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Zhang A, Koroukian S, Owusu C, Moore SE, Momotaz H, Albert JM. Loneliness and Crowded Living Predicted Poor Health in a Sample of Cancer Patients During COVID-19 Pandemic. Clin Nurs Res 2024; 33:370-383. [PMID: 38773912 DOI: 10.1177/10547738241252889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
We investigated the influence of social determinants of health (SDOH), healthcare services, and health behaviors on mental and physical health outcomes of cancer patients between the first winter and the following post-vaccine summer of the COVID-19 pandemic. A three-wave online survey of individuals diagnosed with incident cancer between January 2019 and January 2020 was conducted between November of 2020 and August of 2021 in northeast Ohio. Descriptive analysis and mixed-effect regression analyses were performed. A total of 322 newly diagnosed cancer patients, with 40 African Americans and 282 Whites (215 from metropolitan areas and 67 nonmetropolitan) responded to the survey questions. In Wave 3 ending in August 2021, the survey respondents reported significantly reduced depression (p = .019) on the Hamilton Depression Rating Scale and improved global health (p = .036) on PROMIS. With age, comorbidity, and other demographic and medical variables controlled in the analyses, the feeling of loneliness (p < .001) and crowded living space (p = .001, p = .015) were the two most prominent factors associated with depression, irritability, and poor global health at baseline, with the lowest p values and persistent effect. Self-efficacy of taking preventive measures was associated with reduced depression (p = .001) and improved global health (p = .029). Increasing access to medicine (p < .01) and satisfaction with telehealth appointments (p < .01) were significantly associated with better global health and reduced irritability. Respondents who had private health insurance reported better health than those that had Medicare coverage only (p < .05). This longitudinal, observational study demonstrated the impact of SDOH on health outcomes of cancer patients. Substandard living conditions resulting in loneliness and crowdedness, quality of medical care (e.g., quality telehealth and access to medicine), and personal behaviors (e.g., self-efficacy) were significantly associated with health outcomes in newly diagnosed cancer patients during the pandemic and should be given adequate consideration for the purpose of improving clinical care.
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Affiliation(s)
- Amy Zhang
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Siran Koroukian
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Cynthia Owusu
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Scott E Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Hasina Momotaz
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jeffrey M Albert
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Du C, Li X, Li J, Wang W, Dang M, Cheng J, Xu K, Wang J, Chen C, Chen Y, Zhang Z. Leisure activities as reserve mediators of the relationship between loneliness and cognition in aging. Transl Psychiatry 2024; 14:217. [PMID: 38806497 PMCID: PMC11133303 DOI: 10.1038/s41398-024-02960-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 05/08/2024] [Accepted: 05/21/2024] [Indexed: 05/30/2024] Open
Abstract
Previous studies have found that loneliness affects cognitive functions in older persons. However, the influence of loneliness on different cognitive fields and the internal mechanism of the relationship are unclear. A total of 4772 older persons aged above 50 years (Mean = 65.31, SD = 6.96, 57.7% female) were included in this study. All the participants completed the characteristics scale, as well as the loneliness scale, leisure activity scale, and cognitive function tests in six domains. The results showed that 17.6% of participants had high loneliness, while 16.7% of participants had low loneliness. Associations were observed between higher levels of loneliness and lower scores in general cognitive ability, memory, and executive functions. Mediation analysis suggested that leisure activities, encompassing mental, physical, and social activities, were associated with cognitive functions in the context of loneliness. These results indicate that leisure activities may play a significant role in the relationship between loneliness and cognitive functions in older adults. The study highlights the importance of considering leisure activities in this demographic to potentially mitigate the adverse cognitive effects associated with loneliness.
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Affiliation(s)
- Chao Du
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, 100875, China
- Research Institute of Intelligent and Complex Systems, Fudan University, Shanghai, 200433, China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, 100875, China
| | - Jingyi Li
- CSSC System Engineering Research Institute, Beijing, 100036, China
| | - Wenxu Wang
- School of Systems Science, Beijing Normal University, Beijing, 100875, China
| | - Mingxi Dang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, 100875, China
| | - Jiayin Cheng
- Senior 2 Class 6, The High School Affiliated to Renmin University of China, Beijing, 100097, China
| | - Kai Xu
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, 100875, China
- School of Artificial Intelligence, Beijing Normal University, Beijing, 100875, China
| | - Jun Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, 100875, China
| | - Chuansheng Chen
- Department of Psychological Science, University of California, Irvine, CA, 92697-7085, USA
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China.
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, 100875, China.
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China.
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, 100875, China.
