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Duan T, Cao Z, Huang X, Wang X, Sun T, Xu C. Association of social health with all-cause mortality and cause-specific mortality: A population-based cohort study. J Affect Disord 2024; 359:49-58. [PMID: 38768818 DOI: 10.1016/j.jad.2024.05.081] [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: 09/13/2023] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Previous studies only focused on the individual social factors, without considering the overall social health patterns. The present study aimed to develop an integrated social health score (SHS) and investigate its associations with all-cause, cardiovascular disease (CVD), cancer mortality. METHODS A total of 330,716 participants (mean age 56.3 years; 52.4 % female) from UK Biobank was included between 2006 and 2010, and thereafter followed up to 2021. SHS was calculated by using information on social connections, social engagement and social support. Cox proportional hazards models was used to estimate the hazard ratios and 95 % confidence intervals (CIs) of the association between SHS and all-cause and cause-specific mortality and the 4-way decomposition was used to quantify the mediating effect of lifestyle factors. RESULTS During a median follow-up period of 12.4 years, 37,897 death cases were recorded, including 4347 CVD and 10,380 cancer cases. The SHS was inversely associated with the risks of all-cause, CVD and cancer mortality in a dose-dependent manner (P for trend <0.001). The association between SHS with all-cause mortality was mediated by lifestyle factors including diet score, smoking status and alcohol consumption. CONCLUSION Integrated SHS was inversely associated with risks of all-cause, CVD and cancer mortality, and the associations were partially mediated by lifestyle factors. Our study highlights the importance of maintaining high levels of social health by jointly enhancing social involvement, expanding social networks, and cultivating enduring intimate relationships across the life course.
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Affiliation(s)
- Tingshan Duan
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Zhi Cao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xianhong Huang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xiaohe Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Tao Sun
- School of Public Health, Hangzhou Normal University, Hangzhou, China.
| | - Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China.
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Noguchi T, Ikeda T, Kanai T, Saito M, Kondo K, Saito T. Association of Social Isolation and Loneliness With Chronic Low Back Pain Among Older Adults: A Cross-sectional Study From Japan Gerontological Evaluation Study (JAGES). J Epidemiol 2024; 34:270-277. [PMID: 37690817 PMCID: PMC11078594 DOI: 10.2188/jea.je20230127] [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: 09/12/2023] Open
Abstract
BACKGROUND Per the biopsychosocial model, pain, especially chronic low back pain, which often presents with nonspecific pain, requires a comprehensive approach involving social factors. However, the association of social factors, including social isolation and loneliness, with this condition remains unclear. This study examined the cross-sectional association of social isolation and loneliness with chronic low back pain among older adults. METHODS We recruited functionally independent older adults through a mail survey in 2019 from the Japan Gerontological Evaluation Study (JAGES). Chronic low back pain was defined as low back pain lasting more than 3 months. Social isolation was identified based on face-to-face and non-face-to-face interactions ("not isolated," "isolated tendency," and "isolated"). Loneliness was assessed using the University of California, Los Angeles Loneliness Scale ("not lonely," "lonely tendency," and "lonely"). RESULTS Consequently, 21,463 participants were analyzed (mean age: 74.4 years; 51.5% females); 12.6% reported chronic low back pain. Multivariable Poisson regression analysis revealed that loneliness was significantly associated with the likelihood of chronic low back pain; compared with "not lonely", the prevalence ratio (PR) was 1.14 (95% confidence interval [CI], 1.05-1.25) for "lonely tendency" and 1.40 (95% CI, 1.27-1.54) for "lonely." Social isolation was not associated; compared with "not isolated," the PR was 0.96 (95% CI, 0.88-1.05) for "isolated tendency" and 0.99 (95% CI, 0.89-1.10) for "isolated." A positive multiplicative interaction between social isolation and loneliness for chronic low back pain was found. CONCLUSION Lonelier individuals were more likely to experience chronic low back pain, and those with loneliness and social isolation were synergistically more likely for this condition.
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Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology
- Japan Society for the Promotion of Science
| | - Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Takao Kanai
- Tokyo Metropolitan Tama-Hokubu Medical Center
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | | | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology
| | - Tami Saito
- Department of Social Science, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology
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Saito H, Maeda D, Kagiyama N, Sunayama T, Dotare T, Fujimoto Y, Jujo K, Saito K, Uchida S, Hamazaki N, Kamiya K, Ogasahara Y, Maekawa E, Konishi M, Kitai T, Iwata K, Wada H, Kasai T, Nagamatsu H, Ako J, Momomura SI, Matsue Y. Prognostic Value of Objective Social Isolation and Loneliness in Older Patients With Heart Failure: Subanalysis of FRAGILE-HF and Kitasato Cohort. J Am Heart Assoc 2024; 13:e032716. [PMID: 38726923 DOI: 10.1161/jaha.123.032716] [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: 09/18/2023] [Accepted: 04/15/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Social factors encompass a broad spectrum of nonmedical factors, including objective (social isolation [SI]) and perceived (loneliness) conditions. Although social factors have attracted considerable research attention, information regarding their impact on patients with heart failure is scarce. We aimed to investigate the prognostic impact of objective SI and loneliness in older patients with heart failure. METHODS AND RESULTS This study was conducted using the FRAGILE-HF (Prevalence and Prognostic Value of Physical and Social Frailty in Geriatric Patients Hospitalized for Heart Failure; derivation cohort) and Kitasato cohorts (validation cohort), which included hospitalized patients with heart failure aged ≥65 years. Objective SI and loneliness were defined using the Japanese version of Lubben Social Network Scale-6 and diagnosed when the total score for objective and perceived questions on the Lubben Social Network Scale-6 was below the median in the FRAGILE-HF. The primary outcome was 1-year death. Overall, 1232 and 405 patients in the FRAGILE-HF and Kitasato cohorts, respectively, were analyzed. Objective SI and loneliness were observed in 57.8% and 51.4% of patients in the FRAGILE-HF and 55.4% and 46.2% of those in the Kitasato cohort, respectively. During the 1-year follow-up, 149 and 31 patients died in the FRAGILE-HF and Kitasato cohorts, respectively. Cox proportional hazard analysis revealed that objective SI, but not loneliness, was significantly associated with 1-year death after adjustment for conventional risk factors in the FRAGILE-HF. These findings were consistent with the validation cohort. CONCLUSIONS Objective SI assessed using the Lubben Social Network Scale-6 may be a prognostic indicator in older patients with heart failure. Given the lack of established SI assessment methods in this population, further research is required to refine such methods.
