Does Mode of Contact with Different Types of Social Relationships Predict Depression in Older Adults? Evidence from a Nationally Representative Survey

Depressive symptoms associated with infection prevention measures and daily lifestyle habit characteristics among Japanese community-dwelling older adults during the COVID-19 pandemic

AIM

This study aimed to clarify the relationship between depressive symptoms and infection prevention measures and daily lifestyle habits during the coronavirus disease 2019 pandemic among community-dwelling Japanese older adults.

METHODS

This cross-sectional study was conducted on older residents (age ≥65 years) living in the Tama area of Tokyo and Sapporo, Hokkaido, in 2021. A self-administered questionnaire survey was conducted to collect data on demographics, the impact of the pandemic on physical condition, and depressive symptoms, infection prevention measures, and daily lifestyle habits during the pandemic. The Geriatric Depression Scale was used to assess depressive symptoms.

RESULTS

In total, 554 respondents were included in the analysis. The results of multiple logistic regression analyses revealed that refraining from going out and visiting medical institutions were associated with depressive symptoms. Furthermore, those who went out almost every day were less likely to have depressive symptoms than the others, those who exercised almost every day were less likely to have depressive symptoms than were those who almost never exercised, and those who slept 6-7 h were less likely to have depressive symptoms than were those who slept ≤5 h.

CONCLUSIONS

The findings of the present study suggest the necessity of having a place where older adults with physical and lifestyle concerns can consult with healthcare providers in a location other than a medical institution, even during infectious disease outbreaks. In addition, increasing the frequencies of going out and independent exercise and sleeping 6-7 h may help prevent depression among older adults.

Older adults using social support to improve self-care (OASIS): Adaptation, implementation and feasibility of peer support for older adults with T2D in appalachia: A feasibility study protocol

INTRODUCTION

The prevalence of type 2 diabetes (T2D) is 17% higher in rural dwellers compared to their urban counterparts, and it increases with age, with an estimated 25% of older adults (≥ 65 years) diagnosed. Appropriate self-care is necessary for optimal clinical outcomes. Overall, T2D self-care is consistently poor among the general population but is even worse in rural-dwellers and older adults. In rural Kentucky, up to 23% of adults in Appalachian communities have been diagnosed with T2D and, of those, 26.8% are older adults. To attain optimal clinical outcomes, social environmental factors, including social support, are vital when promoting T2D self-care. Specifically, peer support has shown to be efficacious in improving T2D self-care behaviors and clinical and psychosocial outcomes related to T2D; however, literature also suggests self-selected social support can be obstructive when engaging in healthful activities. Currently available evidence-based interventions (EBIs) using peer support have not been used to prioritize older adults, especially those living in rural communities.

METHOD

To address this gap, we conducted formative research with stakeholders, and collaboratively identified an acceptable and feasible peer support EBI-peer health coaching (PHC)-that has resulted in improved clinical and psychosocial T2D-related outcomes among participants who did not reside in rural communities nor were ≥65 years. The goal of the proposed study is to use a 2x2 factorial design to test the adapted PHC components and determine their preliminary effectiveness to promote self-care behaviors and improve glycemic control among older adults living in Appalachian Kentucky. Testing the PHC components of the peer support intervention will be instrumental in promoting care for older adults in Appalachia, as it will allow for a larger scale intervention, which if effective, could be disseminated to community partners in Appalachia.

TRIAL REGISTRATION

This study was registered at www.clinicaltrials.gov (NCT06003634) in August 2023.

Hierarchy of demographic and social determinants of mental health: analysis of cross-sectional survey data from the Global Mind Project

OBJECTIVES

To understand the extent to which various demographic and social determinants predict mental health status and their relative hierarchy of predictive power in order to prioritise and develop population-based preventative approaches.

DESIGN

Cross-sectional analysis of survey data.

SETTING

Internet-based survey from 32 countries across North America, Europe, Latin America, Middle East and North Africa, Sub-Saharan Africa, South Asia and Australia, collected between April 2020 and December 2021.

PARTICIPANTS

270 000 adults aged 18-85+ years who participated in the Global Mind Project.

OUTCOME MEASURES

We used 120+ demographic and social determinants to predict aggregate mental health status and scores of individuals (mental health quotient (MHQ)) and determine their relative predictive influence using various machine learning models including gradient boosting and random forest classification for various demographic stratifications by age, gender, geographical region and language. Outcomes reported include model performance metrics of accuracy, precision, recall, F1 scores and importance of individual factors determined by reduction in the squared error attributable to that factor.

RESULTS

Across all demographic classification models, 80% of those with negative MHQs were correctly identified, while regression models predicted specific MHQ scores within ±15% of the position on the scale. Predictions were higher for older ages (0.9+ accuracy, 0.9+ F1 Score; 65+ years) and poorer for younger ages (0.68 accuracy, 0.68 F1 Score; 18-24 years). Across all age groups, genders, regions and language groups, lack of social interaction and sufficient sleep were several times more important than all other factors. For younger ages (18-24 years), other highly predictive factors included cyberbullying and sexual abuse while not being able to work was high for ages 45-54 years.

CONCLUSION

Social determinants of traumas, adversities and lifestyle can account for 60%-90% of mental health challenges. However, additional factors are at play, particularly for younger ages, that are not included in these data and need further investigation.

Explaining the Urban-Rural Difference in Late-Life Depression in India: Evidence from a Multivariate Decomposition Analysis Based on Longitudinal Aging Study in India, Wave 2017-18

OBJECTIVES

The study explored the associated factors of depression among older Indian adults and the influences of individual and socio-environmental factors in explaining the rural-urban difference in the prevalence of late-life depression.

METHODS

Data come from the Longitudinal Aging Study in India, with a sample of 30,637 older adults aged 60 and above. Multivariable logistic regression and nonlinear multivariate decomposition analyses were conducted to fulfill the objectives.

RESULTS

About 6.2% older adults in urban areas and 9.5% in rural areas were depressed. Older adults in rural areas had significantly higher likelihood to be depressed than those in urban areas. Poor self-rated health, multiple chronic conditions, functional difficulty, low life satisfaction, social inactivity, low satisfaction with living arrangement, ill-treatment and being widowed increased the risk of depression. Additionally, work status similar to urban older adults, physical activity, living arrangement satisfaction, self-rated health and ill-treatment would decrease the urban-rural difference in depression.

CONCLUSIONS

The study showed significant rural-urban difference in late-life depression, with a rural disadvantage.

CLINICAL IMPLICATIONS

The findings suggest the need for identifying at-risk populations and developing a framework of targeted policy interventions for mitigating the increased risk of late-life depression among older Indians and in rural areas in particular.

Family Ties and Older Adult Well-Being: Incorporating Social Networks and Proximity

OBJECTIVES

This paper examines the family ties of older adults in the United States and how they are associated with mental health and social activity. We compare older adults with 4 types of family ties: adults "close" to family in proximity and social network, "kinless" older adults without a partner or children, "distanced" adults who live far from close kin, and "disconnected" older adults who do not report kin in their social network or do not report a location for some kin.

