1
|
Albasheer O, Abdelwahab SI, Zaino MR, Altraifi AAA, Hakami N, El-Amin EI, Alshehri MM, Alghamdi SM, Alqahtani AS, Alenazi AM, Alqahtani B, Alhowimel A, Uddin S, Khalafalla HEE, Medani IE. The impact of social isolation and loneliness on cardiovascular disease risk factors: a systematic review, meta-analysis, and bibliometric investigation. Sci Rep 2024; 14:12871. [PMID: 38834606 DOI: 10.1038/s41598-024-63528-4] [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: 11/02/2023] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
Data on the association between social isolation, loneliness, and risk of incident coronary heart disease (CVD) are conflicting. The objective of this study is to determine the relationship between social isolation and loneliness, and the risk of developing cardiovascular disease (CVD) in middle age and elderly using meta-analysis. The purpose of the bibliometric analysis is to systematically evaluate the existing literature on the relationship between social isolation, loneliness, and the risk of developing cardiovascular disease (CVD) in middle-aged and elderly individuals. A comprehensive search through four electronic databases (MEDLINE, Google Scholar, Scopus, and Web of Science) was conducted for published articles that determined the association between social isolation and/or loneliness and the risk of developing coronary heart disease from June 2015 to May 2023. Two independent reviewers reviewed the titles and abstracts of the records. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline to conduct the systematic review and meta-analysis. Data for the bibliometric analysis was obtained from the Scopus database and analyzed using VOSviewer and Bibliometrix applications. Six studies involving 104,511 patients were included in the final qualitative review and meta-analysis after screening the records. The prevalence of loneliness ranged from 5 to 65.3%, and social isolation ranged from 2 to 56.5%. A total of 5073 cardiovascular events were recorded after follow-up, ranging between 4 and 13 years. Poor social relationships were associated with a 16% increase in the risk of incident CVD (Hazard Ratio of new CVD when comparing high versus low loneliness or social isolation was 1.16 (95% Confidence Interval (CI) 1.10-1.22). The bibliometric analysis shows a rapidly growing field (9.77% annual growth) with common collaboration (6.37 co-authors/document, 26.53% international). The US leads research output, followed by the UK and Australia. Top institutions include University College London, Inserm, and the University of Glasgow. Research focuses on "elderly," "cardiovascular disease," and "psychosocial stress," with recent trends in "mental health," "social determinants," and "COVID-19". Social isolation and loneliness increase the risk of and worsen outcomes in incident cardiovascular diseases. However, the observed effect estimate is small, and this may be attributable to residual confounding from incomplete measurement of potentially confounding or mediating factors. The results of the bibliometric analysis highlight the multidimensional nature of CVD research, covering factors such as social, psychological, and environmental determinants, as well as their interplay with various demographic and health-related variables.
Collapse
Affiliation(s)
- Osama Albasheer
- Family and Community Medicine Department, Faculty of Medicine, College of Medicine, Jazan University, 45142, Jazan, Saudi Arabia.
| | | | - Mohammad R Zaino
- Physical Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | | | - Nasser Hakami
- Surgical Department, College of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ehab I El-Amin
- Department of Epidemiology, College of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Mohammed M Alshehri
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Saeed M Alghamdi
- Clinical Technology Department, Respiratory Care Program, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulfattah S Alqahtani
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Aqeel M Alenazi
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Bader Alqahtani
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ahmed Alhowimel
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Shadab Uddin
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Husam Eldin Elsawi Khalafalla
- Department of Health Education and Promotion, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Isameldin E Medani
- Obstetrics and Gynaecology Department, College of Medicine, Jazan University, Jazan, Saudi Arabia
| |
Collapse
|
2
|
Hong JH, Nakamura JS, Sahakari SS, Chopik WJ, Shiba K, VanderWeele TJ, Kim ES. The silent epidemic of loneliness: identifying the antecedents of loneliness using a lagged exposure-wide approach. Psychol Med 2024; 54:1519-1532. [PMID: 38497115 DOI: 10.1017/s0033291723002581] [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] [Indexed: 03/19/2024]
Abstract
BACKGROUND A large and accumulating body of evidence shows that loneliness is detrimental for various health and well-being outcomes. However, less is known about potentially modifiable factors that lead to decreased loneliness. METHODS We used data from the Health and Retirement Study to prospectively evaluate a wide array of candidate predictors of subsequent loneliness. Importantly, we examined if changes in 69 physical-, behavioral-, and psychosocial-health factors (from t0;2006/2008 to t1;2010/2012) were associated with subsequent loneliness 4 years later (t2;2014/2016). RESULTS Adjusting for a large range of covariates, changes in certain health behaviors (e.g. increased physical activity), physical health factors (e.g. fewer functioning limitations), psychological factors (e.g. increased purpose in life, decreased depression), and social factors (e.g. greater number of close friends) were associated with less subsequent loneliness. CONCLUSIONS Our findings suggest that subjective ratings of physical and psychological health and perceived social environment (e.g. chronic pain, self-rated health, purpose in life, anxiety, neighborhood cohesion) are more strongly associated with subsequent loneliness. Yet, objective ratings (e.g. specific chronic health conditions, living status) show less evidence of associations with subsequent loneliness. The current study identified potentially modifiable predictors of subsequent loneliness that may be important targets for interventions aimed at reducing loneliness.
Collapse
Affiliation(s)
- Joanna H Hong
- Department of Psychology, University of British Columbia, Vancouver, Canada
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
| | - Julia S Nakamura
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Sakshi S Sahakari
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - William J Chopik
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Koichiro Shiba
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tyler J VanderWeele
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric S Kim
- Department of Psychology, University of British Columbia, Vancouver, Canada
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
3
|
Zhang X, Ravichandran S, Gee GC, Dong TS, Beltrán-Sánchez H, Wang MC, Kilpatrick LA, Labus JS, Vaughan A, Gupta A. Social Isolation, Brain Food Cue Processing, Eating Behaviors, and Mental Health Symptoms. JAMA Netw Open 2024; 7:e244855. [PMID: 38573637 DOI: 10.1001/jamanetworkopen.2024.4855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Importance Perceived social isolation is associated with negative health outcomes, including increased risk for altered eating behaviors, obesity, and psychological symptoms. However, the underlying neural mechanisms of these pathways are unknown. Objective To investigate the association of perceived social isolation with brain reactivity to food cues, altered eating behaviors, obesity, and mental health symptoms. Design, Setting, and Participants This cross-sectional, single-center study recruited healthy, premenopausal female participants from the Los Angeles, California, community from September 7, 2021, through February 27, 2023. Exposure Participants underwent functional magnetic resonance imaging while performing a food cue viewing task. Main Outcomes and Measures The main outcomes included brain reactivity to food cues, body composition, self-reported eating behaviors (food cravings, reward-based eating, food addiction, and maladaptive eating behaviors), and mental health symptoms (anxiety, depression, positive and negative affect, and psychological resilience). Results The study included 93 participants (mean [SD] age, 25.38 [7.07] years). Participants with higher perceived social isolation reported higher fat mass percentage, lower diet quality, increased maladaptive eating behaviors (cravings, reward-based eating, uncontrolled eating, and food addiction), and poor mental health (anxiety, depression, and psychological resilience). In whole-brain comparisons, the higher social isolation group showed altered brain reactivity to food cues in regions of the default mode, executive control, and visual attention networks. Isolation-related neural changes in response to sweet foods correlated with various altered eating behaviors and psychological symptoms. These altered brain responses mediated the connection between social isolation and maladaptive eating behaviors (β for indirect effect, 0.111; 95% CI, 0.013-0.210; P = .03), increased body fat composition (β, -0.141; 95% CI, -0.260 to -0.021; P = .02), and diminished positive affect (β, -0.089; 95% CI, -0.188 to 0.011; P = .09). Conclusions and Relevance These findings suggest that social isolation is associated with altered neural reactivity to food cues within specific brain regions responsible for processing internal appetite-related states and compromised executive control and attentional bias and motivation toward external food cues. These neural responses toward specific foods were associated with an increased risk for higher body fat composition, worsened maladaptive eating behaviors, and compromised mental health. These findings underscore the need for holistic mind-body-directed interventions that may mitigate the adverse health consequences of social isolation.
