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Van Orden KA, Buttaccio A, Conwell Y. The 5D indicators of suicide risk in older adults who are lonely. Ann N Y Acad Sci 2025. [PMID: 40346872 DOI: 10.1111/nyas.15354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2025]
Abstract
Loneliness is associated with suicide ideation, attempts, and deaths in later life. The objective of this study is to describe characteristics of suicide risk among older adults who report clinically significant loneliness grounded in our conceptual model of the 5Ds of late life suicide. Our sample comprises 291 adults aged 60 years and older who screened positive for loneliness (UCLA 3-Item Loneliness Scale score of 6 and above) and subsequently completed baseline eligibility interviews for a clinical trial. Interviews obtained information on loneliness severity, suicide ideation, and the 5Ds of late life suicide: (1) depression (PROMIS depression), (2) deadly means (firearms access), (3) disease (number of chronic conditions), (4) disconnection (objective disconnection, Lubben Social Network Scale; subjective disconnection, UCLA Loneliness Scale), and (5) disability (World Health Organization Disability Assessment Schedule). Subjects demonstrated a high frequency of characteristics associated with suicide risk, with the most common presentation (38%) being the presence of 3Ds-subjective disconnection (loneliness), multimorbidity, and disability. While few subjects presented with only subjective disconnection (loneliness), there was diversity in which other Ds were present and in which combination, suggesting heterogeneous presentations. Upstream suicide prevention efforts could target older adults with loneliness to reach a population with numerous compounding indicators of risk.
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Affiliation(s)
- Kimberly A Van Orden
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - April Buttaccio
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
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Ho ISS, McGill K, Malden S, Wilson C, Pearce C, Kaner E, Vines J, Aujla N, Lewis S, Restocchi V, Marshall A, Guthrie B. Examining the social networks of older adults receiving informal or formal care: a systematic review. BMC Geriatr 2023; 23:531. [PMID: 37653368 PMCID: PMC10470175 DOI: 10.1186/s12877-023-04190-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/23/2023] [Indexed: 09/02/2023] Open
Abstract
PURPOSE To address the care needs of older adults, it is important to identify and understand the forms of care support older adults received. This systematic review aims to examine the social networks of older adults receiving informal or formal care and the factors that influenced their networks. METHODS A systematic review was conducted by searching six databases from inception to January 31, 2023. The review included primary studies focusing on older adults receiving long-term care, encompassing both informal and formal care. To assess the risk of bias in the included studies, validated appraisal tools specifically designed for different study types were utilized. Network analysis was employed to identify the grouping of study concepts, which subsequently formed the foundation for describing themes through narrative synthesis. RESULTS We identified 121 studies relating to the formal and informal care of older adults' networks. A variety of social ties were examined by included studies. The most commonly examined sources of care support were family members (such as children and spouses) and friends. Several factors were consistently reported to influence the provision of informal care, including the intensity of networks, reciprocity, and geographical proximity. In terms of formal care utilization, older age and poor health status were found to be associated with increased use of healthcare services. Additionally, physical limitations and cognitive impairment were identified as factors contributing to decreased social engagement. CONCLUSION This review found that older people were embedded within a diverse network. The findings of this review emphasize the importance of recognizing and incorporating the diversity of social networks in care plans and policies to enhance the effectiveness of interventions and improve the overall well-being of older adults.
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Affiliation(s)
- Iris Szu-Szu Ho
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK.
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK.
- , 47 Potterow, Bayes Centre, Edinburgh, EH8 9BT, UK.
| | - Kris McGill
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
| | - Stephen Malden
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- School of Health in Social Science, Medical School, University of Edinburgh, Doorway 6, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Cara Wilson
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Institute for Education, Community and Society, University of Edinburgh, Old Moray House, Holyrood Road, Edinburgh, EH8 8AQ, UK
| | - Caroline Pearce
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Edinburgh College of Art, University of Edinburgh, 74 Lauriston Pl, Edinburgh, EH3 9DF, UK
| | - Eileen Kaner
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Population Health Science Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
| | - John Vines
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK
| | - Navneet Aujla
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- Population Health Science Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
| | - Sue Lewis
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
- School of Health in Social Science, Medical School, University of Edinburgh, Doorway 6, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Valerio Restocchi
- School of Informatics, University of Edinburgh (Informatics Forum, 10 Crichton St, Newington, Edinburgh, EH8 9AB, UK
| | - Alan Marshall
- School of Social and Political Science, University of Edinburgh, 15a George Square, Edinburgh, EH8 9LD, UK
| | - Bruce Guthrie
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Bio Cube 1, Edinburgh BioQuarter, 13 Little France Road, Edinburgh, EH16 4UX, UK
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Forward C, Khan HTA, Fox P. The experience of living alone as an older woman in the UK during the Covid pandemic: an interpretative phenomenological analysis. BMC Public Health 2023; 23:244. [PMID: 36739409 PMCID: PMC9898705 DOI: 10.1186/s12889-023-14988-2] [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: 09/06/2022] [Accepted: 01/04/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES More people are living alone across the life course: in later life this can have implications for practical and psychosocial support. The Covid pandemic emphasised the importance of this when the UK government restricted movement outside of households to limit the spread of disease. This had important ramifications regarding social contact and practical support. The objectives of this study were to explore the experience of older women living alone during this time, with a focus on health and wellbeing. RESEARCH DESIGN AND METHODS This study used an Interpretative Phenomenological approach. Semi-structured interviews were undertaken with seven women (aged 65 +), living alone in the UK. Interviews were carried out between May and October 2020. Interpretative Phenomenological Analysis was used to analyse the transcripts. RESULTS Findings show that life course events shaped how living alone was experienced in later life. Convergences and divergences in lived experience were identified. Three superordinate themes emerged from the Interpretative Phenomenological Analysis: Productivity, Ownership, and Interconnectedness. DISCUSSION AND IMPLICATIONS Findings highlight the importance of life course events in shaping the experience of later life. They also provide a better understanding of the lived experience of living alone as an older woman, increasing knowledge of this group and how living alone can affect health and wellbeing. Implications for research and practice are discussed, such as the importance of recognising the specific support needs for this group in later life, and the need for further knowledge about groups whose needs are not met by standard practice.
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Affiliation(s)
- Cat Forward
- The College of Nursing, Midwifery and Healthcare, University of West London, London, TW8 9GA, UK. .,Present address: NIHR Health and Social Care Work Research Unit, The Policy Institute, King's College London, Virginia Woolf Building, 22 Kingsway, Strand, London, WC2B 6NR, UK.
| | - Hafiz T. A. Khan
- grid.81800.310000 0001 2185 7124Public Health Group, College of Nursing, Midwifery and Healthcare, University of West London, London, TW8 9GA UK
| | - Pauline Fox
- grid.81800.310000 0001 2185 7124The Graduate Centre, University of West London, London, W5 5RF UK
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