METHODS

Using pooled data from the National Health and Aging Trends Study 2015-2019 for older adults aged 70 and older (N = 24,818 person-waves), we examine how family ties are associated with mental health and social activity, and whether lacking family is tied to poor well-being because older adults' needs are not being met.

RESULTS

Kinless older adults and disconnected older adults have poorer outcomes (lower mental health scores and less social activity), compared to those close to their family. These findings suggest that both the presence and quality of the connection, as measured here via both location and social network, are critical for understanding which older adults are "at risk." Older adults who were not geographically proximate to their close kin (i.e., distanced) were not disadvantaged relative to those close to their families. Unmet needs do not help explain these patterns.

DISCUSSION

Our results highlight that family ties are important for older adults well-being, not just through their existence but also their quality and strength.

Social Isolation and Worsening Health Behaviors Among Older Adults During the COVID-19 Pandemic

OBJECTIVES

We examine the relationship between social isolation, poor health behaviors, and the perceived worsening of older adults' health behaviors following the coronavirus outbreak. We assess the extent to which psychological pathways mediate the relationship between social isolation and worsening health behaviors.

METHODS

Drawing on data from the National Social Life Health and Aging Project Round 3 (2015) and its coronavirus immune disease 2019 (COVID-19) substudy (2020; N = 2,549), we use generalized linear models to explore how indicators of social isolation during the COVID-19 pandemic-infrequent in-person contact with friends and family in 2020 and decreased in-person contact with friends and family since COVID-19 started-are associated with (1) poor health behaviors (low physical activity, drinks per week, smoking, and poor sleep) in 2020 and (2) perceived worsening of health behaviors (reports of decreased physical activity, increased drinking and smoking, and feeling less rested) since the pandemic started.

RESULTS

Infrequent in-person contact was not associated with poor health behaviors. Decreases in in-person contact, on the other hand, were associated with worsening health behaviors. Older adults who reported decreases in in-person contact were more likely to perceive a decrease in physical activity, an increase in drinking, and feeling less rested. Emotional well-being, particularly loneliness compared to anxiety or depressive feelings, partially mediated the relationship between perceived worsening of health behaviors and a decrease in in-person contact with friends, and to a lesser extent, with family.

DISCUSSION

Our study suggests that in-person contact may play a distinct role in shaping older adults' well-being during the pandemic.

Aging alone and financial insecurity predict depression: a path analysis of objective and subjective indices

OBJECTIVES

This study draws on conservation of resources theory and transactional stress theory to guide our understanding of how social isolation, financial insecurity, and social support serve as a balance of both risk and protection for late-life depression.

METHODS

Data were from the Leave-Behind Questionnaire in the 2016 (N = 4293) and 2018 (N = 4714) waves of the Health and Retirement Study. We conducted a cross-sectional path analysis via structural equation modeling, including objective and subjective perspectives. The same model was tested in both samples.

RESULTS

Both social isolation and financial insecurity were associated with depression. We found several mediating risks and protective factors of these relationships. Objective financial status affected depression through both perceived financial insecurity and perceived social isolation, whereas objective isolation affected depression through perceived social support. This mediation model was -significant after adjusting for confounders.

CONCLUSION

This study underscores the importance of investigating the balance between risk and protection for depression, in the rising number of older adults aging alone in society. Findings suggest that objective and perceived measures offer unique windows into psychological constructs. Considering both objective and subjective perspectives may provide alternative targets for subsequent interventions to improve mental health in later life.

Acceptance of communication technology, emotional support and subjective well-being for Chinese older adults living alone during COVID-19: A moderated mediation model

Stringent social distancing measures implemented to control the spread of COVID-19 affected older adults living alone by limiting their social interaction beyond their households. During these restrictions, interactions beyond the household could be facilitated by communication technology (CT) such as voice calls, instant messages. Our study provides evidence on how CT acceptance could influence the emotional support and in turn, subjective well-being (SWB) of older adults living alone. We did a cross-sectional survey with 293 community-dwelling Chinese older adults. Participants were surveyed from September to November 2020 and had completed measures on CT acceptance (competency), emotional support, and SWB. PROCESS Model 1 was used to estimate the conditional effects of CT acceptance (competency) on emotional support for those living alone versus with others. Following which, PROCESS Model 7 was used to estimate the conditional indirect effects of CT acceptance (competency) on SWB through emotional support. Our results suggested that living arrangement moderated the indirect effect of CT acceptance (competency) on SWB. For older adults living alone, CT acceptance (competency) was significantly associated with perceived emotional support and, in turn, their SWB. For older adults living with others, CT acceptance was not associated with emotional support and SWB. Our findings call for more research and support to increase older adults' acceptance of CT as an option for communication to increase emotional support for older adults living alone, even during non-pandemic times.

Factors that promote resilience for older adults and their informal caregivers during the COVID-19 pandemic

OBJECTIVES

The aim of this cross-sectional, descriptive study was to characterize the impact of modifiable activities on older adult mental health during the COVID-19 pandemic and to understand the interaction between older adult behaviors and the mental health of their informal caregivers.

METHODS

This study leveraged the National Health and Aging Trends Study and associated Family and Friends survey completed 2020-2021. Participants included 3,257 community dwelling older adults and 2,062 associated unpaid caregivers, weighted sample sizes 26,074,143 and 21,871,408, respectively.

RESULTS

Older adult engagement in volunteering, religious, or group activities was associated with decreased older adult depression, as was increased walking or vigorous activity. However, online compared to in-person participation correlated with greater loneliness in older adults and anxiety for their caregivers. Finally, increased appreciation by the care recipient correlated with decreased caregiver depression.

CONCLUSION

Overall, a close interaction exists between caregiver and older adult behavior and psychiatric symptoms. Online activities are not an equivalent substitute for in-person activities during required social isolation; however, they remain superior to no participation. Further, increased walking and caregiver appreciation may ameliorate some of the harms of isolation. Health care providers should continue to promote engagement, exercise, and appreciation as ways to improve older adult and informal caregiver mental health.

Associations between changes in social contact pattern and the mental health status of Chinese adults: cross-sectional findings

The study aims to examine the associations between social contact pattern changes and mental health status, including depression, anxiety, and loneliness, among Chinese adults in the context of coronavirus disease 2019 (COVID-19). Data on social contact patterns before and after the outbreak of COVID-19 were obtained from 3511 participants. Mental health (ie, depression, anxiety, and loneliness) was assessed by the 9-item Patient Health Questionnaire, Dark Future Scale, and the 9-scale Three-Item Loneliness Scale, respectively. Poisson regression analyses revealed that the participants who had increased in-person communication were more likely to have mental disorders [depression: prevalence ratio (PR)=1.13, 95% confidence interval (CI): 1.02, 1.26; anxiety: PR=1.15, 95% CI: 1.01, 1.30]. The current study concluded that the in-person communication increase before and after the outbreak of COVID-19 was associated with mental disorders among Chinese adults.

Living alone and mental health: parallel analyses in UK longitudinal population surveys and electronic health records prior to and during the COVID-19 pandemic

BACKGROUND

People who live alone experience greater levels of mental illness; however, it is unclear whether the COVID-19 pandemic had a disproportionately negative impact on this demographic.