Collapse
Affiliation(s)
- Xiaobei Zhang
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
- David Geffen School of Medicine at the University of California, Los Angeles
| | - Soumya Ravichandran
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- School of Medicine, University of California, San Diego, La Jolla, California
| | - Gilbert C Gee
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles
- California Center for Population Research, University of California, Los Angeles
| | - Tien S Dong
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
- David Geffen School of Medicine at the University of California, Los Angeles
| | - Hiram Beltrán-Sánchez
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles
- California Center for Population Research, University of California, Los Angeles
| | - May C Wang
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles
| | - Lisa A Kilpatrick
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
- David Geffen School of Medicine at the University of California, Los Angeles
| | - Jennifer S Labus
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
- David Geffen School of Medicine at the University of California, Los Angeles
| | - Allison Vaughan
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
| | - Arpana Gupta
- Goodman-Luskin Microbiome Center, University of California, Los Angeles
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles
- David Geffen School of Medicine at the University of California, Los Angeles
| |
Collapse
|
4
|
Millett G, Franco G, Fiocco AJ. Understanding the social and leisure needs of lonely and socially isolated older adults living in residential care: a qualitative study. Aging Ment Health 2024; 28:344-352. [PMID: 37735879 DOI: 10.1080/13607863.2023.2258828] [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: 06/21/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023]
Abstract
Objectives: Rates of loneliness and social isolation increase following the transition to residential care and are associated with poor health outcomes. One way to mitigate these experiences is through meaningful recreation, however, there is research to suggest that currently available programming does not meet the needs of lonely and socially isolated residents. Therefore, the objectives of the current study were to investigate: (1) the lived experience of loneliness and social isolation in residential care, (2) engagement and use of available resources by these residents, and (3) insights as to how programming can further address their needs.Methods: Qualitative interviews were conducted with ten staff members and 14 residents. Interviews were transcribed and analysed using thematic analysis.Results: Three themes emerged from the data: (1) Feelings of loneliness and social isolation (subthemes: loneliness and social isolation differ, contributors, and coping strategies), (2) Recreation and social participation (subthemes: program engagement and barriers to participation), and (3) Supporting residents' needs (subthemes: suggestions for meaningful recreation and resources).Conclusion: Loneliness and social isolation are idiographic experiences. Contributors to loneliness and social isolation are also reported as barriers to attending programming. Recommendations are made, many of which rely on greater staffing resources and psychoeducation.
Collapse
Affiliation(s)
- Geneva Millett
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
| | - Giselle Franco
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
| | - Alexandra J Fiocco
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
| |
Collapse
|
5
|
Yamada Y, Ogawa Y, Shimizu S, Matsuoka Y, Yamamoto Y. Longitudinal Association Between Social Isolation and COVID-19 Vaccine Uptake in Japanese Older Citizen: an Observational Study. J Gen Intern Med 2023; 38:2775-2781. [PMID: 37407768 PMCID: PMC10506977 DOI: 10.1007/s11606-023-08286-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/14/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Social isolation is associated with decreased intent to receive vaccination against coronavirus disease 2019 (COVID-19); however, its association with COVID-19 vaccine uptake is unknown. OBJECTIVE The present study aimed to determine the association between social isolation and subsequent COVID-19 vaccination using the data from a representative Japanese sample. DESIGN Longitudinal observational study. PARTICIPANTS Japanese citizens aged ≥ 65 years who participated in the Quality of Life in COVID-19 Era (QoLCoVE) study which began in March 2020. MAIN MEASURES Social isolation was assessed in March 2020 using the abbreviated Lubben Social Network Scale, with a score of ≤ 11 indicating social isolation. To evaluate the relationship between social isolation at the baseline and COVID-19 vaccine uptake (including reservation for vaccine administration) between August and September 2021, we estimated adjusted risk ratios with 95% CIs using modified Poisson regression with adjustment for potential confounders. KEY RESULTS A total of 921 participants met the inclusion criteria in the initial survey, of whom 720 (78.2%) completed the follow-up survey. Median age was 70 years (interquartile range: 66-72), and 329 (45.7%) participants were male. Twenty-one (16.5%) of 127 socially isolated participants, and 48 (8.1%) of 593 non-socially isolated participants did not receive the COVID-19 vaccine. Socially isolated participants were less likely to take COVID-19 vaccine than non-socially isolated participants (adjusted risk ratio 1.98, 95% CI: 1.18-3.32). CONCLUSIONS Social isolation is associated with reduced COVID-19 vaccine uptake among older adults. To further promote COVID-19 vaccination in the older population, support for social isolation might be necessary.
Collapse
Affiliation(s)
- Yoshie Yamada
- Department of Healthcare Epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yusuke Ogawa
- Department of Healthcare Epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sayaka Shimizu
- Institute for Health Outcomes & Process Evaluation Research (iHope International), Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshinori Matsuoka
- Department of Healthcare Epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Emergency Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| |
Collapse
|
6
|
Luo M, Li LW. Within-Person Dynamics of Objective and Subjective Social Isolation in Midlife and Later Life. J Aging Health 2023; 35:182-190. [PMID: 35945654 DOI: 10.1177/08982643221118449] [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: 02/03/2023]
Abstract
ObjectivesTo investigate the within-person dynamics of objective and subjective social isolation among U.S. middle-aged and older adults and to explore gender differences in this relationship. Methods: Four waves of data from the Health and Retirement Study (HRS, 2006-2018, N = 5437) and the multiple group random intercept cross-lagged panel model were used. Results: Within-person deviation in expected subjective isolation predicted deviation in expected objective isolation years later. No corresponding cross-lagged effect of objective isolation on subjective isolation was found. Gender differences were detected: the within-person cross-lagged positive effect of subjective isolation on objective isolation was significant for men but not for women. Discussion: This study provides evidence for a unidirectional relationship between subjective and objective isolation at the within-person level: higher than expected increase in subjective isolation predicts higher than expected increase in subsequent objective isolation. This within-person process is more salient in men than in women.
Collapse
Affiliation(s)
- Mengsha Luo
- Department of Sociology, 12377Zhejiang University, Hangzhou, China
| | - Lydia W Li
- School of Social Work, 1259University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
7
|
Sun J, Jiang W, Li H. Social isolation and loneliness among Chinese older adults: Examining aging attitudes as mediators and moderators. Front Psychol 2022; 13:1043921. [PMID: 36562076 PMCID: PMC9763440 DOI: 10.3389/fpsyg.2022.1043921] [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: 09/14/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Due to labor migration and social changes, the Chinese elderly are facing significant social isolation, along with changes in aging attitudes. However, whether social isolation affects loneliness among the Chinese elderly and whether this relationship is moderated and mediated by aging attitudes is unclear. This empirical study aimed to respond to the above questions in the Chinese context, Based on the data from the 2014 China Longitudinal Aging Social Survey (N = 6,645), the results showed that social isolation is a positive predictor of loneliness; aging attitudes mediate the relationship between social isolation and loneliness. Social isolation affects the loneliness of the elderly partially by weakening positive aging attitudes and strengthening negative aging attitudes; aging attitudes moderate the effect of social isolation on loneliness. For those older adults with higher positive aging attitudes, social isolation has a much smaller effect on loneliness. While for those older adults with higher negative aging attitudes, social isolation has a more substantial effect on their feelings of loneliness. Our results indicate that less social isolation is an effective way to relieve loneliness, and maintaining higher positive aging attitudes and lower negative aging attitudes, is important for the Chinese elderly to prevent loneliness when facing social isolation.
Collapse
Affiliation(s)
- Juanjuan Sun
- School of Sociology and Population Studies, Renmin University of China, Beijing, China,Center for Population and Development Studies, Renmin University of China, Beijing, China
| | - Weikang Jiang
- School of Public Administration, Xiangtan University, Xiangtan, China
| | - Haohao Li
- School of Sociology and Population Studies, Renmin University of China, Beijing, China,*Correspondence: Haohao Li,
| |
Collapse
|
8
|
Mills R, Zullig KJ, Theeke LA, Lander LR, Hobbs GR, Herczyk J, Davis SM. Assessing Loneliness among Adults Receiving Outpatient Treatment with Medication for Opioid Use Disorder (MOUD). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13481. [PMID: 36294057 PMCID: PMC9602554 DOI: 10.3390/ijerph192013481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Loneliness is a significant risk factor for substance use, however, impacts of treatments on loneliness are relatively unexplored. Living in a rural location is a greater risk factor for loneliness. This study examined data from a quasi-experimental study in rural Appalachia, comparing the effectiveness of Mindfulness-Based Relapse Prevention (MBRP) versus Treatment as Usual (TAU) among adults receiving MOUD in outpatient therapy. Our objective was to determine whether observed reductions in self-reported craving, anxiety, depression, and increased perceived mindfulness would also improve loneliness reports. Eighty participants (n = 35 MBRP; n = 45 TAU) were included in the analysis from a group-based Comprehensive Opioid Addiction Treatment program. Outcomes tracked included craving, anxiety, depression, mindfulness, and loneliness as measured by the Revised UCLA Loneliness Scale (R-UCLA). A linear mixed model ANOVA determined the significance of the treatments on changes in loneliness scores at baseline, 12 weeks, 24 weeks, and 36 weeks post-recruitment. Both groups reported significantly reduced loneliness over the course of the study (F = 16.07, p < 0.01), however there were no significant differences between groups. Loneliness was also significantly positively (p < 0.01) correlated with anxiety (0.66), depression (0.59), and craving (0.38), and significantly (p < 0.01) inversely correlated (-0.52) with mindfulness. Results suggest that participation in MOUD group-based outpatient therapy has the potential to diminish loneliness and associated poor psychological outcomes. Thus, it is possible that a more targeted intervention for loneliness would further diminish loneliness, which is important as loneliness is linked to risk for relapse.
