers performing study selection, critical appraisal, data extraction, assessment of confidence, and data synthesis. RESULTS Eleven papers were included in this systematic review. Four synthesized findings were extracted from 10 categories and 42 findings: i) Loneliness and depression result from a lack of physical and social connection for separated long-term care residents and community-dwelling spouses; ii) Community-dwelling spouses feel unprepared and upset with spousal separation due to a lack of psychological support; iii) Behavioral strategies can prevent community-dwelling spouses and long-term care residents from developing loneliness and/or depression; and 4) Community-dwelling spouses have differing abilities to adapt and cope with feelings of loneliness and/or depression. CONCLUSION This review provides a comprehensive synthesis of the feelings of loneliness and/or depression spouses who are separated due to long-term care admission experience. This review has demonstrated that there is a lack of literature inclusive of the voices and perspectives of all spouses affected by spousal separation in long-term care. The limitations of this review include the small number of included studies and the range of quality of included studies. Recommendations include additional research on the lived experience of spousal separation from the perspectives of long-term care residents and their community-dwelling spouses. Further, additional psychological support is needed for separated spouses guided by the suggestions and experiences of long-term care residents and their community-dwelling spouses. REVIEW REGISTRATION PROSPERO CRD42022333014.
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Affiliation(s)
| | - Erika E Petersen
- Health Quality Programs, Queen's University, Kingston, ON, Canada
| | - Amanda Ross-White
- Queen's Collaboration for Healthcare Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
- Bracken Health Science Library, Queen's University, Kingston, ON, Canada
| | - Pilar Camargo-Plazas
- Queen's Collaboration for Healthcare Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
- School of Nursing, Queen's University, Kingston, ON, Canada
| | - Melissa Andrew
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Rylan Egan
- Health Quality Programs, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Healthcare Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
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Nkyi AK, Ninnoni JPK. Purpose in life, loneliness and depression among patients with substance use disorders in the psychiatric hospitals in Ghana. PLoS One 2024; 19:e0299391. [PMID: 38635509 PMCID: PMC11025759 DOI: 10.1371/journal.pone.0299391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/08/2024] [Indexed: 04/20/2024] Open
Abstract
Substance use disorder is a global mental health issue. Purpose in life, Loneliness and depression are key indicators of poor mental health, and people with substance use disorder are more likely to experience low purpose in life, depression, and loneliness. This study aims to further the understanding of purpose in life, depression and loneliness among substance use disorders (SUD) patients in three hospitals in Ghana. It uses a cross-sectional survey design. A total of 425 SUD inpatients were screened. Beck Depression Inventory-II, the revised UCLA Loneliness Scale, and the Purpose in Life Test were utilised to measure depression, loneliness, and purpose in life respectively. Data were analysed using the SPSS version 23 for Windows. Data from 378 participants were collected for this study using a cross sectional survey design; after data cleaning, frequency tables (for categorical variables) and descriptive statistics (for continuous variables) were used to summarise the demographics and the three outcome variables depression, purpose in life, and loneliness. Our findings indicate that overall, participants are more likely to experience low sense of purpose in life, depression, and loneliness compared to the general population. There was no statistically significant relationship between depression and loneliness (r = 0.030, p = 0.567). There was a statistically significant negative relationship between depression and purpose in life (r = -0.514, p < 0.001). There was a statistically significant positive relationship between purpose in life and loneliness (r = 0.147, p = 0.004). There was no gender difference in depression, purpose in life, and loneliness among SUDs patients in psychiatric hospitals. There were no significant differences in purpose in life, depression and loneliness based on marital status. It is anticipated that the findings of this study will inform policies and clinical practice regarding service provision for patients with SUDs.
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Affiliation(s)
- Anthony Kwabena Nkyi
- Department of Guidance and Counselling, Faculty of Educational Foundation, College of Education Studies, University of Cape Coast, Cape Coast, Ghana
| | - Jerry Paul K. Ninnoni
- Department of Mental Health, School of Nursing and Midwifery, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Huijie Z, Haojun J, Zhiping Z, Zhaoyu Y. Association between residential environment and emotional wellbeing among older adults in China: the mediating effect of health lifestyle. Front Public Health 2024; 12:1338079. [PMID: 38699418 PMCID: PMC11063323 DOI: 10.3389/fpubh.2024.1338079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/13/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction The association between the residential environment and emotional wellbeing (EWB) in older adults has received extensive attention from gerontologists, especially during the COVID-19 pandemic; however, the mediating mechanism of how residential environment affects emotional wellbeing has not been fully explored. This study examined the effects of the residential environment on EWB and the mediating role of health lifestyle. Methods This study analyzed the survey data of 493 rural and 515 urban older adults from 2021 Chinese General Social Survey. General linear regression and structural equation models were used to examine the effects of residential environment and health lifestyle. Results Urban participants exhibited clear advantages in EWB, residential environment, and physical activity. Residential environment significantly affected the EWB of older adults, and health lifestyle played a mediating role in this relationship. The residential environment and health lifestyle did not significantly affect EWB in rural participants. Discussion This study revealed differences in the effects of health lifestyles and residential environments on EWB among older adults in rural and urban settings in China. This study provided empirical evidence of mental health disparities between older rural and urban Chinese residents.
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Affiliation(s)
- Zhu Huijie
- College of Humanities and Social Development, Nanjing Agricultural University, Nanjing, China
- Center for Social Research, Nanjing Agricultural University, Nanjing, China
- Jin Shanbao Institute for Agricultural and Rural Development Research Institute, Nanjing, China
| | - Jiang Haojun
- Tourism and Social Management College, Nanjing Xiaozhuang University, Nanjing, China
| | - Zhu Zhiping
- College of Humanities and Social Development, Nanjing Agricultural University, Nanjing, China
| | - Yao Zhaoyu
- College of Humanities and Social Development, Nanjing Agricultural University, Nanjing, China
- Jin Shanbao Institute for Agricultural and Rural Development Research Institute, Nanjing, China
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Mayerl H, Schultz A, Freidl W, Stolz E. Short-term dynamics of loneliness and depressive symptoms: Gender differences in older adults. Arch Gerontol Geriatr 2024; 123:105423. [PMID: 38554653 DOI: 10.1016/j.archger.2024.105423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Previous research examining the relationship between loneliness and depressive symptoms often treated these constructs as static traits rather than dynamic states. The current study focused on the short-term, prospective link between loneliness and depressive symptoms, while also analyzing potential gender differences. METHODS We modeled panel data from seven bi-weekly assessments gathered in the FRequent health Assessment In Later life (FRAIL70+) study. At baseline, the sample size amounted to N = 426 community-dwelling older adults aged 70 years or older in Austria. The relationship between loneliness and depressive symptoms was analyzed using a latent change score modeling framework. RESULTS As regards depressive symptoms, women showed higher initial levels and more change across the three months than men. Loneliness did not considerably change across time for both sexes. Moreover, greater levels of loneliness at a given point in time were associated with an accelerated increase in depressive symptoms two weeks later in women but not in men. CONCLUSION Loneliness appeared to be a potential determinant of future increases in depressive symptoms. The varying effects observed between men and women suggest potential gender differences in short-term fluctuations of depressive symptoms and their underlying mechanisms.
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Affiliation(s)
- Hannes Mayerl
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Anna Schultz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Wolfgang Freidl
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria.