OBJECTIVE

To describe the mental health gap between those who live alone and with others in the UK prior to and during the COVID-19 pandemic.

METHODS

Self-reported psychological distress and life satisfaction in 10 prospective longitudinal population surveys (LPSs) assessed in the nearest pre-pandemic sweep and three periods during the pandemic. Recorded diagnosis of common and severe mental illnesses between March 2018 and January 2022 in electronic healthcare records (EHRs) within the OpenSAFELY-TPP.

FINDINGS

In 37 544 LPS participants, pooled models showed greater psychological distress (standardised mean difference (SMD): 0.09 (95% CI: 0.04; 0.14); relative risk: 1.25 (95% CI: 1.12; 1.39)) and lower life satisfaction (SMD: -0.22 (95% CI: -0.30; -0.15)) for those living alone pre-pandemic. This gap did not change during the pandemic. In the EHR analysis of c.16 million records, mental health conditions were more common in those who lived alone (eg, depression 26 (95% CI: 18 to 33) and severe mental illness 58 (95% CI: 54 to 62) more cases more per 100 000). For common mental health disorders, the gap in recorded cases in EHRs narrowed during the pandemic.

CONCLUSIONS

People living alone have poorer mental health and lower life satisfaction. During the pandemic, this gap in self-reported distress remained; however, there was a narrowing of the gap in service use.

CLINICAL IMPLICATIONS

Greater mental health need and potentially greater barriers to mental healthcare access for those who live alone need to be considered in healthcare planning.

The Temporal Relationship between Depressive Symptoms and Loneliness: The Moderating Role of Self-Compassion

Loneliness and depression are significant mental health challenges among college students; however, the intricate relationship between these phenomena remains unclear, particularly in the context of self-compassion. In this comprehensive study, we employ a cross-lagged panel network (CLPN) analysis to investigate the symptom-level association between depression and loneliness while exploring the potential moderating influence of self-compassion. Our sample consisted of 2785 college students, who were categorized into high- and low-self-compassion groups based on scores from the Self-Compassion Scale. Depressive symptoms were assessed using the Patient Health Questionnaire-9, while the UCLA Loneliness Scale-8 measured loneliness expressions. Our findings indicate that self-compassion plays a crucial role in the relationship between depression and loneliness. Specifically, we observed distinctive patterns within the high and low-self-compassion groups. In the low-self-compassion group, "energy" emerged as the most influential symptom, whereas "motor function" exhibited the highest influence in the high-self-compassion group. Furthermore, among individuals with high self-compassion, the pathway from depression to loneliness was characterized by "guilt-being alone when desired," while the reverse path from loneliness to depression encompassed "left out-feeling sad" and "left out-anhedonia." Conversely, in the low-self-compassion group, depression and loneliness demonstrated a more intricate mutual triggering relationship, suggesting that self-compassion effectively moderates the association between these variables. This study provides valuable insights into the underlying mechanisms driving the interplay between depression and loneliness, shedding light on the pivotal role of self-compassion in this intricate dynamic.

Marital-history differences in increased loneliness during the COVID-19 pandemic: A European study among older adults living alone

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.

Relocation Later in Life and Contact Frequency With Friends: Do Contact Modes Matter?

We examined changes in the frequencies of in-person, telephone, and written or email contact with friends in older adults who move short or longer distances. 3820 adults aged 50 years or older were included from a nationally representative sample from the Health and Retirement Study. Using ordinal logistic regression, we found differential effects of geographical distances on the in-person, telephone, and write or email contact with friends. Specifically, in-person contact frequency was most sensitive to distance. Telephone contact frequency was only impacted by long-distance moves; however, email contact frequency was not influenced by distance. Findings suggest that the impact of relocation on contact frequency exists even though communication technology gives older adults flexibility in maintaining frequent contact with their friends. We discuss our findings through the lens of socioemotional selective theory and social convoy model. Future studies could examine factors linked to changes in the amount and modes of contact.

Health-related quality of life 12 years after injury: prevalence and predictors of outcomes in a cohort of injured Māori

PURPOSE

Studies have found that many people who sustain an injury can experience adverse outcomes for a considerable time thereafter. Māori, the Indigenous peoples of Aotearoa me Te Waipounamu (New Zealand; NZ), are no exception. The Prospective Outcomes of Injury Study (POIS) found that almost three-quarters of Māori participants were experiencing at least one of a range of poor outcomes at two years post-injury. The aim of this paper was to estimate the prevalence, and identify predictors, of adverse health-related quality of life (HRQoL) outcomes in the POIS-10 Māori cohort, 12 years after participants sustained an injury.

METHODS

Interviewers reached 354 individuals who were eligible to participate in a POIS-10 Māori interview, to be conducted a decade after the last phase of POIS interviews (held 24 months post-injury). The outcomes of interest were responses to each of the five EQ-5D-5L dimensions at 12 years post-injury. Potential predictors (i.e., pre-injury sociodemographic and health measures; injury-related factors) were collected from earlier POIS interviews. Additional injury-related information was collected from administrative datasets proximate to the injury event 12 years prior.

RESULTS

Predictors of 12-year HRQoL outcomes varied by EQ-5D-5L dimension. The most common predictors across dimensions were pre-injury chronic conditions and pre-injury living arrangements.

CONCLUSION

An approach to rehabilitation where health services proactively enquire about, and consider the broader aspects of, patient health and wellbeing throughout the injury recovery process, and effectively coordinate their patients' care with other health and social services where necessary, may help improve long-term HRQoL outcomes for injured Māori.

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

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

Diversity in Social Communication and Support: Implications for Loneliness Among LGB Adults

BACKGROUND AND OBJECTIVES

Current research indicates that structural and functional social network attributes influence older adults' well-being. However, these linkages may vary by sexual orientation. This study examines how social communication diversity and support diversity are related to loneliness and differ between lesbian, gay, and bisexual (LGB) and heterosexual adults.

RESEARCH DESIGN AND METHODS

Using data from the American Association of Retired Persons Foundation's Loneliness and Social Connection Survey of adults 45+ (N = 3,009), including 10% who identified as LGB, we derive entropy scores, which capture the extent to which network size and quality of relationships are evenly distributed. A series of linear regressions were conducted to examine sexual orientation, social network indicators, and their interactions in predicting loneliness.

RESULTS

We found a positive association between social communication diversity and loneliness. This finding was qualified by the interaction with sexual orientation. In addition, we found a negative association between support diversity and loneliness, an effect that was stronger for LGB participants than for heterosexual participants. The effect of support diversity on loneliness was much stronger for LGB adults than heterosexual adults.

DISCUSSION AND IMPLICATIONS

While LGB adults tend to score higher on the loneliness scale overall, the findings suggest that communication and support diversity have uniquely different patterns of associations for sexual minority groups. This study highlights the importance of considering multiple dimensions of social networks and has implications for addressing loneliness for heterosexual and LGB adults.