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Affiliation(s)
- Hiroshi Saito
- Department of Rehabilitation Kameda Medical Centre Kamogawa Japan
| | - Daichi Maeda
- Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo Japan
| | - Nobuyuki Kagiyama
- Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo Japan
- Department of Digital Health and Telemedicine R&D Juntendo University Tokyo Japan
- Department of Cardiology The Sakakibara Heart Institute of Okayama Okayama Japan
| | - Tsutomu Sunayama
- Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo Japan
| | - Taishi Dotare
- Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo Japan
| | - Yudai Fujimoto
- Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo Japan
| | - Kentaro Jujo
- Department of Cardiology Nishiarai Heart Centre Hospital Tokyo Japan
| | - Kazuya Saito
- Department of Rehabilitation The Sakakibara Heart Institute of Okayama Okayama Japan
| | - Shota Uchida
- Department of Rehabilitation, School of Allied Health Sciences Kitasato University Sagamihara Japan
| | - Nobuaki Hamazaki
- Department of Rehabilitation Kitasato University Hospital Sagamihara Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences Kitasato University Sagamihara Japan
| | - Yuki Ogasahara
- Department of Nursing The Sakakibara Heart Institute of Okayama Okayama Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine Kitasato University School of Medicine Sagamihara Japan
| | - Masaaki Konishi
- Division of Cardiology Yokohama City University Medical Centre Yokohama Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Centre Osaka Japan
| | - Kentaro Iwata
- Department of Rehabilitation Kobe City Medical Centre General Hospital Kobe Japan
| | - Hiroshi Wada
- Department of Cardiovascular Medicine, Saitama Medical Centre Jichii Medical University Saitama Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo Japan
- Cardiovascular Respiratory Sleep Medicine Juntendo University Graduate School of Medicine Tokyo Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology Tokai University School of Medicine Isehara Japan
| | - Junya Ako
- Department of Cardiovascular Medicine Kitasato University School of Medicine Sagamihara Japan
| | - Shin-Ichi Momomura
- Department of Internal Medicine Saitama Citizens Medical Centre Saitama Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine Juntendo University Graduate School of Medicine Tokyo Japan
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Miki T, Cooray U, Kanai M, Hagiwara Y, Ikeda T. Cultural engagement and prevalence of pain in socially isolated older people: a longitudinal modified treatment policy approach. EClinicalMedicine 2024; 69:102477. [PMID: 38356730 PMCID: PMC10864863 DOI: 10.1016/j.eclinm.2024.102477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
Background It remains uncertain whether cultural engagement positively influences the reduction of pain risk, particularly depending on the social isolation status. The aim of this study was to examine the impact of cultural engagement on the reduction of pain prevalence over a 6-year follow-up period among older people, particularly those experiencing different dimensions of social isolation. Methods This study was a prospective longitudinal study. We analysed the English Longitudinal Study of Ageing cohort, consisting of 6468 community-dwelling adults aged ≥50 years old who provided data in waves 6 (2012-2013), 7 (2014-2015), 8 (2016-2017), and 9 (2018-2019). Self-reported cultural engagement (going to museums, art galleries, exhibitions, the theatre, concerts, or the opera) measured in waves 6-8 was used as the exposure variable. Meanwhile self-reported moderate-to-severe pain in wave 9 was used as the outcome variable. Social isolation was considered in waves 6-8, and the possibility of effect modification was captured by assessing each component of the social isolation index: not married or cohabiting with a partner, fewer than monthly contact with children/other immediate family/friends, and not engaging in any organisations, religious groups, or committees. Findings The estimated pain prevalence was 29.2% (95% confidence interval, 28.1-30.3; reference) after adjusting for time-variant, time-invariant, and loss to follow-up factors. Cultural engagement led to a reduction in pain prevalence to 24.1% for all individuals, representing a decrease of 5.1% (95% confidence interval, 0.6-9.6; P-value, 0.03). In older people who were not married or cohabiting, cultural engagement resulted in a decrease in pain prevalence to 25.8%, a reduction of 3.4% (95% confidence interval, 0.4-6.4; P-value, 0.01). For those with less frequent contact with close family members, the pain prevalence decreased to 25.3%, a reduction of 3.9% (95% confidence interval, 0.2-7.6; P-value, 0.03). Meanwhile, other dimensions of social isolation did not show a significant reduction in pain prevalence. Interpretation Cultural engagement may help to reduce the risk of pain in socially isolated older adults. Those who were single or living alone and had less frequent contact with immediate family were particularly vulnerable. While cultural engagement might help certain socially isolated older people feel better, its effectiveness varies, highlighting the need for targeted interventions. Funding The Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number (22K17648, Ikeda).
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Affiliation(s)
- Takahiro Miki
- Insight Lab, PREVENT Inc., Aichi, Japan
- Graduate School of Rehabilitation Science, Saitama Prefectural University, Japan
| | - Upul Cooray
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
| | - Masashi Kanai
- Insight Lab, PREVENT Inc., Aichi, Japan
- Institute of Transdisciplinary Sciences for Innovation, Kanazawa University, Ishikawa, Japan
| | | | - Takaaki Ikeda
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Miyagi, Japan
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
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Uchida Y, Kanamori M, Fukushima S, Takemura K. Interdependent culture and older adults' well-being: Health and psychological happiness in Japanese communities. Curr Opin Psychol 2024; 55:101729. [PMID: 38096782 DOI: 10.1016/j.copsyc.2023.101729] [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] [Received: 08/27/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 01/28/2024]
Abstract
This review article examined perspectives on the well-being and health of older adults in Japan, a nation renowned for its longevity. We emphasized the impact of social capital and social relationships in local communities, considering both individual and societal factors. The prevailing values in Japanese culture tend to foster a sustained and stable form of interdependent happiness among older adults, suggesting that communal support systems play an important role. This article highlights the value of multi-level datasets, such as the Japan Gerontological Evaluation Study (JAGES) dataset, for understanding the influence of social participation on the health and well-being of older adults. A growing body of evidence underscores the central role of social relationships in the health and well-being of older adults.
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Affiliation(s)
- Yukiko Uchida
- Institute for the Future of Human Society, Kyoto University, Kyoto, Japan.
| | - Mariko Kanamori
- Institute for the Future of Human Society, Kyoto University, Kyoto, Japan; Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Shintaro Fukushima
- School of Arts and Sciences, Tokyo Woman's Christian University, Tokyo, Japan
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Hashimoto K, Takeuchi T, Ihara K, Obuchi S, Kawai H, Hirano H, Fujiwara Y, Hunkyung K, Watanabe Y, Hashizume M. Association Between Ego-Resilience and Social Isolation Among Urban Older People. Gerontol Geriatr Med 2024; 10:23337214241238069. [PMID: 38487274 PMCID: PMC10938606 DOI: 10.1177/23337214241238069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/17/2024] Open
Abstract
Social isolation among older adults affects their physical and mental health. Ego-resilience is associated with flexible adaptation to various environments and acceptable behaviors. However, its association with social isolation among older people is unclear. Therefore, a health survey was conducted with 510 adults aged 65 years or older to assess social isolation, its associated factors, and ego resilience. The results showed that the social isolation group had a lower median ego-resiliency scale score (42.0) compared to the non-social isolation group (38.0). The social isolation group were mostly males without spouses, took time to move, had more depressive moods, and poorer subjective health status. The non-social isolated group had faster maximum walking speed. Low ego-resilience was newly identified as a factor associated with social isolation among older people, as were being male, having no spouse, and depressive symptoms. Mediation analysis revealed that ego-resilience affected social isolation and was partially mediated by depressive symptoms.