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Sun F, Wang F, Hu X, Xue J, Zheng S, Su J, Lu Q. Alexithymia and negative emotions among nursing students: a moderated mediation model. BMC Nurs 2024; 23:167. [PMID: 38459516 PMCID: PMC10921665 DOI: 10.1186/s12912-024-01832-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
Nursing students, who comprise a high percentage of China's college students, experience many psychological problems; however, few studies explored the mechanisms underlying these problems. This cross-sectional study explored the relationships and mechanisms of depression, anxiety, stress, and narrative disorders in senior nursing students. Questionnaires were administered to 380 senior nursing students in Hubei Province using the Sociodemographic Questionnaire, Toronto Alexithymia-20 Scale, Perceived Social Support Scale, 10-Item Connor-Davidson Resilience Scale, and Depression-Anxiety-Stress Scale. After controlling for sociodemographic variables, Hayes' PROCESS macros were used to test how psychological resilience moderates the relationships among narrative disorders, negative affect, and perceived social support. Bootstrap confidence intervals tested for indirect effects. Correlation analyses revealed that alexithymia was correlated significantly positively with depression-anxiety-stress (r = 0.57, 0.56, and 0.58, resp.) and significantly negatively with perceived social support (r = 0-0.46). Psychological resilience was correlated significantly negatively with alexithymia (r=-0.39) and depression-anxiety-stress (r=-0.31, -0.30, and-0.32, resp.) but significantly positively with perceived social support(r = 0.50). Perceived social support was correlated significantly negatively with depression-anxiety-stress (r=-0.33, -0.34, and - 0.42 resp.). Stress was correlated significantly positively with anxiety and depression (r = 0.81 and 0.77, resp.). Psychological resilience was a partial mediator between depression and dysphoria (β=-0.08, p < 0.05). Dysphoria directly predicted anxiety (β = 0.31) and stress (β = 0.37); moreover,alexithymia predicted depression not only directly but also through the mediating effect of psychological resilience. Therefore, educators and clinical administrators must promote and recognise negative emotions among nursing students to help ensure the nursing workforce's stability.
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Affiliation(s)
- Feifei Sun
- Department of Nursing, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Fang Wang
- Xianning Vocational Technical College, 437100, Xianning, Hubei, China
| | - Xiaojing Hu
- Department of Nursing, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Jiaomei Xue
- Society and Law School, Shandong Women's University, Changqing University Science and Technology Park, No. 2399, University Road, 25030, Jinan, Shandong, China
| | - Shangkun Zheng
- Human Resources Department, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Jing Su
- Editorial Board, Journal of Shandong First Medical University, No. 6699 Qingdao Road, Huaiyin District, 250000, Jinan, China
| | - Qinghua Lu
- Department of Infection Management, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China.
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Chen Z, Song X, Lee TMC, Zhang R. The robust reciprocal relationship between loneliness and depressive symptoms among the general population: Evidence from a quantitative analysis of 37 studies. J Affect Disord 2023; 343:119-128. [PMID: 37797753 DOI: 10.1016/j.jad.2023.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Loneliness has long been associated with depressive symptoms, but there is no evidence on the question of "which comes first". To help us to answer this question, this study conducted a meta-analysis using a cross-lagged formula to examine the reciprocal relations between loneliness and depressive symptoms, as well as potential moderators. METHODS The meta-analytic dataset consisted of 37 studies with sample sizes ranging from 52 to 5991. Effect sizes (including autoregressive effects and lagged coefficients) were included. We computed weighted mean effect sizes for the correlation effect and cross-lagged effect between loneliness and depressive symptoms. We also performed a meta-regression to investigate potential moderators. RESULTS The results showed that loneliness and depressive symptoms reciprocally predicted each other over time with similar effect sizes. There was no moderation of our overall effect size in either direction by time interval between measurements, the proportion of female participants, mean age of the sample, or type of measurement. LIMITATIONS Caution should be taken in drawing final conclusions about the relative strength of reciprocal effects between loneliness and depressive symptoms due to the potential influence of varied research focus in the included studies, which could affect the effect size. CONCLUSIONS These findings advance the study of the relationship between loneliness and depressive symptoms by providing evidence that the link between them is symmetrically reciprocal and robust, which may help clinicians to develop effective intervention methods.
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Affiliation(s)
- Zhijia Chen
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiaoqi Song
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Tatia M C Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong; Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China
| | - Ruibin Zhang
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China; Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China; Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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Hayslip B, Maiden RJ, Greil AL. Social and Emotional Loneliness: Their Relationship to Multiple Domains of Cognition in Later Life. Int J Aging Hum Dev 2023; 97:456-478. [PMID: 36476123 DOI: 10.1177/00914150221143961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Despite the fact that the literature suggests loneliness to undermine cognitive functioning in later life, no work has simultaneously examined the relationships between these constructs taking a multidimensional approach to the assessment of each. The present study explored relationships among social and emotional loneliness and both general crystallized (Gc) and general fluid (Gf) ability, as well as to several indices of everyday intellectual functioning in later life. Sequential regression analyses suggested that neither social nor emotional loneliness predicted Gc. However, only when eliminating health as a covariate was more social loneliness associated with lower scores for Gf. Surprisingly, more emotional loneliness was associated with higher scores for Gf. More social loneliness also predicted more everyday cognitive failures and with less positive lifestyle attitudes. These findings support a view of loneliness-cognition relationships in later life that reflects the multidimensional nature of each construct.
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Affiliation(s)
- Bert Hayslip
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Robert J Maiden
- Department of Psychology, Alfred University, Alfred, NY, USA
| | - Arthur L Greil
- Department of Social Sciences, Alfred University, Alfred, NY, USA
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Long EM. Promoting Connection in the Faith Community Through Letter Writing. J Christ Nurs 2023; 40:260-265. [PMID: 37653657 DOI: 10.1097/cnj.0000000000001098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
ABSTRACT Faith community nurses can reduce loneliness and provide connection for homebound members of faith communities through promotion of letter writing. Undergraduate nursing students who were matched with members of their own faith community wrote letters to older adults for 10 weeks as a community service-learning project. Data from the UCLA Loneliness Scale pre- and post-intervention showed reduced loneliness and greater connection among recipients of the letters.
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Affiliation(s)
- Elizabeth M Long
- Elizabeth M. Long, DNP, APRN, GNP-BC, CNS, CNE, is an associate professor of nursing at Lamar University, a gerontological nurse practitioner, faith community nurse, and a Hartford Distinguished Educator in Gerontological Nursing
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Robertson MA, Petersen EE, Ross-White A, Egan R. Experience of loneliness and depression due to spousal separation in long-term care residents and their spouses: a qualitative systematic review protocol. JBI Evid Synth 2023; 21:1672-1678. [PMID: 36999375 DOI: 10.11124/jbies-22-00270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
OBJECTIVE The objective of this review is to describe the experience of loneliness and/or depression due to spousal separation when one or both spouses are admitted into a long-term care facility. INTRODUCTION Loneliness and depression are important concerns for the health and well-being of older adults separated from their spouses due to long-term care placement. Social relationships, specifically spousal relationships, have a significant impact on the mental health of older adults. However, there is limited research on the experience or effect of spousal separation on long-term care residents' and their spouses' experience of loneliness and/or depression. INCLUSION CRITERIA This review will include long-term care residents and their spouses who are over the age of 50 and have a spouse they are separated from due to long-term care placement. Studies will be included in this review if they explore the experiences of loneliness and/or depression due to spousal separation with one or both spouses living in a long-term care facility. METHODS This review will be conducted in line with the JBI methodology for systematic reviews of qualitative evidence. MEDLINE was used for the initial search. A full search strategy was then developed for MEDLINE, CINAHL, Embase, and PsycINFO. The JBI approach to study selection, critical appraisal, data extraction, data synthesis, and assessment of confidence will be used. Two reviewers will pilot test the screening criteria and data extraction protocol. REVIEW REGISTRATION PROSPERO CRD42022333014.