Collapse
Affiliation(s)
- Rosalina Mills
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Keith J. Zullig
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Laurie A. Theeke
- School of Nursing, George Washington University, Washington, DC 20052, USA
| | - Laura R. Lander
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neurosciences Institute, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Gerry R. Hobbs
- Department of Statistics, West Virginia University, Morgantown, WV 26506, USA
| | - Johnathan Herczyk
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Stephen M. Davis
- Department of Health Policy, Management, & Leadership, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| |
Collapse
|
9
|
Gezgin Yazici H, Ökten Ç. The Insomnia and Loneliness of Elderly Individuals and Affecting Factors During the COVID-19 Pandemic in Turkey. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:601-608. [PMID: 35287564 DOI: 10.1080/19371918.2022.2053630] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study aims to examine the loneliness and sleep problems of older people and the variables during the COVID-19 in Turkey pandemic and the variables that affect them. Snowball sampling was used in this descriptive and cross-sectional study. Google forms, personal information form, the UCLA Loneliness Scale III and the Insomnia Severity Index were used to collect data in December 2020. The questionnaire link was disseminated by e-mail and social media. By clicking the link, the participants were automatically directed to information about the study and received informed consent forms. The participants were urged to send the questionnaire to as many individuals as they could. This research was conducted with 412 participants. Education level and perceived health status affected their loneliness. The older people had loneliness and sleep problems during the COVID-19 pandemic, and these problems were affected by sociodemographic variables. Loneliness and insomnia are positively correlated, and loneliness affects the severity of insomnia.
Collapse
Affiliation(s)
- Havva Gezgin Yazici
- Faculty of Health Sciences, Mental Health Nursing Department, Kutahya Health Sciences University, Kutahya, Turkey
| | - Çiğdem Ökten
- Faculty of Health Sciences, Medical Nursing Department, Kutahya Health Sciences University, Kutahya, Turkey
| |
Collapse
|
10
|
Cené CW, Beckie TM, Sims M, Suglia SF, Aggarwal B, Moise N, Jiménez MC, Gaye B, McCullough LD. Effects of Objective and Perceived Social Isolation on Cardiovascular and Brain Health: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2022; 11:e026493. [PMID: 35924775 PMCID: PMC9496293 DOI: 10.1161/jaha.122.026493] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Social isolation, the relative absence of or infrequency of contact with different types of social relationships, and loneliness (perceived isolation) are associated with adverse health outcomes. Objective To review observational and intervention research that examines the impact of social isolation and loneliness on cardiovascular and brain health and discuss proposed mechanisms for observed associations. Methods We conducted a systematic scoping review of available research. We searched 4 databases, PubMed, PsycInfo, Cumulative Index of Nursing and Allied Health, and Scopus. Findings Evidence is most consistent for a direct association between social isolation, loneliness, and coronary heart disease and stroke mortality. However, data on the association between social isolation and loneliness with heart failure, dementia, and cognitive impairment are sparse and less robust. Few studies have empirically tested mediating pathways between social isolation, loneliness, and cardiovascular and brain health outcomes using appropriate methods for explanatory analyses. Notably, the effect estimates are small, and there may be unmeasured confounders of the associations. Research in groups that may be at higher risk or more vulnerable to the effects of social isolation is limited. We did not find any intervention studies that sought to reduce the adverse impact of social isolation or loneliness on cardiovascular or brain health outcomes. Conclusions Social isolation and loneliness are common and appear to be independent risk factors for worse cardiovascular and brain health; however, consistency of the associations varies by outcome. There is a need to develop, implement, and test interventions to improve cardiovascular and brain health for individuals who are socially isolated or lonely.
Collapse
|
11
|
Glass AP, Norris H. Finding Community in Elder Cohousing: Before and During COVID-19. JOURNAL OF AGING AND ENVIRONMENT 2022. [DOI: 10.1080/26892618.2022.2103869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Anne P. Glass
- Applied Gerontology Program, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Haley Norris
- Applied Gerontology Program, University of North Carolina Wilmington, Wilmington, NC, USA
| |
Collapse
|
12
|
Interactions, relationships and belonging: comparing social connectedness and perceived isolation among older women living alone in private homes and in assisted living. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Age-related changes shape social connectedness, isolation and loneliness among older adults. Ageing often accompanies decisions about ageing in place or moving (i.e. senior living facility). Scant research compares these two living arrangements and even sparser research focuses on older women. This study, thus, poses the following questions: How do older women (aged 75+ years) experience social connectedness and perceived isolation? How does this experience vary between older women living alone in private homes and those living in assisted living facilities? Data include semi-structured interviews with women aged 75+ years who live alone in a private home or in an assisted living facility (N = 16). Findings revealed differences in three aspects of social connectedness: interactions, relationships and belonging. Private home participants' interactions underscored intentionality, with minimal investment in forging new or deeper relationships and an emphasis on belonging to the world through awareness, contribution and cognitive ability. The experiences of participants living in assisted living were characterised by availability of interactions and casual relationships. They emphasised belonging to the facility community, while positioning themselves between the status of resident and staff. Surprisingly, most participants in both groups did not express feelings of perceived isolation. Both had adapted their social connectedness expectations to reflect their current situation.
Collapse
|
13
|
Sakr-Ashour FA, Wambogo E, Sahyoun NR. Social Relationships, Food Security, Protein Intake, and Hospitalization in Homebound Older Adults: A PATH Analysis. J Nutr Gerontol Geriatr 2022; 41:201-216. [PMID: 35703450 DOI: 10.1080/21551197.2022.2084203] [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: 10/18/2022]
Abstract
The objective of this study was to measure direct and indirect relationships between food insecurity (FI), protein intake, social relationships, depressive symptoms, and their impact on hospitalization among home-delivered meal (HDM) recipients, compared to controls, using structural equation modeling. The analysis used data from the National Outcomes Evaluation Study (2015-2017) of the OAANSP. HDM recipients' mean usual protein intake was significantly higher than controls, but both groups had mean intakes below recommendations. Eating alone was inversely associated with lower protein intake and greater hospitalizations in controls. FI, prevalent in 25.1% of HDM recipient and 16% of controls, was associated with lower protein intake in both groups. Receiving instrumental social support was directly associated with lesser severity of FI in recipients. and more depressive symptoms only in controls. HDM recipients and controls may be at high risk for protein insufficiency, underscored by high prevalence of FI.
Collapse
Affiliation(s)
- Fayrouz A Sakr-Ashour
- School of Sciences & Engineering, Institute of Global Health and Human Ecology, The American University in Cairo, New Cairo, Egypt
| | - Edwina Wambogo
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland, USA
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland, College Park, Maryland, USA
| |
Collapse
|
14
|
Moeyersons M, De Vliegher K, Huyghe B, De Groof S, Milisen K, de Casterlé BD. 'Living in a shrinking world'-The experience of loneliness among community-dwelling older people with reduced mobility: a qualitative grounded theory approach. BMC Geriatr 2022; 22:285. [PMID: 35387595 PMCID: PMC8984073 DOI: 10.1186/s12877-022-02998-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 03/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Loneliness is associated with severe consequences for both the physical and mental health of older people. Research has shown that mobility limitations are an important risk factor for the emergence and maintenance of feelings of loneliness. The aim of this study was to explore the experiences of loneliness among community-dwelling older people with reduced mobility and its underlying dynamics. METHODS This study employed a qualitative, descriptive design, inspired by a grounded theory approach. Participants were purposively recruited in collaboration with home health care providers. The main inclusion criteria were as follows: aged 75 years or older, being mobile impaired, experiencing feelings of loneliness, and living at home and being cognitively able to be interviewed. Data analysis of 15 semi-structured, in-depth interviews was conducted based on the Qualitative Analysis Guide of Leuven (QUAGOL). RESULTS Loneliness was expressed through all the stories, but it appeared as an elusive, intangible phenomenon. Both indicating the presence of loneliness and describing what this phenomenon means were difficult to express for most participants. Loneliness was experienced as an inherent part of the ageing process characterised by losses, limitations and meaninglessness. Participants described how they have experienced losing grip on the world in which they live and feel isolated in a literally and figuratively shrinking world. Loneliness is described as the feeling that one is unable to address the situation that results in deep sadness and the feeling of no longer being of value to their environment. CONCLUSIONS This study shows that loneliness among community-dwelling older persons with reduced mobility is embedded in experiences of loss related to ageing, among which reduced mobility plays a significant role. The results suggest the existence of a more profound experience of loneliness than might appear at first glance. How to recognise experiences of loneliness and how to support a meaningful existence for community-dwelling older persons should be given priority in health care. The findings of this study can increase professional caregivers' sensitivity to implicit signals of loneliness. Further research is necessary to refine the outcomes and to further explore the role of reduced mobility in the experience of loneliness.