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Affiliation(s)
- Kazuaki Hashimoto
- Toho University Faculty of Medicine, Tokyo, Japan
- Hirosaki University Graduate School of Medicine, Aomori, Japan
| | | | - Kazushige Ihara
- Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kim Hunkyung
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yutaka Watanabe
- Hokkaido University Faculty of Dental Medicine, Sapporo, Japan
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Mizumoto J, Harada Y, Terui T, Horo S, Otaka Y, Yokota Y, Komatsu M, Takeda Y. Identifying Unmet Social Needs in a Patient Living in Isolation: A Case Report. Cureus 2024; 16:e52429. [PMID: 38371131 PMCID: PMC10870694 DOI: 10.7759/cureus.52429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/20/2024] Open
Abstract
Loneliness and social isolation are common among older adults. To deliver high-quality care to older patients, healthcare professionals should know the social conditions of their patients. Addressing social determinants of health (SDH) in daily practice is beneficial to both patients and healthcare professionals. We illustrate a patient with congestive heart failure and cognitive decline whose social conditions improved through an SDH assessment. An SDH assessment has some potential advantages, which include facilitating a comprehensive understanding of patients' social conditions, visualizing how patients' social conditions have changed, deepening interprofessional collaboration, and ameliorating unnecessary negative emotions toward patients. This case report conveys two key messages. Firstly, healthcare professionals have the capability to evaluate patients' social backgrounds and enhance their health and social conditions through routine care. Secondly, the utilization of an SDH screening toolkit can support and enhance this initiative.
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Affiliation(s)
- Junki Mizumoto
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Tokyo, JPN
| | - Yukinori Harada
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, JPN
| | - Toshihiro Terui
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima, JPN
| | - Saori Horo
- Department of Nursing Care, Kinikyo Tomakomai Clinics, Tomakomai, JPN
| | - Yumi Otaka
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, JPN
| | - Yuya Yokota
- Department of Family Medicine, Family Practice Center of Okayama, Okayama, JPN
| | - Masanari Komatsu
- Department of General Internal Medicine, Kagoshima Seikyo Hospital, Kagoshima, JPN
| | - Yuko Takeda
- Division of Medical Education, Faculty of Medicine, Juntendo University, Tokyo, JPN
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Tomida K, Shimoda T, Nakajima C, Kawakami A, Shimada H. Classification of social isolation and factors related to loneliness and life satisfaction among socially isolated individuals. Geriatr Nurs 2023; 54:163-170. [PMID: 37788564 DOI: 10.1016/j.gerinurse.2023.09.011] [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] [Received: 07/11/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE To operationally divide social isolation into four categories and examine the factors associated with social isolation and its relationship with loneliness and life satisfaction. METHODS The participants were community-dwelling older adults aged ≥ 60 years who underwent functional health examinations in Chita City, Aichi, Japan. Multiple regression analysis was used to examine the associations between social isolation, loneliness, and life satisfaction. RESULTS A total of 5,066 participants (mean age 72.0 ± ± 6.3 years, female: 55.4 %) were included in the study. Multiple regression analysis showed that the number of experiences of social isolation, classified into four categories, was positively correlated with loneliness (β = 0.188, ΔR2 = 0.244, p < 0.001) and negatively correlated with life satisfaction (β = -0.076, ΔR2 = -0.178, p < 0.001). CONCLUSIONS Multiple experiences of social isolation classified into four categories were found to be associated with higher loneliness and lower life satisfaction.
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Affiliation(s)
- Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
| | - Takahiro Shimoda
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Chika Nakajima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Ayuka Kawakami
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Kawai H, Ejiri M, Ito K, Fujiwara Y, Ihara K, Hirano H, Sasai H, Kim H, Obuchi S. Social interaction trajectories and all-cause mortality in older adults: the Otassha study. Front Public Health 2023; 11:1248462. [PMID: 37674679 PMCID: PMC10477580 DOI: 10.3389/fpubh.2023.1248462] [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: 06/27/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023] Open
Abstract
Introduction This longitudinal study aimed to identify aging trajectory patterns of social interaction by sex and determine the association between these patterns and all-cause mortality. Methods Participants were 4,065 community-dwelling older adults (1849 men) in Japan, aged 65-89 years, who responded twice or more to a mail survey conducted between 2012 and 2020. Social interaction was examined through the frequency of face-to-face and non-face-to-face contact with non-resident family and friends. The aging trajectories of the social interaction scores were identified using group-based trajectory modeling. Results Two groups were identified among both men and women. Among men with high-frequency interaction, a rapid decrease in the frequency of social interaction was observed after 80 years of age. Conversely, among women, the frequency tended to remain the same, even after 80 years of age. The social interaction score among those aged 65 years in the low-frequency group was approximately 4 points for men and 6 points for women. Among men, no decrease was observed; however, it tended to decline after 85 years of age among women. Among men, the factors associated with the low-frequency group were instrumental activities of daily living score, perceived financial status, and social participation, while among women, they were self-rated health and social participation. The adjusted hazard ratio in the low-frequency group for all-cause mortality was 1.72 (95% confidence interval, 1.27-1.72) for men and 1.45 (95% confidence interval, 0.98-2.14) for women. Discussion In the low-frequency group, men had a higher risk of all-cause mortality than women. Daily social interaction from mid-age is important to reduce the risk of social isolation and all-cause mortality in later life.
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Affiliation(s)
- Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Manami Ejiri
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kumiko Ito
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | | | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroyuki Sasai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hunkyung Kim
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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10
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Wang F, Gao Y, Han Z, Yu Y, Long Z, Jiang X, Wu Y, Pei B, Cao Y, Ye J, Wang M, Zhao Y. A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality. Nat Hum Behav 2023; 7:1307-1319. [PMID: 37337095 DOI: 10.1038/s41562-023-01617-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 04/27/2023] [Indexed: 06/21/2023]
Abstract
The associations between social isolation, loneliness and the risk of mortality from all causes, cardiovascular disease (CVD) and cancer are controversial. We systematically reviewed prospective studies on the association between social isolation, loneliness and mortality outcomes in adults aged 18 years or older, as well as studies on these relationships in individuals with CVD or cancer, and conducted a meta-analysis. The study protocol was registered with PROSPERO (reg. no. CRD42022299959). A total of 90 prospective cohort studies including 2,205,199 individuals were included. Here we show that, in the general population, both social isolation and loneliness were significantly associated with an increased risk of all-cause mortality (pooled effect size for social isolation, 1.32; 95% confidence interval (CI), 1.26 to 1.39; P < 0.001; pooled effect size for loneliness, 1.14; 95% CI, 1.08 to 1.20; P < 0.001) and cancer mortality (pooled effect size for social isolation, 1.24; 95% CI, 1.19 to 1.28; P < 0.001; pooled effect size for loneliness, 1.09; 95% CI, 1.01 to 1.17; P = 0.030). Social isolation also increased the risk of CVD mortality (1.34; 95% CI, 1.25 to 1.44; P < 0.001). There was an increased risk of all-cause mortality in socially isolated individuals with CVD (1.28; 95% CI, 1.10 to 1.48; P = 0.001) or breast cancer (1.51; 95% CI, 1.34 to 1.70; P < 0.001), and individuals with breast cancer had a higher cancer-specific mortality owing to social isolation (1.33; 95% CI, 1.02 to 1.75; P = 0.038). Greater focus on social isolation and loneliness may help improve people's well-being and mortality risk.
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Affiliation(s)
- Fan Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, P. R. China
| | - Yu Gao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Zhen Han
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Yue Yu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Zhiping Long
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Xianchen Jiang
- Department of Chronic Disease Prevention and Control, Quzhou Center for Disease Control and Prevention, Quzhou, P. R. China
| | - Yi Wu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Bing Pei
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Yukun Cao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Jingyu Ye
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Maoqing Wang
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, P. R. China.
| | - Yashuang Zhao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China.