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Affiliation(s)
- Madison A Robertson
- Health Quality Programs, School of Nursing, Queen's University, Kingston, ON, Canada
| | - Erika E Petersen
- Health Quality Programs, School of Nursing, Queen's University, Kingston, ON, Canada
| | - Amanda Ross-White
- Bracken Health Science Library, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality, Queen's University, Kingston, ON, Canada
| | - Rylan Egan
- Health Quality Programs, School of Nursing, Queen's University, Kingston, ON, Canada
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Delaruelle K, Vergauwen J, Dykstra P, Mortelmans D, Bracke P. Marital-history differences in increased loneliness during the COVID-19 pandemic: A European study among older adults living alone. Arch Gerontol Geriatr 2023; 108:104923. [PMID: 36634441 PMCID: PMC9815881 DOI: 10.1016/j.archger.2023.104923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/22/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
The COVID-19 pandemic and related physical distancing measures have disproportionally affected older adults living alone due to their greater social isolation. Unlike previous studies on the subject, the current research recognizes the diversity amongst older adults living alone by considering the impact of marital history. Combining information from Wave 8 of the Survey of Health Ageing and Retirement (SHARE), with data of SHARELIFE and the SHARE Corona survey, we investigated the differential impact of the COVID-19 pandemic on loneliness in older men (N = 1504) and women (N = 4822) living alone. Logistic multilevel analyses were performed on data from 26 European countries and Israel. For men, we found that the short-term widowed were more likely to report increased loneliness than the medium- and long-term widowed and those living apart together (LAT). For women, the results indicated that the short- and medium-term widowed and the divorced were at greater risk for increased loneliness than those in a LAT relationship. Also, medium-term widowed women were more likely to report increased loneliness than their long-term widowed counterparts. The three hypothesized underlying mechanisms - i.e., (i) the opportunity mechanism, (ii) the expectation mechanism, and (iii) the vulnerability mechanism - only played a small role in explaining the observed differences. In sum, our study highlights the importance of recognizing the diversity within the group of older adults living alone when investigating the effects of the pandemic on loneliness, yet the mechanisms behind the stratifying role of marital history are not fully understood.
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Affiliation(s)
- Katrijn Delaruelle
- Ghent University, Department of Sociology, Technicum T1, Sint-Pietersnieuwstraat 41, 9000 Ghent, Belgium.
| | - Jorik Vergauwen
- University of Antwerp, Department of Sociology, Sint-Jacobstraat 2, 2000 Antwerpen, Belgium
| | - Pearl Dykstra
- Erasmus University Rotterdam, Department of Public Administration and Sociology, Burg. Oudlaan 50, 3062 PA Rotterdam, The Netherlands
| | - Dimitri Mortelmans
- University of Antwerp, Department of Sociology, Sint-Jacobstraat 2, 2000 Antwerpen, Belgium
| | - Piet Bracke
- Ghent University, Department of Sociology, Technicum T1, Sint-Pietersnieuwstraat 41, 9000 Ghent, Belgium
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Teshale AB, Htun HL, Hu J, Dalli LL, Lim MH, Neves BB, Baker JR, Phyo AZZ, Reid CM, Ryan J, Owen AJ, Fitzgerald SM, Freak-Poli R. The relationship between social isolation, social support, and loneliness with cardiovascular disease and shared risk factors: A narrative review. Arch Gerontol Geriatr 2023; 111:105008. [PMID: 37003026 DOI: 10.1016/j.archger.2023.105008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the greatest contributor to global morbidity and mortality. Poor social health plays a critical role in CVD incidence. Additionally, the relationship between social health and CVD may be mediated through CVD risk factors. However, the underlying mechanisms between social health and CVD are poorly understood. Certain social health constructs (social isolation, low social support and loneliness) have complicated the characterisation of a causal relationship between social health and CVD. AIM To provide an overview of the relationship between social health and CVD (and its shared risk factors). METHOD In this narrative review, we examined published literature on the relationship between three social health constructs (social isolation, social support, and loneliness) and CVD. Evidence was synthesised in a narrative format, focusing on the potential ways in which social health affects CVD, including shared risk factors. RESULTS The current literature highlights an established relationship between social health and CVD with a likelihood for bi-directionality. However, there is speculation and varied evidence regarding how these relationships may be mediated through CVD risk factors. CONCLUSIONS Social health can be considered an established risk factor for CVD. However, the potential bi-directional pathways of social health with CVD risk factors are less established. Further research is needed to understand whether targeting certain constructs of social health may directly improve the management of CVD risk factors. Given the health and economic burdens of poor social health and CVD, improvements to addressing or preventing these interrelated health conditions would have societal benefits.
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Affiliation(s)
| | - Htet Lin Htun
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Jessie Hu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lachlan L Dalli
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
| | - Michelle H Lim
- Prevention Research Collaboration, School of Public Health, The University of Sydney, New South Wales, Australia.
| | | | - J R Baker
- School of Health, Southern Cross University, Australia; Primary & Community Care Limited, Australia.
| | - Aung Zaw Zaw Phyo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; School of Population Health, Curtin University, Perth, Western Australia, Australia.
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Sharyn M Fitzgerald
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
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13
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Mayerl H, Stolz E, Freidl W. Lonely and depressed in older age: prospective associations and common vulnerabilities. Aging Ment Health 2023; 27:640-645. [PMID: 35341418 DOI: 10.1080/13607863.2022.2056138] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Research demonstrated a close relationship between loneliness and depressive symptoms, but it remains unclear whether these constructs reciprocally influence each other or whether the association is due to common causes. This study aimed at examining how loneliness and depressive symptoms jointly unfold across time and how the relationship varies both within and between individuals. METHODS We used survey data of N = 8472 older adults gathered in the English Longitudinal Study of Ageing, which included eight waves over a time period of up to 15 years. The relationship was analyzed using a latent curve model, allowing us to separate within-person processes from between-person differences in long-term growth. RESULTS Results showed no prospective effects of loneliness on depressive symptoms (or vice versa) at the within-person level. Yet, within-person increases in loneliness were related to within-person increases in depressive symptoms at the same point in time. As regards the between-person effects, greater long-term growth in loneliness went along with greater long-term growth in depressive symptoms. CONCLUSION Our findings did not support the assumption that loneliness and depressive symptoms influence each other over time, but rather suggest that the short- and long-term associations may be due to a common vulnerability to the same causes. Supplemental data for this article is available online at https://doi.org/10.1080/13607863.2022.2056138 .
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Affiliation(s)
- Hannes Mayerl
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - Wolfgang Freidl
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
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14
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Zhang Y, Kuang J, Xin Z, Fang J, Song R, Yang Y, Song P, Wang Y, Wang J. Loneliness, social isolation, depression and anxiety among the elderly in Shanghai: Findings from a longitudinal study. Arch Gerontol Geriatr 2023; 110:104980. [PMID: 36863166 DOI: 10.1016/j.archger.2023.104980] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023]
Abstract
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.
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Affiliation(s)
- Yuwen Zhang
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Jiawen Kuang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Zhaohua Xin
- Lingqiao Community Health Center, Pudong New Area, Shanghai, China
| | - Jialie Fang
- Jing'an District Center for Disease Control and Prevention, Shanghai, China
| | - Rui Song
- Xiaodongmen Subdistrict Community Health Center, Huangpu District, Shanghai, China
| | - Yuting Yang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China.
| | - Ying Wang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Jingyi Wang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
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15
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Hemberg J, Östman L, Korzhina Y, Groundstroem H, Nyström L, Nyman-Kurkiala P. Loneliness as experienced by adolescents and young adults: an explorative qualitative study. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2022. [DOI: 10.1080/02673843.2022.2109422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Affiliation(s)
- Jessica Hemberg
- Department of Caring Sciences, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
| | - Lillemor Östman
- Childcare and Education Department, Luleå Municipality, Luleå Sweden
| | - Yulia Korzhina
- Department of Caring Sciences, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
| | | | - Lisbet Nyström
- Department of Caring Sciences, Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
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16
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A Systematic Literature Review of Loneliness in Community Dwelling Older Adults. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci12010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Research on loneliness is extensive. This paper presents a systematic review of intervention studies, outlining the antecedents to, and consequences of loneliness in community-dwelling older people. Using PRISMA methodology, a systematic literature review was conducted between January and August 2021 resulting in 49 useable articles. Papers were included if they: (a) investigated older people (+50); (b) were living in community dwellings; (c) had been published in English; (d) had titles or abstracts available and, (e) were published between 2016 and 2021. This study found the antecedents and consequences of social, emotional and existential loneliness differ, however, the vast majority of research has not examined the unique types of loneliness and instead kept loneliness as a generic term, despite the acceptance that various types of loneliness exist. In addition, the findings of intervention studies identified through this review have yielded mixed results. Those interventions focused on improving personal and psycho-social resources for older people fared better outcomes than those focused on technological and social connections alone. This paper reports important implications for the future of research conducted on loneliness and interventions accordingly.