Older Adults' Views on Social Interactions and Online Socializing Games - A Qualitative Study

Age-related difficulties and quarantine restrictions impede the possibilities to maintain contact with one's social network. Maintaining these contacts may be supported by digital games. To develop effective and feasible digital tools to foster social interaction, we aimed to explore what older adults find important in social contact and what barriers and enablers they foresee in digital gaming interventions as network support aids. Two focus groups and 20 semi-structured interviews (N = 29) with older adults (aged 55-87) were held to explore the research questions. Furthermore, a questionnaire was administered (N = 29) containing measures of loneliness, frailty, and social network size. Participants found 'reciprocity', 'in-person contact', and 'personal connection' important in contact with strong ties. Online games were not used much for socializing but may be used in the future, particularly by less mobile older adults. Future social gaming interventions should be challenging, user-friendly, and offer the possibility to communicate. Digital co-designed interventions that are feasible, challenging, intuitive, and trigger meaningful communication may strengthen social interactions in older adults. They may be a relevant social support tool in periods of interaction limitations due to functional impairment or social isolation.

Relationship between proximity and physiological stress levels in hunter-gatherers: The Hadza

In recent years there has been a great deal of documentation on how social relationships are related to various aspects of human wellbeing. However, until recently most studies investigating the effects of social relationships on wellbeing have applied social network measures to reported social contacts. Recent advances in the application of bio-loggers in biological studies have now made it possible to quantify social relationships based on in-person, rather than self-reported, social interactions. We used GPS-derived in-camp and out-of-camp proximity data to analyse how in-person proximity is related to Hair Cortisol Concentration (HCC) among Hadza hunter-gatherers. Time spent in close proximity to other camp members was associated with higher HCC, especially in women. In contrast, individuals who spent more time in close out-of-camp proximity to their best friend experienced lower HCC. Our study suggests that physiological costs related to group living might be mitigated by in-person interactions with close friends. We also find that the location (i.e., in-camp vs out-of-camp) of proximity to others and self-perceived friends is associated with HCC among the Hadza.

The Relationship between Social Frailty and Depressive Symptoms in the Elderly: A Scoping Review

BACKGROUND

Various studies have highlighted the correlation between social frailty and depressive symptoms in the elderly. However, evidence of how these two domains influence each other is not clear. The purpose of this scoping review is to summarize the current literature examining social frailty and depressive symptoms.

METHOD

We conducted a scoping review allowing for the inclusion of multiple methodologies to examine the extent and range of this research topic.

RESULT

The search initially yielded 617 results, 14 of which met the inclusion criteria. Five studies were identified from China, six were identified from Japan, two were identified from Korea, one was identified from Ghana, and one was from Asia. The evidence reviewed indicated that five studies met category 5 criteria, and the others met level 3 criteria. The findings from these studies showed that there is a significant relationship between social frailty and depressive symptoms.

CONCLUSION

This scoping review shows that worse social frailty contributes to a significant degree of depression. Further research on screening social frailty and possible interventions in community and medical settings to prevent the elderly from developing depressive symptoms is needed.

Interventions simultaneously promoting social participation and physical activity in community living older adults: A systematic review

Background

In recent years, there has been a global trend toward an increase in life expectancy and the proportion of elderly people among the population. In this regard, it becomes important to promote active and healthy aging. Physical inactivity and social isolation are both risk factors of many chronic illnesses and highly prevalent in older adults. This challenges communities to develop interventions that reduce these risk factors among elderly populations. The main aims of this study were to summarize community-based interventions that aim to simultaneously promote social participation and physical activity in older adults and to examine their effects.

Methods

We performed a systematic review based on the PRISMA standards. Literature searches were conducted in six scientific databases in July 2021. Articles were included if they had an interventional design, focused on older adults living in the community and measured social participation and physical activity as an outcome. The data were summarized narratively due to the heterogeneity of studies and the variety of outcome measures.

Results

Overall, 46 articles published in English were included. The studies were grouped in (1) interventions with main focus on physical activity promotion; (2) social activities that included a physical activity component; (3) health behavior interventions/ health education interventions; (4) multicomponent interventions; (5) environmental interventions. The majority of the reviewed studies reported positive effects of interventions on physical activity and/or social participation. No study reported negative effects. Analysis of quantitative studies showed that multicomponent interventions have great positive effects on both outcomes. In qualitative studies positive effects were found regardless of intervention type.

Conclusion

This review summarizes the evidence about the effects of community-based interventions that aim to promote social participation and physical activity in older adults. Multicomponent interventions seem to be most suitable for simultaneous promotion of physical activity and social participation. However, high variability in measurement methods used to assess both social participation and physical activity in the included studies made it difficult to compare studies and to indicate the most effective.

Systematic review registration

www.crd.york.ac.uk, identifier: PROSPERO [CRD42021268270].

Community participation as a predictor of depressive symptoms among individuals with serious mental illnesses

BACKGROUND

People with serious mental illnesses have elevated levels of depressive symptoms. Limited engagement in meaningful activities, such as work, social interactions, volunteering, and participation in faith, are one plausible explanation for this. Increased community participation over time may be associated with decreased depressive symptoms.

AIM

Examine whether an increase in participation over time predicts a decrease in depression after controlling for depression at the baseline.

METHODS

Participants were 183 adults with schizophrenia spectrum, bipolar disorder, or major depressive disorder who completed the Hopkins Symptom Index - Depression subscale and the Temple University Community Participation Measure. Participants completed these measures at baseline and either a 12- or 24-month follow-up timepoint. Multiple regression analyses were conducted with the depression score as a dependent variable and changes in community participation as a predictor variable. Demographics, baseline depression score, and time interval between baseline and last observation were entered as control variables.

RESULTS

Endorsing more activities as important, participating in more important areas that are important, and participating 'enough' in more important areas over time were each significant predictors of decreases in depression.

CONCLUSION

These findings enhance the connection between community participation and depression and suggest that a focus on participation may be important in terms of boosting both community functioning and treatment goals.

Interpersonal Media and Face-to-Face Communication: Relationship with Life Satisfaction and Loneliness

Framed by need to belong theory, this study considers the role of communication modality, geographic proximity, and the number of close relationship partners to predict life satisfaction and loneliness. A quota sample of American adults (N = 1,869) completed four name generation tasks to identify up to 16 alters, resulting in four alters per participant (n = 7,471). Participants reported the frequency with which they communicated with each alter in the past year in person and through eight interpersonal media. Results suggest that number of relationship partners and frequency of face-to-face interaction were robust predictors of life satisfaction and loneliness. Those living alone faced significant threats to well-being. Video chat and voice call frequency were also associated with greater life satisfaction. Mediation analyses showed voice call frequency was indirectly associated with less loneliness through greater relationship maintenance satisfaction, while lean media was indirectly associated with greater loneliness through relationship maintenance frustration.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10902-022-00581-8.

The mediating role of loneliness on relations between face-to-face and virtual interactions and psychological well-being across age: A 21-day diary study

Lack of social interaction is associated with a heightened sense of loneliness and, in turn, poorer psychological well-being. Despite the prevalence of communicating with others virtually even when physically alone, whether the social interaction–loneliness–well-being relationship is different between face-to-face and virtual interactions and between younger and older adults is relatively understudied. This 21-day diary study examined this question among younger ( n = 91; Mage = 22.87) and older ( n = 107; Mage = 64.53) Hong Kong participants during the early stage of the COVID-19 pandemic (March–May 2020). We found significant indirect effects of shorter face-to-face interaction time on poorer psychological well-being via a heightened sense of loneliness at the within-person level only among younger adults and at the between-person level only among older adults. Independent of loneliness, spending more time with others on virtual interactions was associated with better psychological well-being only among older adults. Taken together, while the mechanisms may be different across age groups, face-to-face interaction remains an effective way to reduce loneliness and enhance psychological well-being even at times when it is discouraged (e.g., pandemic). Although virtual interaction does not reduce loneliness, its positive impact on older adults’ well-being sheds light on the utility of promoting technological acceptance in late adulthood.