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, P. R. China.
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11
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Nakagomi A, Tsuji T, Saito M, Ide K, Kondo K, Shiba K. Social isolation and subsequent health and well-being in older adults: A longitudinal outcome-wide analysis. Soc Sci Med 2023; 327:115937. [PMID: 37167920 DOI: 10.1016/j.socscimed.2023.115937] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Social isolation has become a serious public health issue. However, most previous studies examine the relationship between social isolation and a single outcome. We aimed to conduct holistic assessments to understand the multidimensional impacts of social isolation on health and well-being. METHODS We used the three-wave data (2013, 2016, and 2019) obtained from the Japan Gerontological Evaluation Study. Our exposure, obtained from the 2016 survey, was the Social Isolation Index (SII) comprising five components: no partner, poor interaction with children, poor interaction with relatives, poor interaction with friends, and no social participation). We assessed 36 health and well-being outcomes across six dimensions obtained from the 2019 survey: physical/cognitive health, health behaviours, mental health, subjective well-being, social isolation, and cognitive social capital. Pre-exposure characteristics and prior outcome levels in 2013 were adjusted. We included 47,318 respondents for 4 outcomes (death, dementia, and functional disability) and 34,187 respondents for 32 other outcomes. The Bonferroni correction was used to correct for multiple tests. RESULTS The total SII scores were associated with a wide range of health and well-being outcomes across the six dimensions. Specifically, we found a robust association between an SII score of four or greater with mortality (Odds ratio: 1.89; 95% CI: 1.46-2.43). Among the five components of the SII, poor interaction with friends and no social participation showed robust associations with a wide range of health and well-being. We also found some robust evidence regarding effect modification by gender and age in the associations between the components of the SII and health and well-being. CONCLUSIONS Social isolation, specifically social interaction with friends and social participation, may affect a wide range of health and well-being among older adults.
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Affiliation(s)
- Atsushi Nakagomi
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Cardiology, Chiba University Hospital, Chiba, Japan.
| | - Taishi Tsuji
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Faculty of Health and Sport Sciences, University of Tsukuba, Bunkyo City, Tokyo, Japan
| | - Masashige Saito
- Department of Social Welfare, Nihon Fukushi University, Chita-gun, Aichi, Japan; Center for Well-being and Society, Nihon Fukushi University, Nagoya City, Aichi, Japan
| | - Kazushige Ide
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Koichiro Shiba
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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12
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Abbas H, Aida J, Cooray U, Ikeda T, Koyama S, Kondo K, Osaka K. Does remaining teeth and dental prosthesis associate with social isolation? A six-year longitudinal study from the Japan Gerontological Evaluation Study (JAGES). Community Dent Oral Epidemiol 2023; 51:345-354. [PMID: 35352849 DOI: 10.1111/cdoe.12746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Social isolation was associated with increased mortality and numerous adverse health outcomes. However, the longitudinal association between oral health and social isolation has not been studied. In this longitudinal prospective cohort study, the association between the number of remaining teeth and dental prosthesis use with social isolation after 6-years follow-up was examined. METHODS Functionally independent adults aged 65 years or older, who were not socially isolated in 2010, were followed up until 2016 in the Japan Gerontological Evaluation Study. Data from 26 417 participants were analysed after random forest imputation to address missing data. Logistic regression models were used to calculate the odds ratio (OR) for incident social isolation in 2016 after adjusting for age, sex, educational attainment, income, activities of daily living, living area and having depressive symptoms. RESULTS The mean age of the participants at baseline was 72.3 (SD = 5.0). A total of 1,127 (4.3%) participants were socially isolated at follow-up. Of these, 338 (3.2%) had ≥20 teeth (with or without using dental prosthesis), 171 (3.9%) had 10-19 teeth and used dental prosthesis, 112 (4.2%) had 10-19 teeth and did not use the dental prosthesis, 338 (5.1%) had 0-9 teeth and used dental prosthesis, and 168 (7.6%) had 0-9 teeth and did not use the dental prosthesis. Fully adjusted logistic regression models showed that the OR of incident social isolation was higher for those with fewer teeth; OR = 1.13 (95%CI = 0.96-1.33) for those with 10-19 teeth and OR = 1.36 (95%CI = 1.17-1.58) for those with 0-9 teeth, compared to those with ≥20 teeth. The OR of incident social isolation was lower for those who used a dental prosthesis [OR = 0.90, 95%CI = 0.80-1.02)] compared to those who did not use a dental prosthesis. The interaction between the number of teeth and dental prosthesis use demonstrated that the latter mitigated the incidence of social isolation for participants with tooth loss. Compared to those with ≥20 teeth (with or without prosthesis use), participants with 0-9 teeth that did not use a dental prosthesis were 79% [OR = 1.79, 95%CI = 1.49-2.19] more likely to be socially isolated, whereas participants with 0-9 teeth that used a dental prosthesis were only 23% [OR = 1.23, 95%CI = 1.05-1.45] more likely to be socially isolated. CONCLUSION Tooth loss was the main predictor for social isolation at follow-up, while no dental prostheses use was an additional risk factor. Dental prosthesis use may reduce the risk of social isolation especially in those with severe tooth loss.
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Affiliation(s)
- Hazem Abbas
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Upul Cooray
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
| | - Takaaki Ikeda
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
| | - Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
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13
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Kikuchi M, Onishi R, Takashima R, Saeki K, Hirano M. Effects of a 'social activity program that encourages interaction' on rural older people's psychosocial health: Mixed-methods research. Int J Older People Nurs 2023; 18:e12534. [PMID: 36940188 DOI: 10.1111/opn.12534] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 12/10/2022] [Accepted: 03/06/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND We developed a program that encourages interaction among older people living at home by combining face-to-face and online activities and examined its effects on older adults' psychosocial health. METHODS In this mixed-methods study, we recruited 11 women and 6 men (Mage = 79.5 ± 6.4 years), who lived in a rural community and participated in a senior citizen club. The intervention was conducted for 13 months, comprising monthly face-to-face group and social media activities. For the program process evaluation, we collected focus-group interview data on participants' perceptions of their personal lives, club membership, and community post-intervention. For the outcome evaluation, we collected six outcome measures pre- and post-intervention: loneliness, subjective health, subjective well-being, self-esteem, social support and social activity satisfaction. Finally, through the integration of the process-outcome evaluation, we inferred what effects the program had on participants' psychosocial health. RESULTS In the process evaluation, we identified four themes: 'Stimulation brought about by relationships with peers,' 'Realization as to where they feel they belong,' 'Rethinking of oneself in the community,' and 'Awareness of attachment to and coexistence with the community.' In the outcome evaluation, the outcome measures were maintained without significant decline post-intervention. CONCLUSION Through the integration of the process-outcome evaluation, we deduced three effects of the program on psychosocial health: (1) fulfilment of subjective health, (2) maintenance and assurance of moderate distance connectedness and (3) orientation toward aging in place. IMPLICATIONS FOR PRACTICE This study offers a promising opportunity for further development and research into community-based preventive nursing care intervention strategies to maintain the psychosocial health of homebound older people in communities with social activity groups.