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17
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Stickley A, Kondo N, Inoue Y, Kanamori M, Kino S, Arakawa Y, McKee M. Worry about crime and loneliness in nine countries of the former Soviet Union. SSM Popul Health 2022; 21:101316. [PMID: 36632051 PMCID: PMC9827055 DOI: 10.1016/j.ssmph.2022.101316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/08/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022] Open
Abstract
Worry about crime has been linked to several detrimental outcomes including worse mental health. However, there has been little research on the association between worry about crime and loneliness, even though loneliness is increasingly being recognised as a serious public health issue. To address this deficit, this study examined the association between worry about crime and loneliness in nine countries of the former Soviet Union (FSU - Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine), using data from 18,000 respondents aged 18 and above that were collected during the Health in Times of Transition (HITT) survey in 2010/11. Results from a pooled logistic regression analysis showed that compared to those who reported no worry about crime, individuals with a high level of worry had significantly higher odds of loneliness (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.17-1.75). Sex- and age-stratified analyses further showed that the association was observed in women with a mid (OR: 1.37, 95%CI: 1.10-1.71) and a high level (OR: 1.70, 95%CI: 1.33-2.17) of worry about crime but not in men, and that a high level of worry about crime was linked to loneliness in adults aged 35-59 (OR: 1.39, 95%CI: 1.02-1.91) and 60 and above (OR: 1.64, 95%CI: 1.12-2.40) but not in those aged 18-34. High levels of worry about crime are associated with loneliness in the FSU countries. Reducing crime and its associated worries may have important public health benefits in these countries.
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Affiliation(s)
- Andrew Stickley
- Stockholm Centre for Health and Social Change (SCOHOST), Sodertorn University, Huddinge, Sweden,Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan,Corresponding author. Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mariko Kanamori
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan,Institute for the Future of Human Society, Kyoto University, Kyoto, Japan
| | - Shiho Kino
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan,Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Arakawa
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
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18
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Carbone E, Piras F, Pellegrini FF, Caffarra P, Borella E. Individual differences among older adults with mild and moderate dementia in social and emotional loneliness and their associations with cognitive and psychological functioning. BMC Geriatr 2022; 22:859. [DOI: 10.1186/s12877-022-03517-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/06/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Loneliness is a major health issue among older adults. The aim of this study was to assess the relationship between loneliness, in its social and emotional facets, and the cognitive (language), and behavioral/psychological functioning as well as quality of life (QoL) in people with mild and moderate dementia, i.e., considering dementia severity as an individual characteristic.
Methods
This cross-sectional study involved 58 people with mild dementia and 55 people with moderate dementia. Participants completed the Social and Emotional Loneliness scale, along with measures assessing their language skills, the frequency and severity of their behavioral and psychological symptoms, and their QoL.
Results
Socio-demographic characteristics and depression, but not loneliness or its social and emotional facets, contributed to explain participants’ behavioral and psychological symptoms, regardless of dementia severity. Loneliness explained, though to a small extent (8% of variance), language skills in people with moderate dementia, with social loneliness only accounting for language skills (18% of variance) in this group. Loneliness also modestly accounted for dysphoria symptoms in both the mildly and moderately impaired (6% and 5% of variance, respectively) individuals with social loneliness predicting dysphoric mood in the former group only (7% of variance). Loneliness also explained, to a larger extent, QoL in both the mildly impaired and moderately impaired individuals (27% and 20% of variance, respectively), its social facet predicting QoL in the mildly impaired (30% of variance), and its emotional facet in the moderately impaired (21% of variance) group.
Conclusion
These findings suggest that loneliness and its facets have a clear impact on perceived QoL, and influence the language skills and dysphoria symptoms of people with dementia, to a degree that depends on dementia severity. The assessment of loneliness and its facets in people with dementia considering dementia severity, and the promotion of social inclusion to reduce it should be considered by professionals.
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19
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Marsillas S, Schoenmakers E. Older adults' mentioned practices for coping with loneliness. Eur J Ageing 2022; 19:753-762. [PMID: 36052187 PMCID: PMC9424410 DOI: 10.1007/s10433-021-00658-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 12/20/2022] Open
Abstract
In recent years, loneliness has been receiving increasing attention, yet there remains a lot to learn about how older adults cope with loneliness. In this study, the practices older adults consider for coping with loneliness and the relationship between various types of coping practices, loneliness, and personal resources are examined. Several hypotheses about the relationship between social and emotional loneliness, personal resources, and mentioning coping practices are formulated. Data was collected in Gipuzkoa (Basque Country, Spain) through structured interviews using a telephone survey among a representative sample of older adults aged 55 and over (N = 894). Results show that lonely and non-lonely respondents alike consider a few coping practices and prefer active and individual coping practices over social and passive ones for coping with loneliness. Experiencing emotional loneliness is related to mentioning more individual and active coping practices. Social coping practices were considered less often by respondents who experienced better self-rated health and more often by respondents with vision loss, a higher educational level and higher quality of life. In conclusion, while older adults differ in coping efforts they mention, these differences are only explained to a small extent by their experience of loneliness and available resources. For future research and practice development, a deeper understanding of the process of coping with loneliness is needed.
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20
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Hsu HC, Chao SF. Loneliness, loneliness literacy, and change in loneliness during the COVID-19 pandemic among older adults: a cross-sectional study. BMC Geriatr 2022; 22:707. [PMID: 36028799 PMCID: PMC9412798 DOI: 10.1186/s12877-022-03396-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Loneliness has become a significant public health concern for older people. However, little is known about the association of loneliness, loneliness literacy, and changes in loneliness during the COVID-19 pandemic with mental well-being. The purpose of this study was to explore whether loneliness literacy is related to a lower risk of loneliness, increased loneliness during the COVID-19 pandemic, and improved mental well-being for community-based older adults. METHODS A telephone survey was conducted to collect data from older adults aged 65 years or older in Taiwan (n = 804). Loneliness, change in loneliness during COVID-19, and loneliness literacy were the main variables. Mental well-being was assessed by depressive symptoms and life satisfaction. Related factors included personal level (demographics, health conditions, health behaviors, and problem-focused/ emotion-focused coping strategies), interpersonal level (marital status, living arrangements, social support, social participation, leisure activities, and social interactions during COVID-19), and societal level (areas and regions) factors. RESULTS Four dimensions of loneliness literacy were identified by factor analysis: self-efficacy, social support, socialization, and in-home support. Self-efficacy and in-home support were related to lower loneliness. Lower self-efficacy, higher social support, and higher socialization were related to changes (increases) in loneliness during COVID-19. In-home support may prevent depressive symptoms, while self-efficacy was beneficial for better life satisfaction. In addition, emotion-focused coping may increase loneliness during COVID-19, while satisfaction with family support would be a protective factor against loneliness. CONCLUSION Loneliness literacy is related to loneliness and increased loneliness during the COVID-19 pandemic. Building up an age-friendly community with embedded services/information and learning positive coping and mental resilience strategies are suggested.