Collapse
Affiliation(s)
- Marika Moeyersons
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium
| | - Kristel De Vliegher
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium.,Nursing Departement, Wit-Gele Kruis van Vlaanderen, Frontispiesstraat 8 bus 1.2 1000, Brussels, Belgium
| | - Brooke Huyghe
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium
| | - Sacha De Groof
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium
| | - Koen Milisen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium.,Department of Geriatric Medicine, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Bernadette Dierckx de Casterlé
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 blok d bus, 7001, 3000, Leuven, Belgium.
| |
Collapse
|
15
|
Wang K, Zhang A, Cuevas AG, De Fries CM, Hinton L, Falcón LM. The Association Between Post-Traumatic Stress and Depressive Symptoms Among Older Puerto Ricans in Boston: How Does Loneliness Matter? J Aging Health 2021; 34:786-793. [PMID: 34949131 DOI: 10.1177/08982643211064123] [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: 11/16/2022]
Abstract
OBJECTIVES To examine the association between post-traumatic stress and depression and whether such an association differs by level of loneliness among older Puerto Ricans. METHODS Data were collected from 304 Puerto Ricans aged 60 and above living in the Greater Boston area who responded to questionnaires. We used ordinary least squares regression to examine the association between post-traumatic stress, loneliness, and depressive symptoms. RESULTS Post-traumatic stress was significantly associated with higher levels of depression. The association between post-traumatic stress and depression was stronger for those experiencing a higher degree of loneliness. DISCUSSION In working with older Puerto Ricans experiencing post-traumatic stress, it is important for mental health professionals to incorporate the assessment of loneliness and to prevent and reduce comorbid depression by addressing loneliness through improving social skills, enhancing social support, and reducing maladaptive social cognition.
Collapse
Affiliation(s)
- Kaipeng Wang
- Graduate School of Social Work, 2927University of Denver, CO, USA
| | - Anao Zhang
- School of Social Work, 1259University of Michigan, Ann Arbor, MI, USA
| | - Adolfo G Cuevas
- Department of Community Health, 1810Tufts University, Medford, MA, USA
| | | | - Ladson Hinton
- Department of Psychiatry and Behavioral Sciences, 8789University of California Davis, CA, USA
| | - Luis M Falcón
- College of Fine Arts, Humanities, and Social Sciences, 14710University of Massachusetts Lowell, MA, USA
| |
Collapse
|
16
|
Cornwell B, Schumm LP, Laumann EO, Goldman AW, Compernolle EL. Tracking Egocentric Social Network Change Across Three Rounds of National Survey Data. J Gerontol B Psychol Sci Soc Sci 2021; 76:S266-S275. [PMID: 34918152 PMCID: PMC8678444 DOI: 10.1093/geronb/gbab100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The National Social Life, Health, and Aging Project (NSHAP) has collected 3 rounds of data on older adults' egocentric social networks. We describe the structure of network data collection for different components of the sample and the data that are available for those groups. We also describe survey techniques that were used to track specific personnel changes that occurred within respondents' networks during the 10-year study period. METHOD Descriptive statistics are presented for measures of network size, composition, and internal structure at all 3 rounds, respondent-level summary measures of change in these characteristics between and across rounds, and measures of change associated with the loss and addition of network members across Rounds 1, 2, and 3. Procedures that were used to clean the network change data are also explained. RESULTS The NSHAP network change module provides reliable information about specific changes that occurred within respondents' confidant networks. For returning baseline respondents, there is considerable overlap with respect to which confidants are named in successive rosters, but the norm is for Round 3 networks to be composed primarily of new confidants. DISCUSSION These data provide new insights into the dynamic nature of networks in later life. Data limitations, and directions for future research, are discussed.
Collapse
Affiliation(s)
| | - L Philip Schumm
- Department of Health Studies, University of Chicago, Illinois, USA
| | | | - Alyssa W Goldman
- Department of Sociology, Boston College, Chestnut Hill, Massachusetts, USA
| | | |
Collapse
|
17
|
Zhen R, Li L, Li G, Zhou X. Social Isolation, Loneliness, and Mobile Phone Dependence among Adolescents During the COVID-19 Pandemic: Roles of Parent-Child Communication Patterns. Int J Ment Health Addict 2021; 21:1-15. [PMID: 34785993 PMCID: PMC8584639 DOI: 10.1007/s11469-021-00700-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
During the COVID-19 pandemic, mobile phone dependence (MPD) became a common addictive behavior among adolescents because of social isolation. To understand the underlying mechanisms of the impact of social isolation on MPD, this study examined the mediating role of loneliness and the moderating role of parent-child communication patterns on social isolation and MPD. Six hundred and eighty-three adolescents from a middle school in Huang'gang city, China, were recruited to complete a self-report questionnaire. Data analysis comprised latent profile analysis and structural equation modelling. The results showed that social isolation had a significant and positive indirect effect on MPD via loneliness. In addition, three types of parent-child communication patterns were observed: complex, adaptive, and maladaptive. For adolescents with complex parent-child communication, the indirect relation of social isolation to MPD via loneliness is weaker than that of adolescents with maladaptive parent-child communication. These findings suggested that the indirect effect of social isolation on MPD via loneliness was moderated by parent-child communication patterns. Psychological intervention for MPD should emphasize relieving adolescents' loneliness and improving the quality of their communication with parents during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Rui Zhen
- Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, 311121 China
| | - Lu Li
- The No. 1 Middle School of Xiaochi Town in Huangmei County, Huang’gang, 435500 China
| | - Guoqiang Li
- Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, 311121 China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028 China
| |
Collapse
|
18
|
Seol J, Lee J, Nagata K, Fujii Y, Joho K, Tateoka K, Inoue T, Liu J, Okura T. Combined effect of daily physical activity and social relationships on sleep disorder among older adults: cross-sectional and longitudinal study based on data from the Kasama study. BMC Geriatr 2021; 21:623. [PMID: 34732144 PMCID: PMC8565015 DOI: 10.1186/s12877-021-02589-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 10/26/2021] [Indexed: 12/02/2022] Open
Abstract
Background This study investigated whether daily physical activity of older adults, combined with social relationships, is associated with the risk of sleep disorder. Further, it determined whether a high level of one variable with a low level of the other, leads to a significantly lower risk of sleep disorder than low levels of both. Methods The sample comprised 1339 community-dwelling older Japanese adults: 988 in Study 1 and 351 in Study 2. The level of daily physical activity and range of social relationships were assessed using the Physical Activity Scale for the Elderly and the Lubben Social Network Scale, respectively. The Pittsburgh Sleep Quality Index was used to assess sleep disorder. To test the combined relationships and effects in Studies 1 and 2, the medians for the respective scores of each of the following four groups that the participants were categorized into, were calculated: (1) low activity group with low social relationships, (2) low activity group with high social relationships, (3) high activity group with low social relationships, and (4) high activity group with high social relationships. After adjusting for potential confounders, a logistic regression analysis was conducted in Study 1. After adjusting for potential confounders, a Cox proportional hazards regression analysis was conducted in Study 2. Results Study 1 revealed that the high activity group with high social relationships showed a significantly lower risk of sleep disorder (ORs: 0.585, 95% CI: 0.404–0.847) than the low activity group with low social relationships. Study 2 also revealed that the high activity group with high social relationships showed a significantly lower prevalence of sleep disorder (HRs: 0.564, 95% CI: 0.327–0.974) than the low activity group with low social relationships. Conclusions Our findings suggest that for older adults with high social relationships, being physically active is favorably associated with sleep quality. However, a high level of one variable with a low level of the other has not been confirmed in improving sleep quality among older adults.