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Affiliation(s)
- Mami Kikuchi
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Ryuta Onishi
- Faculty of Nursing, Toyama Prefectural University, Toyama, Toyama, Japan
| | - Risa Takashima
- Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kazuko Saeki
- Faculty of Nursing, Toyama Prefectural University, Toyama, Toyama, Japan
| | - Michiyo Hirano
- Faculty of Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
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14
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Social Isolation and Depressive Symptoms Among Older Adults: A Multiple Bias Analysis Using a Longitudinal Study in Japan. Ann Epidemiol 2023; 77:110-118. [PMID: 36417983 DOI: 10.1016/j.annepidem.2022.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Despite the potential burden of social isolation on mental health, it is unclear which component of social isolation (living alone, lack of social support, and lack of social participation) is mostly associated with depression among older adults and whether it varies by gender. Moreover, previous observational studies have suffered from several systematic biases such as confounding, misclassification, and selection bias. We thus aimed to investigate the risk of social isolation on subsequent depressive symptoms among older men and women, fully taking account of such systematic biases simultaneously. METHODS This study included 15,311 adults from a nationwide longitudinal cohort study of older adults aged ≥65 years in Japan. We employed modified Poisson regression models to estimate the adjusted risk ratio (aRR) of elevated depressive symptoms (the Geriatric Depression Scale: ≥5 vs. <5) in 2016 according to the social isolation index (SII) score (0-5 points) in 2013. Non-probabilistic multiple bias analyses with weighting approach and bounding factor were conducted to adjust for possible confounding, exposure misclassification, and selection biases. RESULTS The mean age (SD) of participants was 72.1 (4.9) years. Adults with the SII score ≥2 showed an increased risk of elevated depressive symptoms than those with the SII score <2 (aRR [95% CI] = 1.57 [1.41-1.76]). All components of SII were associated with elevated depressive symptoms except living alone for women. Our multiple bias analysis showed that an unmeasured confounder needed to have at least moderate relationship (RR=2.0-3.0) with both exposure and outcome to explain away the observed association particularly when social isolation status was independently and non-differentially misclassified. CONCLUSION Among older adults in Japan, social isolation was associated with an increased risk of elevated depressive symptoms, even after taking account of systematic biases simultaneously. Increasing social connection may mitigate the risk of depression, which should be the subject of future research.
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15
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Petersen B, Khalili-Mahani N, Murphy C, Sawchuk K, Phillips N, Li KZH, Hebblethwaite S. The association between information and communication technologies, loneliness and social connectedness: A scoping review. Front Psychol 2023; 14:1063146. [PMID: 37034933 PMCID: PMC10075275 DOI: 10.3389/fpsyg.2023.1063146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/03/2023] [Indexed: 04/11/2023] Open
Abstract
Older adults are at a higher risk of loneliness, compared to other demographics. The use of Internet Communication and Technologies (ICTs) among older adults is steadily increasing and given ICTs provide a means of enhancing social connectedness suggests they may have positive effects on reducing loneliness. Therefore, the aim of this scoping review was to examine the research that explores how ICTs may be implicated in mitigating loneliness and increasing social connectedness among older adults. After the examination of 54 articles, we identified three major themes within the literature: (1) ICTs were associated with a reduction in loneliness and increase in wellbeing. (2) ICTs promoted social connectedness by facilitating conversations. (3) Factors such as training, self-efficacy, self-esteem, autonomy, and the design/features, or affordances, of ICTs contribute toward the associations between ICT use and wellbeing. The heterogeneity of methodologies, statistical reporting, the small sample sizes of interventional and observational studies, and the diversity of the experimental contexts underline the challenges of quantitative research in this field and highlights the necessity of tailoring ICT interventions to the needs and contexts of the older users.
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Affiliation(s)
- Berkley Petersen
- Laboratory for Adult Development and Cognitive Aging, Department of Psychology, Concordia University, Montreal, QC, Canada
- *Correspondence: Berkley Petersen,
| | - Najmeh Khalili-Mahani
- Media Health Lab, Department of Design and Computation Arts, Milieux Institute for Arts, Culture and Technology, Concordia University, Montreal, QC, Canada
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, QC, Canada
| | - Caitlin Murphy
- Centre for Interdisciplinary Research in Rehabilitation (CRIR), Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, QC, Canada
| | - Kim Sawchuk
- Aging and Communication Technologies (ACT), Department of Communication Studies, Concordia University, Montreal, QC, Canada
| | - Natalie Phillips
- Laboratory of Cognition, Aging and Psychophysiology (CAP), Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Karen Z. H. Li
- Laboratory for Adult Development and Cognitive Aging, Department of Psychology, Concordia University, Montreal, QC, Canada
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16
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Social isolation as a risk factor for all-cause mortality: Systematic review and meta-analysis of cohort studies. PLoS One 2023; 18:e0280308. [PMID: 36634152 PMCID: PMC9836313 DOI: 10.1371/journal.pone.0280308] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 12/27/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Although several epidemiological studies have linked social isolation to increased risk of mortality, the magnitude of any effect is unclear, in part because of the use of different measures of social isolation. OBJECTIVE To examine the association between social isolation and all-cause mortality and investigate whether it differs in various subgroups or populations. DATA SOURCES We searched for relevant studies in electronic databases: MEDLINE (1946 to December 31, 2021), EMBASE (1974 to December 31, 2021), and PsycINFO (1806 to December 31, 2021). SELECTION CRITERIA We included both prospective and retrospective cohort studies that examined the association between social isolation and all-cause mortality among adults. DATA COLLECTION AND ANALYSIS Two reviewers screened and extracted data independently. We contacted study authors to obtain missing information whenever possible. Data were pooled using a random effect model to calculate estimates of the effects of social isolation on all-cause mortality. RESULTS Data from studies involving 1.30 million individuals were included. The pooled hazard ratio of social isolation for all-cause mortality was 1.33 (95% confidence interval; 1.26-1.41, heterogeneity: Chi² = 112.51, P < 0.00001, I² = 76%). CONCLUSION Social isolation is associated with increased risk for all-cause mortality. REGISTRATION PROSPERO (CRD42020152351).
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17
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Noguchi T, Sato M, Saito T. An approach to psychosocial health among middle-aged and older people by remote sharing of photos and videos from family members not living together: A feasibility study. Front Public Health 2022; 10:962977. [PMID: 36438251 PMCID: PMC9686400 DOI: 10.3389/fpubh.2022.962977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022] Open
Abstract
Background As an approach to the psychosocial health of people in later adulthood, information and communication technology (ICT) is attracting attention. However, because there is still a disparity issue in ICT use, particularly for older people, considering age-friendly digital interventions is important. We examined the feasibility of an intervention by an age-friendly digital service, remote sharing of photos/videos from families not living together, for psychosocial health in middle-aged and older people. Methods This single-arm study recruited Japanese adults aged ≥ 50 years from web-pages of the social service, Mago-Channel (Chikaku Inc., Japan). Participants used this service for 3 months to receive photos/videos from the smartphones of their families not living together on a device set up on their home TVs and watched them there. Families not living together were encouraged to send photos/videos at least once a week, but no other restrictions on their lives, including their interactions, were imposed. After 3 months, the level of user satisfaction and changes in psychosocial health were assessed. Results Finally, 115 participants were included, and 106 completed the intervention; the dropout rate from the intervention was low (7.8%), and satisfaction with the program was high, indicating high feasibility. While depressive symptoms and loneliness did not change markedly, satisfaction with the relationship of families living together increased significantly, and social interactions improved, including those with families not living together. Conclusions High feasibility of this age-friendly digital intervention and its potential benefits on social relationships were shown, encouraging further trials with a confirmatory study design.