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Affiliation(s)
- Hui-Chuan Hsu
- School of Public Health, Taipei Medical University, No.250, Wuxing Street, 11031, Taipei, Taiwan, R.O.C.. .,Research Center of Health Equity, College of Public Health, Taipei Medical University, Taipei, Taiwan, R.O.C..
| | - Shiau-Fang Chao
- Department of Social Work, National Taiwan University, Taipei, Taiwan, R.O.C
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21
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Freak-Poli R, Ryan J, Tran T, Owen A, McHugh Power J, Berk M, Stocks N, Gonzalez-Chica D, Lowthian JA, Fisher J, Byles J. Social isolation, social support and loneliness as independent concepts, and their relationship with health-related quality of life among older women. Aging Ment Health 2022; 26:1335-1344. [PMID: 34219569 DOI: 10.1080/13607863.2021.1940097] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives: To assess whether social isolation, social support, and loneliness are independently associated with health-related quality of life (HRQoL).Method: Retrospective analysis including 10,517 women aged 70-75 years from the Australian Longitudinal Study on Women's Health (ALSWH). Social isolation, social support (Duke Social Support Index), and loneliness (single item) were investigated for their association with standardised HRQoL (physical [PCS] and mental [MCS] components of the SF-36® questionnaire). Analyses were adjusted for sociodemographic variables and number of medical conditions.Results: Only 3% reported being socially isolated, having low social support and being lonely, and 34% reported being not socially isolated, high social support and not being lonely. Each construct was independently associated with HRQoL, with loneliness having the strongest inverse association (PCS: isolation -0.98, low support -2.01, loneliness -2.03; MCS: isolation -1.97, low support -4.79, loneliness -10.20; p-value < 0.001 for each). Women who were not isolated or lonely and with high social support had the greatest HRQoL (compared to isolated, low social support and lonely; MCS: 17 to 18 points higher, PCS: 5 to 8 points higher). Other combinations of social isolation, social support and loneliness varied in their associations with HRQoL.Conclusion: Ageing populations face the challenge of supporting older people to maintain longer, healthy, meaningful and community-dwelling lives. Among older women, social isolation, low social support and loneliness are distinct, partially overlapping yet interconnected concepts that coexist and are each adversely associated with HRQoL. Findings should be replicated in other cohorts to ensure generalisability across other age groups and men.
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Affiliation(s)
- Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Thach Tran
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Alice Owen
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Michael Berk
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, the Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Nigel Stocks
- Discipline of General Practice, The University of Adelaide, Adelaide, Australia
| | - David Gonzalez-Chica
- Discipline of General Practice, The University of Adelaide, Adelaide, Australia.,Adelaide Rural Clinical School, The University of Adelaide, Adelaide, Australia
| | - Judy A Lowthian
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,Bolton Clarke Research Institute, Bolton Clarke, Melbourne, Australia.,Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Jane Fisher
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Julie Byles
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, Australia
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22
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Shankar A, Kidd T. Loneliness in Older Indian Dyads. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095302. [PMID: 35564697 PMCID: PMC9101006 DOI: 10.3390/ijerph19095302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 02/05/2023]
Abstract
Background: Loneliness has been recognised as a major public health concern in older adults in developed nations, with little focus on low- and middle-income countries such as India. While the protective nature of social relationships on loneliness has been explored in the context of marriage, typically these benefits are examined in individual spouses rather than within the marital dyad. Methods: A sample of 398 opposite-sex married Indian couples (mean age 54.8 years) was obtained from the pilot wave of the Longitudinal Aging Study in India (LASI) conducted in 2010. These cross-sectional data were analysed using the Actor-Partner Interdependence Model, with one’s own and one’s partner’s cognitive function, functional limitations, depressive symptoms, employment status and contact with friends included as predictors of loneliness. Results: There were no gender differences in the pattern of associations. Depression was positively associated with loneliness with actor and partner effects being significant. One’s partner being employed was associated with less loneliness. Conclusions: The sample showed low levels of depression, loneliness, and reduced functionality; however, depression still predicted one’s own and one’s partner’s loneliness. Future work using longitudinal data could examine the role of employment in loneliness, particularly within the context of gender roles.
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Affiliation(s)
- Aparna Shankar
- Department of Psychological Sciences, FLAME University, 401 Phoenix Complex, Bund Garden Rd., Opp. Residency Club, Pune 411001, India
- Correspondence: ; Tel.: +91-206-790-6308
| | - Tara Kidd
- Department of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK;
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23
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Wolfers MEG, Stam BE, Machielse A. Correlates of emotional and social loneliness among community dwelling older adults in Rotterdam, the Netherlands. Aging Ment Health 2022; 26:355-367. [PMID: 33502244 DOI: 10.1080/13607863.2021.1875191] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Loneliness is seen as an important problem, contributing to serious health problems. As a baseline measurement for the evaluation of a community project aimed at reducing loneliness in Rotterdam, loneliness was measured, as well as potential correlates. This article describes models of social and emotional loneliness among older adults. METHODS This study was conducted among 3,821 randomly selected community dwelling citizens of 65 years and older. Loneliness was measured by using the Jong-Gierveld loneliness questionnaire/scale. As potential correlates demographic, health and psychological and social variables were included. Data were subjected to multiple hierarchically regression analysis. RESULTS Emotional loneliness was reported by 60% and social loneliness by 47% of the sample. Women were more emotionally lonely than men , while men reported more social loneliness than women. Emotional social support and quality of life were strongest in predicting emotional loneliness and social capital in the neighbourhood, companionship and instrumental support were strongest predictors for social loneliness. Demographic variables predicted variability in emotional loneliness. CONCLUSIONS The strength of the correlates differed between the two dimensions of loneliness. In the design of interventions to prevent and reduce loneliness among older adults, strategies should be developed aimed at the specific dimensions of loneliness.
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Affiliation(s)
- Mireille E G Wolfers
- Department Research and Business Intelligence, Municipality of Rotterdam, Rotterdam, the Netherlands
| | - Bianca E Stam
- Department Research and Business Intelligence, Municipality of Rotterdam, Rotterdam, the Netherlands
| | - Anja Machielse
- University for Humanistic Studies, Utrecht, the Netherlands
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24
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Kraav SL, Awoyemi O, Junttila N, Vornanen R, Kauhanen J, Toikko T, Lehto SM, Hantunen S, Tolmunen T. The effects of loneliness and social isolation on all-cause, injury, cancer, and CVD mortality in a cohort of middle-aged Finnish men. A prospective study. Aging Ment Health 2021; 25:2219-2228. [PMID: 33939562 DOI: 10.1080/13607863.2020.1830945] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Loneliness and social isolation both increase mortality and are likely to affect health via several pathways. However, information on the potential pathways remains scarce. We investigated the associations between loneliness, social isolation, and mortality, and possible mechanisms underlying these connections. METHODS The analyzed data comprised a prospective population-based cohort of Finnish men (42-61 years at baseline, n = 2588) who were followed up for an average of 23.2 years. Mortality data were obtained from the national population register in 2012. Cox proportional hazards analysis with adjustments for possible confounding factors was used to examine the associations between loneliness and social isolation at baseline and all-cause, injury, cancer, and cardiovascular disease (CVD) mortality. Mediation analysis was conducted to investigate the mechanisms underlying the associations of loneliness and social isolation with mortality. RESULTS Loneliness predicted all-cause mortality, even after adjustments for all covariates. Loneliness predicted cancer mortality, except after adjustments for lifestyle variables or Human Population Laboratory (HPL) depression scores, and also predicted CVD mortality, except after adjustments for HPL depression scores. Social isolation predicted all-cause mortality and injury mortality. The effect of social isolation on all-cause mortality was mediated by loneliness and HPL depression scores. CONCLUSIONS Our findings suggest that both loneliness and social isolation increase the risk of all-cause mortality, while they have differing effects on different causes of death. Loneliness and depressive symptoms may mediate the effect of social isolation on increased mortality.