Collapse
Affiliation(s)
- Jaehoon Seol
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan. .,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. .,Japan Society for the Promotion of Sciences, 5-3-1 Kojimachi, Chiyoda, Tokyo, 102-0083, Japan.
| | - Jaehee Lee
- Master's Program in Physical Education, Health and Sports Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Koki Nagata
- Doctoral Program in Public Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Yuya Fujii
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, 150 Tobukimachi, Hachioji, Tokyo, 192-0001, Japan
| | - Kaya Joho
- Doctoral Program in Human Care Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan.,J-Stretch Association, 1132-1-504 Ochikawa, Hino-city, Tokyo, 191-0034, Japan
| | - Korin Tateoka
- Doctoral Program in Physical Education, Health and Sports Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Taiki Inoue
- Doctoral Program in Human Care Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Jue Liu
- Doctoral Program in Physical Education, Health and Sports Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan
| | - Tomohiro Okura
- Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan.,R&D Center for Tailor-Made QOL, University of Tsukuba, 1-2 Kasuga, Tsukuba, Ibaraki, 305-8550, Japan
| |
Collapse
|
19
|
Faraji J, Metz GAS. Aging, Social Distancing, and COVID-19 Risk: Who is more Vulnerable and Why? Aging Dis 2021; 12:1624-1643. [PMID: 34631211 PMCID: PMC8460299 DOI: 10.14336/ad.2021.0319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 03/19/2021] [Indexed: 01/08/2023] Open
Abstract
Perceived social support represents an important predictor of healthy aging. The global COVID-19 pandemic has dramatically changed the face of social relationships and revealed elderly to be particularly vulnerable to the effects of social isolation. Social distancing may represent a double-edged sword for older adults, protecting them against COVID-19 infection while also sacrificing personal interaction and attention at a critical time. Here, we consider the moderating role of social relationships as a potential influence on stress resilience, allostatic load, and vulnerability to infection and adverse health outcomes in the elderly population. Understanding the mechanisms how social support enhances resilience to stress and promotes mental and physical health into old age will enable new preventive strategies. Targeted social interventions may provide effective relief from the impact of COVID-19-related isolation and loneliness. In this regard, a pandemic may also offer a window of opportunity for raising awareness and mobilizing resources for new strategies that help build resilience in our aging population and future generations.
Collapse
Affiliation(s)
- Jamshid Faraji
- 1Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada.,2Faculty of Nursing & Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | - Gerlinde A S Metz
- 1Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
| |
Collapse
|
20
|
Yu B, Steptoe A, Chen Y, Jia X. Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study. Psychol Med 2021; 51:2414-2421. [PMID: 32338228 DOI: 10.1017/s0033291720001014] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. METHODS This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study (CHARLS) and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. RESULTS Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = -0.03, p < 0.01; mental status: β = -0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = -0.05, p < 0.001; mental status: β = -0.03, p < 0.01) even after controlling for loneliness and all confounding variables. CONCLUSIONS Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.
Collapse
Affiliation(s)
- Bin Yu
- Department of Psychiatry and Psychology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Yongjie Chen
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaohua Jia
- Department of Ultrasound, General Hospital of People's Liberation Army, Beijing, China
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
21
|
Schutz N, Botros A, Hassen SB, Saner H, Buluschek P, Urwyler P, Pais B, Santschi V, Gatica-Perez D, Muri RM, Nef T. A Sensor-Driven Visit Detection System in Older Adults Homes: Towards Digital Late-Life Depression Marker Extraction. IEEE J Biomed Health Inform 2021; 26:1560-1569. [PMID: 34550895 DOI: 10.1109/jbhi.2021.3114595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Modern sensor technology is increasingly used in older adults to not only provide additional safety but also to monitor health status, often by means of sensor derived digital measures or biomarkers. Social isolation is a known risk factor for late-life depression, and a potential component of social-isolation is the lack of home visits. Therefore, home visits may serve as a digital measure for social isolation and late-life depression. Late-life depression is a common mental and emotional disorder in the growing population of older adults. The disorder, if untreated, can significantly decrease quality of life and, amongst other effects, leads to increased mortality. Late-life depression often goes undiagnosed due to associated stigma and the incorrect assumption that it is a normal part of ageing. In this work, we propose a visit detection system that generalizes well to previously unseen apartments - which may differ largely in layout, sensor placement, and size from apartments found in the semi-annotated training dataset. We find that by using a self-training-based domain adaptation strategy, a robust system to extract home visit information can be built (ROC AUC=0.773). We further show that the resulting visit information correlates well with the common geriatric depression scale screening tool (=-0.87, p=0.001), providing further support for the idea of utilizing the extracted information as a potential digital measure or even as a digital biomarker to monitor the risk of late-life depression.
Collapse
|
22
|
Ma T, Gao B. The Association of Social Capital and Self-Rated Health Between Urban Residents and Urbanized Rural Residents in Southwest China. Front Public Health 2021; 9:718793. [PMID: 34513788 PMCID: PMC8425509 DOI: 10.3389/fpubh.2021.718793] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/04/2021] [Indexed: 02/05/2023] Open
Abstract
China has seen an accelerated process of urbanization in the past 30 years. The influence of urbanization on health is complex and primarily influenced by changes in social capital. The purpose of this research was to compare the social capital between urban residents and urbanized rural residents of southwest China and its relationship with self-rated health. It is of great significance to study the difference of social capital between urban and urbanized rural residents to help urbanized rural residents improve their social adaptability and health. Data was collected from 1,646 residents between November and December of 2017 in Chengdu. Three logistic regressions were used to investigate the association between social capital and self-rated health by controlling for demographic variables, lifestyles factors, and health status factors. We observed that urban residents' self-rated health had a higher proportion of “good” than that of urbanized rural residents (P = 0.017). After controlling for factors such as health status and demographic characteristics, participants with higher social capital had better self-rated health. Urbanized rural residents with higher community trust and belonging had better self-rated health (OR = 0.701, 95% CI = 0.503~0.978), however urban residents with higher personal social networks and family relationships had better self-rated health (OR = 0.676, 95% CI = 0.490~0.933 and OR = 0.666, 95% CI = 0.450~0.987, respectively). Different types of communities should focus on the types of social capital from different sources, so as to take more targeted measures to improve the social support of residents and improve their health. Improving residents' social trust and sense of belonging may help urbanized rural residents better adapt to the new living environment and help them complete the identity transformation.
Collapse
Affiliation(s)
- Tianpei Ma
- Laboratory for Aging and Cancer Research, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.,Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Bo Gao
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
23
|
An organizational analysis of how managers must understand the mental health impact of teleworking during COVID-19 on employees. INTERNATIONAL JOURNAL OF ORGANIZATIONAL ANALYSIS 2021. [DOI: 10.1108/ijoa-03-2021-2685] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The unimagined workplace disturbance caused by the Coronavirus, also known as COVID-19, has made many organizations virtual or telework driven workplaces, often without the infrastructure and systems in place to support employees facing these sudden workplace changes (Burrell, 2020). Many stressors accompanied this transition, to include lack of childcare, home-school responsibilities and layoffs and business closings. These stressors have perpetuated concerns for the job and financial security for all workers (Fox, 2020), leading some employees to struggle with the work-life balance out of concern for being laid off due to perceived low productivity (Fox, 2020). This study aims to explore those manifestations.
Design/methodology/approach
This qualitative research case study explores the impact COVID-19 induced telework has on their job satisfaction, mental well-being and aspects of organizational commitment to fill a gap in the literature concerning emerging workplace dynamics due to COVID-19 for small real estate businesses in the USA.
Findings
The results of this qualitative research case study provide knowledge and information about the need for small businesses to be resourceful and resilient in the way that they support and engage remote workers. This qualitative research case study explores the impact COVID-19-induced telework has on their job satisfaction, mental well-being and aspects of organizational commitment for small real estate businesses. The analysis of current work-life structures through a qualitative lens provides trends among workers to gain a greater perspective of the current accelerators and barriers to worker success in a COVID-19 teleworking environment.
Originality/value
This qualitative research case study explores the impact COVID-19 induced telework has on their job satisfaction, mental well-being and aspects of organizational commitment to fill a gap in the literature concerning emerging workplace dynamics due to COVID-19 for small real estate businesses. The value of this research is that majority of the participants were African-Americans, which represents a participant group that is highly under researched.