Loneliness in Europe before and during the COVID-19 pandemic

•

The COVID-19 pandemic has magnified already worrying levels of loneliness in Europe.

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Young adults have been the most severely hit by social distancing measures.

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Living alone has made social distancing measures more painful.

Objective

The purpose of the study is to examine the prevalence of loneliness in Europe in 2016 and during the first months – April-July 2020 – of the COVID-19 pandemic, and to assess whether the risk factors associated with loneliness have changed after the outbreak of the pandemic.

Method

The analysis is based on two cross-country surveys, namely the 2016 European Quality of Life Survey and the 2020 Living, Working and COVID-19 Online Survey.

Results

The COVID-19 pandemic has magnified already worrying levels of loneliness in Europe. Young adults have been the most severely hit by social distancing measures. Living alone has made social distancing measures more painful. Health and financial status are strong associates of loneliness, irrespective of the time period.

Conclusion

This analysis will help anticipate the potential consequences that forced social isolation might have triggered in the population and identify populations more vulnerable to loneliness. Further monitoring is important to assess whether the registered increase in loneliness is transient or chronic and to design targeted loneliness interventions.

The Emotional Lockdown: How Social Distancing and Mask Wearing Influence Mood and Emotion Recognition in Adolescents and Adults

During the COVID-19 pandemic, government-mandated protection measures such as contact restrictions and mask wearing significantly affected social interactions. In the current preregistered studies we hypothesized that such measures could influence self-reported mood in adults and in adolescents between 12 and 13 years of age, who are in a critical phase of social development. We found that mood was positively related to face-to-face but not to virtual interactions in adults and that virtual interactions were associated with negative mood in adolescents. This suggests that contact restrictions leading to a decrease in face-to-face compared to virtual interactions may be related to negative mood. To understand if prolonged exposure to people wearing masks during the pandemic might be related to increased sensitivity for subtle visual cues to others’ emotions from the eye region of the face, we also presented both age groups with the same standardized emotion recognition test. We found slightly better performance in emotion recognition from the eyes in our student sample tested during the pandemic relative to a comparable sample tested prior to the pandemic although these differences were restricted to female participants. Adolescents were also better at classifying emotions from the eyes in the current study than in a pre-pandemic sample, with no gender effects occurring in this age group. In conclusion, while social distancing might have detrimental effects on self-reported mood, the ability to recognize others’ emotions from subtle visual cues around the eye region remained comparable or might have even improved during the COVID-19 pandemic.

Daily social media use, social ties, and emotional well-being in later life

Older American adults are increasingly utilizing communication technologies, but research has seldom explored older adults' daily social media use and its interface with other "offline" social ties. To explore a complementary and/or compensatory function of social media in later life, this study employed data from the Daily Experiences and Well-Being Study (2016-2017) to examine associations between daily social media use, daily social encounters, social network structure, and daily mood. Community-dwelling older adults (N = 310; Mage = 73.96) reported on their overall social network structure (diversity in types of social ties and size of network), their daily social encounters in-person and by phone, social media use, and emotional well-being for 5 to 6 days. Multilevel models revealed that daily social media use was associated with daily mood in the context of daily social encounters and the size of the social network. Individuals reported less negative mood on days with more social media use and more in-person encounters. More daily social media use was associated with more positive mood for individuals with a relatively small social network but not for their counterparts with larger social networks. Findings suggest that social media is a distinct form of social resource in later life that may complement the emotional benefits of daily social encounters and compensate for the age-related reduction in social network size. Future research should consider how socially isolated older adults might use computer-mediated communication such as social media to foster a sense of social connection.

Call me maybe: Risk factors of impaired social contact during the COVID-19 pandemic and associations with well-being

The COVID-19 pandemic caused major societal changes worldwide, with the most notable being lockdowns and restrictions on social contact. We conducted a longitudinal study (total n = 1907) in Germany with two time points to (1) identify demographic risk factors of impaired social contact during the pandemic, as well as investigate potential consequences of (2) impaired social contact and (3) different modes of communication on individuals' well-being during the first lockdown in spring 2020. Results indicate that particularly individuals living alone and being unable to work reported a lower frequency of (face-to-face) contact in comparison with participants living with others or working. Impaired social contact was indirectly associated with a negative development in well-being (life satisfaction, anxiety and depression) over time, and this relation was mediated via relatedness. Moreover, the frequency of face-to-face and phone communication during lockdown was positively associated with relatedness and well-being; however, digital communication was not. The findings stress the importance of maintaining social contact in times of social distancing and of fostering reconnection between individuals once the pandemic is over.

Social networks and mental health change in older adults after the Covid-19 outbreak

OBJECTIVES

This article examines the influence of social networks on selected aspects of mental health following the outbreak of the coronavirus.

METHOD

We linked data from a post outbreak telephone survey in 2020 by the Survey of Health, Ageing and Retirement in Europe, with baseline data from SHARE Wave 6 (2016) (n = 33,485). Two mental health measures (depression and anxiety) were regressed on social network variables relevant to the Covid-19 crisis (frequency of face-to-face contact and frequency of contact through electronic means), controlling for confounders. Interactions of age group and social networks were considered. Baseline mental health was controlled, focusing the analysis on post-outbreak mental health change.

RESULTS

Face-to-face network contact significantly reduced negative mental health changes while electronic contact significantly increased them. The age interactions were insignificant. Country differences were observed.

CONCLUSION

The findings suggest that face-to-face social networks can moderate the negative impact of the COVID-19 pandemic on important aspects of mental health.

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

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.

Lockdown strictness and mental health effects among older populations in Europe

This paper investigates whether lockdown policies aggravated mental health problems of older populations (50 and over) in Europe during the first COVID-19 wave. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE COVID-19 questionnaire) and from the Oxford COVID-19 Government Response Tracker for 17 countries, we estimate the causal effect of lockdown policies on mental health by combining cross-country variability in the strictness of the policies with cross-individual variability in face-to-face contacts prior to the pandemic. We find that lockdown policies worsened insomnia, anxiety, and depression by 5, 7.2 and 5.1 percentage points, respectively. This effect was stronger for women and those aged between 50 and 65. Interestingly, lockdown policies notably damaged the mental health of healthy populations. We close with a discussion of lockdown policies targeted at individuals above 65 and/or with pre-existing conditions.