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Affiliation(s)
- Siiri-Liisi Kraav
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Olutosin Awoyemi
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom.,Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Niina Junttila
- Department for Teacher Education, Centre for Education and Research on Social and Health Services, University of Turku, Turku, Finland
| | - Riitta Vornanen
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Timo Toikko
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,R&D Department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tommi Tolmunen
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
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25
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Freak-Poli R, Wagemaker N, Wang R, Lysen TS, Ikram MA, Vernooij MW, Dintica CS, Vernooij-Dassen M, Melis RJM, Laukka EJ, Fratiglioni L, Xu W, Tiemeier H. Loneliness, Not Social Support, Is Associated with Cognitive Decline and Dementia Across Two Longitudinal Population-Based Cohorts. J Alzheimers Dis 2021; 85:295-308. [PMID: 34842183 PMCID: PMC9198751 DOI: 10.3233/jad-210330] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background: Poor social health is likely associated with cognitive decline and risk of dementia; however, studies show inconsistent results. Additionally, few studies separate social health components or control for mental health. Objective: To investigate whether loneliness and social support are independently associated with cognitive decline and risk of dementia, and whether depressive symptoms confound the association. Methods: We included 4,514 participants from the population-based Rotterdam Study (RS; aged 71±7SD years) followed up to 14 years (median 10.8, interquartile range 7.4–11.6), and 2,112 participants from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K; aged 72±10SD years) followed up to 10 years (mean 5.9±1.6SD). At baseline, participants were free of major depression and scored on the Mini-Mental State Examination (MMSE) ≥26 for RS and ≥25 for SNAC-K. We investigated loneliness, perceived social support, and structural social support (specifically marital status and number of children). In both cohorts, dementia was diagnosed and cognitive function was repeatedly assessed with MMSE and a global cognitive factor (g-factor). Results: Loneliness was prospectively associated with a decline in the MMSE in both cohorts. Consistently, persons who were lonely had an increased risk of developing dementia (RS: HR 1.34, 95%CI 1.08–1.67; SNAC-K: HR 2.16, 95%CI 1.12–4.17). Adjustment for depressive symptoms and exclusion of the first 5 years of follow-up did not alter results. Neither perceived or structural social support was associated with cognitive decline or dementia risk. Conclusion: Loneliness, not social support, predicted cognitive decline and incident dementia independently of depressive symptoms.
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Affiliation(s)
- Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Nina Wagemaker
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Rui Wang
- Aging Research Center, Karolinska Institute, Stockholm, Sweden.,The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Thom S Lysen
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | | | - Rene J M Melis
- Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Erica J Laukka
- Aging Research Center, Karolinska Institute, Stockholm, Sweden
| | | | - Weili Xu
- Aging Research Center, Karolinska Institute, Stockholm, Sweden
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, MA, USA
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26
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Joyce J, Ryan J, Owen A, Hu J, Power JM, Shah R, Woods R, Storey E, Britt C, Freak-Poli R. Social isolation, social support, and loneliness and their relationship with cognitive health and dementia. Int J Geriatr Psychiatry 2021; 37:10.1002/gps.5644. [PMID: 34741340 PMCID: PMC9068834 DOI: 10.1002/gps.5644] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/31/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Poor social health is prevalent in older adults and may be associated with worse cognition, and increased dementia risk. The aim of this study was to determine whether social isolation, social support and loneliness are independently associated with cognitive function and incident dementia over 5 years in older adults, and to investigate potential gender differences. METHODS Participants were 11,498 community-dwelling relatively healthy Australians aged 70-94, in the ASPREE Longitudinal Study of Older Persons (ALSOP). Social isolation, social support, loneliness and cognitive function were assessed through self-report. Outcomes examined were cognitive decline (>1.5 SD decline in cognitive performance since baseline) and incident dementia (adjudicated according to DSM-IV criteria). RESULTS Most participants self-reported good social health (92%) with very few socially isolated (2%), with low social support (2%) or lonely (5%). Among women, social isolation and low social support were consistently associated with lower cognitive function (e.g., social support and cognition β = -1.17, p < 0.001). No consistent longitudinal associations were observed between baseline social health and cognitive decline (over median 3.1 years) or incident dementia (over median 4.4 years; social isolation: HR = 1.00, p = 0.99; low social support: HR = 1.79, p = 0.11; loneliness: HR = 0.72, p = 0.34 among women and men). CONCLUSION Our study provides evidence that social isolation and a low social support are associated with worse cognitive function in women, but not men. Social health did not predict incident cognitive decline or dementia, but we lacked power to stratify dementia analyses by gender.
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Affiliation(s)
- Johanna Joyce
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Alice Owen
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Jessie Hu
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Raj Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Robyn Woods
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Elsdon Storey
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Carlene Britt
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
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27
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Hu J, Fitzgerald SM, Owen AJ, Ryan J, Joyce J, Chowdhury E, Reid CM, Britt C, Woods RL, McNeil JJ, Freak-Poli R. Social isolation, social support, loneliness and cardiovascular disease risk factors: A cross-sectional study among older adults. Int J Geriatr Psychiatry 2021; 36:1795-1809. [PMID: 34231940 DOI: 10.1002/gps.5601] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/20/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Social health reflects one's ability to form interpersonal relationships. Poor social health is a risk factor for cardiovascular disease (CVD), however an in-depth exploration of the link through CVD risk factors is lacking. AIM To examine the relationship between social health (social isolation, social support, loneliness) and CVD risk factors among healthy older women and men. METHODS Data were from 11,498 healthy community-dwelling Australians aged ≥70 years from the ASPirin in Reducing Events in the Elderly (ASPREE) trial and the ASPREE Longitudinal Study of Older Persons sub-study. Ten-year CVD risk was estimated using the Atherosclerotic CVD Risk Scale (ASCVDRS) and the Framingham Risk Score (FRS). RESULTS Physical inactivity and experiencing depressive symptoms were the only CVD risk factors that consistently differed by all three social health constructs. Loneliness was associated with greater ASCVDRS (women: β = 0.01, p < 0.05; men: β = 0.03, p < 0.001), social isolation with greater FRS (women: β = 0.02, p < 0.01; men: β = 0.03, p < 0.01) and the social health composite of being lonely (regardless of social isolation and/or social support status) with greater ASCVDRS (women: β = 0.01, p = 0.02; men: β = 0.03, p < 0.001). Among men, loneliness was also associated with greater FRS (β = 0.03, p < 0.001) and social support with greater ASCVDRS (β = 0.02, p = 0.01). Men were more socially isolated, less socially supported and less lonely than women. CONCLUSION Social isolation, social support and loneliness displayed diverse relationships with CVD risk factors and risk scores, emphasising the importance of distinguishing between these constructs. These findings inform on potential avenues to manage poor social health and CVD risk among older adults.