Collapse
|
24
|
Social Isolation and Its Impact on the Geriatric Community. TOPICS IN GERIATRIC REHABILITATION 2021. [DOI: 10.1097/tgr.0000000000000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
25
|
Gadson DS, Wallace G, Young HN, Vail C, Finn P. The relationship between health-related quality of life, perceived social support, and social network size in African Americans with aphasia: a cross-sectional study. Top Stroke Rehabil 2021; 29:230-239. [PMID: 33866954 DOI: 10.1080/10749357.2021.1911749] [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: 10/21/2022]
Abstract
Stroke significantly impairs health-related quality of life (HRQL). Stroke survivors with aphasia (SWA) experience lower HRQL than stroke survivors without aphasia (SSA) as a result of poorer communication and social functioning. The extent to which aphasia influences HRQL in African-Americans and the components of social functioning that are most important to HRQL warrants further exploration.There were two main objectives of this paper. The first was to survey HRQL domains of communication, physical, mental/emotional, role, and social functioning in African American SWA and SSA. The second was to examine if social support and social network predicted HRQL in SWA.A total of 39 African American adults (62.4 ± 11.10) participated in this descriptive cross-sectional case control study. Patient-reported outcome measures were used to assess HRQL, perceived social support, and social network in SWA, SSA, and normal-aging healthy controls (NAH). Data analysis included an ANOVA and moderator regression to determine if social support or social network predicted HRQL in SWA.SWA reported a significantly lower overall HRQL (p = <.000) than NAH adults. Communication HRQL was the hallmark difference found between SWA and SSA (p = <.000). Social support and social network were relatively similar among all three groups. However, social support and social network did not predict HRQL in SWA.Findings from this study suggest that social HRQL continues to be significantly lower in SWA; however, social support and social network factors do not drive differences among African-Americans. Moreover, communication HRQL remains the hallmark difference between SWA and SSA.
Collapse
Affiliation(s)
- Davetrina Seles Gadson
- Department of Communication Sciences and Special Education, University of Georgia, Athens, United States
| | - Gloriajean Wallace
- Speech Language Pathology, Xavier University of Louisiana, New Orleans, United States
| | - Henry N Young
- Department of Clinical Administrative Pharmacy, University of Georgia, Athens, United States
| | - Cynthia Vail
- Department of Communication Sciences and Special Education, University of Georgia, Athens, United States
| | - Patrick Finn
- Department of Communication Sciences and Special Education, University of Georgia, Athens, United States
| |
Collapse
|
26
|
Ogrin R, Cyarto EV, Harrington KD, Haslam C, Lim MH, Golenko X, Bush M, Vadasz D, Johnstone G, Lowthian JA. Loneliness in older age: What is it, why is it happening and what should we do about it in Australia? Australas J Ageing 2021; 40:202-207. [PMID: 33783951 DOI: 10.1111/ajag.12929] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 11/29/2022]
Abstract
Loneliness is an important health issue facing older people due to its association with poor quality of life and poor health outcomes. This paper aimed to clarify key issues around loneliness among older adults and draw attention to innovative programs and the translation of emerging research into practice. Loneliness is a mismatch between a person's actual and desired social connections, experienced as negative emotions. Older adults are vulnerable to loneliness because of changes associated with ageing. As such, identifying as older is often seen as a burden, negatively impacting self-esteem, sense of purpose and relevance, culminating in loneliness. Interventions combatting loneliness can target individuals, relationships, communities or societies. We advocate for an intersectoral approach to support healthy ageing and reduce loneliness. This will require further research to evaluate new approaches with loneliness as the primary outcome, and additional funding to translate evidence into an integrated multi-level approach to addressing loneliness.
Collapse
Affiliation(s)
- Rajna Ogrin
- Bolton Clarke Research Institute, Brisbane, Queensland, Australia
| | | | - Karra D Harrington
- Faculty of Health, Arts & Design, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Catherine Haslam
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Michelle H Lim
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Xanthe Golenko
- Bolton Clarke Research Institute, Brisbane, Queensland, Australia
| | - Matiu Bush
- Health Transformation Lab, RMIT University, Melbourne, Victoria, Australia
| | - Danny Vadasz
- Health Issues Centre, Melbourne, Victoria, Australia
| | | | - Judy A Lowthian
- Bolton Clarke Research Institute, Brisbane, Queensland, Australia
| |
Collapse
|
27
|
Bevilacqua G, D'Angelo S, Ntani G, Syddall HE, Harris EC, Linaker C, Stevens M, Cooper C, Walker-Bone K. Older working adults in the HEAF study are more likely to report loneliness after two years of follow-up if they have negative perceptions of their work quality. BMC Public Health 2021; 21:574. [PMID: 33757464 PMCID: PMC7988922 DOI: 10.1186/s12889-021-10610-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/09/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Loneliness is an important public health issue associated with mortality and morbidity. Often researched amongst older people, less is known about risk factors for loneliness among adults aged 50-64 years who are in work. We investigated (a) if exit from the workforce increases the odds of loneliness; (b) whether adverse psychosocial work factors are associated with increased odds of loneliness over 2 years of follow-up; and (c) whether the association is stronger among subjects still working compared with those who have exited the workforce. METHODS Data came from the Health and Employment After Fifty (HEAF) study, a large population cohort who provided questionnaire information about work and health at baseline and 2 annual follow-ups. Logistic regression was used to explore the association between psychosocial risk factors and loneliness at follow-up 2, with adjustment for loneliness at baseline, sex, age, self-rated health, living alone, and mental health diagnosis. RESULTS Of the initial 8134 participants, 4521 were working at baseline and provided data for this analysis. Of those, 507 (11.2%) were defined as lonely at 2 years' follow-up. Exiting the workforce was not significantly associated with loneliness (OR = 1.1, 95%CI: 0.7-1.7). However, negative psychosocial work factors predicted loneliness at follow-up. After mutual adjustment, lack of choice at work (OR: 1.5, 95%CI: 1.1-1.9), often lying awake worrying about work (OR: 1.4, 95%CI: 1.0-1.9) and perceived not coping with physical demands of the job (OR: 1.3, 95%CI: 1.0-1.7) were independent predictors, with associations robust to adjustment for demographic factors and health. Associations were only slightly altered when we restricted the sample to those who remained in work until the end of follow-up. CONCLUSIONS Loneliness amongst middle-aged working adults is not predicted by permanent work exit but is predicted by individuals' perceptions about their work. Provision of good-quality work, matched to the capacity of the older worker, could prevent loneliness.
Collapse
Affiliation(s)
- Gregorio Bevilacqua
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Georgia Ntani
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Holly Emma Syddall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Elizabeth Clare Harris
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Cathy Linaker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Martin Stevens
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England
| | - Karen Walker-Bone
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England.
| |
Collapse
|
28
|
Social Isolation, Loneliness, and All-Cause Mortality in Patients With Cardiovascular Disease: A 10-Year Follow-up Study. Psychosom Med 2021; 82:208-214. [PMID: 31842061 DOI: 10.1097/psy.0000000000000777] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Social isolation and loneliness have been associated with increased incidence of cardiovascular disease (CVD), but few studies have evaluated the impact of social isolation and loneliness on mortality in people with existing CVD, and these are limited to Western populations. We examined whether social isolation and loneliness are associated with increased risk of mortality in individuals with established CVD in Taiwan. METHODS The cohort was composed of 1267 patients with confirmed CVD 65 years or older followed up for up to 10 years. Cox proportional hazard regression models were used to examine the association between social isolation and loneliness at baseline and mortality at follow-up by adjusting for demographic variables, health-related behaviors, and health status. RESULTS There were 593 deaths during the follow-up period. Social isolation was associated with increased risk of mortality after accounting for established risk factors (hazard ratio [HR] = 1.16; 95% confidence interval [CI] = 1.06-1.26), whereas loneliness was not associated with increased risk of mortality (HR = 0.95; 95% CI = 0.82-1.09). When both social isolation and loneliness were included in the model, social isolation maintained an association with mortality (HR = 1.16; 95% CI =1.07-1.27). CONCLUSIONS Social isolation is associated with an increased risk of mortality in patients with CVD, and the effects are independent of loneliness. These findings expand our knowledge about the impact of social isolation on the outcomes of CVD in non-Western countries. Efforts to reduce isolation may have substantial benefits in terms of mortality in patients with CVD.
Collapse
|
29
|
Yu B, Steptoe A, Chen Y, Jia X. Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study. Psychol Med 2021:1-8. [PMID: 33478615 DOI: 10.1017/s0033291720001026] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. METHODS This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. RESULTS Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = -0.03, p < 0.01; mental status: β = -0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = -0.05, p < 0.001; mental status: β = -0.03, p < 0.01) even after controlling for loneliness and all confounding variables. CONCLUSIONS Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.