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Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Research Institute, Obu, Japan,Japan Society for the Promotion of Science, Chiyoda, Japan,*Correspondence: Taiji Noguchi
| | | | - Tami Saito
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Research Institute, Obu, Japan
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18
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Park S, Downer B, Nam S, Bae S, Hong I. Association Between Social Participation and Cognitive Function in Community-Dwelling Adults. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2022; 42:344-352. [PMID: 35904347 DOI: 10.1177/15394492221113506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Social participation is associated with cognitive function; however, their causal relationships have not been reported yet. This study was designed to examine the autoregressive effects and bidirectional causal relationship between social participation and cognitive function. In this secondary longitudinal data analysis, we enrolled 4,834 Korean adults. A cross-lagged panel model with fixed effects was used to examine the causal relationships between social participation and cognitive function. Both participation (unstandardized coefficient = .370, p < .001) and cognitive function (unstandardized coefficient = .151, p < .001) had positive autoregressive effects over time. Participation had a cross-lagged effect on cognitive function (unstandardized coefficient = .061, p < .001). However, the cross-lagged effects of cognitive function on participation were not statistically significant (unstandardized coefficient = .051, p = .312). Various health-care programs that promote social participation and improve cognitive function must be established. Additional studies are required to confirm the causal effects of cognitive function on participation.
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Affiliation(s)
| | - Brian Downer
- University of Texas Medical Branch, Galveston, USA
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Suntai Z, White B. Social isolation among older veterans: findings from the National Health and Aging Trends Study. Aging Ment Health 2022; 26:1345-1352. [PMID: 34192481 DOI: 10.1080/13607863.2021.1942434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Social isolation is a critical public health issue that affects multiple domains of well-being among older adults, but little is known about social isolation among older military veterans. As such, the purpose of this study was to estimate the prevalence of social isolation among older veterans and to examine risk factors for social isolation among older veterans. METHOD Data were derived from Round 1 of the National Health and Aging Trends Study, which is an annual, longitudinal panel survey of Medicare beneficiaries aged 65 and older. The sample included 1,683 veterans, who were primarily White and male. Weighted logistic regression models were used to predict severe social isolation (having no social participation) and social isolation (having only one source of social participation) among older veterans, while controlling for age, sex, race, marital status, education, income, and metropolitan residency. RESULTS After accounting for other predictors, results show that veterans who are 85 and older, male, White, unmarried or unpartnered, with lower educational attainment and lower income are greatly at risk of both severe social isolation and social isolation. CONCLUSION The results of this study support past research showing that veterans with limited social and economic capital are at great risk of experiencing adverse outcomes in older adulthood, including social isolation. Interventions should therefore aim to improve social connectedness among this population and should address the risk-factors that contribute to social isolation among older veterans.
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Affiliation(s)
- Zainab Suntai
- School of Social Work, Social Work, University of Alabama, Tuscaloosa, AL, USA
| | - Bethany White
- School of Social Work, Samford University, Birmingham, AL, USA
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20
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Associations of face-to-face and non-face-to-face social isolation with all-cause and cause-specific mortality: 13-year follow-up of the Guangzhou Biobank Cohort study. BMC Med 2022; 20:178. [PMID: 35501792 PMCID: PMC9059436 DOI: 10.1186/s12916-022-02368-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/06/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although social isolation has been associated with a higher mortality risk, little is known about the potential different impacts of face-to-face and non-face-to-face isolation on mortality. We examined the prospective associations of four types of social isolation, including face-to-face isolation with co-inhabitants and non-co-inhabitants, non-face-to-face isolation, and club/organization isolation, with all-cause and cause-specific mortality separately. METHODS This prospective cohort study included 30,430 adults in Guangzhou Biobank Cohort Study (GBCS), who were recruited during 2003-2008 and followed up till Dec 2019. RESULTS During an average of 13.2 years of follow-up, 4933 deaths occurred during 396,466 person-years. Participants who lived alone had higher risks of all-cause (adjusted hazard ratio (AHR) 1.24; 95% confidence interval (CI) 1.04-1.49) and cardiovascular disease (CVD) (1.61; 1.20-2.03) mortality than those who had ≥ 3 co-habitant contact after adjustment for thirteen potential confounders. Compared with those who had ≥ 1 time/month non-co-inhabitant contact, those without such contact had higher risks of all-cause (1.60; 1.20-2.00) and CVD (1.91; 1.20-2.62) mortality. The corresponding AHR (95% CI) in participants without telephone/mail contact were 1.27 (1.14-1.42) for all-cause, 1.30 (1.08-1.56) for CVD, and 1.37 (1.12-1.67) for other-cause mortality. However, no association of club/organization contact with the above mortality and no association of all four types of isolation with cancer mortality were found. CONCLUSIONS In this cohort study, face-to-face and non-face-to-face isolation were both positively associated with all-cause, CVD-, and other-cause (but not cancer) mortality. Our finding suggests a need to promote non-face-to-face contact among middle-aged and older adults.
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21
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Akaida S, Nakai Y, Shiratsuchi D, Tomioka K, Taniguchi Y, Sato N, Wada A, Kiuchi Y, Shono S, Shiiba R, Tateishi M, Makizako H. Association of self-rated health with type and frequency of social interaction during the declaration of COVID-19 state of emergency among Japanese community-dwelling oldest-old adults. Geriatr Gerontol Int 2022; 22:405-411. [PMID: 35315191 PMCID: PMC9111508 DOI: 10.1111/ggi.14379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 02/22/2022] [Accepted: 03/04/2022] [Indexed: 12/30/2022]
Abstract
AIM To investigate whether the type and frequency of social interaction during the state of emergency due to coronavirus disease were associated with self-rated health (SRH) after the state of emergency. METHODS Data from a cross-sectional study were collected for 889 oldest-old adults in Bibai City, Hokkaido, Japan. In total, 612 participants (mean age: 83.0 ± 4.3 years; women: 51.8%) were included in the analysis, taking biological sex into account. The self-reported questionnaire included questions about demographic variables, SRH (July 2020, after the emergency), and the type and frequency of social interaction (March 2020, during the state of emergency). RESULTS There was no significant association between social interaction and SRH in men (P > 0.05). Women who had social interactions (both face-to-face and non-face-to-face) more than once a week during the state of emergency reported higher SRH after the emergency than those who did not (odds ratio 2.17, 95% confidence interval 1.07-4.41). CONCLUSIONS Having both types of interaction more than once a week during the state of emergency was related to higher SRH after the emergency among oldest-old women. It is suggested that having opportunities for both types of interaction at least once a week would potentially be beneficial for high SRH in women, even in situations where the declaration of a state of emergency restricts face-to-face interaction. Geriatr Gerontol Int 2022; 22: 405-411.