Psychological Antecedents and Consequences of Social Integration Based on Self-Disclosure in Virtual Communities: Empirical Evidence From Sina Microblog

Introduction

With the normalization of COVID-19 prevention and control, a large number of intergenerational audiences with different cognition preferences and value orientations have started to pour into non-acquaintance virtual communities (VCs) to address their social needs by disclosing their own thoughts, feelings and experiences toward certain topics. To avoid the negative impacts of self-disclosure, this study introduced the concept of social integration into cyber society among non-acquaintance VCs, such as the topic-based VCs. Our theoretical model considers both the psychological antecedents and consequences of VC audiences’ social integration and our findings have implications for public online (and even offline) social life. Moreover, this research could play a guiding role in improving VC audiences’ social integration status in future online learning and telecommuting scenarios.

Method

To assess the theoretical model constructed in this manuscript, we conducted an online survey in two different topic-based VCs among Microblog and yielded 472 useable responses from intergenerational audiences, among which 28.81% were born before 1985, 26.67% were born from 1985 to 1995, and 48.52% were born after 1995. Our sample consisted of 208 individuals from Health Regimen VC and 264 individuals from Star Chasing VC, 200 (42.37%) were men and 272 (57.63%) were women.

Results

Our structural equation model (SEM) indicated that individuals’ self-disclosure in topic-based VCs might not directly guide them to acquire social integration. However, intimacy and cognitive communion derived from VC audiences’ self-disclosure might not only enhance their social integration, but also improve their psychological well-being. In addition, VC audiences’ social integration mediated the relationship between intimacy and psychological well-being, and the relationship between cognitive communion and psychological well-being. Moreover, VC audiences’ intimacy was found to have a direct influence on their cognitive communion.

Conclusion

In the context of topic-based VCs, audiences’ self-disclosure could significantly foster their intimacy and cognitive communion with others, and both intimacy and cognitive communion are conductive to VC audiences’ social integration. Thus, audiences in topic-based VCs who wish to improve their psychological well-being need to disclose themselves and build corresponding psychological foundations (i.e., intimacy and cognitive communion) to enhance their social integration. Meanwhile, topic-based VCs should pay attention to the cultivation of intimacy and cognitive communion among audiences while encouraging them to reveal themselves.

An Evaluation of an ACT-Based "Aging Resiliently" Group

OBJECTIVES

There were two quality improvement aims in this project: (1) to evaluate the outcomes of a six-week closed geriatric focused Acceptance and Commitment Therapy (ACT)-based group called "Aging Resiliently" offered in a primary care setting, and (2) to obtain feedback from group members in order to make relevant modifications to future groups.

METHODS

Four cohorts of veterans ages 58 and older participated in the group (N = 17). Paired samples t-tests were computed to determine the significance of changes on pre- and post- self-report measures of depression, experiential avoidance, and life satisfaction. Veterans also provided feedback in the form of an open-ended feedback questionnaire.

RESULTS

There were statistically significant improvements in depressive symptoms and satisfaction with life, but not in experiential avoidance. Two major themes emerged from the feedback questionnaire about what group members found to be the most helpful: (1) self-reflection/values, and (2) the social process of the group.

CONCLUSIONS

At our institution, the Aging Resiliently group yielded meaningful outcomes for older veterans presenting with different problems related to aging.

CLINICAL IMPLICATIONS

This Aging Resiliently group proved to be a potential effective, feasible, and acceptable psychotherapy for older veterans in our established local primary care setting.

Can changes in social contact (frequency and mode) mitigate low mood before and during the COVID-19 pandemic? The I-CONECT project

BACKGROUND/OBJECTIVES

The coronavirus disease 2019 (COVID-19) global outbreak allowed a natural experiment to observe how older adults changed social patterns and how it affected their emotional well-being. We studied the frequency and modes of social contact and their effects on older adults' mood before and during the COVID-19 pandemic.

DESIGN

Phone-based surveys were administered weekly before and during the COVID-19 pandemic.

SETTING

Participants were recruited from Portland, Oregon, and Detroit, Michigan.

PARTICIPANTS

Older adults ≥75 years old (n = 155, age = 81.0 ± 4.5, 72.3% women) were included in a randomized controlled trial, the Internet-Based Conversational Engagement Clinical Trial (I-CONECT).

MEASUREMENTS

Low mood was self-reported as feeling downhearted or blue for three or more days in the past week. Social contact was self-reported by the amount of time spent in interactions, with whom (family, friends, others), and via which modes (in-person, phone/video call, text/email/letter).

RESULTS

A total of 5525 weeks of data were derived from 155 participants. Before the COVID-19 pandemic, average social interaction time spent in-person, on phone/video call, and via text/email/letter was 406, 141, and 68 min/week, respectively. During the COVID-19 pandemic, time spent in-person was reduced by 135 min/week, while time spent via phone/video call and writing increased by 33 and 26 mins/week, respectively. In-person family contact was associated with less low mood regardless of the pandemic (odds ratio = 0.92, p < 0.05). There was a COVID-19 × text/email/letter with friends interaction (odds ratio = 0.77, p = 0.03), suggesting that during the COVID-19 pandemic, an increase of 1 h of writing with friends per week was associated with a 23% decrease in the likelihood of experiencing low mood.

CONCLUSION

The lost in-person time relating to COVID-19 restrictions tended to be partially compensated for with increased calls and writing time, although overall social interaction time decreased. During the COVID-19 pandemic, at least two types of social interactions (writing to friends and in-person family time) showed promise for mitigating low mood for older adults with limited social resources.

Perceived changes in social contact during COVID-19 pandemic in the United States

The COVID-19 pandemic and its restrictions have led to a shift in how people connect with others. This study investigated (a) profiles of social contact change across social ties and modes of contact, (b) predictors of these profiles, and (c) the association between these profiles and mental health during the pandemic. Participants (N = 2,098; Age mean = 50.94, range = 18-98; 48.3% female) were surveyed online twice, once prior to the pandemic (January 31-February 10, 2020) and again early in the outbreak (March 18-29, 2020). A latent profile analysis identified profiles of social contact change across social ties and communication methods. Additional analyses identified predictors of group membership and their association with mental health. Three latent groups were identified: (1) the "majority group" (77%) slightly restricted in-person contact and had a small increase in phone and text use, (2) the "high technology use group" (13%) restricted in-person contact and increased the use of all technology-based methods, and (3) the "isolated group" (10%) decreased in both in-person and technology-based contact. Compared to the majority group, the high technology use group reported higher depression and anxiety, whereas the isolated group reported higher loneliness. There were three distinct profiles of how adults in the United States changed their communication patterns with others early in the pandemic that were linked to distinct patterns of mental health. The results have implications for the development and the delivery of mental health treatment in times of social (physical) distancing.

Not "The More The Merrier": Diminishing Returns to Daily Face-To-Face Social Interaction Frequency for Well-being in Older Age

OBJECTIVES

While being socially active is beneficial for well-being in older age, it is unclear whether effects of social interactions on well-being indicate "the more the merrier" or they have limits as individuals socialize more or less across different days. This study addressed diminishing returns to social interaction frequency for well-being.

METHOD

We examined data from an event-contingent experience sampling study from 116 Swiss older adults (65 to 94 years old) over 21 days. Participants reported face-to-face social interactions once they occurred and daily well-being (i.e., positive and negative affect, loneliness) in the evenings.