Collapse
Affiliation(s)
- Bin Yu
- Institute of Psychology, Tianjin Medical University, Tianjin, China
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Yongjie Chen
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaohua Jia
- Department of Ultrasound, General Hospital of People's Liberation Army, Beijing, China
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
30
|
Sopcheck J. Helpful Approaches for Older Adults Living in a Retirement Community to Move Forward After the Death of a Significant Other. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2020; 16:219-237. [PMID: 32233748 DOI: 10.1080/15524256.2020.1745352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The loss of a significant other often creates emotional distress for family members that can hamper the ability to meet everyday challenges and pursue wellness. The aim of this qualitative study was to understand the challenge of losing a significant other for older adult family members and the approaches identified as most helpful to promote their own well-being after this person dies. Story inquiry method guided the interview process with 15 older adult bereaved family members residing in a continuing care retirement community. Theory-guided content analysis was used for data analysis. Two themes described the challenges: uneasiness that permeates everyday living and precious memories and patterns of disconnect that breed discontent. Appreciating the rhythmic flow of everyday connecting and separating and embracing reality as situated in one's lifelong journey are the themes that encompass the helpful approaches used by participants. This study provided insights about the benefits of living in this community such as social networking and a possible drawback such as the frequency of death among residents. Future research should continue to investigate social service resources that older adults find most helpful after a significant other dies and the use of reminiscence groups as a form of bereavement support.
Collapse
|
31
|
Lu J, Zhang N, Mao D, Wang Y, Wang X. How social isolation and loneliness effect medication adherence among elderly with chronic diseases: An integrated theory and validated cross-sectional study. Arch Gerontol Geriatr 2020; 90:104154. [PMID: 32593092 DOI: 10.1016/j.archger.2020.104154] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/10/2020] [Accepted: 06/12/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Social isolation and loneliness have been described as epidemics among elderly patients with chronic disease. Those epidemics also associates with these elderly's low medication adherence behavior. However, there is a scarcity of research on establishing mechanisms of elderly patients' medication adherence referred to their social isolation and loneliness. METHODS A mixed-methods design with integrated theory and validated cross-sectional study was used. The integrated theory was constructed by Berkman's conceptual model and the mechanism model of loneliness. The cross-sectional survey was conducted in six districts of Taiyuan, China, through a stratified random cluster sampling method. RESULTS Low social support mediated the association between social isolation and suboptimal medication adherence in the whole sample, also in multimorbidity patients. Social isolation was positively associated with loneliness, but loneliness couldn't be considered as a mediator between social isolation and medication adherence. In serial mediation model, social isolation caused less social support and more loneliness, and resulted in suboptimal medication adherence in whole sample. In addition, this serial mediational model was not different between patients in non-multimorbidity and multimorbidity. CONCLUSIONS Social isolation and loneliness are related but independent constructs. Interconnected psychosocial mechanisms explain the influence the mechanism of medication adherence from social isolation and loneliness, and the effective paths of social isolation will increase as the chronic disease evolves. The interventions should initially focus on emotional health to establish a multi-perspective supporting system, which contains tangible support, informational and emotional support, positive social interaction, and affectionate support, especially for the multimorbidity patients.
Collapse
Affiliation(s)
- Jiao Lu
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China.
| | - Na Zhang
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Danhui Mao
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuan Wang
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaoli Wang
- School of Business, Jiangnan University, Wuxi, China
| |
Collapse
|
32
|
Abstract
AbstractThe aim of this study was to explore associations between internet/email use in a large sample of older English adults with their social isolation and loneliness. Data from the English Longitudinal Study of Ageing Wave 8 were used, with complete data available for 4,492 men and women aged ⩾ 50 years (mean age = 64.3, standard deviation = 13.3; 51.7% males). Binomial logistic regression was used to analyse cross-sectional associations between internet/email use and social isolation and loneliness. The majority of older adults reported using the internet/email every day (69.3%), fewer participants reported once a week (8.5%), once a month (2.6%), once every three months (0.7%), less than every three months (1.5%) and never (17.4%). No significant associations were found between internet/email use and loneliness, however, non-linear associations were found for social isolation. Older adults using the internet/email either once a week (odds ratio (OR) = 0.60, 95% confidence interval (CI) = 0.49–0.72) or once a month (OR = 0.60, 95% CI = 0.45–0.80) were significantly less likely to be socially isolated than every day users; those using internet/email less than once every three months were significantly more likely to be socially isolated than every day users (OR = 2.87, 95% CI = 1.28–6.40). Once every three months and never users showed no difference in social isolation compared with every day users. Weak associations were found between different online activities and loneliness, and strong associations were found with social isolation. The study updated knowledge of older adults’ internet/email habits, devices used and activities engaged in online. Findings may be important for the design of digital behaviour change interventions in older adults, particularly in groups at risk of or interventions targeting loneliness and/or social isolation.
Collapse
|
33
|
Ingram I, Kelly PJ, Deane FP, Baker AL, Goh MCW, Raftery DK, Dingle GA. Loneliness among people with substance use problems: A narrative systematic review. Drug Alcohol Rev 2020; 39:447-483. [PMID: 32314504 DOI: 10.1111/dar.13064] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/10/2020] [Accepted: 03/06/2020] [Indexed: 12/12/2022]
Abstract
ISSUES Despite the serious implications of loneliness on health and wellbeing, little is understood about this experience across people with substance use problems. This systematic review aimed to examine: (i) correlates and predictors of loneliness; (ii) theories underpinning loneliness; (iii) methods employed to measure loneliness; and (iv) loneliness interventions for people with substance use problems. APPROACH Empirical sources were identified from key databases for all publications preceding February 2019. Overall, 41 studies met the eligibility criteria and were included in the review. KEY FINDINGS Findings from this review suggest that loneliness is related to poor physical and mental health, substance use, the quality of relationships, stigma and perception of ill treatment by others. Although cognitive theories have proposed cognitive patterns underlying the onset and maintenance of loneliness, they had not been investigated in relation to measurement or intervention efforts. Just one loneliness measure (UCLA Loneliness Scale) is valid for use with this population. Finally, only a single loneliness intervention had been trialled and was not found to be efficacious in reducing loneliness for people with substance use problems. IMPLICATIONS Understanding possible links between loneliness and substance use and how to alleviate loneliness is important for this population in terms of their wellbeing and recovery. CONCLUSION Loneliness is prevalent and experienced as problematic among people with substance use problems. Future research should focus on employing longitudinal designs, using validated, multidimensional measures of loneliness and on developing and trialling loneliness interventions that meet the specific needs of people with substance use problems.
Collapse
Affiliation(s)
- Isabella Ingram
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Melvin C W Goh
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Dayle K Raftery
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | | |
Collapse
|
34
|
Mund M, Freuding MM, Möbius K, Horn N, Neyer FJ. The Stability and Change of Loneliness Across the Life Span: A Meta-Analysis of Longitudinal Studies. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2020; 24:24-52. [PMID: 31179872 PMCID: PMC6943963 DOI: 10.1177/1088868319850738] [Citation(s) in RCA: 147] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Individuals experience loneliness when they perceive a deficiency in the quality or quantity of their social relationships. In the present meta-analysis, we compiled data from 75 longitudinal studies conducted in Asia, Australia, Europe, and North America (N = 83, 679) to examine the rank-order and mean-level development of loneliness across the life span. Data were analyzed using two- and three-level meta-analyses and generalized additive mixed models. The results indicate that the rank order of loneliness is as stable as the rank order of personality traits and follows an inverted U-shaped trajectory across the life span. Regarding mean-level development, loneliness was found to decrease throughout childhood and to remain essentially stable from adolescence to oldest old age. Thus, in contrast to other personality characteristics, changes in loneliness are not generally related to age. Implications for theory are discussed.