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Affiliation(s)
- Shoma Akaida
- Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan.,Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Yuki Nakai
- Department of Mechanical Systems Engineering, Faculty of Engineering, Daiichi Institute of Technology, Kagoshima, Japan
| | - Daijo Shiratsuchi
- Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan.,Department of Rehabilitation, Japan Community Health Care Organization, Kumamoto General Hospital, Yatsushiro, Japan
| | - Kazutoshi Tomioka
- Department of Rehabilitation, Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital, Kagoshima, Japan
| | - Yoshiaki Taniguchi
- Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan.,Department of Physical Therapy, Kagoshima Medical Professional College, Kagoshima, Japan
| | - Nana Sato
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Ayumi Wada
- Department of Rehabilitation, National Hospital Organization, Osaka Toneyama Medical Center, Toyonaka, Japan
| | - Yuto Kiuchi
- Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan.,Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Saki Shono
- Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Ryuhei Shiiba
- Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan.,Department of Rehabilitation, Tarumizu Municipal Medical Center, Tarumizu Chuo Hospital, Kagoshima, Japan
| | - Mana Tateishi
- Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan.,Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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Kusama T, Kiuchi S, Tani Y, Aida J, Kondo K, Osaka K. The lack of opportunity to eat together is associated with an increased risk of weight loss among independent older adults: a prospective cohort study based on the JAGES. Age Ageing 2022; 51:6540137. [PMID: 35231092 DOI: 10.1093/ageing/afac022] [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: 09/01/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE the present study aimed to investigate the relationship between the frequency of eating together and the risk of weight loss in older adults. METHODS this was a three-year follow-up prospective cohort study based on a self-reported questionnaire. We used data from the Japan Gerontological Evaluation Study (JAGES) conducted in 2016 and 2019. The participants were independent older adults aged ≥65 years in Japan. We used >5% weight loss during follow-up as the outcome variable and frequency of eating together as the explanatory variable. The relative risks (RRs) and 95% confidence intervals (95% CIs) were estimated based on the Poisson regression model with a Huber-White sandwich estimator for standard errors, including possible confounders. RESULTS among 56,919 participants, the mean age was 73.0 years (1SD = 5.5) at baseline, and 47.9% were male. About 15.1% (n = 8,596) of the participants experienced >5% weight loss during follow-up. The proportion of each category of the eating together frequency was 36.6% for 'every day', 10.3% for 'several times a week', 26.8% for 'several times a month', 20.5% for 'several times a year' and 5.8% for 'seldom'. Compared to 'every day', only 'several times a year (RR = 1.07, 95% CI = 1.01-1.13)' and 'seldom (RR = 1.17, 95% CI = 1.08-1.27)' were significantly associated with the increased risk of >5% weight loss. CONCLUSION there is a temporal association between less frequent opportunities to eat together and the increased risk of weight loss among independent older adults.
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Affiliation(s)
- Taro Kusama
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
| | - Yukako Tani
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, 113-8510, Tokyo, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, 113-8510, Tokyo, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chuo-ku, Chiba, 263-8522, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, 474-8511, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, 980-8575, Japan
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Influence of "Face-to-Face Contact" and "Non-Face-to-Face Contact" on the Subsequent Decline in Self-Rated Health and Mental Health Status of Young, Middle-Aged, and Older Japanese Adults: A Two-Year Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042218. [PMID: 35206406 PMCID: PMC8872531 DOI: 10.3390/ijerph19042218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/04/2022]
Abstract
This study aims to identify the independent influence of face-to-face contact (FFC) and non-face-to-face contact (NFFC) on the subsequent decline in self-rated health and mental health status by age. A total of 12,000 participants were randomly selected among residents in the study area, and 1751 of them responded to both the 2016 and 2018 mail surveys. The participants were subsequently classified into three age groups (25-49: Young adults; 50-64: Mid-aged adults; and 65-84: Older adults). Social contact was assessed by computing the frequencies of FFC and NFFC. Multiple logistic regression analysis showed the risk of social contact on the decline in self-rated health and World Health Organization-Five Well-Being Index. Both FFC and NFFC were significantly associated with maintaining mental health; however, the impacts of FFC on mental health were more significant than that of NFFC among older adults and young adults. Compared with the no contact group, FFC was significantly associated with maintaining self-rated health in mid-aged adults. The influence of FFC and NFFC on health differed by age group.
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Noguchi T, Nakagawa T, Komatsu A, Ishihara M, Shindo Y, Otani T, Saito T. Social functions and adverse outcome onset in older adults with mild long-term care needs: A two-year longitudinal study. Arch Gerontol Geriatr 2022; 100:104631. [DOI: 10.1016/j.archger.2022.104631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 11/24/2022]
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25
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Cheng GHL, Sung P, Chan A, Ma S, Malhotra R. Transitions between social network profiles and their relation with all-cause mortality among older adults. Soc Sci Med 2021; 292:114617. [PMID: 34871852 DOI: 10.1016/j.socscimed.2021.114617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/23/2021] [Accepted: 11/28/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND The importance of social network in mortality among older adults has been acknowledged. However, existing studies typically overlook the interplay among social network indicators, and seldom consider the change in social network over time. We take a person-centered approach to identify transitions between social network profiles, and examine the linkage of such transitions with subsequent mortality risk. METHODS Data came from 2738 older Singaporeans enrolled in a longitudinal study. Latent transition analysis examined nine social network indicators assessed at two time points, two years apart to reveal the corresponding transitions between social network profiles. Adjusted Cox regression then associated the identified transitions with all-cause mortality risk in the subsequent four years. RESULTS We observed three diverse social network profiles (that featured diversified social interaction and involved both household and non-household members) and three relatively restricted social network profiles (that focused on household or non-household members). Compared to sustained diverse profiles over time, sustained restricted profiles or a transition from diverse to restricted profiles entailed increased mortality risk. The mortality risk following a restricted-to-diverse profile transition could be as low as that associated with sustained diverse profiles. CONCLUSIONS Dynamics of social network profiles have implications for mortality risk in later life. To promote longevity, initiatives are needed to help older people to maintain or shift to diverse social network profiles.
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Affiliation(s)
- Grand H-L Cheng
- School of Arts and Social Sciences, Hong Kong Metropolitan University, Hong Kong(1).
| | - Pildoo Sung
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
| | - Angelique Chan
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore; Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Stefan Ma
- Epidemiology and Disease Control Division, Ministry of Health, Singapore
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore; Health Services and Systems Research, Duke-NUS Medical School, Singapore
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26
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Social isolation: An underappreciated determinant of physical health. Curr Opin Psychol 2021; 43:232-237. [PMID: 34438331 DOI: 10.1016/j.copsyc.2021.07.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 02/08/2023]
Abstract
While a sizable body of research demonstrates the associations between social connection and health, much of the recent focus in the broader public and to some extent among academics has been on loneliness, with more objective/structural aspects often assumed to be proxies for more influential relationship factors such as relationship functions and quality. However, evidence suggests the actual presence of others (proximity and regular contact) is essential, and many studies document these structural indicators have just as powerful and, in some cases, more potent effects on indicators of health and well-being. This paper summarizes the evidence on social isolation and health and provides a framework for why social isolation may be a powerful predictor of health and mortality.