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Affiliation(s)
- Jessie Hu
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Sharyn M Fitzgerald
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Alice J Owen
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Johanna Joyce
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Enayet Chowdhury
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,School of Public Health, Curtin University, Perth, Australia
| | - Christopher M Reid
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,School of Public Health, Curtin University, Perth, Australia
| | - Carlene Britt
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Robyn L Woods
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - John J McNeil
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.,Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
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28
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Etherson ME, Smith MM, Hill AP, Flett GL. Feelings of not Mattering and Depressive Symptoms From a Temporal Perspective: A Comparison of the Cross-Lagged Panel Model and Random-Intercept Cross-Lagged Panel Model. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2021. [DOI: 10.1177/07342829211049686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Are feelings of not mattering an antecedent of depressive symptoms, a consequence, or both? Most investigations focus exclusively on feelings of not mattering as an antecedent of depressive symptoms. Our current study examines a vulnerability model, a complication model, and a reciprocal relations model according to a cross-lagged panel model (CLPM) and a random-intercept cross-lagged panel model (RI-CLPM). A sample of 197 community adults completed the General Mattering Scale (GMS), the Anti-Mattering Scale (AMS), and a depression measure at three time points (i.e., baseline, 3 weeks, and 6 weeks). GMS and AMS scores were associated robustly with depressive symptoms at each time point. Other results highlighted the need to distinguish levels of anti-mattering and mattering. CLPM analyses supported a reciprocal relations model of anti-mattering (assessed by the AMS) and depressive symptoms and a complication model linking mattering (assessed by the GMS) and depressive symptoms. The RI-CLPM analyses provided tentative support only for a complication model of anti-mattering and depressive symptoms. Our findings highlight the differences between measures of the mattering construct and the need to adopt a temporal perspective that considers key nuances and the interplay among feelings of mattering, feelings of not mattering, and depression.
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Affiliation(s)
| | - Martin M. Smith
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Andrew P. Hill
- School of Science, Technology, & Health, York St John University, York, UK
| | - Gordon L. Flett
- Department of Psychology, LaMarsh Centre for Child & Youth Research, York University, Toronto, Ontario, Canada
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29
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Kraav SL, Lehto SM, Junttila N, Ruusunen A, Kauhanen J, Hantunen S, Tolmunen T. Depression and loneliness may have a direct connection without mediating factors. Nord J Psychiatry 2021; 75:553-557. [PMID: 33719828 DOI: 10.1080/08039488.2021.1894231] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF THE ARTICLE There is growing interest in loneliness and its various adverse effects on mental and physical health. While depression is one of the adverse health effects associated with loneliness, there have been some limitations in previous studies: 1) Research has mostly been carried out either in depressed patient samples or in general population samples with depressive symptoms as an outcome, 2) the follow-up times have been rather short, and 3) the mechanisms through which loneliness associates with depression are still unclear. MATERIALS AND METHODS We examined the association between loneliness and incident depression and possible mechanisms underlying this association in a population-based sample of middle-aged men (N = 2339; mean age 53; mean follow-up time 23.5 years). The association between loneliness and depression was explored with Cox proportional hazard analysis, and mediation analyses were performed with the PROCESS macro for SPSS. We used 13 health and lifestyle-related variables as covariates for adjustments in multivariate models and as mediators in simple mediation models. RESULTS Those with depression as an outcome (n = 99) had significantly higher loneliness scale scores at baseline, and baseline loneliness was associated with depression, despite adjustments for potential confounding factors. No mediating factors were observed. CONCLUSIONS There was a strong direct association between loneliness and the incidence of depression. Based on our results, we encourage future researchers to look for possible mediators in wider range of variables.
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Affiliation(s)
- Siiri-Liisi Kraav
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,R&D department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Niina Junttila
- Department for Teacher Education, Centre for Education and Research on Social and Health Services, University of Turku, Finland
| | - Anu Ruusunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tommi Tolmunen
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
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30
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Physical Activity, Mental Health and Wellbeing of Irish Adolescents During Covid-19 Restrictions. A Re-Issue of the Physical Activity and Wellbeing Study (PAWS). PHYSICAL ACTIVITY AND HEALTH 2021. [DOI: 10.5334/paah.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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31
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Own health, spousal health and transitions in loneliness among middle-aged and older adults in China. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Abstract
This study examines the effects of own and spousal health on transitions in loneliness over time among married middle-aged and older adults in China, and explores the possible gender differences in these effects using data from the three waves of the China Health and Retirement Longitudinal Study (2011–2015). The sample includes 6,422 men and 6,391 women who were married and aged 45 and older at the baseline survey. Middle-aged and older adults with poorer physical and emotional health statuses are more likely to transition into and less likely to transition out of loneliness in a two-year period. Spouse's emotional health also affects both types of transition in loneliness and spouse's functional limitation affects transition into loneliness through spouse's emotional health. In addition, for married men, their own functional limitation is significantly associated with their transitions into and out of loneliness. For married women, their spouse's functional limitation is significantly associated with their transition into loneliness and this is mainly through its association with spouse's emotional health. Also, for married women, their spouse's emotional health is significantly associated with their transition out of loneliness. Social interventions to reduce feelings of loneliness need to take a couple approach and consider both spouses’ health problems and how they may affect their daily activities and their interactions with each other and with others.
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32
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Gyasi RM, Adam AM. Does financial inclusion predict a lower risk of loneliness in later life? Evidence from the AgeHeaPsyWel-HeaSeeB study 2016-2017. Aging Ment Health 2021; 25:1254-1261. [PMID: 32597193 DOI: 10.1080/13607863.2020.1786006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE For many older people, loneliness represents a common source of impaired quality of life particularly in the context of poor access to financial services. This article examines the association between financial inclusion and loneliness in older adults and explores the moderating effects of gender and physical activity in this association. METHODS One thousand two-hundred participants completed the Short Form Revised UCLA Loneliness Scale assessing loneliness during 2016-2017 Aging, Health, Psychological Well-being and Health-seeking Behavior (AgeHeaPsyWel-HeaSeeB) Study. Financial inclusion was assessed using an 8-item Financial Instrument Scale. RESULTS Multiple ordinary least squares (OLS) regressions showed that increases in financial inclusion were associated with decreases in loneliness in the total sample (β = -0.679, p < 0.001) and in women (β = -0.787, p < 0.001) but not in men (β = -0.594, p = 0.084). The negative effect of financial inclusion on loneliness was pronounced among those who engaged in physical activity (β = -0.646, p < 0.042). CONCLUSIONS Findings underscore the importance of financial inclusion for loneliness in later life particularly among older women and those who engage in physical activity. Encouraging and strengthening financial inclusion may crucially improve psychological health and emotional well-being among aging adults.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Anokye M Adam
- Department of Finance, School of Business, University of Cape Coast, Cape Coast, Ghana
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33
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Hyland P, Shevlin M, Murphy J, McBride O, Fox R, Bondjers K, Karatzias T, Bentall RP, Martinez A, Vallières F. A longitudinal assessment of depression and anxiety in the Republic of Ireland before and during the COVID-19 pandemic. Psychiatry Res 2021; 300:113905. [PMID: 33827013 PMCID: PMC9755108 DOI: 10.1016/j.psychres.2021.113905] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/27/2021] [Indexed: 01/21/2023]
Abstract
Few studies have examined changes in mental health before and after the outbreak of COVID-19. We examined changes in the prevalence of major depression and generalized anxiety disorder (GAD) between February 2019 and March-April 2020; if there were changes in major depression and GAD during six weeks of nationwide lockdown; and we identified factors that predicted major depression and GAD across the six-week lockdown period. Nationally representative samples of Irish adults were gathered using identical methods in February 2019 (N = 1020) and March-April 2020 (N = 1041). The latter was reassessed six weeks later. Significantly more people screened positive for depression in February 2019 (29.8% 95% CI = 27.0, 32.6) than in March-April 2020 (22.8% 95% CI = 20.2, 25.3), and there was no change in GAD. There were no significant changes in depression and GAD during the lockdown. Major depression was predicted by younger age, non-city dwelling, lower resilience, higher loneliness, and higher somatic problems. GAD was predicted by a broader set of variables including several COVID-19 specific variables. These findings indicate that the prevalence of major depression and GAD did not increase as a result of, or during the early phase of the COVID-19 pandemic in Ireland.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Ireland; Trinity Centre for Global Health, Trinity College Dublin, Ireland.