RESULTS

On average, participants had 2.09 face-to-face social interactions per day. Linear and quadratic effects from multilevel models conjointly indicated that a higher number of daily social interactions was associated with higher daily positive affect and lower daily negative affect and loneliness, but that well-being reached its peak at 2 to 3 times above participants' typical daily interaction frequency. Once these numbers were surpassed, the benefit of additional social interactions diminished. Additionally, participants who typically had fewer social interactions, were unmarried, lived alone, and had more health conditions showed stronger associations between daily social interaction frequency and well-being.

DISCUSSION

Our findings suggest the benefits of social interactions on well-being exhibit diminishing returns. Social interactions may play a bigger role in older adults with less satiation for desire to belong and a limited future time perspective. We discuss these findings in terms of the belongingness hypothesis and the socioemotional selectivity theory.

The Social Bridging Project: Intergenerational Phone-Based Connections With Older Adults During the COVID-19 Pandemic

Millions of Americans aged 65+ are socially isolated and millions more report feeling lonely. Social isolation and loneliness in older adults were compounded by stay-at-home orders and other COVID-19 prevention measures. Although many Americans experienced no difficulties transitioning to the use of electronic devices as their primary means of communication and connection, some older adults were not similarly able to espouse this shift. Our aim was to reduce the impact of social isolation on older adults, increase their comfort in expressing feelings of loneliness, and assist them in acquiring technology skills and accessing telehealth and community supports. Participants received wellness calls for conversation, resource access and technology-based support. Most participants reported decreased loneliness and increased connectedness after the calls; half reported increased ease in expressing their feelings. Programs that provide phone-based support for older adults may reduce loneliness and increase social connectedness.

Persistence of mental health deterioration among people living alone during the COVID-19 pandemic: a periodically-repeated longitudinal study

Background

This longitudinal study aimed to investigate how psychological distress levels changed from early to middle phases of the new coronavirus (COVID-19) pandemic depending on the living arrangements of individuals.

Methods

An internet-based, longitudinal survey of 2,400 Japanese people was conducted every 5–6 weeks between February 2020 and January 2021. The presence of severe psychological distress (SPD) was measured using the Kessler’s psychological distress scale. Living arrangements were classified into two groups (ie, living alone or living with others). Mixed-effects logistic regression analysis was performed to assess whether changes in SPD status were different depending on living arrangements.

Results

Of 2,400 respondents, 446 (18.5%) lived alone. Although the proportion of SPD in both individuals living alone and those living with others increased to the same extent in the early phase of the pandemic, the distress levels decreased after the early phase of the pandemic in the group living with others, compared with the group living alone, for which SPD remained high. The odds ratio (OR) of developing SPD in interaction term with survey phases tended to be higher among those who lived alone than those who lived with others in Phase 6 (OR 1.89; 95% confidence interval [CI], 0.99–3.64) and Phase 7 (OR 1.88; 95% CI, 0.97–3.63).

Conclusion

During the COVID-19 pandemic, those living alone are persistently at a higher risk of SPD compared to those living with others. Effective countermeasures targeting those living alone, such as enhancing online communication or providing psychological therapies, are essential.

Widowhood and Health Status Among Chinese Older Adults: The Mediation Effects of Different Types of Support

Although many studies have suggested that widowhood is related to worse health conditions among older adults, few have examined the mediation effects of social support between widowhood and health. Employing mediation analysis to a sample of data from the 2014 wave of China Longitudinal Aging Social Survey (CLASS), this study examined the mediation effects of social support, including emotional support, instrumental support, and companionship, in the widowhood-health association among older adults. The results indicated that the negative effect of widowhood on older adults' health was in part attributable to decreased emotional support and companionship. Specifically, emotional support exerted a significant role in the widowhood-mental health association, and companionship exerted a significant role in widowhood-physical health and widowhood-mental health associations. In the subsample analysis, the mediation effects were only significant among female older adults, and among rural older adults. Our findings highlight the importance of emotional support and companionship in maintaining health among widowed older adults and strategies should pay more attention to female and rural widowed older adults.

Digital technology use and depressive symptoms among older adults in Korea: beneficial for those who have fewer social interactions?

OBJECTIVES

Our study examines the relationship between digital technology use and depressive symptoms among older Koreans and whether social interaction moderates the relationship.

METHODS

The data were drawn from the 2017 Survey of Living Conditions and Welfare Needs of Korean Older Persons, a nationally representative survey. Digital technology use was measured by the number of digital functions that respondents perform with their electronic devices. Social interactions were measured by the frequencies of face-to-face and remote connections with friends or neighbors. Relationships were estimated with multiple regression analyses.

RESULTS

Digital technology use was inversely associated with depressive symptoms even after adjusting for covariates including cognitive function. Both remote and face-to-face connections with friends or neighbors were associated with fewer depressive symptoms. An interaction between digital technology use and remote contact also was detected: the effect of digital technology use on depressive symptoms was more beneficial for older adults with infrequent remote contact with friends or neighbors than for those with frequent remote contact.

CONCLUSION

Findings suggest that digital technology use can reduce depressive symptoms of older adults, especially those who have fewer social interactions. Educating older adults to increase their digital literacy level and use of remote interactions may improve their psychological wellbeing, perhaps even during times of a viral pandemic.

Friendships in Old Age: Daily Encounters and Emotional Well-Being

OBJECTIVES

Having friends in old age is linked to higher levels of happiness and life satisfaction. Yet, we know little about older adults' emotional experiences when they encounter friends throughout the day. This study examined whether older adults reported (a) more pleasantness, (b) fewer conversations about stressful experiences, and (c) better mood when they had contact with friends compared to when they had contact with other social partners or were alone throughout the day. We also examined whether these experiences varied by the friendship closeness.

METHOD

Adults aged 65+ (n = 313) from the Daily Experiences and Well-being Study provided background information and listed and described their close social partners. Participants then completed ecological momentary assessment (EMA) surveys every 3 hr for 5 to 6 days where they reported their encounters with social partners, rated the pleasantness and indicated whether they discussed stressful issues during these encounters, and rated positive and negative mood.

RESULTS

Multilevel models revealed that encounters with friends were more pleasant and were associated with fewer discussions about stressful experiences compared to encounters with romantic partners or family members throughout the day. Encounters with friends were also associated with better mood, though this link only held for encounters with friends who were not considered close.

DISCUSSION

Findings are discussed in terms of functionalist theory, socioemotional selectivity theory, relationship ambivalence, and the benefits of less close ties. This work facilitates the understanding of how daily contact with friends can promote older adults' emotional well-being.

Indications of Depressive Symptoms During the COVID-19 Pandemic in Germany: Comparison of National Survey and Twitter Data

BACKGROUND

The current COVID-19 pandemic is associated with extensive individual and societal challenges, including challenges to both physical and mental health. To date, the development of mental health problems such as depressive symptoms accompanying population-based federal distancing measures is largely unknown, and opportunities for rapid, effective, and valid monitoring are currently a relevant matter of investigation.

OBJECTIVE

In this study, we aim to investigate, first, the temporal progression of depressive symptoms during the COVID-19 pandemic and, second, the consistency of the results from tweets and survey-based self-reports of depressive symptoms within the same time period.