Collapse
Affiliation(s)
- Marcus Mund
- Friedrich-Schiller-Universität Jena, Germany
| | | | | | - Nicole Horn
- Friedrich-Schiller-Universität Jena, Germany
| | | |
Collapse
|
35
|
Hawkley LC, Wroblewski K, Kaiser T, Luhmann M, Schumm LP. Are U.S. older adults getting lonelier? Age, period, and cohort differences. Psychol Aging 2019; 34:1144-1157. [PMID: 31804118 PMCID: PMC10621618 DOI: 10.1037/pag0000365] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Media portrayals of a loneliness "epidemic" are premised on an increase in the proportion of people living alone and decreases in rates of civic engagement and religious affiliation over recent decades. However, loneliness is a subjective perception that does not correspond perfectly with objective social circumstances. In this study, we examined whether perceived loneliness is greater among the Baby Boomers-individuals born 1948-1965-relative to those born 1920-1947 and whether older adults have become lonelier over the past decade (2005-2016). We used data from the National Social Life, Health and Aging Project and from the Health and Retirement Study collected during 2005-2016 to estimate differences in loneliness associated with age, birth year, and survey time point. Overall, loneliness decreased with age through the early 70s, after which it increased. We found no evidence that loneliness is substantially higher among the Baby Boomers or that it has increased over the past decade. Loneliness is, however, associated with poor health, living alone or without a spouse-partner, and having fewer close family and friends, which together accounted for the overall increase in loneliness after age 75. Although these data do not support the idea that older adults are becoming lonelier, the actual number of lonely individuals may increase as the Baby Boomers age into their 80s and beyond. Our results suggest that attention to social factors and improving health may help to mitigate this. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
- Louise C Hawkley
- Academic Research Centers, The National Opinion Research Center (NORC) at the University of Chicago
| | - Kristen Wroblewski
- Department of Public Health Sciences, Biological Sciences Division, University of Chicago
| | - Till Kaiser
- Department of Psychology, Ruhr University Bochum
| | | | | |
Collapse
|
36
|
Dhand A, Longstreth WT, Chaves PHM, Dhamoon MS. Social Network Trajectories in Myocardial Infarction Versus Ischemic Stroke. J Am Heart Assoc 2018; 7:e008029. [PMID: 29654192 PMCID: PMC6015408 DOI: 10.1161/jaha.117.008029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 03/20/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Changes in social networks are rarely examined before and after various diseases because of insufficient data. CHS (The Cardiovascular Health Study) offers an opportunity to compare social network trajectories surrounding well-adjudicated myocardial infarction (MI) or stroke events. We tested the hypothesis that social networks will be stable after MI and decrease after stroke. METHODS AND RESULTS We examined trajectories of the Lubben Social Network Scale score (LSNS, range 0-50) before and after vascular events over 11 years. The LSNS assesses engagement in family networks, friends' networks, and social supports. We used a linear mixed model with repeated measures and fixed effects to compare the change in social network score before and after events in 395 people with MI and 382 with ischemic stroke. Over a mean of 12.4 years of follow-up for MI and 11.1 years for stroke, we examined an average of 4 social network scores for each participant. We controlled for sociodemographics, baseline cognitive function, and comorbidities. The participants' mean age was 73.5, 51% were women, and 88% were non-Hispanic white. After MI, the social network trajectory remained stable compared with the baseline trajectory (-0.06 points per year, adjusted P=0.2356). After stroke, the social network trajectory declined compared with the baseline trajectory (-0.14 points per year, adjusted P=0.0364). CONCLUSIONS Social networks remained stable after MI and declined after stroke. This small and persistent decline after adjustment for potential confounders is notable because it deviates from stable network trajectories found in CHS participants and is specific to stroke.
Collapse
Affiliation(s)
- Amar Dhand
- Department of Neurology, Brigham and Women's Hospital/Harvard Medical School, Boston, MA
- Network Science Institute, Northeastern University, Boston, MA
| | - W T Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA
| | - Paulo H M Chaves
- Benjamin Leon Center for Geriatric Research and Education, Herbert Wertheim College of Medicine, Miami, FL
| | - Mandip S Dhamoon
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
| |
Collapse
|
37
|
Yu B, Steptoe A, Niu K, Ku PW, Chen LJ. Prospective associations of social isolation and loneliness with poor sleep quality in older adults. Qual Life Res 2017; 27:683-691. [PMID: 29188485 DOI: 10.1007/s11136-017-1752-9] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE There is evidence for negative associations between social isolation and loneliness and sleep quality in older adults. However, it is unclear to what extent these two factors independently affect sleep quality. This study examined the simultaneous associations of social isolation and loneliness with sleep quality in a longitudinal study of older adults. METHODS Data were analyzed from the Social Environment and Biomarkers of Aging Study in Taiwan collected in 2000 and 2006, involving a cohort of 639 participants (mean age = 66.14, SD 7.26). Poisson regression models were conducted to examine the association of social isolation and/or loneliness with sleep quality at follow-up after adjusting for multiple confounding variables. RESULTS Univariate analysis showed that sleep quality was inversely associated with both social isolation and loneliness. After demographic, health, cognitive factors, and depressive symptoms were controlled in multivariable analysis, social isolation at the baseline still predicted poor sleep quality 6 years later (incident rate ratio, IRR 1.14; 95% CI 1.04-1.24; p < 0.01), while the association between loneliness and sleep quality was no longer significant (IRR 1.08; 95% CI 0.94-1.23; p = 0.27). The results were unchanged when participants who had poor sleep quality at the baseline were excluded from the analysis. CONCLUSIONS These findings confirm an adverse effect of social isolation on the sleep quality of older adults, but indicate that this effect is independent of loneliness. Social isolation and loneliness seem to have distinct pathways in affecting the sleep quality of older adults.
Collapse
Affiliation(s)
- Bin Yu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.,Department of Epidemiology and Public Health, University College London, London, UK.,Institute of Psychology, Tianjin Medical University, Tianjin, China
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Po-Wen Ku
- Department of Epidemiology and Public Health, University College London, London, UK. .,Graduate Institute of Sports and Health, National Changhua University of Education, No. 1 Jin-De Rd., Changhua City, 500, Taiwan.
| | - Li-Jung Chen
- Department of Epidemiology and Public Health, University College London, London, UK. .,Department of Exercise Health Science, National Taiwan University of Sport, No. 16, Section 1, Shuang-Shih Rd, Taichung, 404, Taiwan.
| |
Collapse
|
38
|
Austin J, Dodge HH, Riley T, Jacobs PG, Thielke S, Kaye J. A Smart-Home System to Unobtrusively and Continuously Assess Loneliness in Older Adults. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2016; 4:2800311. [PMID: 27574577 PMCID: PMC4993148 DOI: 10.1109/jtehm.2016.2579638] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/15/2016] [Accepted: 05/20/2016] [Indexed: 01/29/2023]
Abstract
Loneliness is a common condition in older adults and is associated with increased morbidity and mortality, decreased sleep quality, and increased risk of cognitive decline. Assessing loneliness in older adults is challenging due to the negative desirability biases associated with being lonely. Thus, it is necessary to develop more objective techniques to assess loneliness in older adults. In this paper, we describe a system to measure loneliness by assessing in-home behavior using wireless motion and contact sensors, phone monitors, and computer software as well as algorithms developed to assess key behaviors of interest. We then present results showing the accuracy of the system in detecting loneliness in a longitudinal study of 16 older adults who agreed to have the sensor platform installed in their own homes for up to 8 months. We show that loneliness is significantly associated with both time out-of-home (\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{upgreek}
\usepackage{mathrsfs}
\setlength{\oddsidemargin}{-69pt}
\begin{document}
}{}$ {\beta } = -0.88$
\end{document} and \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{upgreek}
\usepackage{mathrsfs}
\setlength{\oddsidemargin}{-69pt}
\begin{document}
}{}$p<0.01$
\end{document}) and number of computer sessions (\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{upgreek}
\usepackage{mathrsfs}
\setlength{\oddsidemargin}{-69pt}
\begin{document}
}{}$ {\beta } = 0.78$
\end{document} and \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{upgreek}
\usepackage{mathrsfs}
\setlength{\oddsidemargin}{-69pt}
\begin{document}
}{}$p<0.05$
\end{document}). \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{upgreek}
\usepackage{mathrsfs}
\setlength{\oddsidemargin}{-69pt}
\begin{document}
}{}$R^{2}$
\end{document} for the model was 0.35. We also show the model’s ability to predict out-of-sample loneliness, demonstrating that the correlation between true loneliness and predicted out-of-sample loneliness is 0.48. When compared with the University of California at Los Angeles loneliness score, the normalized mean absolute error of the predicted loneliness scores was 0.81 and the normalized root mean squared error was 0.91. These results represent first steps toward an unobtrusive, objective method for the prediction of loneliness among older adults, and mark the first time multiple objective behavioral measures that have been related to this key health outcome.
Collapse
Affiliation(s)
- Johanna Austin
- Oregon Center for Aging and Technology Department of Neurology Oregon Health & Science University Portland OR 97239 USA
| | - Hiroko H Dodge
- Oregon Center for Aging and Technology Department of Neurology Oregon Health & Science University Portland OR 97239 USA
| | - Thomas Riley
- Oregon Center for Aging and Technology Department of Neurology Oregon Health & Science University Portland OR 97239 USA
| | - Peter G Jacobs
- Department of Biomedical Engineering Oregon Health & Science University Portland OR 97239 USA
| | - Stephen Thielke
- Department of Psychiatry and Behavioral SciencesUniversity of WashingtonSeattleWA98102USA; Geriatric Research, Education, and Clinical CenterSeattle VA Medical CenterSeattleWA98108USA
| | - Jeffrey Kaye
- Oregon Center for Aging and Technology Department of Neurology Oregon Health & Science University Portland OR 97239 USA
| |
Collapse
|