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Usama SM, Kothari YL, Karthikeyan A, Khan SA, Sarraf M, Nagaraja V. Social Isolation, Loneliness, and Cardiovascular Mortality: The Role of Health Care System Interventions. Curr Cardiol Rep 2024:10.1007/s11886-024-02066-x. [PMID: 38713361 DOI: 10.1007/s11886-024-02066-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE OF REVIEW The world is proliferating rapidly, with science and technology advancing at an incredible rate. These advances have, however, ushered in an age with a rise in social isolation (SI) and loneliness. SI is an objective term that refers to lacking social contact or support. On the other hand, loneliness is subjective and refers to feeling alone or isolated. These concepts are rapidly gaining prominence mainly due to their negative impact on the physical and psychological health of the population, mainly through behavioural modifications that encompass substance abuse, decreased physical activity and unhealthy food habits, and poor sleep hygiene. This review summarizes the pathophysiology, evaluates the evidence behind impact of SI on cardiovascular mortality, and interventions to overcome SI. RECENT FINDINGS Through proposed mechanisms, such as activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, both SI and loneliness have strong evidence linking them to cardiovascular morbidity and mortality. A systematic review and meta-analysis of 90 prospective cohort studies including 2,205,199 individuals reported that SI was independent predictor of cardiovascular mortality with a point estimate of 1.34 (95% confidence interval:1.25-1.44). The evidence so far is compelling and necessitates urgent action with the implementation of strict policies to tackle this issue. As healthcare professionals, it becomes even more critical to remain vigilant, recognize this insidious pandemic, and take appropriate action.
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Affiliation(s)
| | - Yash Lalit Kothari
- Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | | | - Syed Anjum Khan
- Department of Critical Care Medicine, Mayo Clinic Health System - Southwest Minnesota Region, Mankato, MN, USA
| | - Mohammad Sarraf
- Division of Interventional Cardiology, Department of Cardiovascular Medicine, 200 1st St SW, Rochester, MN, 55905, USA
| | - Vinayak Nagaraja
- Division of Interventional Cardiology, Department of Cardiovascular Medicine, 200 1st St SW, Rochester, MN, 55905, USA.
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Grigorian K, Östberg V, Raninen J, Brolin Låftman S. Loneliness, belonging and psychosomatic complaints across late adolescence and young adulthood: a Swedish cohort study. BMC Public Health 2024; 24:642. [PMID: 38424596 PMCID: PMC10903051 DOI: 10.1186/s12889-024-18059-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Loneliness and belonging refer to social connectedness and are associated with young people's health; however, the relationship between these constructs and their impact on health is still being discussed. A dual continuum model of belonging and loneliness has been suggested, consisting of four groups depending on the state of loneliness and belonging: socially fulfilled (low loneliness, high belonging), socially indifferent (low loneliness, low belonging), socially searching (high loneliness, high belonging), and socially distressed (high loneliness, low belonging). The aim of this study is to examine loneliness and belonging in a Swedish sample of 17-18-years-olds who were followed over 3 years, and the associations that these aspects share with young people's psychosomatic complaints during these ages. METHODS Swedish cohort data collected among late adolescents (age 17-18 in 2019) who were followed up in young adulthood (age 20-21 in 2022) (n = 2684) was used to examine the associations between loneliness, belonging, and psychosomatic complaints. Loneliness and belonging were measured by single items and the cross-combinations of these. Three psychosomatic complaints were assessed: stomach ache, headache, and difficulties falling asleep, and a summary index was calculated. RESULTS Linear regression analyses showed that loneliness was positively and belonging was negatively cross-sectionally associated with psychosomatic complaints. The socially fulfilled group reported fewer psychosomatic complaints compared to all other groups, while the socially distressed group reported the highest level of psychosomatic complaints. Additional adjustment for sociodemographic characteristics barely affected the estimates. The prospective analysis supported these patterns; however, after adjustment for earlier psychosomatic complaints, the only statistically significant difference in subsequent psychosomatic complaints was found between the socially fulfilled and the socially distressed groups. CONCLUSIONS Loneliness and belonging (separately and the cross-combinations of these) were cross-sectionally associated with psychosomatic complaints in late adolescence and in young adulthood. Prospectively, only the most vulnerable group in the dual continuum model, the socially distressed group, experienced more psychosomatic complaints than the socially fulfilled group, indicating a temporal relationship. Knowledge about the more nuanced links may be useful for developing specific public health recommendations and interventions for youth, targeting the most vulnerable groups.
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Affiliation(s)
- Karina Grigorian
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
| | - Viveca Östberg
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Jonas Raninen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Sara Brolin Låftman
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Thomas SP. The Loneliness Epidemic and Its Health Consequences. Issues Ment Health Nurs 2024; 45:1-2. [PMID: 38262039 DOI: 10.1080/01612840.2024.2302786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Affiliation(s)
- Sandra P Thomas
- College of Nursing, University of Tennessee, Knoxville, Knoxville, Tennessee, USA
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