METHODS

Based on a cross-sectional population survey of 9011 German adolescents and adults (n=4659, 51.7% female; age groups from 15 to 50 years and older) and a sample of 88,900 tweets (n=74,587, 83.9% female; age groups from 10 to 50 years and older), we investigated five depressive symptoms (eg, depressed mood and energy loss) using items from the Patient Health Questionnaire (PHQ-8) before, during, and after relaxation of the first German social contact ban from January to July 2020.

RESULTS

On average, feelings of worthlessness were the least frequently reported symptom (survey: n=1011, 13.9%; Twitter: n=5103, 5.7%) and fatigue or loss of energy was the most frequently reported depressive symptom (survey: n=4472, 51.6%; Twitter: n=31,005, 34.9%) among both the survey and Twitter respondents. Young adult women and people living in federal districts with high COVID-19 infection rates were at an increased risk for depressive symptoms. The comparison of the survey and Twitter data before and after the first contact ban showed that German adolescents and adults had a significant decrease in feelings of fatigue and energy loss over time. The temporal progression of depressive symptoms showed high correspondence between both data sources (ρ=0.76-0.93; P<.001), except for diminished interest and depressed mood, which showed a steady increase even after the relaxation of the contact ban among the Twitter respondents but not among the survey respondents.

CONCLUSIONS

Overall, the results indicate relatively small differences in depressive symptoms associated with social distancing measures during the COVID-19 pandemic and highlight the need to differentiate between positive (eg, energy level) and negative (eg, depressed mood) associations and variations over time. The results also underscore previous suggestions of Twitter data's potential to help identify hot spots of declining and improving public mental health and thereby help provide early intervention measures, especially for young and middle-aged adults. Further efforts are needed to investigate the long-term consequences of recurring lockdown phases and to address the limitations of social media data such as Twitter data to establish real-time public mental surveillance approaches.

StARTalking: An Arts and Health Program to Support Undergraduate Mental Health Nursing Education

Community arts and health programs are recognized as powerful contributors to mental health and wellbeing, reducing social isolation and strengthening community connection. They attract individuals with diverse lived experience and are invaluable learning environments for consumers and undergraduate mental health nursing students. This paper reports on the evaluation of StARTalking, a community arts and health program in Melbourne, Australia. The study aimed to better understand the consumer and student experience participating in the program. The themes, Finding connection/Taking time out, clearly indicate that embedding arts and health in mental health nursing education supports consumer and student learning, health and wellbeing.

Living Alone During COVID-19: Social Contact and Emotional Well-being Among Older Adults

Objective

The COVID-19 outbreak and associated physical distancing measures altered the social world for most older adults, but people who live alone may have been disproportionately affected. The current study examined how living alone was associated with daily social contact and emotional well-being among older adults during the pandemic.

Method

Adults (N = 226) aged 69+ completed a brief survey assessing their living situation, social contact with different social partners (in person, by phone, electronically), and emotions during the morning, afternoon, and evening the prior day.

Results

Older adults who live alone were less likely to see others in person or to receive or provide help. Living alone was associated with more positive emotions concurrent with in-person contact. In contrast, phone contact was associated with higher levels of negative affect among those living alone, but not among those who live with others. Older adults who live alone were more likely to have contact with friends (rather than family).

Discussion

Findings suggest older adults who live alone may be more reactive to social contact during the COVID-19 outbreak than older adults who reside with others. In-person contact may confer distinct benefits not available via telephone contact, suggesting that possible interventions during the pandemic may work best with safe forms of in-person contact, possibly with nonfamily members.

Psychological Pathways Linking Parent-Child Relations to Objective and Subjective Sleep Among Older Adults

OBJECTIVES

This study investigated whether older adults with better relationships with their adult children have better subjective and objective sleep quality than older adults with less positive relationships with their children. We also examined whether depressive symptoms and loneliness mediated the association between parent-child relationships and sleep among older adults.

METHODS

Data were used from the second wave of the National Social life, Health, and Aging Project, in which 548 respondents (age 62-90) participated in the sleep survey to measure their actigraph sleep activity for three consecutive days. Respondents also reported sleep quality (i.e., sleep duration and insomnia symptoms), contact frequency, and emotional closeness with their children.

RESULTS

Results from structural equation modeling showed that greater emotional closeness with children was directly associated with better objective sleep characteristics (i.e., sleep fragmentation and amount of sleep). Also, more frequent contact with children was directly related to fewer insomnia symptoms among older adults. Moreover, emotional closeness with children was indirectly linked to insomnia symptoms via depressive symptoms among older adults.

DISCUSSION

This study provided evidence for psychological pathways linking parent-child relationships and older parents' subjective sleep. The findings have implications for health professionals and family counselors who help people with sleep problems and relationship difficulties.

Effects of Web-Based Social Connectedness on Older Adults' Depressive Symptoms: A Two-Wave Cross-Lagged Panel Study

Background

Depressive symptoms are the most prevalent mental health concern among older adults (possibly heightened during the COVID-19 pandemic), which raises questions about how such symptoms can be lowered in this population. Existing research shows that offline social connectedness is a protective factor against depression in older adults; however, it is unknown whether web-based social connectedness can have similar effects.

Objective

This study investigates whether social connectedness on a support website protects older adults against depressive symptoms over the course of a year, above and beyond the protective effect of offline social connectedness. The secondary aim is to determine whether older adults with increased depressive symptoms are more likely to engage in social connectedness on this website. Thus, we examine depressive symptoms as both an outcome and predictor of web-based social connectedness to fully understand the chain of causality among these variables. Finally, we compare web-based social connectedness with offline social connectedness in their ability to lower depressive symptoms among older adults.

Methods

A total of 197 adults aged 65 years or older were given access to a social support website, where they were able to communicate with each other via a discussion forum for a year. Participants’ social connectedness on the web-based platform, conceptualized as message production and consumption, was measured using behavioral log data as the number of messages participants wrote and read, respectively, during the first 6 months (t₁) and the following 6 months (t₂) of the study. Participants self-reported their offline social connectedness as the number of people in their support networks, and they reported their depressive symptoms using the Patient Health Questionnaire-8 both at baseline (t₁) and at 12-month follow-up (t₂). To ascertain the flow of causality between these variables, we employed a cross-lagged panel design, in which all variables were measured at t₁ and t₂.

Results

After controlling for the effect of offline support networks at t₁, web-based message consumption at t₁ decreased older adults’ depressive symptoms at t₂ (β=−.11; P=.02), but web-based message production at t₁ did not impact t₂ depressive symptoms (β=.12; P=.34). Web-based message consumption had a larger effect (β=−.11; P=.02) than offline support networks (β=−.08; P=.03) in reducing older adults’ depressive symptoms over time. Higher baseline depressive symptoms did not predict increased web-based message consumption (β=.12; P=.36) or production (β=.02; P=.43) over time.

Conclusions

The more messages older adults read on the web-based forum for the first 6 months of the study, the less depressed they felt at the 1-year follow-up, above and beyond the availability of offline support networks at baseline. This pinpoints the substantial potential of web-based communication to combat depressive symptoms in this vulnerable population.

International Registered Report Identifier (IRRID)

RR2-10.1186/s13063-015-0713-2