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Koyama S, Saito M, Cable N, Ikeda T, Tsuji T, Noguchi T, Abbas H, Miyashiro I, Osaka K, Kondo K, Watt RG, Aida J. Examining the associations between oral health and social isolation: A cross-national comparative study between Japan and England. Soc Sci Med 2021; 277:113895. [PMID: 33882441 DOI: 10.1016/j.socscimed.2021.113895] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/23/2021] [Accepted: 03/31/2021] [Indexed: 12/12/2022]
Abstract
In Western countries, the most important part of the face in communication is the mouth, whereas it is the eyes in Asian countries; thus oral health could be more important in social interactions in Western countries. Our aim was to examine differences in the association between oral health status and social isolation among older people by comparing Japan and England. We used cross-sectional information obtained from adults aged 65+ in two ongoing prospective cohort studies: The Japan Gerontological Evaluation Study (JAGES, N = 120,195) and the English Longitudinal Study of Ageing (ELSA, N = 3,958). The dependent variable, social isolation score (SIS) was calculated from five factors (marital status, social support from children, social support from family, social support from friends, and social participation). The independent variables were self-reported number of remaining teeth (0, 1-9, 10-19, ≥20) and denture use (≥20 teeth, 10-19 teeth with denture, 10-19 teeth without denture, 0-9 teeth with denture, 0-9 teeth without denture), while the covariates in the model were: sex, age, educational attainment, self-rated health, number of comorbidities, household annual equivalized income, mental health status, daily living activities, and smoking status. We examined associations between oral health status and SIS by applying an ordered logit model by country. Compared to England, more Japanese participants were socially isolated (1.4% vs. 5.8%), but fewer were edentulous (13.1% vs. 7.7%). In both countries, poorer oral health further increased the odds of being socially isolated. Pooled analysis of the ordered logit model with an interaction term showed that the association of number of remaining teeth with SIS was stronger in edentulous participants and in England (odds ratio = 1.50, 95% Confidence interval:1.26-1.80). In both countries, oral health was associated with social isolation; this association could be stronger in England than in Japan.
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Affiliation(s)
- Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Ohtemae, Chuo Ward, Osaka, 541-8567, Japan.
| | - Masashige Saito
- Department of Social Welfare, Nihon Fukushi University, Okuda, Mihama-cho, Chita-gun, Aichi, 470-3295, Japan.
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom.
| | - Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan; Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba Ward, Sendai City, Miyagi 980-8574, Japan.
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, 3-29-1 Otsuka, Tokyo, 112-0012, Japan.
| | - Taiji Noguchi
- Department of Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi, 474-8511, Japan.
| | - Hazem Abbas
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba Ward, Sendai City, Miyagi 980-8574, Japan.
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Ohtemae, Chuo Ward, Osaka, 541-8567, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba Ward, Sendai City, Miyagi 980-8574, Japan.
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo Ward, Chiba, 260-8670, Japan.
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom.
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo Ward, Tokyo, 113-8510, Japan; Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba Ward, Sendai City, Miyagi, 980-8574, Japan.
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28
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Noguchi T, Saito M, Aida J, Cable N, Tsuji T, Koyama S, Ikeda T, Osaka K, Kondo K. Association between social isolation and depression onset among older adults: a cross-national longitudinal study in England and Japan. BMJ Open 2021; 11:e045834. [PMID: 33737442 PMCID: PMC7978252 DOI: 10.1136/bmjopen-2020-045834] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Social isolation is a risk factor for depression in older age. However, little is known regarding whether its impact varies depending on country-specific cultural contexts regarding social relationships. The present study examined the association of social isolation with depression onset among older adults in England, which has taken advanced measures against social isolation, and Japan, a super-aged society with a rapidly increasing number of socially isolated people. DESIGN Prospective longitudinal study. SETTING We used data from two ongoing studies: the English Longitudinal Study of Ageing (ELSA) and the Japan Gerontological Evaluation Study (JAGES). PARTICIPANTS Older adults aged ≥65 years without depression at baseline were followed up regarding depression onset for 2 years (2010/2011-2012/2013) for the ELSA and 2.5 years (2010/2011-2013) for the JAGES. PRIMARY OUTCOME MEASURE Depression was assessed with eight items from the Centre for Epidemiologic Studies Depression Scale for the ELSA and Geriatric Depression Scale for the JAGES. Multivariable logistic regression analysis was performed to evaluate social isolation using multiple parameters (marital status; interaction with children, relatives and friends; and social participation). RESULTS The data of 3331 respondents from the ELSA and 33 127 from the JAGES were analysed. Multivariable logistic regression analysis demonstrated that social isolation was significantly associated with depression onset in both countries. In the ELSA, poor interaction with children was marginally associated with depression onset, while in the JAGES, poor interaction with children and no social participation significantly affected depression onset. CONCLUSIONS Despite variations in cultural background, social isolation was associated with depression onset in both England and Japan. Addressing social isolation to safeguard older adults' mental health must be globally prioritised.
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Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Japan
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University, Sendai, Japan
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Takaaki Ikeda
- Department of Health Policy Science, Yamagata University Faculty of Medicine Graduate School of Medical Science, Yamagata, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry School of Dentistry, Sendai, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry School of Dentistry, Sendai, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
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29
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Saito M, Aida J, Cable N, Zaninotto P, Ikeda T, Tsuji T, Koyama S, Noguchi T, Osaka K, Kondo K. Cross-national comparison of social isolation and mortality among older adults: A 10-year follow-up study in Japan and England. Geriatr Gerontol Int 2020; 21:209-214. [PMID: 33350047 PMCID: PMC7898799 DOI: 10.1111/ggi.14118] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 11/11/2020] [Accepted: 11/27/2020] [Indexed: 01/03/2023]
Abstract
AIM Existing evidence links social isolation with poor health. To examine differences in the mortality risk by social isolation, and in socio-economic correlates of social isolation, we analyzed large-scale cohort studies in Japan and England. METHODS Participants were drawn from the Japan Gerontological Evaluation Study (JAGES) and the English Longitudinal Study of Ageing (ELSA). We analyzed the 10-year mortality among 15 313 JAGES participants and 5124 ELSA respondents. Social isolation was measured by two scales, i.e., scoring the frequency of contact with close ties, and a composite measurement of social isolation risk. We calculated the population attributable fraction, and Cox regression models with multiple imputations were used to estimate hazard ratios (HRs) for mortality due to social isolation. RESULTS The proportion of those with contact frequency of less than once a month was 8.5% in JAGES and 1.3% in ELSA. Males, older people, those with poor self-rated health, and unmarried people were significantly associated with social isolation in both countries. Both scales showed that social isolation among older adults had a remarkably higher risk for premature death (less frequent contact with others in JAGES: hazard ratio [HR] = 1.18, 95% confidence interval [CI]: 1.05-1.33, in ELSA: HR = 1.27, 95% CI: 0.85-1.89; and high isolation risk score in JAGES: HR = 1.30, 95% CI: 1.12-1.50, in ELSA: HR = 2.05, 95% CI: 1.52-2.73). The population attributable fraction showed less frequent contact with close ties was attributed to about 18 000 premature deaths annually in Japan, in contrast with about 1800 in England. CONCLUSIONS Negative health impacts of social isolation were higher among older Japanese compared with those in England. Geriatr Gerontol Int 2021; 21: 209-214.
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Affiliation(s)
- Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Mihama, Japan.,Center for Well-being and Society, Nihon Fukushi University, Mihama, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan
| | - Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Taiji Noguchi
- Department of Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Katsunori Kondo
- Center for Well-being and Society, Nihon Fukushi University, Mihama, Japan.,Department of Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.,Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
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