| | - Mark Shevlin
- School of Psychology, Ulster University, Northern Ireland
| | - Jamie Murphy
- School of Psychology, Ulster University, Northern Ireland
| | - Orla McBride
- School of Psychology, Ulster University, Northern Ireland
| | - Robert Fox
- Department of Psychology, Maynooth University, Ireland
| | | | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Scotland
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34
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Lee SL, Pearce E, Ajnakina O, Johnson S, Lewis G, Mann F, Pitman A, Solmi F, Sommerlad A, Steptoe A, Tymoszuk U, Lewis G. The association between loneliness and depressive symptoms among adults aged 50 years and older: a 12-year population-based cohort study. Lancet Psychiatry 2021; 8:48-57. [PMID: 33181096 PMCID: PMC8009277 DOI: 10.1016/s2215-0366(20)30383-7] [Citation(s) in RCA: 153] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Loneliness is experienced by a third of older adults in the UK and is a modifiable potential risk factor for depressive symptoms. It is unclear how the association between loneliness and depressive symptoms persists over time, and whether it is independent of related social constructs and genetic confounders. We aimed to investigate the association between loneliness and depressive symptoms, assessed on multiple occasions during 12 years of follow-up, in a large, nationally representative cohort of adults aged 50 years and older in England. METHODS We did a longitudinal study using seven waves of data that were collected once every 2 years between 2004 and 2017, from adults aged 50 years and older in the English Longitudinal Study of Ageing (ELSA). The exposure was loneliness at baseline (wave two), measured with the short 1980 revision of the University of California, Los Angeles Loneliness Scale (R-UCLA). The primary outcome was a score indicating severity of depression measured at six subsequent timepoints (waves three to eight), using the eight-item version of the Centre for Epidemiologic Studies Depression Scale (CES-D). Analyses were linear multilevel regressions, before and after adjusting for social isolation, social support, polygenic risk scores, and other sociodemographic and health-related confounders. The secondary outcome was depression diagnosis, measured using a binary version of the CES-D. FINDINGS 4211 (46%) of 9171 eligible participants had complete data on exposure, outcome, and confounders, and were included in our complete case sample. After all adjustments, a 1-point increase in loneliness score was associated with a 0·16 (95% CI 0·13-0·19) increase in depressive symptom severity score (averaged across all follow-ups). We estimated a population attributable fraction for depression associated with loneliness of 18% (95% CI 12-24) at 1 year of follow-up and 11% (3-19) at the final follow-up (wave eight), suggesting that 11-18% of cases of depression could potentially be prevented if loneliness were eliminated. Associations between loneliness and depressive symptoms remained after 12 years of follow-up, although effect sizes were smaller with longer follow-up. INTERPRETATION Irrespective of other social experiences, higher loneliness scores at baseline were associated with higher depression symptom severity scores during 12 years of follow-up among adults aged 50 years and older. Interventions that reduce loneliness could prevent or reduce depression in older adults, which presents a growing public health problem worldwide. FUNDING National Institute on Aging and a consortium of UK Government departments coordinated by the National Institute for Health Research.
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Affiliation(s)
- Siu Long Lee
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Eiluned Pearce
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Olesya Ajnakina
- Department of Behavioural Science and Health, University College London, London, UK; Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Farhana Mann
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Francesca Solmi
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Andrew Sommerlad
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Urszula Tymoszuk
- Centre for Performance Science, Royal College of Music, Imperial College London, London, UK
| | - Gemma Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.
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Typologies of Loneliness, Isolation and Living Alone Are Associated with Psychological Well-Being among Older Adults in Taipei: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249181. [PMID: 33302603 PMCID: PMC7764280 DOI: 10.3390/ijerph17249181] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/05/2020] [Accepted: 12/06/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Loneliness, isolation, and living alone are emerging as critical issues in older people's health and well-being, but the effects are not consistent. The purpose of this study was to examine the clustering of loneliness, isolation, and living alone, the risk factors and the associations with psychological well-being. METHODS The data were collected from the 2019 Taipei City Senior Citizen Condition Survey by face-to-face interviews and included a community-based sample (n = 3553). Loneliness, isolation, and living arrangement were analyzed by cluster analysis to define Loneliness-Isolation-Living-Alone clusters. Multinomial logistic regression was used to examine the factors related to Loneliness-Isolation-Living-Alone clusters, and linear regression was used to examine association of clusters with psychological well-being. RESULTS Five clusters of older adults were identified and named as follows: Not Lonely-Connected-Others (53.4%), Not Lonely-Isolated-Others (26.6%), Not Lonely-Alone (5.0%), Lonely-Connected (8.1%), and Lonely-Isolated-Others (6.9%). Demographics, financial satisfaction, physical function, family relationship, and social participation were related to the Loneliness-Isolation-Living-Alone clusters. Compared with the Not Lonely-Connected-Others cluster, the Lonely-Connected cluster and Lonely-Isolated-Others cluster had higher depressive symptoms and lower life satisfaction, and the Not Lonely-Isolated-Others cluster reported lower life satisfaction; the Not Lonely-Alone cluster was not different. DISCUSSION Loneliness and isolation are negatively associated with psychological well-being, and living arrangement is not the determinant to loneliness or isolation. Older adults are suggested to strengthen their informal social support, and the government may encourage social care and create an age friendly environment to reduce loneliness and isolation.
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36
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Donovan NJ, Blazer D. Social Isolation and Loneliness in Older Adults: Review and Commentary of a National Academies Report. Am J Geriatr Psychiatry 2020; 28:1233-1244. [PMID: 32919873 PMCID: PMC7437541 DOI: 10.1016/j.jagp.2020.08.005] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/13/2020] [Indexed: 01/31/2023]
Abstract
The authors of this review both served on the National Academy of Science, Engineering, and Medicine Committee that produced the report, "Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System." In 2018, the AARP Foundation commissioned the National Academies to establish a committee to research and develop a report on social isolation and loneliness in persons 50 years of age and older. Emphasis was placed upon the role of the healthcare system in addressing this fundamental public health problem. The committee released the report in February 2020 as the Corona Virus Disease 2019 pandemic was beginning to spread to North America. In this review, the authors share central findings and conclusions from the report as well as how these findings may be relevant to the care and well-being of older adults during this historic pandemic. The health protective benefits of social distancing must be balanced by the essential need for sustaining social relationships.
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Affiliation(s)
- Nancy J. Donovan
- Division of Geriatric Psychiatry, Department of Psychiatry (NJD), Brigham and Women's Hospital, Boston, MA,Department of Neurology (NJD), Brigham and Women's Hospital, Boston, MA,Department of Psychiatry (NJD), Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Dan Blazer
- Department of Psychiatry and Behavioral Sciences (DB), Duke University Medical Center, Durham, NC.
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Oliveira LMD, Abrantes GGD, Ribeiro GDS, Cunha NM, Pontes MDLDF, Vasconcelos SC. Loneliness in senescence and its relationship with depressive symptoms: an integrative review. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2019. [DOI: 10.1590/1981-22562019022.190241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abstract The increase in life expectancy and the percentage increase in the older population are related to the reduction in quality of life and social life due to the biopsychosocial changes inherent to the aging process. The present study aimed to verify scientific evidence on the relationship between loneliness and depressive symptoms among older adults. An integrative review was carried out using the following databases: SCOPUS, PubMed, Medline, Web of Science, CINAHL and PyscINFO, applying the descriptors indexed in the Mesh Terms and DeCS “aged”, “loneliness”, “depression”. The PICOS strategy was used to prepare the title and guiding question and the PRISMA methodological guidelines were used to write the report of this review. A total of 827 articles were identified, of which 23 were selected, 16 from the database and seven through a reverse search. Loneliness and depression have some characteristics in common, so that when one of these conditions develops in older adults, another is stimulated. Thus, loneliness is a major risk factor for the development of depression, just as depression is an aggravating factor for loneliness in older adults.
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